hospitals and the medical assistants on inhabited islands and atolls would be essential, not only for the exchange of necessary medical information and instructionsy but also for decisions as to emergency q, medical evacuations. This alternative provides a suggested organiza- tion of the health-delivery system of the Marshall Islands, with the United States playinga major role in the direction and management of the progranwhite.preserving local authority and participation. The estimated cost for the first year of this plan would be Fuvoe, By THe $10,908,300, of which $3 million would be previded—feom Marshall A Islands Government, fundiag<ecuvees. The second alternative contained in the Loma Linda proposal contemplates,comprehensive medical care for only the peoples of the four named atolls of Enewetak, Rongelap, Utirik, and Bikini. This alternative would provide improved primary care on the four named atolls and on other islands and atolls where peoples from these four atolls now reside. ghler THe FiasT This alternativeprovides for the improvement of the secondary and tertiary services at the hospitals on Majuro and Ebeye. The hospitaleservice improvements would provide the necessary support for the primary care system and would reduce costs associated with medical referrals out of the Marshall Islands.