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5.

Definition of Comprehensive

Health Care

The Interior Department proposes to provide to the contractor the following
definition of comprehensive health care:
Primarv Care
Primary care is the care received when the patient first seeks assistance
from the medical care system. The care at that point would include the
care and treatment of the simpler and/or more common illnesses, or
determine the need for consultation with or referral to medical specialists.
In addition to immediate care, primary care may also include ongoing
responsibility for the patient in both health maintenance and therapy.Secondzrv Care
Secondary care is the care provided by medical specialists who generally
do not have first contact with the patient, for example, neurologists,
This care generally cannot be provided
internists, and dermatologists.
at the primary care level and is obtained upon consultation or referral
through the primary health care system.
Tertiary Care
Tertiary care consists of se?mices provided by highly specialized medical
and neurosurgeons.
such services
personnel, for example, #@ologists
generally require highly sophisticated technological and support facilities,
such as intensive care units and specialized surgical facilities. These
specialized services and facilities generally are not available at the
secondary care level.
6.

Responsibilities

of the Contractor

The Department of the Interior proposes to require the contractor to
offer advice, by mid-November, on at least the following issues:
(a) A plan to provide for comprehensive health care for the
inhabitants of Bikini, Enewetak, Rongelap, and Utirik, and for the
<fitiitan=>
of additional atolls if they have been affected by radiation
As noted in point 2 above, in
from the nuclear weapons testing program.
deciding whether the inhabitants of additional atolls have been so
affected, the Secretary would consider information obtained from on-site
health evaluations of the people of those atolls, and other relevant
information presented to him.
It would be anticipated that the health evaluations would focus initially
on atolls of the Northern Marshall Islands, beyond the four specified.
The sequence in which atolls would be investigated would be developed
following consultation with the representatives of the people of each of
the affected atolls and the Government of the Marshall Islands.

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