The MacNeil/Lehrer NewsHour

seth seth fifth oh oh believe me not to let him watch and i'm robert mcneill in new york after tonight's news summary our major focuses on spiraling hospital costs and how to control him in reforming health care we have a pulse on the new report and a

discussion then special correspondent paul martin reports on the politics behind shortages of power and water in sarajevo you can literally dissolve as well and my new york life yet another example of new york lives wise investment philosophy man and by the corporation for public broadcasting and by the annual financial support from the woods like you jack kevorkian was charged today in detroit for assisting a suicide a felony under a new michigan law kevorkian admitted helping a thirty year old man suffering from a terminal nerd disease to kill himself earlier this month the former pilot just as assisted in seventeen suicides since

nineteen ninety and is called the michigan law mr l a judge entered a not guilty plea on behalf of good work in her surrendered to police this afternoon he was later released on one hundred thousand dollars bail if convicted kevorkian could face up to four years in prison housing starts were down two point seven percent in july the commerce department reported today that was despite the lowest mortgage rates in two decades senate minority leader bob dole said the day republicans were ready to work with president clinton on reforming the nation's health care system he said any plan that mandates employers to provide coverage would be a hard sell with the republicans but he said they were prepared to discuss today spoke of the nation's governors are meeting in tulsa oklahoma one day after mr clinton addressed the same group it should be a bipartisan effort and that said very clearly it's got to be bipartisan is not going to work because in this case i don't think it's a partisan issue in a sense are republicans or somewhere

democrats or somewhere else we have different democratic groups supporting different plans with every republican groups supporting different plants so to make that passion that have a broad cross section of republicans and democrats i'm sorry more than fifty percent of age that you get a pretty good cross section to really make it work and money to say is the republican leader in my view bipartisanship was not just picking off enough republicans to get the bill passed that may be a victory that is not bipartisanship we will look at the rise in administrative cost of health care right after this new summer nasa today chose bowling as the prime contractor for its twenty two billion dollars space station program but also chose the johnson space center in houston as headquarters for the newly scaled down project and february president clinton ordered it cut back from its original thirty one billion dollar bizarre no progress was reported today at the bosnian peace talks in geneva the negotiations between the muslims serbs and croats became hung up over the division of

territory in eastern bosnia we had a report narrated by vera freinkel on worldwide television news optimism still held sway as bosnian serb leader radovan karadzic and his aides swept into the latest round of the geneva talks on the war torn republic of bosnia the former yugoslavia is no candidate for quick fix solution is east and bosnia and it's a muslim enclaves with a talking point describe the smiles bosnia's muslim president and his savvy large bird could find no in common ground international mediator loaded into the european community by giving un again practice patients the problem is deciding which side gets which parts of eastern bosnia including the circus each muslim enclaves of jet a russian day in srebrenica all three towns with declared safe havens by the un parented shoelaces said the muslims could have no more than thirty percent of bosnian parity in any peace package

president is a big election was about forty percent of the talks in bosnia's muslim president also expressed new skepticism about a tentative agreement reached yesterday that would give the un temporary control of the capital sarajevo it finalized it would end the serb siege of the city david changer of independent television news filed this report from sarajevo the un protection forces say they can start implementing a plan to demilitarize sarajevo within twenty four hours but it could take weeks even months to complete the task there are three thousand un troops already deployed in and around the city including a lot's attachment on mount edmund many bowl be needed if the political plan worked out in geneva is be fully implemented a key part of the scheme is the withdrawal of heavy artillery the sense of place in a ring around the city even calls to them to be pulled back to positions twenty miles away from sarajevo putting the city out of their range

for the first time since the siege began the plan depends on the goodwill of both sides on the confrontation line in return for the serbian withdraw the mainly muslim boston army will deliver their heavy artillery to mounting points in the city if we can get an agreement to start this process right now we are ready to go and we can be within twenty four hours to begin that process convoys are now getting into sarajevo on what the new land routes opened up weather service use for the first time this week to deliver sixty nine tons of humanitarian aid un troops and engineers are now working on a second route into the city and excise code named operation lifeline but the people in sarajevo are still dependent on the airlift of food and medical supplies they'll enough is reaching the city to meet their needs day by day not enough to stockpile supplies were coming we just a lot of the single shopper and tell a supermarket open where people can go and it has become their

