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