see genetic effects, etc. These arguments are difficult] to substan- tiate or refute, but will certainly continue to be mised. It is widely accepted that the secondary and selected tertiary care for the affected people will be provided by thd hospitals on Majuro and Ebeye. (The population numbers on Rorgelap, Utirik, a Kili (for Bikini people) and Enewetok are not suffidient to either justify or support more than primary care provided assistant on the individual atolls). a medical This will reqdire a major improvement in the services provided by these two haspitals. It is ethically impossible to provide improved health care for the affected peoples and deny it to their neighbors ilies because they do not qualify. land even fam- This means that - care developed on all atolls (approximately 50%) wi people, as well as the secondary care in the hospit designed for and available to other Marshallese citqzens. The only other alternative, a duplicate health care system throughout, is both unrealistic and politically and economically unacceptable. The Marshallese Government officials have made cleaw their desire PL iow-48 for the Burton Bill impact to be a national one, rafher that treating parts of their newly emerging state preferentiafly. logic is understandable. Their While trying to unify rather diverse island people into a new nation, it is not helpful UY. S. continue to deal independently with some atol Health care systems become less cost-effective the population they serve. The 30,000 population of th@ qmailer the Marshall Islands is already so small as to raise economic isques. Further reducing this to the approximately 2,000 people "digectly" affected will only marginally reduce the total costs. In oter words, a