groceries there's no bus service running people caught him to leave the city will long way from almost ridiculous of our loud the siege of the city is far from over four people were killed yesterday trying to collect firewood from the frontline that nothing else to cook their food with authorities in the former soviet republic of georgia today said they had arrested a suspect in the killing of us diplomat frank woodruff they said they now believe his murder was a botched attempt at highway robbery woodruff died aug eight after he was struck by a single bullet while riding in a car with a cheap bodyguard for georgian president eduard shevardnadze it was reported that woodruff was an agent of the cia and was in georgia to train security personnel for shevardnadze yesterday's report of rescuing five women from the wreckage of a collapsed hotel in thailand has turned out to be false army officers at the mistake occurred because of incorrect messages sent by volunteers at the same the sec story hotel collapsed friday officials said one hundred and two bodies

have been recovered so far that's a tremendous honor tonight now it's on to health care reform our report from syria go the health care reform debate is where we begin again tonight the specific issue reducing administrative costs are new chief washington correspondent margaret warner is in charge president clinton laid out his strategy for fixing america's health care system in a speech to the nation's governors yesterday tonight we take one large piece of the puzzle administrative costs in the nation's hospitals a recent study found one dollar out of every four spent in hospital goes to administrative overhead will debate whether this is too much to spend on paperwork and if so whether clemens overhaul would cut out the fat we start with the president's comments on administrative waste we know now

we're spending far more money about about on the dollar probably administratively just on paperwork pushing for granted any of our competitors or a decade ago the average doctor took home about seventy five cents on the dollar came out of the climate the best town of fifty two cents on the ball and only ten years because we are all watching paperwork impose favor the government and be so the fact that only i stay says fifteen hundred separate health insurance companies writing thousands and thousands of different thomas abbott doctor friend in washington he recently hired somebody not even to do paperwork but just to stay on the phone the call insurance companies every day to beat them up to play what is already been covered minute ride out of the pockets of the nurses that work in this climate and there is a story like that and every health care establishment in america but there are plenty of stories like that in hospitals across america and that's where we go next business correspondent paul solomon a public station wgbh has this background report on

exactly where some of those hospital administrative costs go he's been mayor of austen's fame that israel hard to see why costs were so high this man was seriously injured in a car accident just to stay in this hospital cause fifteen thousand a week no matter what shape if you need a special bed like he does add another thousand we don't have a hospital bill for a patient like this includes all sorts of charges which seem exorbitant the dollar has been an ally we took an itemized bill to beth israel's chief financial officer jean watts or not surprisingly was defended oh well and are seen as a lot of latch of twenty four thousand are seeing is a lot of today's day three hundred million dollar budget seems like a lot but in the end if you believe the beth israel is there the medically this was necessary in the show is

appropriate and what we did was appropriate it cost it cost that in part because of the charge that added to every item or overly general expenses like these building well as generate stories salary itself overnight here is dominated by administrative costs which says a new study in the new england journal of medicine amounted to one fourth of the two hundred and fifty billion dollars we spend on hospital care in nineteen ninety now a sizable chunk of these administrative costs comes from the struggle between those who provide health care and those who pay for riders like beth israel hospital actually do as much as they can to get as much money as possible from the barriers principally insurance companies or the government the players were equally hard the show at no more than they absolutely have to and the more these two side struggle the higher administrative costs now under the current system hospitals need administrative staff to protect them from the fires and we try to improve the services and we charged for reform

insurance companies to protect their interests in storm he's well trained pretty well paid nurses write in the hospital to scrutinize bills and challenge charges forcing the hospital fired their people to defend themselves we asked beth israel susan proceed in prison or rather expensive game one is that it's a little bit of it is neither buys shiite jobs being again but in advance an offensive is because theyre just gone back and forth on the other hand under the current system each side's administrative costs seem absolutely necessary and says jean wahl as when beth israel's costs or challenge his administrators bp insurance companies administrators to die that a break the number of things just to employ more people of course besides fighting insurance companies hospitals must also fend off the government's watchful year scrutinizing medicare and medicaid bill the government's people are also highly trained and they do a pretty well they

