COVINGTON & BURLING Mr. Wallace O. Page Six December 17, Green 1980 and low levels of radiation exposure, the Government of the Marshall Islands views as critical to the implementation of P.L. 96-205 the conduct of medical screening, including blood analysis and other testing, of people of all of the atolls of the Marshall Islands. Such testing, and the even more critical follow up medical care, are long overdue and go to the heart of the health care program mandated by P.L. 96-205. other observations made and conclusions reached in the report, particularly in the section entitled Four Atoll Proposal, are extremely sound and echo views previously expressed by the Government of the Marshall Islands. We particularly wish to express our concurrence with the con- clusion of Loma Linda that the only cost effective, economically sensible way to implement the health care plan reguired by P.L. 96-205, given the great number of fixed costs, is to have the health care services which are provided utilized by the entire population in the area serviced, namely the entire population of the Marshall Islands. In addition to the economic wastefulness of limiting the available services to some, but not all residents,. we strongly affirm the conclusion of the Loma Linda School of Health that denial of available medical services to part of the Marshallese population would be ethically impermissible under the guidelines of the medical profession and general ethical principles. It remains the position of the Government of the Marshall Islands that every atoll in the Marshell Islands was exposed to radiation from the nuclear weapons testing program within the meaning of P.L. 96-205 and that health care made available under that law must be provided without discrimination to the people of all of the atolls of the Marshall Islands. The Loma Linda report states on page 2 of the Four Atoll Proposal Section that "[i]t is medically impossible to distinguish in any particular individual whether a disease complex or symptom is radiation related or not." Similarly, on page 12 of the Health Status section the report states that "“[it] is inherently difficult and impractical to dis- : awd 0 Despite the unjustifiable conclusions stated in the Loma Linda report regarding the existence of radiation related health problems in the Marshall Islands, many of the