Abstract
The United States has been a leader in biomedical science for decades, in large part because of the strategy used by the National Institutes of Health (NIH) to invest its budgetary portfolio. They identified talented young scientists from each generation and gave them the resources they needed to initiate and maintain strong research programs. However, recently this investment has become less diversified, with a larger fraction of grant dollars in the hands of a smaller fraction of researchers. This threatens the future of our field, as many productive early and midcareer scientists are facing having to close their labs. NIH and others have studied this problem, gathering data that suggest that over a certain level of funding to an individual investigator, there are diminishing returns in scientific output. Here I review these data and examine the issues that led NIH to propose and then reverse a cap on funding to individual investigators, the Grant Support Index. I consider other proposed solutions, and call on all in the field to examine whether the status quo is acceptable, and if not, urge them to propose and advocate for concrete alternatives.