meanwhile back here at the hospital more employees are needed to carry the government's trust here with customized computer program the hospital's people scanned the vast array of federal reimbursement rules looking for loopholes which within of stature to be fat offering all our basic of laughter and one is a tractor with complications and always will detail the medical terms like it's more pronounced that if you can find them in the medical record group says patients have a higher level of which one bill but quite understandably payers like blue cross blue shield try to capture the hospital's effort here by limiting hospital stays and what is the nations first name this room is filled with recertification nurses if you're one of the two million or so massachusetts residents are insured by blue cross anyone go to the hospital you call the eight hundred number on your card records answered here

the sole job of these nurses is that decided the hospitals they've really necessary and if so how long it should last and so it goes each side responding to the other and costing us all of the process four years of the iraq war is to have a lot of blue cross puts it its it's a constant cat and mouse game looking for wears places where they can maximize revenue we're constantly on the other side trying to uncover areas where i don't like that trying to stay one step ahead or people to with interest and an amazon invoice and women falling or spending spending money on the cat and mouse game and on other forms of paperwork in personnel made necessary by our multi layered system a system that last year require one point two million hospital administrative staff to care for a

daily average of less than nine hundred thousand patients what the administration's major health reform bills of course has been to slash costs and recently the hospital administrator hillary rodham clinton saw their support for the president would streamline the system if we do not simplified the burdens on our healthcare system we can never provide health care to every american at an affordable cost in order to do that we need to move toward a single form system we need to do all that we can to implement more efficient means of electronic and computerized billing we need to understand clearly that it is no longer acceptable for the paperwork hospital to be growing at four times the rate of that caregiving hospital the administration hopes to save six billion dollars a year just by cutting the authors of the new england journal study of suggested that

savings could go as i as fifty billion but only if the administration would adopt a single payer government funded program like canada and at this point that seems highly unlikely earlier today i discuss what to do about the problem of hospital administrative costs with four people with very different views can afford is the deputy assistant secretary for policy at the health and human services department he was a member of the presidents health taskforce dr david himmelstein is a professor at harvard medical school and a co author of the new england journal of medicine reports he's also a spokesman for physicians for a national health program michael bromberg is the executive director of the federation of american health systems a trade association of private hospitals and you'd have now is the west coast director of consumers union an advocacy group that publishes consumer reports magazine and i want to start with you your study had a rather startling statistic which was in the last twenty five years the number of americans in a hospital on a

given day has dropped dramatically from about one point four million a day to eight hundred fifty thousand yet at the same time the number of administrative managers and clerks has quadrupled from about four hundred and fifty thousand to about one point three million have this happening at once costen was costing us about twenty five percent of total hospital spending about one in every four dollars now goes for paper pushing and it happens because of the multiple payer system and the competition in our system we've allowed market forces to really want our health care system more than any other nation on this earth and unfortunately that's what the president is depending on to attack this problem we don't think that'll work you know if anything make the problem worse mr thorpe do you accept that the us has announced this is administrative costs are they twenty five percent of hospital costs one of his twenty five percent but i would certainly agree with his general thrust of that discussion that administrative costs are high we really think that they're way too high and that as you'll see the president said has already talked about some specific ways of reducing them so i

we agree completely that there are high we think there are and a necessary burden on the system that in many sectors there strangling of physicians and hospitals and insurance companies and patients and physicians and providers so on joel possibly of the discussion and arguments i think we finally are very well they actually <unk> would you agree or fourteen hundred member hospitals in your group you think do they think of instant messaging we know that about him we get complaints every day about the paperwork and i think the studies ago and we tend to think it's more like eighteen percent to twenty four percent and so what one would agree it's a serious problem we should have a goal of reducing at everything mrs clinton said on the tape i agree with we should have electronic gone i will point out however for purposes of the conversation that there are good administrative costs that administrative costs for example it isn't that what's most of our schools that had the gospel as about twenty people working a full time doing nothing but medicare forms and maybe up to a hundred people doing all insurance forms customizable scent of ways full time people to do nothing

