MS. MARY WOOLLEY, RESEARCH!AMERICA: Good afternoon. Good afternoon, ladies and gentlemen. Good afternoon and welcome. My name is Mary Woolley. I'm the president of Research!America. Research!America, as you know, is an alliance of over 500 organizations of all kinds who are committed to research, to putting research to work, in order that we have a healthier citizenry, a healthier world, and a healthy economy. Our over 500 members represent well over 125 million Americans who join us in a commitment to research. At this time every year as part of our commitment to research, we organize a national forum to provide our members with the opportunity to hear from some of the nation's most distinguished leaders what they see as the current challenges facing research in our nation. Right now in these early years of the 21st century, we are at a time where there are considerable tensions between science and society. And I believe that were going to be hearing today some very thoughtful and provocative observations about what to expect and about what each of us can do to address and overcome those tensions, so that we truly can put research to work. Now, I want to thank ... before we begin, I want to thank the people that have made this forum possible. You can see on the screen behind me almost all of our sponsors of this year's national forum. The AAAS unfortunately is not listed there, the American Association for the Advancement of Science. But it should be. And we thank the AAAS as well as other long-standing sponsors, Pfizer, Abbott, United Health Foundation and Infocast. And this year a special thanks to two new sponsors, to organizations we're working with in new ways this year and going forward, NEMA, the National Electrical Manufacturers Association, and The Hill, the Washington-based publication available in print and on the web. Thank you all. And my thanks to the Research!America board members, an absolutely outstanding group of people who give freely of their time and a lot of it in the interest of serving our mission. And finally to our wonderful staff, all of my colleagues at Research!America. Thank you all. [applause] Now it is my pleasure this afternoon to introduce our keynote speaker, the president of the National Academy of Sciences, Dr. Ralph Cicerone. Dr. Cicerone is an atmospheric scientist who has helped shape science policy at the highest levels. His research and policy leadership have been recognized on the citation for the 1955 Nobel Prize ... '95, excuse me, Ralph ... 1995 Nobel Prize in Chemistry. With the Franklin Institute 1999 Bower Award and Prize for Achievement in Science, the American Geophysical Union 2002 Roger Revelle Medal, and the World Cultural Council 2004 Albert Einstein World Award in Science. Before Dr. Cicerone was elected this past year as Academy President, he was a Chancellor of the University of California in Irvine. We are delighted to welcome him today. Ralph. [applause] DR. RALPH CICERONE, NATIONAL ACADEMY OF SCIENCES: Thank you, Mary. I will speak about a report that we issued a few months ago that Mary and John Porter requested. But before doing that, thinking about the theme of the annual meeting this year for Research!America, "Science and Health in the 21st Century-Leadership Requirements and Public Expectations," it caused me to think back to the 20th century when most of us grew up. And one fact that stands out that most of you are very well aware of is that in the United States, life expectancy increased from something like 46 years at the beginning of the century to about 77 years at the end of the century. That is obviously very dramatic. It's as if every year that a person lived in that century, he or she could count on an extra four months of life expectancy than what was expected at the beginning of that year. That is incredibly dramatic. How did it happen? Well, we probably all have our favorite explanations. But I think certainly the causes include antibiotics, immunizations, water treatment and water quality, the segregation and handling of waste, advancements in nutrition, refrigeration. In a word, nearly all of the explanations stem from science and technology, medicine and education in general. So as we look into the 21st century and ask what kind of leadership requirements we have and what the public will expect, I'm not sure how to match those two. But I think the leadership requirements are fairly clear. So the subject that I'm going to talk about now is ... I'm going to start a couple of slides. I have seven or eight slides which I hope will be visible. This is the cover page of a recent report [Rising Above the Gathering Storm] that the National Academy of Sciences, the National Academy of Engineering and the Institute of Medicine worked on jointly. The report was requested in May or June of 2005 by Senator Lamar Alexander and Senator Jeff Bingaman together with endorsements from Congressman Boehlert and Bart Gordon. They asked a series of questions. But the dominant question was what actions can and should the federal program undertake to assure prosperity, to enhance the scientific and technological basis of prosperity and security in the 21st century? So the emphasis was on federal actions. And like we always do, we put together a committee last summer. And, of course, this speaks right to the issue of leadership. The committee consisted of twenty people. You'll recognize some of the names being leaders of universities, several corporate CEOs, Craig Barrett, the current chair of Intel, Gail Cassell from Eli Lilly and so forth, up and down the list, three Nobel Prize winners, one in medicine, two in physics, some educators and other very experienced people. People who had already participated in similar studies of how the United States can improve its science and technology base for the future and what the country needs. And led very ably by Norman Augustine who's had an amazing career in private industry as well as government. The committee decided to organize its response to that set of questions along the lines of two key challenges. One was prosperity means opportunities for employment to maintain a standard of living. So what does it require to create high quality jobs for Americans? And then secondly, somehow to respond to the nation's need for energy, clean, affordable and reliable energy supplies. So they tried to put this all together. They worked over the latter part of the summer and early fall by listening to other experts, by looking at as much data as they could find and by trying to discern what trends there were. And I think it's fair to say that there was no single piece of data that was compelling, but probably 30 or 40 different trends that attracted their attention and led them to the recommendations which came in four major categories. Senator Alexander and Senator Bingaman asked for ten actions. The committee produced twenty. They were in four different categories. And the first one . . . I'm just going to give you a sample of each of the four. The first one and the highest priority identified by this group of Americans was K-12 science and math education above all else. This is a recommendation in various forms that many individuals and groups have made over the years. In fact, I think there's very little new in this report. Almost everything that was suggested has been suggested before. Nearly every action that was suggested has been in fact implemented somewhere before. And there is a working model. The particular focus on K-12 education was to try to create, nurture and enhance teachers who are expert in subject matter that they teach. Now, I just moved here from California and the last time I looked, two-thirds of the high school teachers of biology in California are not biologists. They're phys ed teachers who are being asked to teach biology. In the physical sciences and mathematics, grades five through nine in the United States, over 90 percent of the teachers have no certification or degree in the math or sciences that they're teaching, in the physical sciences. Well, the assumption of this group and the experience in the programs they had worked with, Roy Vagelos through Merck and Norman Augustine through Lockheed and other people, Gail Cassell through Lilly, some of the educational programs they've supported over the years have been based on teachers who not only are enthusiastic about their subjects, but who have a firm grounding in them. So the particular set of recommendations was to create and help more teachers who have a subject matter grounding in their fields. The second general category was federal support for research. The first one is something that Research!America took on, on behalf of Biomedical Research many years ago. And through all of you working together over many years, you were able eventually to essentially double the NIH budget. Mr. Porter and Mr. Rogers sitting here had a great deal to do with that. The top bullet here is to somehow increase federal investment and long-term basic research with special focus on physical sciences, engineering, mathematics, information sciences. And the way this is playing out, it's primarily at the National Science Foundation, the Department of Energy and the National Institutes for Standards and Technology, NIST. There are a few other recommendations of the same kind. The third category was to greatly increase the flow through educational opportunities for undergraduates and graduate students in the sciences and mathematics. And to try to maintain the attractiveness of the United States for foreign students in the same subjects with a lot of important details here that I won't go into. And then finally, to try to reinvigorate the national commitment towards creativity and innovation in the entire climate for entrepreneurship, through research opportunities for students at universities all the way through intellectual property protection and modernizing and standardizing our patent system to providing broad band access and so forth. So this is the flavor of the recommendations. There were, as I say, twenty all together. And what's been unusual is that I think all of us agree for various reasons in the last several months, there has been a remarkable groundswell of positive reaction to this report and to the reports of several other groups and to a number of proposals. For example, there are a number of pieces of legislation now pending to take on some of these actions recommended for the federal government. The first one that I list here in the Senate sponsored by two Republicans and two Democrats whose names you see, Alexander, Domenici, Bingaman and Mikulski, plus about 65 other co-sponsors now equally split amongst Republicans and Democrats entitled "Protecting America's Competitive Edge." This legislation tries to implement each of the 20 recommendations in the report that I just summarized, each and every one of them, through a series of bills that are integrated. And along with this, Senator Baucus has focused on one of the particular recommendations to create this new innovative agency inside the Department of Energy focused on energy, research and technology. A national innovation initiative which is closely related, coming from very different recommendations, of course. And then, of course, the President's State of the Union message and activity in the Senate to implement those particular recommendations which are all along the same lines. In the House, there's a very long list. I just show a few here in particular to implement the American competitiveness initiative that the President announced sponsored by Congressmen Wolf and Boehlert. The bottom line there is (the) Mathematics and Science Teaching Core Act of 2006 which is sponsored by Congressman Saxton and Senator Schumer, largely at the behest of some people who have been supporting mathematics education in the State of New York for some years. A mathematician who's also a very successful investor with recommendations that strongly overlap those of this Gathering Storm report to create and maintain and reward a new generation of teachers who will be highly educated in the mathematics that they're teaching and so forth. So there is some hope. And yet, the task is enormous. The annual price tag of the 20 recommendations that our group concluded were the right mix of actions, the annual price tag was about $10 billion a year. Not for one year, not for two years, but for a lot of years. In fact, as the physical sciences and engineering side of the federal budget would increase by ten percent per year, obviously, the annual increment would even have to grow a little bit. But the good news there has been a very strong bipartisan response with I must say an inspiring commitment to get the details right, to try to find out what model is the recommendation based on. What has happened in the city of Dallas where some of these things have been tried or in the New York area or wherever, the Philadelphia area? What is the record of each of these recommendations? Who has opposed the recommendations? Why are they opposed? There's been a great behind the scenes effort to understand the assumptions and the recommendations and what would be required not only to implement them the first time, but to keep them going. So I'm optimistic. And yet, judging from the experience that many of you had in doubling the NIH budget and all the good that's come from that, I think we have to dig in for the long term. Because the country really has to be reminded of the opportunities that science and technology and medical research have to offer. We somehow take things much too much for granted. And as all of you know, we have to continually remind people of the opportunities and of the alternatives facing a world where there is no competition where we've been very, very successful in dominating many, many fields of research and invention and commercialization. So a lot of people have become complacent. And the world we're facing now has much, much more competition. We hope it will be healthy to everyone's benefit. But our first job is to be able to compete. And that I think is the bottom line of this particular report. So I'll stop there, Mary. And I look forward to the discussions of the remainder of the afternoon. And thank you for the opportunity. This is a group I feel very comfortable with. Thinking about the increase in life expectancy of the 20th century, all of you knew that. And all of you know the basic reasons there are so many groups in the United States who take it all for granted, didn't know it, didn't know the reasons, don't know how much commitment it takes, the role of leaders and the role of leaders shaping public opinion and showing them options the way you people do. So I'm very comfortable being here. And I hope that we can do a lot of good things together in the short time that I'll be here. Six years. Thank you, Mary. [applause] MS. MARY WOOLLEY: Okay. We're going to take just a short break in order that the panelists of the next piece of the forum will have a chance to come up and get situated and get our electronics ready. So if you'd like to get a cup of coffee or just stand up for a minute or two, we'll call you back in order in a few minutes. Thank you. [BREAK] MR. BILL LEINWEBER, RESEARCH!AMERICA: It's my pleasure and honor this afternoon to introduce to you the chairman of Research!America, the chair of our board of directors, someone that is familiar to most of us in this room because of his long distinguished career as one of the nation's most outstanding advocates for medical and health research during his 21 years in the U.S. House of Representatives as chair of a subcommittee that was particularly important and remains particularly important to all of us, that being the Appropriations Subcommittee for Labor, Health, Human Services and Education. And really a leader and champion during those years in making the doubling of the budget of the National Institutes of Health a reality. But