36. 政府问责局在其 2013 年的报告(见上文第 29 段)中指出，关岛的保健制度规模不足。参与补充环境影响说明的关岛纪念医院管理局的官员们承认，根据国家医院标准，关岛需要约 500 个急症护理床位才能完全满足该岛的需求；但是，医院管理局仅提供了 162 个这样的床位。除了这些基础设施方面的挑战之外，官员们还列举了许多与人员配置有关的问题，包括难以招募和保留足够数量的保健工作人员。美国卫生与人类服务部将关岛定为医疗服务不足的地区，这表示该地区的初级保健提供者过少，婴儿死亡率高、贫困率高和/或老年人口多。关岛还被描述为卫生专业人员短缺地区，这表示关岛缺乏初级医疗服务、牙科或心理健康服务提供者。尽管军事人员及其受扶养人通常不使用当地卫生设施，但关岛政府预期，任何与调整有关的国防部文职人员、移民和建筑工人都能使用这些设施。
36. The Government Accountability Office, in its 2013 report (see para. 29 above), noted that the health system of Guam was undersized. Officials from the Guam Memorial Hospital Authority participating in the supplemental environmental impact statement acknowledged that, using national hospital standards, Guam needed some 500 acute-care beds to fully meet the island’s needs; the Authority, however, provided only 162 such beds. In addition to those infrastructure challenges, officials identified a number of problems relating to staffing, including difficulty in recruiting and retaining an adequate number of health-care personnel. The United States Department of Health and Human Services has designated Guam as a medically underserved area, which means that it has too few primary care providers, a high rate of infant mortality, a high rate of poverty and/or a large population of older persons. Guam also qualifies as a health professional shortage area, which means that it experiences shortages of primary medical care, dental or mental health providers. Although military personnel and their dependants generally do not use local health facilities, the Government of Guam anticipates that any Department of Defense civilian, any migrant and any construction worker associated with the realignment will be able to use the facilities.