they run after doctors to get them to certify readmissions under oath because that's a law that they have to be certified we have to go out and find the positions because they don't just come and do it on the other hand there are some like having a chaplain's office having security and a hospital an intercity all the way up to quality standards of medical records that you would want to do away with so what's not think that all of this twenty four percent of the studies that some of it's pretty good but we are the credit ms belle would you agree with mr bromberg at some administrative costs actually are there to help protect consumers are getting do you think there are entirely too high as well well there are definitely two high but there's no question that some administrative cost health plan an institution but what were talking about here days heavy get the wasteful administrative costs out of the system so that we can provide all consumers with quality care dr himmelstein let me turn back to you now and as we talk about solutions are president clinton has of course dedicated managed competition

system saying that electronic elena national health credit card some streamlining the process would cut a lot of what is the unnecessary this trip cost about do great we don't think that that really has much to offer in all it's an attempt to sell damaged goods to the american people at this point really what are the president is advocating is more bureaucracy in order to oversee the bureaucrats who are already they are my hospital and every other hospital in the country really does most of its billing by now electronically already six billion dollars they say they could say with electronic billing is a pittance compared to the potential savings of a canadian style program there's at least fifty billion dollars worth of ways to be gotten there and the president's program will get any significant portion of that and of course the canadian system is the single payer system the government takes just right and what they have done as you said instead of relying on bureaucrats to oversee everything that doctors and patients do they will pay hospitals like of fire department is paid in this country they give them a budget and this someone check a

month for one twelfth of their total budget and they don't look over their shoulders at everything that that each doctor and patient is doing you know there's an old saying that the chinese have have used that there's no point in going to bed early in order to save candles if the result as twins and that's really what our attempted administrative oversight of medical care has been in this country one was just four let's hear the defense of how president clinton's plan would attack these administrative costs well the president's proposal as is going to be unveiled in the fall is going to dramatically change the culture of how we practice medicine i think it's true that within the current system if you look at electronic billing savings and other types administrative savings it seem relatively small but what we're proposing is a fundamental recall of how we practice medicine oh we agree that's others too much overseeing too many czech checkers are too many bureaucrats are looking over physician shoulders we really are talking about a very substantial overhaul of how healthcare structured delivered in practice in addition

to some the things that the first lady talked about with respect or streamlining electronic billing and so on and that we are really going to push for a tremendous amount of standardization no longer will they be fifteen hundred different claims formed there be a single point four that opposition small hospitals and providers will use that will help them and sleet and saving administrative cost the hospital has to face in addition i were going to have electronic of billing as has been talked about we're going to simplify some of the coronation of benefits a tremendously that the health plans and i probably have to use that to try to collect money from patients' i'm short i think that the reforms were talking about in terms of community rating on electronic billing standardization of healthcare forms and restructuring how health care and manage care in particular is currently structured with in this delivery system will save a lot of money if we accept that say sixty billion years spent on administrative

costs how much of that can be saved by all the streamlining attacking well we've we've done a couple of smith's internally and one study that i completed one i was at the university north carolina before a joint administration and we looked at administrative costs in a system up in rochester ah which relies on community rating it has a single claims for their so multiple players in the system a big expenses are very very streamline is a simple system as a one way paying our hospitals one way of pain providers in the system there's no wonder writing that is the health insurers don't have to go out and look for healthy patients a very simplified system i am what we found was that in the hospital's up their mother their administrative costs ran about ten or eleven percent of total expenses compared to canada's nine percent but the us that average gained fifty year if we take that the hillsides and house's twenty five percent perhaps as an upper bound but still we think that the system that were talking about low project to be

