I wonder how far we can take this.
The scholarly society publishers, clustered under the banner of the "DC Principles," have issued a press release on their offer to NIH to set up a system of direct links from PubMed to the articles in the journals that they publish. It is presented as an alternative to the NIH manuscript submission policy, and it isn't quite that, but it opens up possibilities that librarians ought to embrace. The press release (and the proposal that is also on the website) is short on technical details, but the ability to easily make direct links from the PubMed citation to the full text of the article is something that we all want.
It barely addresses the archiving/preservation issue, but that could be easily solved (LOCKSS and a dark archive).
The major problem, of course, is that not all NIH-funded research is published in those journals -- but this is where speculation gets interesting. Suppose you're an author, getting ready to send your article out. You're aware of the NIH policy and, despite the fact that it's a royal pain in the ass, you want to be a good citizen and get your article into PMC. You can send it to the leading Elsevier journal in your field, and go through the hassle of posting your manuscript to the NIHMS..., or you can send it to one of the Highwire journals and not worry about it. All NIH needs to do is modify the policy so that articles published in journals that participate in the linking program (and make all of their content freely available in 12 months or less) are considered to be in compliance.
The critical issue with scholarly publishing today is not open access -- it's the fact that over the past thirty years, the academy has turned over responsibility for scholarly publishing to the for-profit sector. The DC Principles publishers are anachronistic holdouts -- thank god! They tend to be less expensive than commercially published journals, and they're run by the faculty and department chairs and deans on our campuses. They share our goals -- to get scholarly information into the hands of those who need it. My biggest frustration with the whole open access debate is that it has put librarians and the society publishers in opposition. Instead of working together to transform scholarly publishing, we waste time and energy arguing. This proposal is an opportunity to get us all on the same side of the fence -- where we ought to be.