beyond that, a champion for all research. John Porter, as chair of Research!America, currently a partner in the law firm here in Washington of Hogan & Hartson. It's my pleasure and please join me in welcoming John. Thank you. [applause] MR. JOHN EDWARD PORTER, CHAIR, RESEARCH!AMERICA: Okay, Bill. I'm going to take you everywhere I go. Thank you for that very, very kind introduction. I want to join Mary and Bill in thanking you for joining us in our national forum. We also want to thank Ralph Cicerone for his very excellent keynote remarks. At our annual meeting this morning, I noted that in these very challenging and promising times for our nation's research enterprise, it is critical that as a community of advocates we work together and commit to taking action and conveying messages to the public, to opinion leaders, to decision makers in the media that demonstrate the life saving and economic value of research in our country. We have this afternoon convened an exceptionally distinguished panel of leaders to share their thoughts and insights with us. And I'm confident the panel conversation will further provide motivation for all of our collective efforts. It is my pleasure to introduce our moderator for this afternoon's panel discussion. It is only fitting that a panel of the caliber of those with us today would be guided in conversation by one of the nation's foremost commentators, David Gergen. For 30 years, David Gergen has been an active participant in American national life. He served as Director of Communications for President Reagan and held positions in the administrations of Presidents Ford and Nixon. In 1993, he put our country before politics when he agreed to first serve as counselor to President Clinton on foreign policy and domestic affairs and then as special international adviser to the President and to Secretary of State Warren Christopher. David currently serves as Editor-at-Large at U.S. News & World Report. He is Professor of Public Service and the Director of the Center for Public Leadership at the John F. Kennedy School of Government at Harvard University. He is a frequent lecturer around the world and frequently serves as an analyst on various news programs. In the fall of 2000, he published a book titled, Eyewitness to Power: the Essence of Leadership Nixon to Clinton. David is active on many nonprofit boards and is Chairman of the National Selection Committee for the Ford Foundation's program on innovations in American government. A native of Durham, North Carolina, David is an honors graduate of Yale University and of the Harvard Law School. He served for three and a half years in the United States Navy. And David and his wife Ann have been married since 1967 and are the parents of two adult children, Christopher and Catherine. If you want someone who is thoughtful, if you want someone who is caring about this country and its directions, if you want someone who is careful to get it right and if you want someone who is engaged and right at the forefront of all the policy that's made in America, you want David Gergen. And very frankly, I wish he were in the White House right now. David. [applause] MR. DAVID GERGEN, U.S. NEWS & WORLD REPORT: Good afternoon. I'm privileged to be here. And thank you for this opportunity. It's a stellar panel. I'm looking forward to this conversation as I know many of you are. I know we are in the National Press Club here in Washington. And so perhaps it is fitting that you ask someone with a background in journalism to be your moderator, but I want you to be on notice. You know, journalists, those of us are quick to see patterns in things. We're always looking. We look for two or three bits of evidence. And we immediately spot a pattern and reach fairly large conclusions. I'm reminded of a journalist who woke up one day on the fifth day of May ... May being the fifth month of the year ... caught bus number 55 to work, noticed that he arrived five minutes late to work, went up to his office on the fifth floor and said, ah-hah. There's a pattern here. And off he zoomed to the racetrack and put down his entire life savings on the fifth horse in the fifth race. And sure enough, his horse came in fifth. So it's good to be in the company of scientists who think, you know, who are much more careful with their work and speak from a more profound place. And I think all of us are looking forward to their comments. Whether you're a journalist or a citizen or a concerned parent, it is perfectly obvious, I think, or increasingly obvious to most of the American people, that we have a number of storms gathering off our coast. That in the environment there is increasingly the question among scientists not whether we have global warning, but indeed when it may become irreversible. We all look at the latest information from Greenland. We look at the question of the nation's finances and the imbalances. And economists tell us you cannot continue indefinitely with these imbalances. There will be a slide at some point. The question is whether there will be a soft or a hard landing. We look at the question of obesity in the country and people who've looked at this have wondered whether in fact given the obesity rates and what's happening with children who are being born today, whether the next generation conceivably could have shorter lifespans than the current generation. The kind of storms that are out there, one can see and worry about whether we're preparing ourselves adequately, whether a category four or category five hits us, whether we're going to be washed under. But of all the storms ... and I think the one that is now front and center on the minds of the American people is what they sense maybe happening to us with the rising tide of competition that's coming from a number of countries especially in Asia. And whether we in fact are going to be able to maintain our lead in science and technology, engineering and math in ways that prepare us adequately for the future and protect American jobs and the standard of living in this country. Increasingly as I go around the country and talk to people who are the CEOs of major corporations like Intel or Microsoft or talk to the presidents of universities like MIT and Harvard and Duke and others, what I hear is the same pattern of reflection and a growing concern about our capacity to deal with these issues. I don't want to put too bleak a face on this. But Andy Grove, who is an iconic figure in Silicon Valley who co-founded Intel, a wonderful CEO there, did write a book saying ... with the title Only the Paranoid Survive. And I think it accounts for some of the success of Intel under his leadership. But he's teaching a course at Stanford these days. And he's told me he thinks that the report by the National Academies is too optimistic. What you've heard from Ralph Cicerone today is even more optimistic than he believes the future holds. And he's been working on this with his graduate students at Stanford. And they have made calculations that unless we change course in a serious significant way with regard to science, technology, engineering and math ... and science is spoken of here in a broadly framed, including the biological sciences . . . that unless we become more serious about these challenges, that he believes we will see an erosion, an erosion in the living standards of our children, if not our children certainly our grandchildren, in the range of 40 percent. An erosion in living standards in the range of 40 percent. Now, those are very bleak numbers. I've never seen any other numbers which come anywhere close. But if we're just 30 percent, we're in trouble in a variety of social ways. And the coherence and the stability of our society will be challenged. And there will be an enormous number of people, especially at the lower end, who get hurt in that environment. So this is the issue that we're all grappling with. And everyone from the chancellor of the schools of New York, Joel Klein, to the people who are running large corporations, like Craig Barrett, are really worried about this issue. And so this is a particularly timely panel. The science community has begun to speak up. The people up on the Hill began to speak up. The President then embraced this in his State of the Union address. And yet, we find ourselves today with a feeling maybe this isn't gaining the traction that it deserves. Maybe we're not paying it serious enough attention to this yet. Is the Congress really listening? Is the nation really coming together? It feels nothing like the post Sputnik era when there was a great sense of rallying in the country. It doesn't feel that way yet. The question is what's the nature of the problem? And how do we build momentum for success? Those are the big issues that hang over this panel today and that I think we have with us people who are authorities on this issue, have thought a lot about it. And I think there could be no better panel. And I congratulate Research!America for bringing together this kind of talent. I think it's really a tribute to the quality of Research!America that it could assemble this panel and that we could have this experience today to listen to these good folks. I'm going to get out of the way. I'm going to pose a question and we'll just start. If I might, we'll start on my far left, your right. And just ask the panel first of all to frame the issue as they see it. And then I'd like to come back to the question of how do we achieve success? But I think we need a little more framing. Dr. Cicerone has helped us set this up. And he will speak. Because he's on the other end, he can have a chance to reflect on some of the remarks that are made. But if each of you could reflect briefly on this. And let me start on the far left. And I want to make sure ... it's Elias, is it not? Yes, Elias Zerhouni, who is, as you know, heads ... leads the nation's medical research agency. He oversees the NIH- 27 institutes and centers, more than 17,000 employees. A man who has said recently that he wants to start a campaign to educate the American people about what the investments of NIH have brought to the country already. So people understand why it's vital that the funding continue to be robust. Dr. Zerhouni. DR. ELIAS ZERHOUNI, NATIONAL INSTITUTES OF HEALTH: Well, thank you. I think the question you've posed is probably the core question in terms of long-term strategic imperatives for us. And when you look at our field of interest and that is biomedical research, and you look at the growth of health care expenditures in modern economies. And you realize that in the next ten years our health care expenditures will double to 20-22 percent of GDP. And you're looking at a need for us to completely transform the way we practice medicine. Because if we practice it the way we know it today 20 years from now, the game will be lost. We have to transform that. We can't transform that without a scientific workforce that is completely able to interact across disciplines. There is no progress possible right now without interdisciplinary collaboration between physical sciences and biological sciences. There's no such thing as basic science, fundamental science, biological science. There's good science and there's bad science. America has to be the producer of good science. And you can't do this unless you become paranoid as you mentioned by the next generation of scientists coming up. And if they don't have quantitative training and they don't have a mastery as we did in the Sputnik era of the complexity of biology today, we at NIH will lose. So I'm completely on board in the sense of making sure that the nation doesn't lose its momentum and doesn't lose the sense that an NIH investment is an investment. It's not a cost. It is the fundamental investment. Because at the end of the day, how are you going to transform society or the city or our ability to control the societal events without new discoveries? I don't know how you would do it. MR. DAVID GERGEN: Let me press you on an issue that arises periodically now in the press about this. And that is, well, NIH has had its big boom in spending. It doubled in spending in I don't know how many years, a fairly short period of time. We've been investing heavily. Now it's a time for the physical sciences. And some have interpreted the National Academy's report to be mostly about the physical sciences. If you look at it, if you read what it actually says, it talks about the importance of the biological sciences as well and that they're inter-dependent. Could you address that particular issue of why the biological sciences need this? DR. ELIAS ZERHOUNI: That's a very good point. I was talking to Norm Augustine at the time of the generation of the report and the committee that generated the report clearly stated in their front page that what you need is a balanced policy where you have whole fields of investigations balanced together. Because the synergy that you have between a physicist working with a computational biologist and working with a tumor biologist, a cancer biologist, is greater than the sum of the parts. So it's clear that you can't rob Peter to pay Paul. What you have to do is maintain the momentum across a wide front. And that's what I think if the message that I've heard from Norm . . . I mean, Dr. Augustine . . . in the report that I heard. MR. DAVID GERGEN: I want to come back at some point and talk about whether the Congress has heard that message as well. Myrl Weinberg, IS President of the National Health Council- that's an umbrella organization whose members are national organizations committed to quality health care. Its core constituency is about 50 of the leading voluntary health agencies representing approximately 100 million people with chronic diseases and/or disabilities. Your views please. MS. MYRL WEINBERG, NATIONAL HEALTH COUNCIL: Well, I think that what we all know is that the power of the people could be greater. And so what we represent are about 100 million people with chronic disease disabilities and their families. I think that one of the pieces that we are missing are the right messages for the right audiences. And I know that Research!America, the National Health Council, Dr. Zerhouni, we are all attempting to come up with messages that will help people in the United States understand the complexities of these issues, the interrelationships and why we need to have a patient consumer movement in the United States to make sure that many of these recommendations in fact occur. So I think having the right messages, taking into account ... we talk a lot about health literacy, targeting your messages to the right audiences at the right reading level with the right culture and language, we have a big challenge in the United States to get these messages out, so that people understand them and therefore can take appropriate action. MR. DAVID GERGEN: Let me come back to this. I want to help, if you can, focus in on why the question of disabilities and the issues that you're concerned with fit into this issue of we've got to do something about science. We've got to take science more seriously. Can you focus that or sharpen that a bit more? MS. MYRL WEINBERG: Absolutely. I think the most important thing to our constituencies is science and medical research. That's where the treatments, the improvements in the quality of their lives, the cures will come from. It will come from research at the National Institutes of Health. It will come from programs that are run by the Center for Disease Control and so on. So they look to the research and science communities for the answers to make their lives better, healthier and longer. MR. DAVID GERGEN: And what about our competitive position? Does that affect our competitive position? The chronic disease issue. How does it relate to competitiveness? MS. MYRL WEINBERG: Well, I think that it relates in many ways. Clearly, if our population is less healthy over time, then we have fewer people to engage in the