an insurance reforms the streamlining of how we do business in a hospital and really weeding out the necessary paperwork that we'll look at having administrative cost of hospitals that are not the similar to what we've seen in the rochester area so we think that a very substantial amount of savings perhaps not exactly beloved candidate were very very close and so what is that and billions of dollars well if we think that this year that we're spending fifty or sixty billion dollars in administrative costs and hospitals are that we could probably save a third of that so that's a very substantial amount of savings in terms of reducing paperwork and unnecessary care the minister brown bear dr himmelstein says his system with the canadian system single pair could see fifty billion why would we choose a system that could only save twenty bill well in one word quality dilemma get to use the phrase that the doctor did damage goods before i think what's less translate what he's for and what i think are damaged goods which is let's everybody stand up and rip up their

private insurance cards and turned everything over to the government and let them run single payer system that is single payer is governor and i just don't think the american people are ready to trust that year because of the experience in canada germany and other countries in that experience is that they save administrative costs in different ways that i'm sure we would like number one they have waiting lists a number today have rationing of technology and number three every way on one such they sometimes triple the lengths of stay in america which means fewer patients which means less administrative cost because there's little turnover and dr poland just give you one question i'm still waiting to find one person in this country you can call me on the phone and tell me that they know anyone who voluntarily got on an airplane and flew to canada because they thought the healthcare there was better and that my my response to that is i go into any gospel american finding people from all over the world who come here just the quality of care mr matson our congressman for a while it did just that two years ago when the candidate for his care because the high technology procedure he wanted and needed was not available in this

country the fact is that canadians live longer than we do they get more care than we do they have more doctors visits more hospital stays a variety of crimes the waiting list that you've talked about a really an invention of our insurance industry and the lobbyists against the canadian says the quality of care by every measure we have this it was finally triggered this question suspected ministry of cost because there's so many different issues here not like to try to keep his focus now on tell me do you think that american consumers in the end would be just to take it from the perspective of how much is spent an administration going to a single payer system or are there things that with the low administrative costs in canada the candidate is giving up in the way it's a quality control analyzing data about the outcomes of procedures things that actually help improve the quality of care even though they're considered administrative i think what's important here is to think about what would happen in the united states if we adopted a single payer system and what you find are enormous savings on administrative costs continued high quality care and would be able

to provide health care to all americans without increasing the dollars we're currently spending and that's been found by the congressional budget office and the gao another study so we can continue to spend what we are today and get coverage to all americans giving those thirty seven million folks without coverage what they really need one thing that isn't clear to me is how having a single payer system would eliminate this cat and mouse game that we just saw on paul simon's report on a seesaw beth israel hospital whether somebody with er patient was private or a medicare patient the hospital i'd go through the same procedure which was justifying these cost her and put them in a category and so on here's here's the key the key is that under the single payer system the house was given a budget it's no different than the consumer operates within any given month you know how much he had to spend and that's how much you can spend and so you operate your entire system to stay within their budget or to do better and that's one of the key points in a single payer system and we hope that the president's plan will include a

budget for the health care system mr thorp lets up but what i don't understand and conversely is how president clinton's plan that would eliminate this cat and mouse game that seems too even if you went to electronic billing it's simplified form you still have the hospital negotiating with still with its fifteen hundred private insurers would extend five hundred all these different companies in this cat and mouse game well the main very costly the main idea behind the president's proposals that we're going to fundamentally restructure the way that managed care is practice i mean one of the problems is that this cat mouse game of having managed care vendors from topeka over looking at the shoulder of a physician doing a procedure in sacramento is not very fact that it's something that caused a lot of anger in the broader community ice caused a tremendous amount of paperwork and we think that that form of managed care is in fact what we're going to propose is to restructure the incentives in the system for example the president has talked about providing a global budget as a

framework for healthcare spending decisions what that means is that the whole incentive structure i would suspect the whole health plans negotiate with hospitals will change they will negotiate basically fixed contracts with hospitals and physicians and providing incentives for those hospitals especially to stay within that overall budgetary framework that means that the health plans don't have to do a patient by patient analysis of what's inappropriate are not appropriate in terms of the emissions rather what we want to do is move to a system where the health plans and hospitals within a cap updated system will find ways internally to provide the highest quality care without having somebody looking over the shoulder for every mission a good example would be the way that the mayo clinic practices the mayo clinic is perhaps one of the best provider of medical care the lover's in this country it operates essentially on effects budget that has had very low rates of increase and health care spending they provide very high quality care and they don't rely on the sort of paperwork and illustrator of a

