Don and I both perceive the spectrum ranging from a university-supported,
intermittent field team, utilizing house staff and attendings to perform

periodic

support of the Marshallese in the area of general medical care

without secondary or tertiary committments. The other end of the spectrum
would include a series of permanent on-site medical facilities delivering
primary, secondary and remote tertiary care. A single hospital ship, like
a small version on project H.O.P.E., is an alternative.
.

_

The key to success of the program, of course, is to make the universities

an offer they just can't turn down. I discussed some of the benefits accruing
The kicker, of course, would be the overhead on the millions that would be

required to operate such a program.
I am sure that unless we can provide some solid proof of continued support
(funding-and-philosophy)

from our current funding base that the universities

would be very reluctant to gamble on BNL's good intentions.
Both Don and I agree that it will take at least 24 months to establish a
functional unit in the field. I think,

in addition, that it will take equally

as long to develop and implement the Burton Bill. At some point (? 18 months
into development)

the interfaces between:

1. Brookhaven National Laboratory

a

2. the Los Angeles area universities
3.

the groups implementing the Burton Bill (? Public Health Service)

4. The Marshallese health-care system administrators
should be clarified in a series of co-ordinating meetings. At this point

the responsibilities and allocation of funds could be clarified. Prior to that
time the funding for the BNL/university program will need to come from some
other source. I doubt if we will have any solid information or committment
of the amount the Yates committee will consider adequate for the details of
the implementation of the Bill due in DOI in Jan "81.
In summary,

the BNL/university affiliations will need to proceed parallel

and concurrently with the. development of the Burton Bill with independent

oc

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funding. At some point in the future a sharing of funding should be anticipated.

ee eee

to the universities in my letter to Dr. Henderson dated August 16,1979..

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