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By Andrew Peterson

U.S. organ donation systems have a supply and demand problem. The number of individuals in need of life-saving organs outstrips supply. The National Kidney Foundation reports that, as of November 2016, over 120,000 individuals are waiting for a life-saving organ transplant in the U.S.. Of these individuals, 100,791 require kidney transplants with a median wait time of 3.6 years. Many die before receiving a transplant. It is estimated that 13 individuals die every day waiting for a kidney.

There are several proposed solutions to this problem. Some have argued that the U.S. should adopt a mandatory deceased donation policy. This would resolve supply shortages and curb the illegal practice of organ trafficking. Another option is a regulated organ market. This approach would incentivize the exchange of human body parts between parties who are not be motivated by altruism.

These solutions are ethically messy, and policy makers might be reluctant to attach their names to these ideas. But what if we could avoid the ethical mess by leveraging technology?

What if we could print an organ?

We are in the midst of a 3-D printing revolution, and the prospect of printing organs is not mere science fiction. Reports in Nature and the Economist highlight that 3-D printing is already used for artificial joints, bone grafts, and cartilage structures. The U.S. market for printed body parts is greater than $500 million, and annual growth is increasing exponentially. Printing organs is favorable as compared to other methods, such as xenotransplantation: printed organs can be customized, can be printed on demand, have no viability window, and are not susceptible to zoonotic disease.

Despite this potential benefit, printing whole organs still faces technical obstacles. This is where policy makers have an opportunity to act. Below we highlight two recommendations that could position the U.S. as a medical technology leader in the 3-D printing revolution, and could ultimately save lives.

Recommendation 1: Incentivize collaborations between scientists and industry

The growth of the 3-D printing industry has already outpaced market forecasts. Economist project the industry will be worth $20 Billion by 2020. This pace of growth can be leveraged toward increased medical technology research by incentivizing relationships between science and industry. Federal research dollars could be used for match making in research project grants, or broad investment in University infrastructures that promote collaboration. The U.S. is already leading 3-D printing innovation. This model could put the U.S. in a position to make one of the most profound medical technology breakthroughs of the 21st century.

Recommendation 2: Promote discussion of ethical issues associated with printed body parts

New technologies bring new ethical questions. Printed body parts are no exception. Should we maximize equitable access of printed organs—or 3-D printing units? Should insurance companies pay for printed organs as they do for prosthetic technologies? And should printed organs be enhanced beyond normal function? These questions require discussion between industry leaders, scientists, and science and technology policy experts. Federal dollars can promote these discussions by integrating ethical analyses into research projects. The U.S. Human Genome Project and BRAIN Initiative use this incentive model. Federal dollars that support the 3-D printing revolution can do the same.

What's Wrong with National Security S&T?

Mike Swetnam

I have an appointment with the Director of IARPA (the Intelligence Community version of DARPA) tomorrow. I tried to arrange for one of my assistants to join me but was told that they need 3 days to process clearance for anyone visiting them.


I can and have seen the President on very short notice. I have often visited the Director of Central Intelligence within an hour of asking. But visiting IARPA requires 3 days?

I know that it only takes about 3 minutes to look up one's government clearance status on the the IC's computers. Why three days to clear a visit?

I can apply for and get a house mortgage approved on-line in about an hour. I can get a car loan in about 15 minutes. I went to the dentist last week. He x-rayed my bad tooth, diagnosed it, pulled it, and put in a post for a new tooth in about an hour.

Three days to clear someone to visit a small IC agency?

Science and Technology is moving at break-neck speed. New ideas go from laboratory demos to products in hours. Pokemon Go topped a billion dollars revenue in less than three days after its release!

So, ask me again, "What's wrong with US Government S&T or US government research?"

I can answer that question in about 3 milli-seconds.

Within the next 10 years, American ingenuity can give us the power to engineer the environment on a global scale in order to overcome the challenges associated with climate change. It will be advancements in bio- and geo-engineering technologies that make this possible, and these technologies represent new industries and opportunities for American corporations and entrepreneurs. The next Administration should foster the development of a new industry in climate engineering so American innovation can help us engineer our way out of the climate problem. Scientific trends clearly show that the climate is changing more rapidly than in times past, even if people disagree why and whether humans are the cause. The nature of this latest shift in the global climate is likely to lead to great harm and suffering around the world if a strategy is not developed to develop and use tools for engineering our world on a grander scale. Today’s discussions and debates focus on trying to correct these trends by rolling back carbon output, ignoring the negative economic consequences of that approach. A truly successful solution will focus, not on carbon output, but on technologies that can recapture and repurpose this carbon, while also affecting the other factors that control climate.

The answer is not to try and reverse these changes, but rather to use science to engineer our way out of the climate challenge.