burden song type of system that we talked about that relies on managed care vendors questioning the positions within the mayo clinic system that type of integrated not work oh whether it's male or the lahey clinic or intermountain health care is an actual example of the salt lake city area that relies on internal incentives to provide high quality care rather than having extra will manage care vendors question patient by patient position by position decisions why has seventy fulltime people who do nothing but talk utilization review firms from the managed care organizations and talk to the doctors who practice in those places my colleagues who practice they're not practicing and three major modes know very well that the kind of managed care plans you're talking about or administratively incredibly cumbersome and complex if anything more so than the current system and the fact is that the president has really admit it that there aren't administrative savings upfront by saying that that he's not in a phase in coverage for the

uninsured for another five to seven years until after the next election because they're not really sure that they have any savings at all on administration and in the near term or i would suggest you in the fourth year and i think that raises one interesting point which is that in a hat heavily hmo system say california it history of savings are highly effective when our highest administrative costs in the country had it very easily because those have an incentive to focus on the seventy six percent of the cost that we're not talking about example if you're spending twenty four percent of your money in a hospital on administrative costs and that side of the operation as able to keep ten people out of the hospital all together you say one hundred percent of the other seventy six percent of the costs and that's the sentiment of the current structure before scanners explained it's restructured secondly and perhaps my friend ken that while i agree with a lot of this managed competition strategy at the mayo clinic sets its own budget that doesn't like washington dc or the state capitol in minnesota say here's your budget that's it you can spend one penny more and it's in it's a very bad analogy because i wanna see what the

mayo clinic thinks of a global budget when we finally find out how it's defined him of the court until its very important and third to dr himmelstein common about quality and canada and outcomes and quality of life just let me say that i wish that our hospitals in this country and their emergency rooms were not filled with violence victims of violence victims of crack and and drug abuse and other kinds of self abuse because i think if you had just had some your statistics for the way the americans are amusing themselves you'd find our quality of care is far superior to cannes i feel you know very well that smoking is a much bigger cause of hospitalization and cracker heroin use drinking as well and they have bigger problems with that in canada there are fifty five million people abuse alcohol and draw and tobacco and there are only nine hundred thousand of using crack and heroin and anyone who works at the hospital know that apple and tobacco is a far bigger problem and it's a bigger problem in canada than in here so that's really just a false argument canadians would provide better quality care for their population at a cost a thousand

dollars per person less than we do and a half of that difference five hundred dollars per person is savings on bureaucrats on paper pushers who do nothing useful for patients that's really the bottom line in this bill as long as we agree that the bottom line is quality let's leave it up to the americans to decide which system they preferred is that is the bottom line here i wish only that up to the american people in polls consistently show that the american people favor a single payer canadian style plan and the question in our washington lobby it's really going to determine what we get where is the president going to provide leadership that doesn't try and sell us the damaged goods of managed competition but provides is what the american people i think the gentleman that news now gentlemen thanks very much and thanks very much to margaret and let me formally out welcome you to the macneil are family at the summit tomorrow i am very glad that you've got that so well still to come on the newshour tonight a report on the politics

behind crucial shortages in sarajevo but first this has pledge week on public television we're taking a short break announcer that you're a public television station can ask your support that support helped keep programs like this on the air the station's not taking a pledge right the newshour continues with a look at the bosnian peace talks in geneva no progress was reported today a new dance were cast on an agreement reached yesterday for demilitarization of the capital sarajevo gabi rado of independent television news reports from geneva just beyond the entrance is the map of the country they are headed by sect inside a surprisingly modest room of the participants ones together around a small table for the fund comfortably close together here president in a big event the muslim leader who's pleaded to the world to stop the genocide as people thought the trades small talk with his art enemy the bosnian serb out of unconscious and within arm's reach of