number of occupations that we need, the experts that Dr. Zerhouni spoke about. In the meantime, our whole population, which I think could happen, with other things that are going on with our federal and state programs, then we will just have fewer and fewer people potentially that enter into the professions that actually will make us competitive. MR. DAVID GERGEN: Okay. Thank you very much. John Leonard. Dr. Leonard is the Vice President for Global Medical and Scientific Affairs at Abbott. He joined Abbott in 1992 as head of the antiviral venture in the pharmaceutical products division. Dr. Leonard, your view from Abbott. DR. JOHN LEONARD, ABBOTT: I work in a corporation, as you just said. And the life blood of our ability to carry out R&D comes from the scientists that work in our corporation. Our corporation is based in the United States. But our scientists are based all around the world. And we look for scientists wherever we can find them. I think that it's important to understand that in the final analysis, corporations are ultimately stateless. And even though we have much of our R&D taking place here in the United States, it's entirely possible to imagine a future where the bulk of that work takes place offshore, carried out by foreign-born scientists. We can still call them an American corporation. But we can have much of that work being done elsewhere. MR. DAVID GERGEN: Can you talk about the relative cost of science here versus ... scientists here versus overseas these days, Say in China or Mexico? DR. JOHN LEONARD: Well, from a purely labor point of view, there is vast differences. I mean, it's no secret that people working in India or China can work for a fraction of what similarly skilled people will do here in the United States. The way we approach that ... and I think the way that many people in our industry approach it is to have the very, very technically advanced work done predominately here in the United States. And the more repetitive type things potentially considered for work being done offshore. MR. DAVID GERGEN: How much of your R&D operation have you moved offshore? DR. JOHN LEONARD: We haven't moved it offshore. Most of our work is done here in the United States we're proud to say. I'll just make the point that it is a global environment. We are a global corporation. And as we go and look to the future and look for where we will build plants and where we will source our scientists, the range of choices that's now available to us is vastly greater than it was a decade or two decades ago. MR. DAVID GERGEN: Would you also address ... people tend to think of this mostly as, well, we've got to do far more training in K-12. And we've got to change the universities. But in fact, there is a corporate environment that can encourage companies to invest here versus overseas. Could you address that for us? The tax environment, the regulatory environment, the other issues which go to ... the National Council's report addressed that. DR. JOHN LEONARD: It's a key point. And I thought some of the points that were brought up in that report were very insightful. It's not enough just to have the scientists. The scientists have to work somewhere. They work in an environment that is defined by their coworkers, by the universities that surround them, the resources they have, the investment environment, et cetera. I think that we can look elsewhere in the world and look for success ... examples such as Ireland, a virtual backwater from an R&D perspective 20 years ago who's a leading light now. It's no secret that Singapore's had similar success. And we see it now happening in China and India. I think we should learn from those success stories and make sure that not just the scientists but all of the other elements that have contributed to the success are things that we consider here. MR. DAVID GERGEN: It's interesting. The Irish story in some ways shows how quickly things can change in a competitive environment. I mean, to think where they've come from to be the leading ... to have the highest standard of living in Europe in just like that. And you can see how quickly Japan went down. I mean, that's why people think this could be ... you could be on a knife edge much more easily than you think and go down very quickly. Or somebody else could rise very quickly. I was looking for the numbers in the report that you brought out. There was one statistic which I thought was quite interesting on the question of hiring overseas. A company can hire nine factory workers in Mexico for the cost of one in America. A company can hire eight young professional engineers in India for the cost of one in America. That's the relative challenge. All right. Let's move on now if we could to Carolyn Clancy who is the Director of the Agency for Healthcare Research and Quality. It's the lead federal agency charged with improving the quality, safety, efficiency and effectiveness of health care for all Americans. Carolyn Clancy. DR. CAROLYN CLANCY, AGENCY FOR HEALTHCARE RESEARCH AND QUALITY: Thank you and good afternoon. So I come at the questions, the broad questions, that you are asking from the perspective of noting that too often our health care system fails to deliver the benefit of science to patients who can benefit. I've been incredibly excited by the discoveries and the potential for additional discoveries that I hear about from Dr. Zerhouni and many others. But discovery alone if we don't also in tandem fix the delivery system is unlikely to solve all of our problems. So the competitiveness issue that's top of mind for me is what health care is costing us today. Which means that it's often far less expensive for employers to locate elsewhere. So it's sort of downstream impact of our failure to reap the benefits from the science and the discoveries that we have made already. As I look into the future, it seems incredibly clear to me that we need much stronger bridges between discovery and the application of that discovery in a way that we can only begin to imagine now. I think advances in informatics, just as they're affecting physical and biological sciences, are also going to have a profound impact on the delivery of what we've learned from science to benefit patients. So the last point I would make is it's very hard to anticipate the shape of the future. And my guess is that we not only need to be worried about the pipeline of scientists, but also that we have the capacity to train them as science changes to keep up with those changes. I'm sure a lot of senior scientists now funded by NIH now find that they need new skills, or that they need to hire people with those new skills, because of the rapid changes that we're seeing in science. MR. DAVID GERGEN: It's useful to think about ... health care, what is it now? Sixteen percent of GDP? And rising. And some people believe that trends are not ... if we don't reform health care, it's going to hit 25 percent. As a major CEO told me the other day, they see that as a tax. That's a tax that goes directly to their bottom line. And their issue is if you get those taxes too high, again, they face the question why shouldn't we go overseas to avoid the taxation? So there is a parallel question of how we reform the health care system in conjunction with ensuring we invest in R&D and ensuring we invest in science. DR. CAROLYN CLANCY: Absolutely. And, I mean, just to put a parallel number on it, over the past forty years or so, the economist Uwe Reinhart has estimated that we have pretty much an annual eight percent increase. Some years, it's a little higher. Some years, it's a little lower. But eight percent pretty much does it every single year. And employers and their employees are feeling that in a big way right now. Last year, we reported in our annual on health care quality for the nation that quality improved overall 2.8 percent. Now, I'll celebrate any movement forward, but ... MR. DAVID GERGEN: Quality improved 2.8 and prices went up? DR. CAROLYN CLANCY: About eight [percent]. Just as general benchmarks. MR. DAVID GERGEN: Thank you. Declan Doogan. I want to make sure I've got that pronounced right. I hope I do. Okay. Thank you. Dr. Doogan is the Senior Vice President, head of Worldwide Development at Pfizer. Another corporate representative here, but it's critical players from the corporate world at this table to talk about these issues. Dr. Doogan. DR. DECLAN DOOGAN, PFIZER: So I understand from Dr. Cicerone's report and also from the introductory comments, sort of the size and nature of the problem about the competitive advantage or otherwise that America has in the world today and the encroaching competition, particularly from Asia. I think at this point, we truly do have a competitive advantage. And that is in the area of knowledge creation. I think the knowledge creation is exquisite in this country and will continue to be so. But we have to look at collaborations between scientists, between other providers of health care, educators, et cetera, to create those alliances which will take us to a new place, a new place which frankly our competitors in lesser developed countries do not enjoy at this point in time. And we should use the notion of their gaining on us to galvanize us into doing some pretty important things. Dr. Zerhouni talked about this before. And I think it's about despite having an appetite for more medicines, more technological advance, I'd like to think that it's the hunger to succeed and it's the hunger that's missing. It's the idea that we were great and we're still great, but are we? What does it take to be great again? And if there was some humility around what we do and the recognition we could improve greatly, it would have a wonderful effect on the society. Now, that sounds very philosophical. But to our own organization, we see ourselves as a global organization just like Dr. Leonard said. We are providers of pharmaceutical solutions as part of the health care answer. And it's our job to go to the best places where knowledge is created. And we'll go anywhere for that. We're quite unashamed about that. But we want to bring all of those providers together to create future health care solutions for America and for the world. MR. DAVID GERGEN: The Scots have always been known as people who are very careful with their pennies, right? DR. DECLAN DOOGAN: You could say that. MR. DAVID GERGEN: With good reason. I wanted to ask you, Dr. Doogan, if I might, about the issue of immigration and whether the technology companies are very worried about the H1B visas, lifting the cap on H1B visas because they're not getting ... but that question is caught up in the immigration and border control issue up in Congress. Is it as much an issue for the pharmaceutical companies as it is for the technology companies? Whether you in fact can have the flow into your workforce here in this country? DR. DECLAN DOOGAN: Well, it's difficult to ask somebody who's just recently acquired a green card. But what I will say is that Pfizer corporately has enjoyed the fruits of other countries' education. And we have a large number of foreign workers working within the shores of America. But that doesn't matter as much as the fact that we have access globally to the talent. And technology has a huge impact on that. We are [a] knowledge-creating business. And so knowledge we can garner via the technology from all sectors of the planet now. But necessarily, we have to have the right people co-located. And it's the co-location factor that preys on our mind a number of times. What is the critical mass of people you have to gather to create that creative spark to make these new intuitive leaps? MR. DAVID GERGEN: How much of your R&D operation was overseas say 20 years ago versus today? DR. DECLAN DOOGAN: If you think about overseas, if you're thinking outside of the U.S., we have invested substantially both in the U.S. and in other parts of the world. Their second largest research enterprise is in the U.K. It's our European headquarters. And I would say that Pfizer has benefited mightily from the output of those laboratories over the past 10 to 15 years. But it has gone to the greater corporate good. Yes, we have created employment. We have created employment in Europe. We've created employment around the world. But we've also succeeded in creating large numbers of job opportunities within the U.S. as well. MR. DAVID GERGEN: And your market itself, are you finding that ... where is the growth, the biggest growth areas? Where are the biggest growth areas for your company? DR. DECLAN DOOGAN: Well, recently from a very low base, we're finding Asia is a substantial market opportunity for us. It is a growing middle class within the Asian region that matters. We see and many other companies see that as a huge potential opportunity for the future. MR. DAVID GERGEN: Thank you, sir. I've been honored in the last couple of years to work with Dr. Julie Gerberding who became in 2002 the Director of the Centers for Disease Control. She has many, many responsibilities, including thinking through what threat that might present to the country. I think many of you have seen her on television in recent weeks on that subject. She joins us now from Atlanta. Dr. Gerberding, thank you very much for coming. DR. JULIE GERBERDING, CENTERS FOR DISEASE CONTROL AND PREVENTION: Thank you. You know, from where we sit at CDC in the public health system, we have a lot of different scientific disciplines that we use to protect people's health. But we do stand strong on one dimension and that really is the importance of prevention as the best investment that we can make. And as a society, we've made a very strong spiritual commitment to health protection, to health promotion and prevention and, more recently, preparedness. But I think we've really failed to shore up that spiritual commitment with the true scientific and societal investments we need to really make a difference. And we're paying a price for it. When I look around the globe today, I see the urgent threats that are in the news, the influenza and the SARS and the terrorism threats. But I also see the urgent realities. And, you know, today in America, 4,100 people will be diagnosed with diabetes related to their obesity. More than 300 people will start dialysis for end-stage renal disease today, 230 people will have a leg amputated and 55 people will go blind. That's an urgent reality. And we just simply can't sustain this lack of investment in effective prevention sciences. But I also wanted to pick up on a point that came to my mind when you were speaking about the importance of building the science of connectivity. Because this isn't something that one agency or one discipline or even one country can do. We really do have to learn how to connect. And the science of connectivity in terms of communication or informatics or the other kinds of systems approaches to problems solving really are essential if we're going to make that kind of difference. MR. DAVID GERGEN: All right. Dr. Gerberding, let me ask you this question. There's an urgency in the National Academy's report about really investing more heavily at the federal level in the sciences, across the board. This may be awkward for you to address. But the fact is I believe the most recent budget has a cut in funding for CDC. Is that correct? DR. JULIE GERBERDING: That is correct. MR. DAVID GERGEN: And how are you all going to grapple with that? How does that fit into this mosaic? DR. JULIE GERBERDING: Well, obviously it creates a challenge. And we do what every family does when their budget is short. They have to really prioritize and make sure that the investments they're making are trying to accomplish the most that they can. But I think one of the silver linings in this challenge for us is learning to look outside of our own agency for opportunities to leverage. So we're talking to Dr. Zerhouni about how CDC and NIH can do more together. And we have to talk to the National Science Foundation about where