jer XII. Four Atoll Proposal - Issues and Alternatives A. Introduction Both the Department of Energy historically, and the Burton Bill more recently, have identified the people of Bikini, Enewetok, Rongelap and Utirik as having the most direct radiation effects. Those individuals ac- tually included were decided by various factors, primarily their Tocation during the nuclear testing activities. Not surprisingly there are many anecdotal challenges to the established list of affected individuals which will probably continue to be claimed throughout this and perhaps even succeeding generations. It is increasingly evident that the actual health impact of radiation on even the most directly affected is minimal. This not only further com- plicates any attempt to distinguish these individuals from others, but also raises the question of the need for maintaining this distinction. In many respects, the categorical separation of the affected and non-affected groups appears to primarily be a political issue. The language of Public Law 96-205 reflects the difficulty in establishing this distinction and also what responsibility the U. S. Government should assume for both the health and political/sociological impact of their nuclear testing program. In the narrowest sense it calls forthe pro- vision of primary, secondary and tertiary care for the "peoples of" the four most directly affected atolls. Certainly any plan proposed should include this comprehensive care for this particular identified group, but limitation of improved health care to only these people raises serious political, ethical, and cost-effective issues. these more specifically. It is important to detail