the bosnian croats multiple bunch of forces or even today denying the un access the most the pacific coast of the world for six weeks the company's co chairman appeared to have decided it is only this exploding clothes intensive atmosphere which the chance of breaking development that law just before the cameras were excluded from this remarkable scene and official brought in more maps of the operating table a two hour session with a day devoted to the cobbled of eastern bosnia but certainly to highlight differences so far no agreement has been reached the muslim side presented my theme of the month as the end of the whole area of the delegation of the rhubarb republican sen scott however is prepared to consider the question of revenues up that our aunt gardiner is by the lack of progress this morning both sides have expressed willingness to continue discussing this matter on the face of it the serbian spectacles and breaking new ground as the enclaves the

seventies as evan grass that already designated muslim safe areas would serve surrounding them but keeping their distance according to the map the muslims they vote yesterday most of eastern bosnia should be returned to them the region fell to the surge in some of the fiercest battles of the war of the muslims say they have a moral right to it he's from boston area is is a place that suffered the worst kind of genocide the vast majority of people have been expelled and they need a chance to go back to that churches in some municipalities in eastern bosnia muslims were a majority in over ninety percent and we can do nothing else but just ask for whatever charity was was absolute majority of gazans to be given back to the tour bus in a republic in sarajevo itself the un about the floating around trying to repair the damage done in among local muslims following its claim yesterday that the city was not on the siege the back that claim the un can go into the ride a resumption of aid convoys engineers are able to their roots

more humanitarian supplies into gold in the un laid the ground for further out they serve enemies they have to lay down their arms should be open city proposals from geneva become reality of all the companies co chairman himself admitted his salary of a man needed a great deal more water view and it gets you some muscle and to make and take down barricades to make a severe allergy yes that was going to be one of the tasks small the early stages of demilitarization so new science human the diminution checkpoints and those checkpoints that exist to have and to a man and you in sweden is accompanying me a local police this was off putting in so you actually like that his spokesman said the senate a manmade hole the un in a wide ranging commitment the exact nature of that is a matter for the security council to stop to decide but there been examples and in the

past where where whole countries have been put under un administration and it means i think that the un would be making the decisions and the post of the president is a ticket which left the confines of the day and gave a gloomy account of the progress being made the disc of the maps of a debate within hours it would be but i don't see in congress during one of this afternoon sessions the mediators apparently wrap the croatian and muslim leaders over the knuckles about the continuing fighting in the most our area lord owen and twelve stoltenberg accused the two rival armies of using force to try and change the math on the ground it is a brief reminder of the large charts hanging in the conference rooms behind may represent biden's bloodshed the tearing apart of the nation as negotiators try to end the siege of sarajevo

residents of bosnia's capital continue to suffer terrible privations due to shortages of water and power special correspondent paul martin looks at the politics behind these shortages american fly at sarajevo's only bakery many tons of it not that that was being used the bakery owned by the state had been able to produce a hundred and fifteen thousand loaves a day until the first of july with all the electricity was cut off just as it was throughout so you know things have been done before but never quite as bad as this week filled with a bakery manager scannable and bout come to light because they've occupied the city the serbs can cut off its natural gas and gasoline supplies whenever they wish and sometimes it happens but when it comes to water and dangerous city in sarajevo things are not as clear cut as they seem there was some water in this idea of pumping station the day we filmed there is no way for the engineers to pump it to any of the city's three hundred thousand people for more than a month before the pumps have been idle

electricity was not reaching them the united nations water expert could barely sit and watch helplessly water does sometimes flows through this pumping station but the engineers can only find enough pressure even then to reach only a quarter of sarajevo's citizen three quarters of the people still get nothing except this they spend hours each day searching for water from underground wells or rivers or canals are occasionally making gathering whatever water trickles down to this pumping station innovative why it's called politics politics does indeed live behind sorry of those wartime power shortages united nations personnel say when they've tried to repair a crucial karline sarajevo that