there are overlaps there. And, of course, we're reaching more to the private sector. So we're working hard to be more effective with less. But I'm not going to pretend it's not a challenge. MR. DAVID GERGEN: Thank you. Dr. Arden Bement who came in 2004 to run the National Science Foundation. Now, in many ways you've suddenly become the favorite kid on the block. Because everybody's talking about with all of this new funding the NSF has got to now really have a great deal. But I'm sure from where you're sitting, the outlook may not be quite that rosy. You may still have a lot of concern about where we're headed. DR. ARDEN BEMENT, NATIONAL SCIENCE FOUNDATION: Well, taking a global view, it's important that we have an educated public and decision makers that understand what's really driving our economy in a knowledge context. Most of the nations in the world get it. It's the investment in education. It's the investment in research and development. And it's the investment in research infrastructure. And in that regard, the United States is not quite an aging nation. But there are other nations that are aging. And yet, there are developing nations that have a relatively young age. And their motherload or their goal for the future are the young people who can be educated, that can play a role in the knowledge economy. The related point is, going back to Thomas Friedman's book, The World is Flat, with regard to information and communication technologies, he makes very good points in his gook. In many cases, the world has flattened. But there's still some topology left. And the United States has a few spikes left. And our spikes are represented by our strong universities, our strong research infrastructure and also our innovation system which has for many years had the ability to take new concepts and bring them into the marketplace faster than anyone else, develop killer applications that could destabilize markets all around the world. Now, those tall spikes are being challenged by many nations around the world. Every country now wants to increase their research and development intensity as a ratio of gross domestic product in order to get their spikes up to where our spikes are. So we have to continue to protect our position. The other point is that the National Science Foundation really focuses on frontier research. We tried to dog the frontier. And when you get to the frontier, you discover that all the sciences tend to converge. And as a result of that, in addition to the biosciences, we had growing investments of biochemistry, biophysics, biomaterials, bioinformatics, biogeochemistry, on and on and on. And you were talking about the disabled people a moment ago. In order to make them more productive in our society, we're developing artificial retinas. We're developing artificial cochleas. We're developing a number of methods that will give them the ability to use computers, to have greater mobility and to become very useful members of our society as well as sighted engineers, very important. MR. DAVID GERGEN: So from your point of view ... the press may represent this as you're sort of in competition with NIH for federal funding. But from your point of view, these are complementary. DR. ARDEN BEMENT: Absolutely. Yes, I don't think there's any question about that. It's been recognized by many in this room that the physical sciences and the health sciences are very complementary and have had great impact on our economy and our development of medical products, medical materials and have contributed greatly to our overall economy around the world. MR. DAVID GERGEN: Could you give us some sense of what we're facing in terms of investments? If you looked at ... if the rest of the world ... or let's say China had an NSF. How much are they ... how rapidly are they increasing their investment versus what we're doing on our side? You've looked at all of their combined investments. DR. ARDEN BEMENT: The one thing that keeps me awake at night ... MR. DAVID GERGEN: We're getting down to the real point. DR. ARDEN BEMENT: China right now is investing about one percent of their gross domestic product on research and development. But their economy is doubling about every eight to nine years. Their long-range plan is three percent of their gross domestic product by 2020. They want trade balance in R&D licensing. (Another goal they want) to achieve is they want to have a commanding position in developing technical standards for the industries and for the markets that they expect they'll be in a dominant position in a relatively short period of time. And they no longer want to be dependent on the rest of the world to determine how China's going to trade in the open marketplace. The third thing is they're investing very heavily in education. They're building universities at a very rapid rate. And so, going back to my earlier comment, they understand that their value for the future is having a highly literate math and science workforce. And that's what will drive their economy in the future. We need to worry about that. MR. DAVID GERGEN: Dr. Bement, you said that China is now investing one percent of GDP in science and technology. They want to get it up to three percent. What are the comparable numbers for the United States? DR. ARDEN BEMENT: We're currently at 2.67 percent. And I have no projections, though, of where that's likely to go over the next 15 years or so. But there are only about three other countries, maybe four, in the world that have a research intensity higher than us. I think Japan is clearly over three percent. And the Scandinavian countries are over three percent. But most other countries are less than 2.67 percent. And in absolute terms, the United States is investing more in research and development than the other G8 countries combined. So we're making very substantial investments. On the other hand, we also have to worry about the rate of change. We just can't be static. You just can't look at a snapshot and take a static point of view. MR. DAVID GERGEN: So it's the dynamic perspective that really comes into play in this national economy for the whole issue of the gathering storm. That's the reason it's gathering. DR. ARDEN BEMENT: That's the reason it's gathering. Industry has taken the lead. I think members of Congress understand it quite well. So that's the reason why there's ... I think that's the reason why science and technology policy has come back up on the radar screen. MR. DAVID GERGEN: Thank you. Helen Darling is the President of the National Business Group on Health. It was formerly the Washington Business Group on Health. It's a nonprofit membership organization that really works with large employers on their health care problems. And those, of course, are manifold. So this is an issue that's front and center for you these days. Please. MS. HELEN DARLING, NATIONAL BUSINESS GROUP ON HEALTH: Well, I think health care costs, interestingly, the study that Research!America put out, the public also agrees with large employers that their number one concern, their priority, is health care costs, broadly. And second, prescription drug costs. And third, problems with the delivery system. So interestingly, the public in this survey at least is identical with the concerns of big business and large employers, including a lot of public sector employers who probably will suffer the most. Because among other things, they have very high costs and a totally unfunded liability. So the politicians in the room will probably know that your colleagues at state, local and federal government are in for a big shock. Health care costs have doubled in the last less than ten years, they will double again as Dr. Zerhouni mentioned. Also, I think importantly, that's to about $4 trillion dollars. And in 2015, 60 percent of the $4 trillion will be public sector. And that's sort of everybody thinking about these things. Which means that by then the entire cost of the current health care system will be what the federal government and the state government's responsible for. And if people don't think that's going to change priorities, they haven't been paying attention. But that's a source of great concern. MR. DAVID GERGEN: Are we moving towards a time when large corporations are going to try to dump out of their health care and pension commitments and put those over on the government? MS. HELEN DARLING: We don't talk about dumping. MR. DAVID GERGEN: Slipping, sliding, whatever one might want to do. MS. HELEN DARLING: There certainly are many corporations that are already gone. Because they were doing business in a way, including the fixed costs. But they simply went into bankruptcy. MR. DAVID GERGEN: Are we starting to look at blue chip companies that certainly are going to be doing that increasingly? MS. HELEN DARLING: A lot of them are gone. And more of them will be gone. And certainly, we see in the recent Medicare extension or the new prescription drug act, we saw for the first time the federal government actually putting money into private corporations to get them to continue to cover their retirees. So I think we certainly have some natural experiments going on. I think the point that we'd very much like to make are really two. One, we need to broadly define the way we use science, very much like Dr. Clancy talked about. We have billions of dollars worth of excellent medical treatments that have been recommended and came from science, but in fact are not being delivered at the bedside. And in fact in many instances, it could be up to 50 percent of the time the average American is not getting the excellent care that they should be getting which has already been discovered from these billions of dollars of investment. So reallocating some money, whatever pockets it comes from, to make sure that everybody gets the best medicine is essential. MR. DAVID GERGEN: Let me ask this question. I puzzle over this kind of question. One of the reasons we're told health costs go up so much is we're discovering all these new drugs and we can extend life. And therefore, it costs more. On the other hand, there are obviously some discoveries that go on in health care or if you move to say digitalizing the system, you can bring costs down. The more we invest in NIH, do we bring health care costs down? Or do they go up? MS. HELEN DARLING: They go up. MR. DAVID GERGEN: They go up. MS. HELEN DARLING: But the thing is the problem is in the United States, we have what's called layering on of technology. In fact, a gentleman and I were just talking about it. You get a new test or you get a new something. And whether it's a screening test or treatment, anything. And we have a tendency, for a whole bunch of reasons which we could spend hours on, but we have a tendency to keep doing the other things and then do the new on top of that. It's called layering on. It becomes incredibly expensive. MR. DAVID GERGEN: Did you want to respond to that, Dr. Zerhouni? DR. ELIAS ZERHOUNI: Right. I think there's a distortion that we need to avoid. And that was that bad technology costs you more money as you deploy it. And if you look at telephones, the prediction was that eight phones was all the world could afford when Alexander Graham Bell put it. And I think it depends on where you are on the curve of technology and discovery. I think if you look at the challenge right now is that the technology's not driving the cost. It's the delivery component and the deployment of our assets in terms of providing the care. So if you look at 1960, you had about three people delivering care for any one individual. Today it's twenty. So I think what is very important here is to ask yourself the question are we at the peak of medical technology? Are we where medical technology should end? And my view is no. I think we need to identify those among the people who are going to develop heart attacks would now ... all the people receive therapy, we need to find the markers to tell us who is going to get it. So that you can be predictive. And then personalize the approach years before the disease leaves the patient to hospital care. So I think to give up on knowledge and discovery because intermediate technologies like the computer in 1950 you couldn't afford but one for the country, it's the same thing as saying we want to stop technology because we can't believe that the system will adapt to it. MR. DAVID GERGEN: Thank you. As we transition to Dr. Cicerone, I wanted to go back to one more fact that came out of the Gathering Storm report. The amount invested annually by the U.S. federal government in research in the physical sciences, mathematics and engineering combined equals the annual increase in U.S. health care costs incurred every twenty days. Think about that. Dr. Cicerone. DR. RALPH CICERONE: That is an astounding figure. There were some Senate hearings last summer where I heard one Senator discuss a possible way of paying for the $10 billion worth a year recommendations out of this Gathering Storm report. And he pointed out that looking some years ahead, health care costs in the United States were ... to the federal government, the cost to the federal government, were to increase 41 percent in his projection. And by cutting that increase to 40 percent, that extra one percent saving could pay for all of these recommendations. I went home and checked his numbers because I did not believe he was right. He was correct. MR. DAVID GERGEN: So the total cost of this whole package of recommendations is $10 billion? DR. RALPH CICERONE: If you count all the R&D tax credits as a cost to the federal government, yes. MR. DAVID GERGEN: And our monthly cost in Iraq is about? Monthly? How much are we spending there a year? DR. RALPH CICERONE: Maybe eight, seven, I don't know. MR. DAVID GERGEN: So two months in Iraq is what we're talking about here for the competitiveness of the country. That's what we're dealing with. Let me ask you this question about we were just hearing from Dr. Bement about China and its investment and moving up from one to three percent. And I'm curious about the future of university research in China versus here. What is your outlook on that question? DR. RALPH CICERONE: It's pretty stunning. I've spent most of the last 20 years at a research university. And like my colleagues at research universities all around the country, we had so many visits from Chinese delegations, but also from all over the world, basically trying to figure out why American graduate schools are so successful. They are very much trying to imitate the American graduate school. And as Dr. Bement said, they're building universities left and right. Things which we haven't done for the last 40 years or so. MR. DAVID GERGEN: Let me relay the conversation I had with Larry Summers, the president of Harvard a few months ago. If you had to name the top 10 universities, research universities in the world, how many would be American? What would you ... would you venture a guess on that? DR. RALPH CICERONE: Eight or nine. MR. DAVID GERGEN: Eight or nine. And have you thought 20 to 25 years from now how many are likely to be American? DR. RALPH CICERONE: It will be less. MR. DAVID GERGEN: He thought as many as five would be Chinese. DR. RALPH CICERONE: I don't think so. MR. DAVID GERGEN: But it will be less. DR. RALPH CICERONE: When you look at the top ten universities and say which one of them is going to be pushed out of the way, you realize how tough a job it is. We've got some tremendous universities. But one of the things I would like to speak about, Mr. Gergen, is the emphasis on getting more American students interested in science and mathematics again. This country has benefited enormously from wave after wave of immigrants, usually people running away from something and running towards opportunity. An unfortunate case of Jews before and during the second World War and afterwards, Eastern Europeans and others during the Cold War, many other nations sending people since then. But now those people are