We can do the same to address the climate change problem today; we can use science and engineering to fix our problem and generate new economic growth. Today we are rapidly improving our ability to engineer biology to take on the properties we want, which in turn will give us new ways to engineer the environment. Pairing our advancements in bio-engineering technologies with other geo-engineering technologies gives us even more of an opportunity to take control over how the Earth changes. The opportunity exists for us to engineer a better tomorrow. To capitalize on the next big engineering opportunity, the next Administration should:

Provide the right incentives to engineer a solution to the climate problem. American innovation is what makes this country great; let’s apply that American innovation to climate engineering. Putting in place policies and regulations that encourage corporations and entrepreneurs to invest in climate engineering will usher in a new era of economic prosperity.

Ensure responsible development of bio- and geo-engineering technologies. The technologies that exist to manipulate the natural world are incredibly powerful. In the hands of the ignorant or the malicious, they could be used to destroy the world rather than improve it. New policies and control regimes will be needed to ensure these technologies are developed and used responsibly.

Study the science of the natural world and develop precision models of the climate. Unlocking the secrets of Nature will be essential to engineering our way out of the climate problem. Better scientific models of the climate will foster innovation in new technologies to improve the environment. Additionally, better models will allow safer and more efficient uses of these technologies to improve the world.


The next Administration needs to develop a comprehensive strategy that capitalizes on advancements in bio- and geo-engineering technologies in order to engineer our way out of the climate problem by helping open up new climate engineering industries for American capitalism to thrive. This will require new breakthroughs in the life and earth sciences, better models of the climate, and new control regimes to ensure these powerful tools are responsibly used and developed.

The answer to the climate challenge is to move forward, not to go back. We need to use our science and technology to develop a capability that will benefit humanity for millennia to come. The next Administration has an opportunity to not just rebuild America, but to rebuild Earth.

This week we will be publishing excerpts from the Potomac Institute's latest report,
“THINK BIG: BIG Science, BIG Opportunities, and BIG Ideas.” THINK BIG argues that innovation in science and technology are the keys to American economic strength and national security. Rather than a return to the infrastructure, economy, and healthcare systems of the past, the report calls for a vision for the future.

American medicine provides some of the world’s most innovative treatment, but variability of care across the healthcare system is high, the costs are becoming unbearable, and the overall system has not kept up with rapid technological change. The next Administration has made reforming the healthcare system a priority. The best way truly revolutionize the practice of medicine is to look to the future and leverage the power of data, scientific, and technological advances.
The future of medicine in America works for the patients, not for the status quo. It harnesses technological advancement, open data, and personal data to bring innovation to the forefront, to lower costs, prevent disease, and improve treatment. To reach this future, we need policy solutions and funding plans that are as pioneering, flexible, and as rapid as the science and technology that will bring us new cures.

Incremental revisions to current policy and funding programs cannot get us to this future; visionary policy and programs that are designed from the foundation up will. Piling more layers on the ailing and crippled healthcare policy foundation of the past works against us and keeps our systems locked into a dysfunctional and obsolete framework. Structuring regulation and targeting investment together towards a data-driven, risk sharing, and patient-centered future for medicine are key to enabling a brighter future.

An effective revolution in medicine should:

Harness the potential of big data and internet-of-things devices. The future of medicine will take advantage of real-time sensing and data collection capabilities. Diagnostics will transcend reliance on comparisons to average expected values and be determined by the precision of individual health baselines. Individualized treatment and diagnosis will often happen outside of the clinic during daily life. Data from every patient and every treatment will be integral to the continuous evaluation and re-evaluation of medical practice.

Shine a light onto healthcare economics. The current system obscures economic data in order to continue charging America more for providing poorer care; transparency is key to building the healthcare system of the future. Price discovery coupled with real-time analytics will reduce costs and abuse, reveal inequities so that they can be addressed, and enable competition and the development of new mechanisms for cost sharing, liability, and insurance.

Train the healthcare workforce of the future. Artificial-intelligence-based medical education systems, modular certification infrastructure, and simulation-based practicums will allow us to develop the types of skilled providers that we need where and when we need them. Future licensing and certification requirements will be based upon the knowledge and skills that practitioners need for the practice of medicine in a real-time, data-driven world.

Re-envision the biomedical research system. The future of research will be built upon a foundation of artificial intelligence and real-time sensors. It will be relieved of barriers to data access. Better physical models of human health will be realized, ushering a new a new era of personalized medicines and treatments that target causes instead of symptoms of disease. Research will be a national pursuit with every patient participating as a partner. Enabled by a system that connects everyone and everything, clinical trials will be long-term, large cohort, and diverse. Discoveries will come from our homes and our high schools as well as our universities and industry.


America needs a healthcare plan for the future, designed to shape a system that will support innovations in healthcare delivery, treatment, science, and technology for 2050 and beyond. The new Administration has an opportunity to reimagine healthcare as we know it and make America the world leader in healthcare innovation and opportunity. A revolutionized American healthcare system can be the greatest system that the world has ever seen!

This week we will be publishing excerpts from the Potomac Institute's latest report,
“THINK BIG: BIG Science, BIG Opportunities, and BIG Ideas.” THINK BIG argues that innovation in science and technology are the keys to American economic strength and national security. Rather than a return to the infrastructure, economy, and healthcare systems of the past, the report calls for a vision for the future.

