¢ @ @ & & & The three enclosed documents have not been fully reviewed by the Department or other affected agencies, nor have the proposals for heaith care, monitoring, anc education beer. intecratec. They differ as to their ceosraphical coverace anc contain some Guplicaticr of costs, as in the case of transportation and communication. In addition, the cost estimates have not been reviewed in any detail. The development of a single, integrated plan based on the three attached proposals cannot effectively be accomplished until various issues are resolved, and accordingly, none of the three proposals here transmitted has the endorsement of this Department or the Administration. We believe them to be useful and professional products, however, anc they will unquestionably be important in the development of the plan required by the law. From the foregoing, it will have become clear that a number of questions require further consideration. The most fundamental is the matter of the coverage of the program -- whether it should extend to all of the people of the Marshalls, to the people of the four named atolls wherever they reside and to the people of the “other atolls” that are found to have been affected, or to the current residents of selected atolls only, and if a distinction should or can be made between radiation and non-radiation related injuries and illnesses. Should an effort be made to provide for health care for peoples of named and affected atolls that is separate and apart fror. the health care program available to the general population of the Marshall Islands? Does the term “integrated”, which the statute uses in describing the comprehensive health care program, mean that such program is to be integrated with medical programs of the Marshall Islands Government, or does it instead describe the relationship between the primary, secondary, and tertiary levels of care? To what extent should the beneficiaries of the health program, in whatever way they are defined, receive secondary and tertiary care within the Marshall Islands? Finally, if the peoples of atolls other than the four named in the statute should be provided the comprehensive care envisioned by Public Law 96-205, through what means and by what criteria should those other atolls be identified? These are among the issues that will require attention in the weeks to come. Sipcerely, S ncaacl Enclosures ~-7- — a