Set forth the criteria for the selection of an approach:
attaining the objectives, with
each approach being stated in
Performance or resuits
, terms of:
As in Options A, B and C,
the restatement of objectives
.
addittor.,
1. The definitions of the
role (moral/fiscal) of the
administrators of DOI and
red by
DOE to carry through on the
"10r,
statements of principal made
at the Oct. 12, 1978 - DOL/DOE/
DOD meeting in Washington, D.C.
the needs
‘eople and
|pulation of the Marshall Islands is about 22,000 people -
i
of these only about 2,000 would be completely covered by
pertinent findings in populat on
defined under
,
Option BD.
"Objectives
Who: With the expansion of the
patient population, it would
medical officers and their staffs.
medical teams;
Total cost
be wise to set up (2) field
(A)
the BNL-
acute exposure study team
care at Ebeye and Majuro.
!
However, based wpon our present operating expenses (Option
C) with a cumulative budget of about 1 million the expansion
study group ~ under contract ~ o i to Option D should cost about 1 to 1's million extra.
bith supported by adequate-19 -20 °
Flexibilit
Ftexipiitty
|.
This o ption gives
.
7:
i in scheduling
heduld
.
S
‘
us the greatest flexibility
Where: As in Option C.
examinations in the field, due to the increased on-site
.
.
When: As in Options A, Band C. medical and transportation resources
How:
As in Option C - plus
“added manpower to support 2 field
teams plus at least O 5
trained hysicians at Majuro and
Ebeye - supported by para-
is
Avoidance of untoward consequences
This option offers the best proof of a sincere-U.S. commitment to the people.
This should help greatly in improving the
image of U.S. in ail of the media - U.S. as well as international.
In addition, with the new "free association", the Marshallese
medical personnel, Physician
Assistants and nurse
practitioners.
might decide to fill the primary medical care vac ium with Japanese
physicians (with the good possibility that left wing - antinuclear MD's might become entrencned in the Marshalls).
.
Risk
tk
:
,
Really impossible to develop a reasonably accurate figure.
needs no restatement.
3. Lf limited
health
care.
.
:
.
1
t
i
The remaining 20,000 would benefit greacrly by
the general improvement in the quality of care at the
primary centers, -- but that would be a secondary goal of
the medical staff - working with the existing Marshallese
'
naz
denaads
instituted as
screening and follow-up of
(covering peoples of Rongelap "
Utirik) and (B) the “low level
responsibility . the choice some compromise between Options
C and D is indicated,
ajor expansion
necessary to
han twice: the
Research based upo- a sound primary - secondary care delivery
system will provide optimum care for each patient. The total
.
Full directed data base,
concerning the status of the
peoples of Bikini and Eniwetok.
©, 2. Té full health care respon' sibility is assumed - Option D
*
.
quate
-, it
What:
will be dependentupon:
» 1978)
1sit o-appears
Fhe
d
V. Selection Criteria
Develop possible approaches to
objectives in consideration
of restraints.
Chouc
‘NB.
Analysis
,
pleasece
a
e
under "Total
:
t
s
+
2
5
.
Least risk of all options - unless commitment was made and
then not honored.
Cost/effectiveness
As in Options A,B and C.
we
Timing
This is the optimun cime for implementing Option D - for two
reasons: A) The movement toward “free association" has placed
ease see Sect
rte wieomeeeenn
9
omnes
‘
the Marshall Islands in a state of transition,
The revisions in
the healch care delivery systems could wove along most smoothly
in this period of general and economic transition.
E i- liett of
E needs.
B) The people
of Bikini and Eniwetok are demanding quick and decisive answers
to their very legitimate requests.
5052228
5952228
ee eee eee
Aestatement of refined
1S Opticon
sent pre-
and
tv.
ae
.
Translation
_
Til.
ee
torte fallout