(a) It is in line with the overall policy of assisting the natives to a high level of economic self-sufficiency, instead of permitting them to become increasingly dependent on a dole system, (b) It is essential, if the Medical Practitioners now tn school are to make a livelihood in private practice when they return to their home islands; obviously, they could not compete with free medical services, and would lose their knowledge and skills so expensively obtained by turning to other meansoflivelihood. (c) The policy is psychologically sound, for it is a recognized principle that goods and services for which one pays are likely to be better utilized and more appreciated than gratuitous ones. Psychiatrists and psychoanalysts always charge to the limit of the patient’s resources to make him feel that he must cooperate fully in the treatments to realize full value on his investment. (d) Trust Territory natives were quite accustomed to paying for medical attention under Japanese rule; the Japanese provided free medical service until 1922, when they began to charge at a rate of one quarter of the rate charged Japanese for the particular treatment, and in 1927 they adjusted the rates upward, creating three different classes according to the economic well-being of the various administrative districts.!7 Civil administrators were directed to indoctrinate the natives along the following lines: (a) Explain to the natives that paying for treatment is an American custom. (b) Appeal to their pride (consideration might be given to the advisability, in certain districts at least, of establishing a slightly higher rate of pay for “chiefs and people of high rank” in order to relate paying for medical services with prestige). (c) Compare medical services and medicines with trade goods for which the people are thoroughly accustomedto pay. (d) Point out that payments revert to the district and will be used to purchase more medical supplies. (e) Point out that before long, the payments will be going to their own Medical Practitioners.?® The policy of payment for medical and dental fees was never completely understood or adheredto bythe native peoples. The Japanese had charged them for such services but American medical care had been free for four years before the policy was reinstituted so that the islanders had become accustomedto expectfree treatment. In some areas, especially in the Marshalls. where in prewar days the /rozj had paid the medical expenses of their people, the regulations, according . DepHiComTerPacls Itr ser 1892 dtd 22 Dee 28. ComMarianas msg of 21 Aug 48. 883 500b023