One morning late last month, the financial futures of hundreds of medical students in the Bronx changed forever. A gift of $1 billion from Ruth Gottesman, a former professor at the Albert Einstein College of Medicine and chair of its board of trustees, will make the school tuition-free in perpetuity.

The donation, one of the largest in U.S. higher education history, is an act of generosity that will undoubtedly improve life for Einstein¡¯s students and potentially benefit the surrounding community, one of the nation¡¯s poorest.

It also highlights how much U.S. colleges and universities rely on wealthy donors ¡ª and raises the question of whether more systemic changes would better serve students and society.