Grantsmanship and Stewardship: A Public View

Abstract

CONFLICTS ARISING out of Federal grants management, subject of this meeting, go to heart of some of thorniest and most portentous problems of public policy. In addition to long-standing, but f ar-fromsettled, issues of Federal-State-local government relations, management of Federal grants involves newly emerging relationship of Federal Government to higher education, a relationship so important and so complex that it has been called the new federalism. It involves relationship of government to science and of government to health, relationship of public and private activities-a perennial issue in American society and an area where we have demonstrated a talent for pragmatic and nondoctrinaire compromise. It involves relationship of administrative process to substantive purpose and relationship of specialized expert to generalist, who is responsible, at least in theory, for both policymaking and general administration. Since total subject is so all encompassing, we have chosen to confine ourselves to one significant segment, management of Federal grants for research in health field. This in no way implies disregard for vast field of grants-in-aid for other health activities. On contrary, one of our major theses is that many of problems of research grants management have been magnified precisely because instrument of research has been overextended by expecting it to carry too great a portion of Government's overall responsibility for health of people. Had we balanced vast expenditures that have gone for medical research since World War II with more funds for medical education and for facilitating access to sto:rehouse of medical knowledge that already exists, problems in all three areas-research, education, and patient caremight have been considerably lessened. Here we concerntrate, however, on medical and health-related research, especially programs of National Institutes of Tfealth, which account for nearly two-thirds of total Federal expenditures in this field (1) and for threefourths of sponsored research in U.S. medical schools. NIH programs, procedures, and problems set tone for all medical research. They also shed light on broad general issues. On recipient side, we focus our discussion on medical schools, nearly half of whose total budgets are now underwritten by Federal programs. The statistics (locumenting postwar explosion in medical research are familiar but bear reemphasis. According to NIH officials, total national expenditures for this purpose are expected to reach $1.9 billion in fiscal 1965. Within this overall growth, role of Federal Government has expanded far beyond that of anly other source. In 1947 it accounted for less than one-third of total. For 1965 its estimated $1.3 billion (2) will represent more than twothirds of total. NIH expenditures alone will come to an estimated $850 million in 1965. Mrs. Somers is research associate, industrial relations section, Princeton University, and Dr. Somers is professor of politics and public affairs, Princeton University.