Science and Policy Leaders Detail a Vision for 2009 (and Beyond) at AAAS Forum

Former U.S. Rep. John E. Porter, a forceful science and medical research advocate during 21 years in the House, urged scientists and allies to channel their frustration into constructive political engagement that will help the next president deal with critical issues that have languished in recent years.

Speaking during a plenary session of the AAAS Forum on Science and Technology Policy, Porter offered a cautiously optimistic assessment, saying that all three of the major party candidates still in the race favor stem cell research and evidence-based decision-making, and oppose teaching religious ideas in public school science classrooms.

But Porter, a moderate Republican and chairman of the Research!America health research advocacy group, offered a bluntly critical analysis of U.S. science policy under President George W. Bush, and suggested that much work will need to be done to make up for Washington's inaction on issues such as innovation and climate change.

"Scientists are, by every measure, the most respected people in America," he said. "But if the public and policymakers never hear your voices, never see scientists, never are exposed to science, never understand its methods, the chances of its being high on the list of national priorities will be very low.

"We—all of us—must make the case, day in and day out, why all science research, technology, and innovation must be among the nation's highest priorities again."

Porter's speech drew sustained applause, and it embodied a view prevalent at the Forum: While U.S. policy on innovation, climate change, stem cell research, energy, and other critical issues has been characterized by political obstruction and inertia, the upcoming presidential election presents the science and engineering community—and the nation—an opportunity to help navigate a new course.

"We have every reason to believe that we can create something new and better," said Robert C. Cresanti, managing director of investments at Ocean Tomo, an intellectual capital firm. "And I think the next election must be a turning point."

"Next year should be—must be—a breakout year for our country," added former AAAS President Gilbert S. Omenn, professor of Internal Medicine, Human Genetics, and Public Health at the University of Michigan. "It is not a time for treading water or muddling through."

The AAAS Forum on Science and Technology Policy is regarded as the premier event of its kind in the United States, focusing on federal budget and R&D issues; public- and private-sector research; education; innovation; and other high-profile domestic and international S&T issues. The 33rd annual Forum, held just a few blocks from the White House on 8-9 May, attracted more than 500 policymakers from government, education, industry, and other fields, plus more than two dozen journalists.

Indeed, the White House was a central focus of this year's event, in speeches, panel presentations and informal discussions. Porter, a partner in the Hogan & Hartson law firm, was featured in a 9 May panel discussion, "Science & Technology, the 2008 Election, and Beyond." In addition to Cresanti and Omenn, the other speakers were: Peter R. Orszag, director of the Congressional Budget Office and Ernest J. Moniz, professor of physics and Cecil and Ida Green Distinguished Professor at the Massachusetts Institute of Technology. The panel was moderated by New York Times science writer Claudia Dreifus.

Porter, who served in Congress as a Republican from Illinois, offered political context for the months ahead—and a candid critique of science policy in recent years.

Funding for key federal agencies that deal with health, energy, and other areas of research has declined in real terms over the past five fiscal years, he said. At the same time, the administration "at times has suppressed, rewritten, ignored, or abused scientific research.

"All of this has been devastating for the scientific community, our research institutions, and our younger scientists and their families," he continued. "It has stalled our scientific leadership at a time when global challenges to America's science and technology preeminence are growing every day.

"It has helped to undermine our economic progress, which can... sustain and increase our living standards only through scientific research, technology, and innovation. And not least, it has slowed progress toward discovery and thus toward better, longer, healthier, more secure, more productive lives for our citizens."

The federal government's fiscal hurdles will continue to be daunting for the next president, according to Congressional Budget Office Director Peter Orszag. Challenges in health care, climate change, infrastructure and other fields can be effectively addressed if policies are driven by an evidence-based assessment of which solutions work, and which don't, he asserted.

Orszag called climate change one of the nation's most serious long-term problems. "Think of this as an insurance issue," he said. "By taking action today, we can reduce the risk [in the future], but we have to pay a premium up front to do that."

Medicaid, Medicare and Social Security comprise about 10% of the nation's gross domestic product, but 75 years from now, Orszag said, that could approach 25%, driven mostly by growth in Medicaid and Medicare expenditures. While many analysts blame that growth in medical expenses on demographics and an aging population, the problem is in fact driven by the rising cost of care per beneficiary, not the number or type of beneficiaries.

Currently, Americans, their insurers, and the government pay $700 billion per year for health services that are do not materially affect the patient's outcome. Orszag added. The number is startling, but, "embedded in the nation's central long-term fiscal challenge appears to be a substantial opportunity," he continued. "Can we reduce health care costs without impairing health outcomes?"

The answer, he suggested, is yes. For example, a comparison of the best hospitals in the nation finds that the costs per patient during the last six months of life vary dramatically. Similarly, Medicare spending per beneficiary in the most expensive regions is double that of such spending in the least expensive regions.

All of which leads Orszag to conclude that the next administration will have an opportunity to reform the system by working to restrain costs without compromising care. That will require Americans to lead healthier lives, and behavioral changes by the health care system, too—improved care for those who do fall ill and more efficient care of chronic conditions.

Cresanti, who left the Bush administration last fall as under secretary of the Department of Commerce for Technology and chief of the Technology Administration, also noted changes in the U.S. economic landscape. In 1975, he said, about 83% of the assets of major U.S. companies were tangible; by 2005, 80% of the assets were intangible intellectual property.

