This report stems from results of a workshop organized by The American Association for the Advancement of Science, and sponsored by The Funding First Program of the Mary Woodard Lasker Trust, and The Burroughs Wellcome Fund. The workshop, whose participants included more than thirty experts in the federal budget process, public policy, and scientific research, was designed to discuss alternative funding mechanisms for medical research outside the traditional appropriations process. Participants were asked to debate the question of whether such alternative mechanisms are both feasible and compelling as a means of securing dedicated support for medical research.