finding opportunities at home. They have many more attractions to stay home. And, inadvertently, we have made it much more difficult for them to come here since September 11th. So we're sending them a message we don't want you anymore. And they're hearing that there are great opportunities at home. So to the extent that we have built our competitive success, our dominance, partly on immigrant talent, we're throwing it away right now. We absolutely have to reverse that trend to make people feel more welcome here again. The entrepreneurial creative people who want to take risks and who can build our country, but also educate our own American students. It takes a lot more educated people to run a democracy than it does a dictatorship. And we need them. MR. DAVID GERGEN: I'm glad you raise that. It goes back to the question of the H1B visa numbers. I will tell you the politics ... John Porter would know this, about anybody else in this room ... but for some members of Congress who have been standing up for increasing visas, they get killed back home right now. Because it gets wrapped into the immigration issue and you're soft on immigration. And it's like it's a very difficult proposition. Please. MS. HELEN DARLING: I'm glad you brought that up again. Because this is a big issue in corporate America. It has been one for a while. We used to actually get all the way to March before we capped the number you could have in any given year. So you had the whole rest of the year which you couldn't bring anybody in. And there are a lot of pretty ridiculous political issues around the H1B visas. But it's another piece of the puzzle that all together, if you put all the pieces together, we are working against bringing people in who, among other benefits to the American people, is being surrounded by other smart, trained people, whether they're here for a little while or not is itself very stimulating and exciting and everybody wins. And yet, we're really messing up on that one as well. MR. DAVID GERGEN: Let me ask you, Dr. Cicerone, you have to come back to the training, the education of more Americans in science and math. The impression one has is that we're going backwards, not forwards on that question, that the trend lines are the other way. And how do we change the culture? You've recommended increasing the number of teachers. Would that be sufficient to change the culture? DR. RALPH CICERONE: There's a powerful feeling from the people out in the trenches that our children are getting turned off at an early age on math and science, partly because some of their teachers are afraid of the subjects themselves and are not well equipped to do the teaching and, therefore, to convey the excitement that goes with creativity and innovation. So the idea is to leverage all of our efforts with teachers. The teachers are just so important. The teachers need some help too. MR. DAVID GERGEN: Should the focus be on the lower schools or should it just be in high school? We just had a national summit conference here among the governors about American high schools. Bill Gates came in and said high schools in this country are obsolete. Where would your focus be on the K-12 spectrum? DR. RALPH CICERONE: Well, I have to admit I'm not an expert. But I think many of us would be able to walk into a school room and with a decent amount of preparation teach almost any subject up to about grade four. Seriously. There's some research that shows this. But to teach let's say a good course in biology in the eighth or ninth grade takes some special education that most of us don't have. We're in physics. So I think you'd have to focus the subject matter content expertise at the older grades. MR. DAVID GERGEN: At the older grades. And do you have any sense of the scoring when we do pretty well internationally in the fourth grade. Internationally, we stack up reasonably well in the fourth grade scores. By the eighth grade, we're starting to show some slippage. And by the twelfth grade, it's gone. That's when we really get slammed. So is it somewhere between the fourth and twelfth or somewhere between the eighth and twelfth? DR. CICERONE: Effort is needed everywhere. We know that early childhood development is part of it, nutrition early on. Just everything is involved. But to be strictly focused on your point, yes. I think focus on the higher grades. I'd like to make one more comment. You mentioned Sputnik a few minutes ago about whether we're rallying the way we did in 1957 and the answer's no. The United States graduated more physicists in 1956, the year before Sputnik, than we did last year. Twice as many in fact. So our resolve has really slipped. MR. DAVID GERGEN: You mean in absolute numbers? DR. RALPH CICERONE: Twice as many in 1956 as in 2004. MR. DAVID GERGEN: With a population that was about 60 percent the size? DR. RALPH CICERONE: Fifty or sixty percent, right. MR. DAVID GERGEN: So the question becomes ... and thank you for teeing it up really well ... that's the landscape. How do we change it? How do we generate the momentum? How do we achieve success? Let's go back through the panel one more time. Then we're going to open this up to your conversation. Dr. Zerhouni, from your perspective, NIH, you looked at the political landscape. You have to pay attention to the political landscape, Even as you pay attention to science. How do we change this? DR. ELIAS ZERHOUNI: It's our number one worry, the generation of new scientists, new investigators. And when we look at it and we ask the young scientists or hopeful scientists, what we hear is that there is a disconnect actually between K-12 and undergraduate and post-graduate education. So I guess to go back to what Julie [Gerberding] was talking about, sometimes the value is making sure there are no disconnects and connectivities there. And what we find is that society in some ways has devalued the professions in science. I mean, when you were a scientist at 25, you have a choice. You can go to a certain investment bank or law. Or you go to science. And you won't get your first grant at NIH until you're age 39. So the risk/benefit analysis of our young scientists ... MR. DAVID GERGEN: Say that again now? DR. RALPH CICERONE: If you looked at NIH 30 years ago, 35 percent of our new scientists were 35 years or younger. I have an example that I always give. This is the example: Marshall Nirenberg was a Nobel Prize at NIH. He started his research, independent research, at 27. He discovered the genetic code at 31, received his Nobel Prize at 35 or 36. Today, he wouldn't get his first NIH grant until after he got his Nobel Prize. MR. DAVID GERGEN: You're kidding? Why is that? I don't understand. DR. RALPH CICERONE: Because we have rigidified our system. As you grow, and as any organization grows, it becomes rigid. We've built barriers between different categories of disciplines and the way you get there. And the prospects are not what they are for a Chinese scientist. I went to China. Being a scientist in China is the top of the social standing. Being a scientist here now is more like you depend on the goodness anD willingness of Congress to support you. And then it's touch and go. It's increased one year and flat the next and decreased the next. You know, scientists are not ... I mean, young bright Americans are not stupid. And they look at it and they say is this a career that I really want to go to? If I'm told that in '56 I could go to the moon and get paid and be at NASA? And all of these scientists are now retiring. And the new ones are saying, you know what? I'd rather go into marketing or investment banking and so on. So I'm making a ... I'm overstating the case obviously. But I think integration across the life cycle of a scientist and the career path of the scientist is important from K to 39 years to get your first grant. MR. DAVID GERGEN: Well, that's an extremely interesting point. Dr. Bement, in the life cycle, when do people often make their best discoveries? If we look back over the last ... well, over history, what do we learn about ... DR. ARDEN BEMENT: It depends on the field. Mathematicians and physicists usually make their best discoveries at a relatively young age. It's pretty hard to generalize, but in many cases in other fields, it takes longer. But the response I'd like to make is it's critically important we give young people research experiences throughout their educational career, even starting in high school. We're putting much more focus on freshman, sophomore, junior and senior research experience as an undergraduate in colleges. And also providing a greater continuity between undergraduate and graduate research. And furthermore, we're focusing our career grants, which is a very generous grant, on young pre-tenured faculty So that they can get the research teams up relatively early. MR. DAVID GERGEN: That's interesting. If people started on the research side in the eleventh and twelfth grade, do they get hooked. They just get excited about what they're doing? DR. ARDEN BEMENT: You bet your life they do. And even in the fifth grade. You don't have to wait to high school. We can teach them very important research principles even in elementary schools. DR. RALPH CICERONE: That's very interesting. I want to come back, Dr. Zerhouni, to the politics of getting this done. This is a very political city. How does one generate the political support to get something serious done about this? When you've got a sense not quite of lethargy, but a real sense of dysfunctionality right now that's quite pervasive? You know, on Capitol Hill, one talks to leading senators and they say, you know, the system is broken down. We're not going to get much more done in the next three years. And getting the appropriation bills out of here. Don't expect large ambitious projects. How do you generate ... after all, the time is ticking here. Or to put it another way, the storm gathers more force over time. So time is not necessarily on our side. DR. ELIAS ZERHOUNI: David, I still have a few more things to do with my agency before I get fired. [laughter] MR. DAVID GERGEN: That's a fine point. DR. ELIAS ZERHOUNI: But I think the number one thing is what you're doing. And I think that if you educate and you present facts in the most objective way and you make your point, I think one of the problems we have we haven't really made the point in educating our political leaders about the value of science in society. If we don't revalue the scientific professions as a strategic investment with the country, everything we do at the education level, you won't get the best teachers. If you do it at undergraduate education you won't really have the focus of universities on that issue. So there is a societal need from the top down and from the bottom up to revalue what it is that science and technology has done for our country. I'm looking at Dr. Wheeler there, Cass from the AHA [American Heart Association]. You know how much we spent for each one of us in America over the past thirty years on cardiovascular research? $110. This is what all of you here, all of us, have spent in total over the past thirty years. $4 a year is what we spent. For that, we've spared a million lives a year by reduction, 60 percent reduction in mortality from heart disease and 70 percent in stroke. So the question is is science and technology an investment for the future? And I think that is the debate that we need to have. Relative to other priorities obviously. MR. DAVID GERGEN: I think we spent more than that on the cookies over here today. Do you have scientists come out to NIH ... I mean, members of Congress who come out to NIH? Do you have delegations that in effect come and visit and get a sense of the excitement that you all have about the future of biological research? DR. RALPH CICERONE: We do. And not enough. Not enough. Washington is, as you know, a very difficult town, busy and you don't have a lot of time to really educate yourself. But we had lately a Congressman who came. His grandfather dropped dead of a heart attack. His father had a heart attack, went to surgery and died from complications. He had a heart attack. He went to the hospital, was treated by an NIH doctor. And within an hour was saved because of stent and new technologies which [are] maybe transitional technologies for curing. And eventually we will have preventive technologies rather than curative technologies. Survived. Was back to work in four hours. Came to NIH, visited us and said, you know, this is the story. My granddad died. My father was operated on, didn't make it. I had this very minimally invasive surgery. I'm here. And what I want you to do is . . . I just had a baby. And I want my baby not even to have to feel heart pain, a heart attack or have that issue. That's the trend. If we can't do this with our legislators, nothing I think will convince the rest of us to put that re-evaluation of science in society. MR. DAVID GERGEN: If I could be permitted a personal comment to those of you who are in science. One of the things that I've discovered is that a lot of us who are non-scientists don't understand, that it's very hard for us to share in the excitement that you have about what's over the horizon, what the possibilities are, that your sense of what human possibilities are, that those of us who are in the humanities . . . you know, it's a barrier for us to get over and see and get into it . . . is the excitement of science, not just the competition that really I think can get people turned on and say, yeah. We ought to do that. If you can come close to that, yeah. DR. DECLAN DOOGAN: I think you make a great point. And what I would say is I think we've done a very bad job of communicating the potential that exists within science and medicine and allied sciences. Because I believe that, as Dr. Bement said, when people come and get in contact with the scientific experience, it is energizing. We can see it from folks that work in our place who are engaged in some sort of scientific endeavor. They're excited a lot of the time. What kills them is bureaucracy. You mentioned big institutions. If you take the bureaucracy and mitigate the effects of bureaucracy and allow the space for creativity and an entrepreneurial spirit within the scientific endeavor, I think you can see some good things happening. But my worry is that the society doesn't yet value the scientific endeavor in the way that it did 50 years ago. And I think we have to capture the hearts and minds of the public. And we all have a part to play in that. MR. DAVID GERGEN: Ms. Weinberg, I want to come back to you about generating momentum for success in these areas. MS. MYRL WEINBERG: I think of all of these areas, to me one of the biggest problems we have in the country is the national debt. And when you look at the debt and the way it's growing and there's no end in sight and you trace that back to comments that have been made across the board where we have program after program after program that because I think of the pressure that is on our nation and policymakers looking to the time they're in office and then what happens later, feeling intense pressure to cut vital programs, whether it's CDC, Medicaid, across the board, it starts to undermine. And so in all of the areas we've discussed, to me there is no sense of urgency in the nation. There is no understanding of the interrelationships of all of these issues, whether it's education, NIH. And I think that it's not going to be only the scientists and researchers that convey the excitement which they should and they do. And hopefully, we'll all do better together. But it is going to be the people. I'll go back to my first point. If we don't find a way when you have such barriers to having any of these recommendations be implemented because of the situation our nation's in, if we don't find a way to have the people that can benefit if we are more competitive in science and health care, then they're the ones that need to understand why they should