There is concern in the Marshall Islands that the new hospital planned for the capital, Majuro, is too expensive.
The facility has gone from a 20 million US dollar proposal to 45 million and now back to about 32 million but not including equipment, which will add millions more to the cost.
Although the Ministry of Health is promoting the plan, both the United States government and officials in the Marshall Islands outside of the Ministry of Health question the need for such a costly facility when most health problems in the country are preventable.
The proposal calls for a nearly 50 percent increase in the current 87-beds now at the hospital, but a US official says the occupancy rate is still only 60 percent.
The Marshall Islands has one of the highest rates of tuberculosis in the region, increasing health problems from water-borne illnesses, the highest teen pregnancy level in the Pacific and difficulty in eradicating leprosy.