come under fire though that tax goes up in the hills above the sun whole tone of the show was from the muslim led bosnian army hear that on another hit and run mission against the sale herbs or techniques that target is to inflict damage on the ski serb held factory these soldiers don't deny smashing electricity pylons nearby they're proud of it you should have the train to go no no the tracks he used these days not by trains but by people they lead to the factory for russia the bosnian government claims is the biggest ammunition producer in the whole of former yugoslavia there's no electricity or chains of trolley buses they'd be easy targets anyway then he spotted protected by large containers and buy disputed railroad cars the factory manager risks here

each day driving along this road so that we once we got infected cell where the trains stand idle the bosnian army on the hill began their daily bombardment the shelling has often set off fires in part of the once hundreds of serbs and muslims had worked here now the factories at a standstill at least the part of it we were allowed to visit at this formal force one and plant the german supervises have gone and production of course had seized even before the electricity was cut off by the bosnian army is bombardment of the bushes power lines production of ammunition and arms allegedly takes place in the same complex probably underground but no one would confirm that or even show us where it was that the muslim led government forces have cut russia's power lines have so far failed to cut the bumpy road out of the serb

held town government forces can fire passes by both of their frontline position nearby and the town's former actor the road out links with russia with a surge is temporary capitol and twelve kilometers away from sarajevo is the former ski resort of parlay hear the bosnian serb leader radovan karadzic is quick to accuse the muslim led government of deliberately infecting misery on its own citizens more than the regime is responsible for covering all people in trial many times we have repaired the electricity and water and then destroyed by the more press now the ira the blueberry to us again we are conscious about the normal part by more than religion before they are trying to gain the international sympathies by suffers from the book is that i do they claim that the problem is that

interest is going to your arms factory in for gosh it and they don't want you to make more shells to shell this city how to respond to that whether they have or four pound bomb factory and i mean huge victory in twenty twenty is any sense that aisle and then the temperate us our shows not only in motion about throughout the country and then i think that is not that is the record for an activity before affected but to cut it and the bosnian government leader it is a big event recently signed his documents promising not to use essential supplies like water electricity and gas as a means of warfare but both sides continue to do it as the man in charge of the united nations relief effort in boston recently acknowledged electricity and water are weapons of all one side has a generation of the amazon has a home and they play games with each other back in

sarajevo the search for firewood to cook food with his becoming increasingly difficult the hobbit and trees left in central park yet their rulers in the muslim led government still refused to allow the electricity line injuring for russia to be reconnected it would bring electricity and water to everyone in the center but the government says it would mean their citizens would face even heavier shelling the behind the scenes pressure they've been under from the united nations to restore electricity to the area was being strongly resisted by the bosnian leadership we don't want to actually this huge military complex and we also encourage or not those of people they have in english and not enough on building mission so you cut out whether or not to participate in this business of helping the aggressive get this huge electrical power for what the emissions are and

my choices these are gas pipelines been laid between homes which were already connected to the gas system before the wall and houses that are not the problem for weeks have been that the gas was not getting through to anyone serves control most of the route of the natural gas pipeline that supposed to bring gas to sarajevo from russia while belgrade serbia they came close to admitting his forces had stopped the natural gas for work as there are now again and more than totally covered hall we have to a few areas of the problem those boys who is an adult it's a brilliantly and i'll promise fit into russia's because the gas is

coming from from russia and the new anti get supplies now that the gas and you don't negotiate back in sarajevo shortages of water for scott's together net any remaining water sources so that just one serve shelton cause carnage today though the american family of a pleasant surprise so they can go downstairs in the second floor apartment and five precious commodity just a few days it's been

effectively cut off again the major stories of this tuesday jack kevorkian was charged in detroit with a felony crime for assisting a suicide earlier this month it is the first test of the new michigan law the commerce department reported housing starts were down two point seven percent in july and senate minority leader dole said congressional republicans were ready to work with president clinton on reforming the nation's health care system in iraq one image and that's the newshour tonight we'll see you again tomorrow night and robert macneil and nine new york life is proud to provide funding for the macneil lehrer newshour yet another example of new york lives wise investment philosophy nice nice

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