be demanding these kinds of changes, the support that agencies need, et cetera. And I just want to give one example. If we had a real commitment as a nation to doing something that would make us more competitive, improve something health care and save a heck of a lot of money, it would be to immediately put money into having electronic medical and personal health records. People would get engaged in their care. Mistakes would be avoided. We'd save a ton of money. And yet, we're unable to do that because of the overall situation we're in. And we have such a "siloed" system in every way that if there is money saved, we can't redirect it in a way that it goes to the areas where it's needed most. So I think instead of talking about this technology or this medicine is too expensive, that's not what we should be talking about. We should be talking about there's enough money in the system now to pay for all of these things and improve health and have lower health costs. We can't even modernize the technology in the very system where we're not competitive. MR. DAVID GERGEN: I'm glad you raise that. My understanding that one of the institutions in America, one of the few institutions, where you really can see the benefit of moving towards an electronic system is one of the most surprising and that's the Veterans Administration. That they really invested a lot. You know, we used to think of Veterans hospitals as being sort of second rate and they were downstream. But they've invested in it and it's now paying off. And their costs, their annual cost increases, are pretty flat compared to the rest of society. Is that right? MS. MYRL WEINBERG: That's exactly right. In fact, one of the things we've been doing is bringing the Undersecretary for Health, Dr. Perlin, to meetings of the leaders of all of the groups like American Heart and Cancer and Diabetes, so that we really get the information, not only in significantly improved health outcomes, which they've documented, but the cost savings to the system. And I'll just give you one example. It's the kind of thing that they're able to track because they are a closed system. They're able to track that when someone comes to the office when they were at a paper based system, they tracked every person that had to pull that paper and get it through and get it to the doctor and have it read. That cost $5.00. It cost one cent to hit the button on the computer and bring up the record. MR. DAVID GERGEN: And the Veterans Administration it might be noted is also a single payer system. MS. MYRL WEINBERG: That's right. MR. DAVID GERGEN: That's not to say a single payer system for everybody would be right. But it is to say that is a single payer system. Helen Darling, do you have a view on that by the way? MS. HELEN DARLING: Single payer system? MR. DAVID GERGEN: Well, where savings can be found. So that you don't have these continuing pressures and you do have enough money to invest in R&D. MS. HELEN DARLING: Yes, there are lots. And I would agree with what Myrl said. But also, if you could take something like health care-acquired infections, which are rampant, cost billions of dollars, hurt people. There's a lot of money there that in fact could be available for other things. We also know in the political process there's a lot of money in any federal budget that's passed that is well known to everybody to not be needed over many years. Some bases, military bases, when I worked for a senator from Minnesota, there were labs that everybody agreed we didn't need. But it had 30 jobs and nobody wanted to lose it. So you have to find ways to allow people to exhibit some political courage on the things where everybody agrees it's a total waste. But give them something. Like maybe that would be the community in which you would give 40 extra . . . or summer workshops for kids in math or science. So you do some very specific almost dollar for dollar tradeoffs. So that you move the math and science agenda forward by getting some money out of things that need to go. MR. DAVID GERGEN: Thank you. Let me come back to Dr. Leonard. You do not stand, as someone down to your left does, in some peril if you talk about the politics of trying to get things changed. DR. JOHN LEONARD: Oh, I didn't say that. MR. DAVID GERGEN: Perhaps you do. Perhaps we all do. I still want to come back to this. How do you generate momentum politically in the political system to get some urgency to this and get real change? Or are we just going to pick away at this and not be successful as we pick away at so many other things? DR. JOHN LEONARD: You know, I think it's multi-factorial. It's multi-factorial. I think that there has to be a broad based ... MR. DAVID GERGEN: I think you're safe from being fired on that basis, yeah. Multi-factorial. Nobody ever ... DR. JOHN LEONARD: No, I'm being serious. We talk about this in our own corporation. We are engaged, as we speak, thinking about these very issues and what voice our corporation should have locally and nationally. Abbott Laboratories will be one of the hosts of something called BIO which is the biotechnology industry organizations' annual event. Our CEO will be the keynote speaker. And one of the things that he will emphasize to that gathering of 20,000 scientists from our industries are individual responsibilities to carry this message forward. I know that at the level of our government affairs office, we engage our local representatives in these issues. I think, you know, it's bigger than just that. Ultimately, I believe it is a cultural issue here and it is who we are. You mentioned the humanities before. That struck me. I can't think of doing anything more human than science. It is what separates us from all else. Some of the best humanists were scientists. And I think that one of the things, you know, we can talk about the economic valuation. It is the valuation of being human. And I think that within our families, within our schools, within our communities, it is something that we must absolutely demand of each other. We need potent advocates, all of us, the people we know. We need sustained attention from multiple quarters. We need national recognition of accomplishments, et cetera, et cetera. And it's something that we can't wait for a Sputnik to happen and then 50 years later, oh, the next crisis. This is something that happens every single day. MR. DAVID GERGEN: Let me ask you this. The Democrats have a bill that they introduced early on which was almost straight out of the Gathering Storm report. And then the President came forward with a parallel proposal in the State of the Union. Is there a corporate coalition that's forming behind and giving support in Congress to getting major legislation through that would provide for these teachers and provide for the increased funding? Is there a corporate coalition that's coming together on that? DR. JOHN LEONARD: I'm probably not the best person to speak to that. I think there is to some extent how well organized it is, how unified it is and how much of a consensus there is behind it would probably be debatable. But I think that that's a step that should be taken. I think there are some very prominent business leaders, Bill Gates for example, who speaks on this all of the time. But whether or not we can say 80 percent of the Fortune 500, for example, as part of something, I don't know. MR. DAVID GERGEN: Because when corporate America does get behind tax bills, things often happen. And there have been other areas that they've gotten quite concerned about and legislation changes. It does make a difference. Carolyn Clancy, your perspective on how we get the legislative momentum, the political momentum to make the kind of reforms that are necessary. DR. CAROLYN CLANCY: Well, it strikes me that Julie Gerberding started to lay this out a little bit. I think that we have not always connected the dots for people as much as we can. I mean, right now what's keeping every governor awake at night in America is the Medicaid budget. And it's only going to get worse. I think there are such huge opportunities there for moving disease prevention and treatment way upstream from where we are right now. I mean, to put it concretely in our quality report, the good news is we are improving the care of people in the dialysis program. And that is actually a good thing. The really bad news is we are not doing a good job at all from accelerating the path to getting into the dialysis program. And that's where we ought to be focusing our energies. The other point I wanted to pick up that Myrl Weinberg made is I think there's a way to package this in a vision that people would understand. I think what happens when times get very tough is people get torn between thinking about a big vision and where we're going as a country and for [the] future versus something that's doable right now and feasible even if it's only a small piece of the puzzle. The point that Myrl Weinberg made about personal health records offering people an incredibly important new tool to get engaged in their health is quite important. On the other hand, most of the patients in this country are not prepared for it and simply handing them an electronic health record, it's going to make some things more transparent to them. It's not going to give them the skills they need, the skills to ask questions to say what's the evidence? Is this the right treatment for me and so forth? So I think the same paths that will make people better patients and perhaps wiser consumers of care will also help us to fill the scientific pipeline and presumably have better teachers and so forth. But I think it's that kind of sort of framing these pieces together that might have some real salability. MR. DAVID GERGEN: IBM is one company ... I believe there are others maybe coming on ... who are encouraging people as they retire to go teach in the public schools and go teach science and math in public schools. I think they have 100 coming out this year that they're helping along the way. Is that something that would also help if other corporations got engaged in that? DR. CAROLYN CLANCY: It's hard to imagine that it wouldn't. My brother is sort of a self volunteered. Left corporate America to go teach high school science and math. I think inspired both by the need for science and math, but also a need for a lot of the students to have male role models. MR. DAVID GERGEN: The IBM Foundation told me they were trying to sign up 100 corporations that might be willing to commit 100 apiece. And that gives you a fair number if you did that on an annual basis. Dr. Doogan, let me come back to you, sir, on your perspective again on the politics of getting this done. How does one generate ... are you all engaged in efforts on the Hill and working with the White House and working with the Democrats to get something accomplished here? DR. DECLAN DOOGAN: Well, I think our Chairman, Dr. McKinley, is very active on the Hill and advocating for improved investments and health care and better conditions in America. I think that a number of things that strike me are alongside the technological advancements that we have in this country is this sort of strange parallel world where we see a decreasing health care situation with the epidemic of obesity and diabetes. And I think that most of the public can relate to the problem of obesity. Because if you see the advertising that's on for remedies on the television and so on. And I think to galvanize around that, for example, as something that the public can relate to, scientists want to engage in and recognizing the downstream benefits of attacking the problem I think could be one area where we could look at wonderful partnerships being created between pharmaceutical companies, the front line health care providers, politicians and various other groups like food companies, et cetera. Something like that where we could all bring our might together to solve a problem, we'd have substantial effect, both in the short and the long term. So I would really see that some action around that would be a wonderful initiative and would continue to drive the wealth of the country by better use of our dollars. MR. DAVID GERGEN: Dr. Gerberding, within the federal government itself, is there ... this issue has arisen, often put on the White House doorstep. Where are you guys on your domestic policy? Why aren't you ... you know, do you have a domestic policy? Why aren't you pushing anything? But, you know, the responsibility here rests well beyond the White House in terms of the federal government, gathering its own forces to try to help educate the public and educate the Congress to get something done behind this competitiveness agenda. Are there efforts going on within the federal ... at the upper levels of the federal government beyond the White House to try to come together? Or is this sort of every agency for itself? DR. JULIE GERBERDING: No, I think there's very definitely collaboration. And the issue in my mind isn't that people don't know this is important. I think Congress knows that science saves lives. I think Congress knows that good science will save money and build a stronger economy. I don't think the issue is the need for more information or more evidence. I also think that Congress gets elected by people who decide that those things are important in their decisions about voting. And until Congress really feels the connection between a desire to have a strong scientifically based economy or a prevention agenda at the local level that it isn't a factor that influences their decisions at the grassroots level. And what we need to do is better communicate to the public about why they should make their voting decisions on these criteria. One of the challenges that I have ... and there are many exceptions to this. But I actually am often troubled by scientists communicating to the public. I'm not sure that we're always the best communicators. And we are learning how to translate. And one of the ... actually the great gifts that Congress has given CDC is a new global communication center with state of the art television studios. And when we start using those studios to deliver messages about the importance of science and the importance of prevention to children in this country and make it exciting for them and fun and interesting, I think we'll begin to lay a groundwork for a different dialogue in the future. So I guess I'm saying this is a grassroots solution. MR. DAVID GERGEN: Do you find a receptivity on the part of the media to talk about science? I don't. DR. JULIE GERBERDING: I think it's difficult. And I'm sitting in the National Press Club. So I'd like to come back here again too. But I do think that it's a tough job. Where we've had the most success is with the scientific media who have come to the boot camp that CDC supports for the press, teaches them about our business and helps them be informed. So that when they write, they're writing stories from a frame ... a knowledge base that allows them to be effective translators. MR. DAVID GERGEN: Right. It's an interesting question. Many of the gatekeepers in the media as far as I'm concerned assume that science is tough. It's not going to sell. Let's go do another crime story. But, in fact, as of a few years ago, The New York Times, you know, its Tuesday science section, after it was established, the Tuesday newspaper sold more out on the streets than any other newspaper during the weekday. It spiked on Tuesdays which was a ... and they interpreted it as ... their science team interpreted as it had a lot to do with that special section and trying to make it accessible to people. Dr. Bement, your views on this. Where do we stand? What's the likelihood of getting serious legislation that in effect provides most of what the President and indeed the Democrats are seeking on this competitive area? DR. ARDEN BEMENT: Yes, thank you, David. I'd like to go back and indicate that the momentum that has built was largely started by industry, especially