Put another way: The United States has committed to a "knowledge economy," but frequently that initiative does not receive sufficient political or public support—or sufficient engagement from scientists and engineers. There is interest in important individual issues such as climate change or curing cancer, Cresanti said, but not enough attention paid to coordinating and focusing the broad science and technology efforts of the U.S. government to advance innovation across a broad spectrum.

For example, he said, one of the factors that led to the dissolution of the Technology Administration was "a lack of engagement from the science community."

Research is critical, he said, but it has to be followed up with an effort to make the results useful. "We have an obligation to take the taxpayers' money that has helped support some of this research and turn it into some tangible, beneficial intellectual property that serves our society, our companies and our economic infrastructure," he said. "Paying attention to those points is essential to the next administration."

When asked whether the Commerce Department could be rewired to be more effective as an engine of innovation, Cresanti replied that the Commerce Department "is not the only answer."

The federal government is preoccupied with enormous international issues, he said. And so, when it comes to White House leadership on innovation policy, "there's nothing that's more important than the relationship between the science adviser... and the president."

Similar points about the importance of the White House science policy personnel were made by Porter, Cresanti, Omenn and Moniz. They urged that the science adviser to the president and other top S&T positions should be appointed as early as possible, and some suggested that the adviser should be included in the president's inner circle.

Omenn, who served as associate director of the Office of Science and Technology Policy under President Jimmy Carter, said "an experienced, diverse group" of S&T leaders should be working this summer and fall to identify candidates to serve as science adviser to the next president. At the same time, a list of candidates for the top 50 S&T positions should be prepared so that they can be submitted to the Senate for approval along with the president's nominees for cabinet positions and agency heads.

Once sworn in, he said, the new president must begin "to re-order the priorities of the nation."

Within days or weeks, the administration should announce specific steps to reduce greenhouse gas emissions, Omenn said. It should seek quick passage of an appropriation for the America COMPETES Act, which would dramatically increase federal investment in key research agencies, support new initiatives in science-related education, and improve the U.S. innovation infrastructure. It should make a dramatic new commitment to carefully regulated stem cell research, and redirect NASA from its planned Mars visit to improved science and environmental-sensing programs.

In the long term, he explained, the administration must address the "grand challenges" facing the world, and it must do that in part through federal investment in research and development. He focused specifically on three long-term challenges for the next administration:

• Medical care: Omenn said that hundreds of millions of dollars are spent each year on treatments that address symptoms, rather than causes, of illness, due to our lack of knowledge of the underlying mechanisms. Like Orszag, he called for broad new research into prevention, patient behavior, and quality and safety of care to guide reform of the medical care system and cost containment.

• Climate change: Public concern about the effects of climate change will give the next president support for making "a bold call to action," Omenn said, and he noted that all three of the major presidential candidates have pledged to address the issue. Omenn said that stabilizing levels of CO₂ at 500 parts per million would be possible if global emissions from fossil-fuel combustion in 2050 could be cut in half from "the mid-range business-as-usual estimate of 14 billion metric tons" of CO₂ per year. [The Intergovernmental Panel on Climate Change last year concluded that atmospheric concentrations of carbon dioxide over 550 ppm would be dangerous.]

• Energy: The new administration must take action across a range of venues, Omenn said. It must "reverse our extreme dependence on foreign oil" and accelerate use of renewable fuels. It must halt construction of coal-fired plants unless they are equipped to capture and store carbon emissions, and it should carefully renew the aging nuclear power segment of the energy sector. The president and the administration, he said, should engage the public in community-based efficiency and conservation programs.

Moniz, who served as under secretary of the Department of Energy in the Clinton administration from October 1997 until January 2001, agreed that energy will be crucial to the next presidency.

When asked by Dreifus what his top wish for the next administration would be, he replied: "We need to really implement a strong carbon-pricing policy... so that it reshapes our energy and environmental agenda" in a way that both addresses climate and improves national security.

Moniz also recommended that, in addition to a science adviser, the president appoint an assistant to the president for energy who would work with the energy secretary to bring together science, technology, environment, agriculture, economy, competitiveness, fiscal, and other energy-related concerns through inter-agency coordination.

Moniz served from 1995 to 1997 as associate director for science in Clinton's Office of Science and Technology Policy. He has been on the faculty at the Massachusetts Institute of Technology since 1973, and currently is Director of the MIT Energy Initiative.

Energy is a highly capitalized enterprise, generating trillions of dollars a year, and energy policy is therefore complex and highly competitive, Moniz explained. He cited a Clinton-era program, the Partnership for a New Generation of Vehicles, as an example of how policy unfolds in that environment.

The program was a collaborative effort involving numerous federal agencies, the national laboratories, the major U.S. auto companies and other interests; the goal was to produce a full size concept car with gas mileage that tripled current rates, up to 80 miles per gallon. Ford, Chrysler and General Motors each produced prototypes that got 72 mpg, although the auto companies chafed at sharing proprietary information in production.

When Bush replaced Clinton in 2001, the initiative ended rather than pursue production models. In its place, Bush unveiled his own vehicle-of-the-future plan: the FreedomCAR, which stressed the use of hydrogen fuel cells. That program, Moniz said, "has vanished into oblivion."

Edward W. Lempinen

30 May 2008