Earlier quoted context omitted.
Sorry, that argument falls flat. We're talking about schools with multi-billion dollar endowments, new sports stadiums, branded new facilities, fat tuition fees from international students and a ton of pet projects by the university. But no, the NIH needs to "subsidize" general fund through NIH grants? > The university is free to spend them as it sees fit, rather than according to what some big important outsider say…
I believe the median endowment of an R1 university is around $1 billion. That corresponds to $30 million to $40 million of sustained income a year. Enough to fund a single reasonably large academic department, or about as much as grant overheads. Except that universities usually can't use their endowments as they see fit. Big donors often prefer funding fancy buildings and other singular things over daily operations.…
Doctors talk about how their salaries, the highest in the world, couldn't possibly be lower and blame insurance and the hospitals. Hospitals tell stories about all the uncompensated care they provide, how they can't tell doctors how to practice and how patients would be dying on the streets if they got $1 less and the problem really lies with doctors and insurance. Insurance companies talk about how hospital spending is out of control and most of the money is paid out in claims and how doctors fees have exploded.
Etc, etc, etc.
The truth is that the cost of university has skyrocketed over the past few decades. University budgets have grown well beyond inflation for decades. The administrative class has exploded in terms of head count and campuses have gotten more and more luxurious (try comparing them with one in Europe or Canada!).
In the end if universities couldn't possible move money around to cover what amounts to a few percentage of their total budgets, then I don't know what to say. Maybe the slate needs to be wiped clean and we start again with a system that makes more sense in terms of where the dollars come from and go.