‘United States Departmer

Attachment C


APR 46 top]

Honorable Alex GC. Fremling
Acting Assistant Secretary for
Environmental Protection,

Safety, and Emergency Preparedness
Department of Energy
Washington, D.C. 20585
Dear Mr. Fremling:
Thank you for your letter of March 27, 1981, on the matter
of medical costs associated with non-radiation related
medical conditions among the Rongelap anc ttirik people.
We realize that this matter has been the subject of several
discussions in the past, but unfortunately circumstances are
such that resolution to the satisfaction of all concerned
does not appear possible until the adoption of a health plan

pursuant to Public Law 96-205.

We understand the reasons why the visiting Brookhaven National
Laboratory and contractor physicians on the Rongelap and
Utirik medical survevs have feit it necessary in the past te
refer non-raciation related medical cases to Honolulu.
times there have undoubtediv been emergency conditions thet
varrantec such action.
Additionallv, the Majuro Hospite:
obviously did not have the capability
to treat certain

The fact remains,


that the Marshall

Islands Government

has the responsibility for providing reguler medical care tc
its citizens.
The Marshall Islands Government receives
approximately $2 million a year in Federal funds specifically

for health services, as part of its annual grant-in-aid fron
the Office of the High Commissioner. In the FY 82 budget


the health operation allocation for the Marshall

Islands is set at $2,075,000.
Of this amount, $378,000 is
earmarked for outside referral costs.
Additionally, the
Government of the Marshall Islands appropriates funds from
local revenues for medical referral costs, since for the
last several years these referrai costs often have exceeded
There also has been local criticism of the use of
the medical referral program, and this led to the establishment


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