through the report of the Council on Competitiveness. And there are a number of corporations that are not just committed, they're engaged. And they're engaged not only in trying to sell this package, but they're engaged in public education. You mentioned IBM. But there's Dow Corning. There's Intel. There's Dupont. There's Microsoft. There are many other companies, Merck, that are directly engaged in public education. And that's the point I want to make. There are many school districts where the business sector is directly engaged, they do much better in math and science education. That's a demonstrated fact. And so it's not just the expectation that the teacher sets. It's not just the expectations that the school sets or even the school district. It's the expectations that the community sets. So community action, keeping score, keeping track, continually improving, I think is really the key to success. Now, we get to the question of advocacy. Unfortunately, the general belief is that all advocacy occurs in Washington. And I think many of you who have been part of this recognize the closer that you get to saturation, the quicker the signal to noise ratio approaches zero. So that local advocacy, grassroots advocacy, community advocacy, really accounts for quite a bit. And as you know, all politics are local. So having local advocates, I think, in trying to educate the public and engage the public in some of the issues we've been talking about I think is critically important, which gets me to the last point. We oftentimes ... and this is your media question ... we oftentimes inform the public about science and the wonders of science, but we have not yet gotten to engagement. And with modern information technology, we could actually engage the public in science. And we could bring science into the public classrooms. NASA started that movement, actually under Dan Golden. He wanted to engage the public in science on the space station. Well, that's yet to develop. But if the science agencies had their own channel, we could put children on research vessels vicariously. We could put them in observatories. We could have them be involved in cosmological studies. We could have them involved in ecological studies. And that's here and now. That can be done. MR. DAVID GERGEN: Say that again. You said if the science agencies had their own channel. Do you mean television channel? DR. ARDEN BEMENT: Yes. MR. DAVID GERGEN: That's a novel idea. I have not heard that before. Could you expand on that a little bit? How would you do that? You'd start your ... you'd get funding for it. DR. ARDEN BEMENT: Well, NASA has a channel. There's no reason why you couldn't have a multi-agency channel. DR. JULIE GERBERDING: CDC is getting a channel. MR. DAVID GERGEN: CDC is getting a channel. You guys are all going to be anchors pretty soon. Great. You'll be household names. DR. ARDEN BEMENT: Your job is secure. MR. DAVID GERGEN: The more the merrier. But what would you do with it? If you had a channel, what would you ... that's a really interesting idea. Could you have it interactive with schools and that sort of thing? DR. ARDEN BEMENT: Well, let me just give you an example. We're developing an undersea research vessel which will be the successor to Alvin, Except this vessel will actually explore 95 percent of the ocean bottom. And it would be quite possible to have children involved in actually selecting samples to take. And then following the examination of those samples to see what they represent. That could be possible. MR. DAVID GERGEN: Wow. That's really interesting. DR. ARDEN BEMENT: And that's just a small example. MR. DAVID GERGEN: And not very expensive. DR. ARDEN BEMENT: Not very expensive. We could ... MR. DAVID GERGEN: One-day increase in health care costs. DR. ARDEN BEMENT: We could actually involve children in Arctic exploration or Antarctic exploration and actually go out and vicariously by television work with the penguins. That could be done. MR. DAVID GERGEN: Now, that could put a documentary maker out of business, if you started messing around with penguins. DR. ARDEN BEMENT: No, but our ability to do real time research coverage by television is here now. It's not futuristic at all. MR. DAVID GERGEN: That's fascinating. Ms. Darling, your views on, again, about this generating public and political support. MS. HELEN DARLING: Well, based on what's been said, one thing to do would be to break down the negative facts, the things that have gotten everybody appropriately frightened down to the local and state level. So if you take a state ... let's say the current head of the National Governor's Association from Arkansas, how many scientists and mathematicians would you want Arkansas to produce? And you could take it at every level, at the local level. And then talk about what we need to do if Arkansas ... if each of those locations is going to have a standard of living that isn't significantly lower than where it is. So taking it back to the local and state level, with hard numbers, let them see the consequences. If you look at the kinds of jobs. Again, not to pick on Arkansas, but if you look at job growth in Arkansas with a few exceptions, probably around the university, all the job growth is in things like low pay, retail, fast food and mostly low level hospital employees, low level in terms of wages, significantly lower than where it is. So you could just take each of those ... I mean, this is something somebody could do and model it. You could see if you could change state by state ... and maybe you'd start with the most successful ones and see how you can do it. And even think about things like maybe they don't have the capacity at the state university. But would the state be willing to spend some money to send them off to a nearby university that has the capacity? And essentially get them thinking this is a war that we have to fight if we're going to save the quality of life in the United States. And that's even recognizing that there's a lot that's really good about global competitiveness. MR. DAVID GERGEN: Good. We come back to you, sir, for the last question from here. And then we'll open this up. You've been really thinking about this probably longer than anybody else on the panel in terms of their report. Because this is a report after all that was requested by Congress. You responded to the Congress. They then began introducing legislation. The administration then introduced legislation. Are you optimistic, sir, that we in fact are going to have comprehensive legislation to carry out the main recommendations of the report? DR. RALPH CICERONE: I am. MR. DAVID GERGEN: You are. DR. RALPH CICERONE: I am. MR. DAVID GERGEN: Do you think we'll have it this year? DR. RALPH CICERONE: Yes. I think there has been an amazing example set in a bipartisan way, especially in the Senate, but with some leading proponents in the South, people who behind closed doors are doing the right things. And they want to work together and get something done. I think though the problem is larger than legislation. And getting back to the theme of this meeting, leadership of all kinds and what the public desires and needs and expects. I think we need a very broad communications effort. And I think everybody on the panel has just said that in different ways. I came over to visit with Mary Woolley and John Porter a couple of times in my first few months here to ask about this great record that Research!America has achieved over the years of finding out what's on the minds of the public, how much they know, what they'd like to know and where they don't know enough. And I'd like to submit one of the roles ... I'm going to look at Mr. Gergen now because he's a master of this ... storytelling. I think President Reagan was as good as anybody at that. And another great leader was Lewis Thomas who, of course, led Sloan Kettering. His books, which told in a very dramatic way the excitement of science and the enormous financial value of prevention as opposed to treatment. Lewis Thomas' books have many stories in them. We have to get out there and tell the stories and do it in the home districts as Dr. Bement said to reinvigorate the entire sense of excitement and what can be done, stories about people's opportunities and careers. Of course, to be practical, maybe some scary stories too. But we have to get the story out there. I think Congress will follow. MR. DAVID GERGEN: That's a striking point. And Howard Gardner has written a book called Leading Minds. And it's all about leadership, and the central argument of that book is that the best leaders are ones who create narratives in the minds of their followers about what the group or the organization is trying to accomplish. And if you have a convincing narrative, people will then buy into and want to be part of the larger ... and then that narrative is made up of many strands of individual stories that persuade people or inspire or scare or whatever. And by the way, I also think that nuggets, factual nuggets, are very helpful as I thought with your competitive or your Gathering Storm report. I was quite impressed that you had those last two or three pages of those nuggets. Those are something like for somebody like me, you can see that those are wonderful things to be able to grab hold of. I thought you were on the way towards communicating, and indeed your executive ... DR. RALPH CICERONE: Those are Norm Augustine's babies. And it drove our staff crazy making sure they were all accurate. MR. DAVID GERGEN: But, you know, Norm Augustine is a fellow who's written a book about Shakespearean leadership and understands the importance of stories to leadership. And the Shakespearean stories really go right to the heart of what he does. So we're in a court here. The floor is now open for about a half an hour. And we wanted to go through a couple of rounds. Yes, sir. Please, if you would identify yourself when you stand up. There are microphones. We do have a C-SPAN audience that has joined us. We're very grateful for that. And if you would, please, sir, identify yourself. DR. DENNIS AUSIELLO, MASSACHUSETTS GENERAL HOSPITAL, HARVARD MEDICAL SCHOOL: Yes, my name is Denny Ausiello. I'm chairman of medicine at Mass General Hospital, Harvard Medical School and a member of the board of Research!America. I'd like to take the point of the partnership that has been a thread of all of the speakers today to another level and perhaps then challenge the panel to address how we could use it in an effective way. In the most fundamental sense, biology is not a science. But it is the most elegant expression of chemistry, physics and mathematics. And I think in that light, we as scientists, and I as a biological scientist, have not done a great job to tell the stories of the seamlessness between those enterprises. And particularly the elegance of the most fundamental science and biological outcomes and biological achievements. And coming back to the point that Dr. Zerhouni and Dr. Gerberding made earlier, the future of biological health care and science really lies in pre-symptomatic disease prevention and management. And most of the tool kits and the activities and the language that is being spoken to achieve that really are coming from the most fundamental science in physics, mathematics and chemistry. And so if we're going to provide an educational framework that the population in our country can understand, it seems to me it can't be segregated. It has to be a continuum. And I would like to ask Dr. Zerhouni and perhaps Dr. Cicerone to comment on what are the goals of the educational process? Because I think if we go back to the era when we're going to emphasize mathematics and we're going to emphasize physics and emphasize chemistry, all of which happened in my generation and I'm very pleased for, I think that might be a mistake. And the query I would have is can we look to a more integrated scientific educational process that would bring the magic of the most fundamental science into the biological arena and link that to biological outcome which may make scientific achievement a much more palatable and exciting opportunity for our next generation? MR. DAVID GERGEN: Dr. Zerhouni. DR. ELIAS ZERHOUNI: I think Dr. Cicerone ... I think Ralph should answer that first. Is he there? MR. DAVID GERGEN: We've got an (inaudible) here. Do you want to tackle that? DR. ELIAS ZERHOUNI: I thought Arden was first. MR. DAVID GERGEN: Okay. Arden will take that. Okay. DR. ARDEN BEMENT: Your point is very well taken. The thing that we're looking to is development of better visualization models using information technology which is one way you cannot only integrate graphically the complexity of some biological structures at a fairly complex level to include membranes and macrophages and so forth. But you can actually get inside the model and begin to think about it. And part of that is really taking a plethora of data and synthesizing it and trying to understand how you take data and convert it to new knowledge and new understanding. And that synthesis process in the past was not given very much credence or not very much credibility by the science community. It was more discovery rather than synthesis. But that's changing dramatically, and I think over time by getting to a systemic level and being able to deal with higher levels of complexity than we had before, by getting out of our narrow channels and bringing in more interdisciplinary involvement, we'll be able to do much of what you're talking about, have a much more integrated approach. DR. RALPH CICERONE: I would like to make a comment. I thought that was a great question. We have so much work to do. I'll give you just two examples of things that give some specific focus to what you were saying. One is the way we layer the sciences in junior high, middle school and high school, where it's generally biology or earth sciences first and then chemistry and finally physics. It should be upside down. It should be the other way around. I don't know why physics is taught last. Maybe at some point it was thought to be more regal and more difficult and required more mathematics. But biology's changing so fast that I think we should reverse it, physics first, then chemistry, and then biology if we have to have the layer cake approach. And then even in universities, what we as university professors call an introductory course in the sciences for 90 percent of the students, it turns out to be a terminal course. And we teach them as if all of these students are just starting on the path towards a Ph.D. in physics. It's the last course that they're required to take in the sciences. We're teaching them all upside down and wrong. So we have an enormous amount of work to do that maybe won't cost so much money as it will rethinking the whole exercise. MR. DAVID GERGEN: How would you rethink the introductory course at the university level? DR. RALPH CICERONE: I think it would be very much what Dr. Ausiello, chair of Medicine at Mass General, I think what you had in mind was not so much specific facts but in the way people ask questions, what is the value of science. DR. ELIAS ZERHOUNI: I would just say that, the key here to understand, the disciplines have been created as a means to science, not an end in themselves. And I think what Denny's talking about is the need for us to break the silos between disciplines and teaching science again rather than the disciplines of science. In chemistry, for example, it's well known ... a Nobel Prize in chemistry one time told me, he said, the way we teach chemistry today is designed not to ignite the young mind, but to cremate the young mind. MR. DAVID GERGEN: Well, he certainly knew how to tell a story. Please. DR. FRANCESCA GRIFO, UNION OF CONCERNED SCIENTISTS: Thank you. I'm Francesca Grifo. I'm the Director of the Scientific Integrity Program at the Union of Concerned Scientists and, I might add, ex-science teacher, former high school science teacher, former university