The United States spends around $30 billion a year on the National Institutes of Health, an agency that has been called the "jewel in the crown of the federal government." The NIH is by far the nation's most important single funder of medical research — the scientific work that drives our university labs, our drug companies, and our major hospitals — and its budget amounts to an enormous bet that by advancing basic medical science, we can reap improvements in national healthcare. In one arena, at least, that bet is paying off: America has become the unquestioned global leader in biomedical science. But biomedical science is not the same thing as health, and in a very important sense, our investment in the NIH is not fully paying off. The agency's own mission statement holds that its ultimate goal is applying knowledge to "enhance health, lengthen life, and reduce the burdens of illness and disability."