Mrs. Ruth Van Cleve December 15, 1980 Page Two nize the shortcomings of the study's two plans and propose a third plan. The Loma Linda study proposed two five-year budgets for the operation of comprehensive primary, secondary and tertiary health care programs in the Marshall Islands -- one for the entire Marshall Islands 33,000) (population approximately and one for the people of the four atolls of Bikini, Enewetak, Rongelap and Utirik (population approximately 3,000). The budget figures are as follows: Year Islands Four Atolls $10,908,200 $10,603,700 $12,103,300 $11,917,100 $14,598,200 $17,766,700 $20,700,000 WwW Year NN Entire Marshall $14,824,100 Year em eee GINSBURG, FELDMAN, WEIL AND BrREesSs $18,120,500 Year 3 $21,124,500 Year See pages 104 and 110 of the Loma Linda study. The differences between these two programs are miniscule. According to the Loma Linda study, the five-year cost of the four-atoll program would be $75,585,700. For an incremental cost increase of less than 2 percent -- $1,494,900 -- compre- hensive health care could be provided for all the Marshall Islands. The reason for the slight difference is simple: The Loma Linda study interpreted the "people" of the four atolls to include all the people of such atolls, wherever they may be residing. The “peoples” of Bikini Enewetak, Rongelap and Utirik are now living on approximately one-half of the 26 atolls in the Marshall Islands, including the heavily -.,populated atolls of Majuro and Kwajalein, so that over 75% of the present Marshallese people have members of the fouratoll populations among them. As a result, the Loma Linda projections for a four-atoll program closely parallel its projections for a comprehensive program. While Loma Linda's cost projection for a comprehensive program may be realistic, they seem to make no sense when