(40) XIII. Utilization of United States Public Health Service Alternativ It was requested that costs be developed for having an United States Public Health Service implement and provide com health care for the Marshall Islands. It would be presumptio that costs could accurately be defined for a USPHS program. ing a cost difference, it was assumed that the basic program, ency such as ehensive to assume developquipment, supply levels, and facilities would be the same as considered in developing the other budgets. The area where major cost differenc was felt to be in Personnel Cost. would occur Again, it is not known spe ifically how USPHS would staff the program but, the estimate for cost crease with a USPHS administered program for the first year is approximat Ty $225,000 increasing to $466,560 in the fifth year. This would be true f both the comprehensive program and the four atoll program. In addition to the higher cost is the consideration of ability to the Marshall Islands. ogram accept- Without exception, each are of investi- gation concluded that U. S. skill levels were desired but the Islands did not want a "U. S. administered program". arshall While t is attitude cannot be quantified, it certainly would have an affect on th utilization of the program with a resulting effect on the benefit for the ollars in- vested. cceptability Because of higher costs and, more importantly, the u of this alternative, it is recommended that it not be given s rious consideration.