The future of American industry should be to maintain its position as a world leader by employing a bold, strategic national industrial policy. Instead of reacting to the forces of globalization, America should harness the forces of globalization to our benefit. We should be the major pioneer of new industries, and a nation that works with global supply chains, while maintaining a robust and secure domestic ecosystem to prevent reliance on other countries. This is necessary not only for economic vitality but also for national security.

Harness Globalization to Benefit the U.S.

Globalization has allowed large and small companies in every industry to operate without allegiance to any single country. Instead of fighting that reality, we should leverage America’s strengths to incentivize companies to bring their business to the U.S.

Respect and Protect Ideas. A major strength of the American business environment is that companies that invest in innovation can profit from good ideas. In today’s global marketplace, IP protection has become highly valuable, but current systems need updating to keep pace with the rapid rate of technological change. The damages to the U.S. economy due to IP theft have also grown to the level of hundreds of billions of dollars per year. A new IP system is needed that is based on two simple principles: 1) if taxpayer dollars funded the creation of the IP, then the public owns it, and 2) if IP was generated in the American private sector, then our country should put its full weight behind protecting that IP on the global market. The U.S. needs to show the world that it is a place where IP rights are clear and protected.

Change Industrial Tax Policies to Bring Companies to the United States. U.S. tax policy currently incentivizes some companies to move their operations and profits offshore. The U.S. has one of the highest corporate tax rates (35%) in the world, and taxes U.S. companies on foreign profits, which leads them to stash foreign earnings offshore rather than bringing them back to the U.S. These policies are counterproductive and dis-incentivize businesses from operating in the U.S. or investing their earnings in the U.S. economy. Industrial tax policy should make it more attractive to bring businesses here, guided by the principles that if companies want to sell here, they should put their business here. This would include reducing the corporate tax rate to a globally competitive rate of 15% and encouraging reinvestment of foreign profits in the U.S. without penalty.

Protect industries that are critical to national security. In failing to recognize the reality of global supply chains, the U.S. has also come to rely on other countries for critical resources, leaving strategic industries vulnerable to manipulation by our adversaries. We need to recognize that some industries – such as energy and semiconductors – should not be fully globalized, because they introduce fundamental vulnerabilities. A bold industrial policy must operate based on the principles that we must protect our vital industries. Providing tax reductions to industries critical to our national security would incentivize a healthy domestic ecosystem for those industries. If an industry is critical to our national security, we should be willing to take extra steps to ensure its protection.

Creating the Industries of the Future

Commercial industry changes at much faster rates than the U.S. government. New industrial policies need to look to the future of industry, not the present. Countries have the most to gain by being the heart of innovation in existing and emerging industries.

Invest in Research and Development (R&D) to seed the industries of the future. The industries that will be of major global significance in the next 10 to 20 years are evident today, and the U.S. government should invest in helping them grow in this country. The scientific fields of bioengineering, neuroscience, materials science, and machine learning have rapidly advanced, producing a wealth of knowledge that will drive the development of new technologies. The U.S. should place considerable focus on funding applied R&D in these areas, to harvest the many fruits that basic research has yielded.

Foster innovation and transition hubs. Centers for Industrial Innovation (CII) can accelerate the generation of new technologies and start-up companies, as well as provide workforce development. If the Federal government is an active player in such centers for innovation, it allows for continued access to new ideas that can be transformed into technologies uniquely suited for government applications. Government input and funding of such centers will insulate them from becoming captive to the largest players of the industries they support. Connecting these CII to Regional Extension Centers (a major policy program that propelled the agricultural revolution of the last century) will help U.S. companies leverage emerging technologies sooner, allowing faster increases in industrial efficiency.


The U.S. needs a unified strategic industrial policy that leverages America’s strengths on the global stage. The White House should release a public document detailing an industrial policy strategy within the first 100 days. Such a policy should make the financial environment easier for companies to bring their business to the U.S. – including lowering the corporate tax rate to 15% and not taxing international profits brought into the U.S. As well, it should consolidate copyright and patent laws into a single, simplified legal structure for IP protection. These new policies should focus on protecting American IP globally, making companies pay their fair share for goods sold in the U.S., and incentivize companies to bring their business back to this country. The U.S. should also institute policies focused on creating industries of the future by funding R&D efforts in strategic areas that will seed emerging industries, fostering the formation and growth of centers for industrial innovation, and supporting advancements in and widespread adoption of automation in all industries. With these policies, American industrial leadership will be driven by the smartest workforce in the world, strong IP protections, innovative research and development, centers that transition ideas into new technologies and markets, and economic policies that help businesses thrive.

This week we will be publishing excerpts from the Potomac Institute's latest report,
“THINK BIG: BIG Science, BIG Opportunities, and BIG Ideas.” THINK BIG argues that innovation in science and technology are the keys to American economic strength and national security. Rather than a return to the infrastructure, economy, and healthcare systems of the past, the report calls for a vision for the future.