The need for both expatriate and national staff is accepted now and in the foreseeable future, but appropriate educational programs will dependence on outside personnel. lessen Stated priority areas include upgrading secondary care facilities and addition of some tertiary care functions, strengthening managerial and fiscal controls, improving communication and transport capability between clinics on out-islands and central secondary care facilities, activities and recruiting and upgrading staff. including initial qualification and Quality assurance continuing education of staff, preventive maintenance of equipment, and the monitoring of process and outcome of care need marked expansion. continued alcoholism, in such areas hypertension, as patient immunization, and Specific emphasis needs to be community diabetes, health and dental education, services. Care of radiation-related illness, although still of major emotional and political importance, is reaching a level that should be integrated into the health care system of the country. Tensions among Marshallese perceptions exist with regard to family planning, extent of external referrals, degree of support for terminally il] and elective care, qualification and level of health care providers for the smaller or more isolated population groups, and siting and number of health care facilities. The Marshallese view the financing of health care as coming from Marshall Islands Government general revenue, United States Government obligation as Trust Territory administrator and as a consequence of health effects of the U.S. nuclear weapons testing programs, private corporation contribution for the health care of its employees, special program and project grants from foreign governments, foundations and other agencies, and to a limited degree from patient revenue. Although there may be a role for private practice, the government intends that through its health care facilities no one needing health care will be denied access to it. The final overriding concern is related to the phasing out of the Trust Territory of the Pacific Islands and the assumption of the status of a Freely Associated State by the Marshallese Government. This will impinge on the health care system in a number of ways, such as manpower training relationships, licensure standards, activities, supply procurement, etc. health planning and evaluation It is expected that new expertise wil] need to be developed in a number of critical areas, and that the full impact of this changed relationship will probably not be known until it occurs. ©