professor. And I go back to Dr. Zerhouni's comments. Because I think one of the things that he talked about was what is it that squashes the excitement of a 25-year-old scientist about to go into the system? And I think one of the things that we haven't mentioned here is the idea that if we choose a federal career, a federal scientific career, that in fact there's a very high likelihood that our research results will be politicized, if we can even get them out of the agency into the mainstream. And it's one of the things I think is missing from the Gathering Storm report is really how do we address the politicization of science. And I'd just be thrilled to hear from any of you on that point. Thank you. MR. DAVID GERGEN: Does someone want to respond to that? Dr. Zerhouni. DR. ELIAS ZERHOUNI: Well, our position is very clear. I think that science should be above politics. Because when you look at the objective science, whether it be disease, it doesn't really check your political affiliation. And I think it would be great disservice to the country if we end up at the point where federal agencies no longer provide independent unimpeachable advice to inform policy, whatever that policy ends up being. So I think it's very important. I say it and state it again. We make sure that science does not become a political punching ball, That it really remains what it has always been. And that is the activity of looking for facts and not ... be factual and not factional if you will. And I think government scientists or any other scientists, I think we should be very clear that there's got to be a separation between the policies and the politics of decisions made on the basis of science and other factors and science itself. MR. DAVID GERGEN: Sensitive issues, especially these days. Please. MR. AL MILIKIN, WASHINGTON INDEPENDENT WRITERS: Al Milikin, Washington Independent Writers. Do any of you object to destroying a human embryo for embryonic stem cell research? MR. DAVID GERGEN: That's not quite the subject matter of the day. But if one individual wants to respond to that, the floor is open and the question's posed. Someone want to respond to that? Arden, are you responding there? DR. ARDEN BEMENT: Well, embryonic research is not within the scope of the National Science Foundation. So we haven't taken a position on it. Now, that's not to say that we don't support stem cell research. We do a lot of work in somatic stem cells and other types of research. And we have supported stem cell development from yeast. But we haven't gotten into human stem cells. MR. DAVID GERGEN [to Dr. Zerhouni]: But you must support a good deal of stem cell research. DR. ELIAS ZERHOUNI: We do. And I think this is one of the most polarized issues right now in society. And I think science is somewhat hostage to that in the sense that society has not come to a consensus. And typically, when you deal with ethical issues, we've reviewed the history of ethical issues. If you look at blood transfusions, they were considered also at one time questionable. In some religious denominations still today do not accept blood transfusions. And I think at the end of the day, society will come to a measure of good versus bad. And every advance in medicine would be surgery or blood transfusions, always been either rejected or accepted on the basis of eventually that first patient that gets to benefit from an advance versus the first person who gets harmed by it. And I think people eventually make that balance. So from our standpoint, the science is advancing to a point where it's coming so close to fundamental questions of society like origin of life and so on that no one can glibly answer that question without thinking about the balance of risk and benefit relative to the state of the science as we know it. MR. DAVID GERGEN: Dr. Cicerone, I would take it that your argument would be that the issue of the gathering storm ought to be on a separate track from the question of stem cells or global warming or evolution versus intelligent design and these other issues that have come into the national dialogue. DR. RALPH CICERONE: Yes, I think so. I think Dr. Zerhouni just stated it very well. There's no glib answer to a question like that last one. The National Academy of Sciences has released a couple of reports now on proposed guidelines, ethical guidelines, for stem cell research. And the answers that we came up with guided by ethicists and scientists and medical practitioners and people who work against various diseases have gone along the lines that Dr. Zerhouni said. It's not glib. There are certainly embryos being created in fertilization clinics which would otherwise be discarded. That's perhaps a different ... an easier answer. If an embryo is going to be discarded anyhow, perhaps it could be used for research. Earlier stage embryos, certain guidelines against not purchasing embryos and putting a woman or a couple in an ethical bind over making money out of the transaction. And then being aware of international differences that are developing on the answer to that question. But I hope that we will all treat these issues separately. And I think, yes, they would be on a separate track from the rest of the discussion today. MR. DAVID GERGEN: Why don't we cover the questions ... we will address those who are standing now. And then we will call it a day. We've got about four people. Yes. Identify yourself if you would please. DR. SAM SILVERSTEIN, COLUMBIA UNIVERSITY: My name is Sam Silverstein. I'm a professor of physiology and medicine at Columbia. I'm a member of the Research!America leadership. I'd like to make a comment and then address a question to the panel which I think, Mr. Gergen, you addressed to them repeatedly, but got no answer. MR. DAVID GERGEN: I appreciate your support. DR. SAM SILVERSTEIN: The comment is that C.P. Snow pointed out to us a long time ago that there are two cultures. And in fact when one asks people what is culture, they will tell you it's poetry. It's music. It's writing. But it's not science. In fact, what distinguishes contemporary civilization from the past is in fact that science is the very root of contemporary culture. When one looks at (the) public agenda and what it says American parents are worried about, they are not worried about the education of their children and science. They're worried about lots of other things, but not that. I think what we're looking at here is just a failure of leadership. And we ought to say it like it is. We have not seen leadership at the national level. And we have not seen leadership at the local level. In fact what we're beginning to see in many areas is that grassroots leadership at the local level is having to take over because in fact the political leadership seems to be astray. The question I'd like to put to the panel, and that you raised repeatedly, is how do we get some kind of synthesis? Myrl Weinberg wants us to have electronic medical records. And she's right. Elias Zerhouni wants us to invest more heavily in the NIH and he's right. Judy Gerberding wants more money for the CDC and she's right. And all of you want more money for education. And, in fact, the amount of money all of you want and all of us want is a pittance compared to the benefits that those dollars will bring. So I'd like to ask the panel the question I think that you have been leaning on them to answer. How do we get together even in this room to support one another, because Myrl Weinberg doesn't disagree with Dr. Zerhouni. And there's no disagreement between Julie Gerberding and the members of the panel on her side. Or between the business community for that matter in the main. What is it that we're missing that we could do? That's (the) synthetic kind of question that was being asked by Dennis Ausiello in education. What is missing in the synthesis of our politics that doesn't allow us to do what we all know is the right thing? MR. DAVID GERGEN: Dr. Cicerone, do you wish to respond? DR. RALPH CICERONE: I'm just a scientist. MS. HELEN DARLING: The short answer is what you started with which is leadership. It will take leadership, political leadership, to make it happen. MR. DAVID GERGEN: Well, let me ask you another aspect. Let me just come back. Would it be worthwhile to form a coalition, as we have seen on other issues in the past, that brought together the presence of the major research universities in the country? With the CEOs of the major companies who are deeply concerned about this. With people from the scientific community who are on the forefront that would include Nobel Prize winners and others. And other leading citizens in a coalition that would continue pushing for change on an ongoing basis. There was an advertisement, for example, a full page advertisement in the Times, I believe, and a couple of other newspapers here recently that had the names of a number of people. But I haven't sensed that there was a coalition that it was actively working. There was the competitiveness council in its earlier form when Chuck Vest was there from MIT. That really did have an impact some years ago. And I've seen other such groups work before. Is it worthwhile to consider formulating something like that, raising the money privately, in the private sector. I can just tell you I can name ten university presidents I know would join like that if they thought there was a way they could make a really big difference here in this city. And be heard. DR. JOHN LEONARD: In a short answer, I think yes. And I am reminded what can happen within companies when there are things, laws or legislation that's being proposed that is either very much in our interest or against our interest. We have an amazing ability to orchestrate massive letter campaigns. I mean, Mr. Porter I'm sure can tell us about being on the receiving end of many of those letters as constituents express their interests. I'm thinking about my own corporation. We have 60,000 to 70,000 employees worldwide. And the county where I live, 15,000, all of whom are readily reachable by our leadership in a day. And it is ... if the will is there, I don't think it's going to come from any one person. But this coalition you're describing could potentially start the ball rolling where a few very prominent leaders from different walks of life, private industry, universities, et cetera, we might surprise ourselves. We might surprise ourselves with what we can do. MR. DAVID GERGEN: Do you have a response to that? DR. SAM SILVERSTEIN: Well, I agree. John [Porter] and Mary [Woolley] will tell you that I've believed for some time that Research!America should create a council of business leaders. As President of FASEB, that's what I did when we wanted to change the Republican policy on science in 1995, and we succeeded by bringing business leaders to Speaker Gingrich. I believe that this is not just a tactic. It is an accurate reflection of how America works. And I think Bill Gates' comments about how American high schools are indeed antediluvian are correct. But we're not going to fix them in this room. That requires one by one, teacher by teacher, et cetera. But we can bring together major groups to insist that we start doing the right thing. I think your suggestion is a very good one. And we ought to try and extract some kind of synthetic activity out of this hugely intelligent and thoughtful panel. Because the recommendations that you've heard across the board, as I said, are a pittance compared to the $2 trillion that are saved every year just by the decrease in deaths from cardiovascular disease or the amount of money that we could save in other ways by using our heads instead of fighting about it. So, Mr. Gergen, if you would like to lead us, we'd be glad to have you. MR. DAVID GERGEN: I can assure you there are better people. But I can help you sell the story. Please. MR. JONATHAN PECK, INSTITUTE FOR ALTERNATIVE FUTURES: Jonathan Peck, Institute for Alternative Futures. I was thinking back to one of the great leadership moves in reaction to Sputnik. And our President said in ten years, we're going to put a man on the moon. And I'd asked the panel if you could set a goal that would galvanize science in the public mind as a great success story, what would it be? Would it be predict and prevent these medicines we can see, these diseases we can see, of obesity? Or what goal would you put that could galvanize all these sciences? MR. DAVID GERGEN: Someone want to take a crack? Yes, Dr. Doogan. DR. DOOGAN: I would like us to cure cancer and Alzheimer's disease, because these are two of the greatest opportunities rather than issues. And I think that people could relate to that. I'm not ignoring other diseases. There's a huge amount of work to do in mental illness, for example. But I think those two are tantalizing in the opportunity. MR. DAVID GERGEN: Other thoughts about what goals might be realistic, in sight, 10 years away? DR. JOHN LEONARD: I'll offer one up. And it's not health care based. But it would be energy independence and the use of renewable energies. I think that that's something that would touch absolutely every single American every single day of his or her life. MR. DAVID GERGEN: Good. Thank you. You want to jump in briefly on that point? MALE SPEAKER: Yeah, I'm a reporter. And I saw much of this happen. And I saw Richard Nixon start the war on cancer to get rid of it. Johnson's President. Johnson starts to have the war on heart disease, cancer and stroke. They were so determined at that time to abolish diseases. But those research efforts didn't quite make it. And I (inaudible). MR. DAVID GERGEN: That's helpful. We have two more. And we'll go to you. MS. MARCELA GAITAN, NATIONAL ALLIANCE FOR HISPANIC HEALTH: Marcela Gaitan with the National Alliance for Hispanic Health. My question has to do ... it's following up on the comments by Dr. Zerhouni and Dr. Cicerone on the need to invest in the next generation of scientists. In thinking about the diversity of our schools nowadays, how can we address the issue of increasing the number of minority (inaudible) groups in the professions of engineering and mathematics, health sciences? MR. DAVID GERGEN: I'm really glad you brought that into the conversation. Dr. Gerberding. DR. JULIE GERBERDING: I don't have an easy answer. But I think the principles are the same no matter what group you're specifically interested in exciting about science. We'll have to use different tools different messages, different opinion leaders and perhaps different channels. But I think the fundamental principle here is that if you excite children about science and you create a world of possibilities for them and somebody to take them by the hand and help them believe they can get there, they'll come. They will be excited and they will join in. MR. DAVID GERGEN: Do you think we also need to change the cultural, the norms, the expectations for young scientists, young doctors so that this isn't ... our daughter is now going through her residency and she has a young child. I find it stunning that the system is so ... does what it does ... puts the pressure on these young mothers that it does in health care. And I can see why it would be discouraging to others. I don't understand why we can't fix these systems so that young women can move into science and these other fields without the conflicts that they face. DR. JULIE GERBERDING: I agree with you completely. I have to have a caveat here because I was extremely fortunate as a little girl to know at age four I was going to be a scientist and a doctor. And no one stood in my way until I was approaching tenure. And so I was very, very fortunate. But I've made it a personal mission. And that is another challenge to the people in this room. Every one of us could reach to a little girl or a child that you're interested in and take that child by the hand and help remove some of those barriers. DR. CAROLYN CLANCY: I had the privilege to speak at a biomedical sciences career program last week at Harvard which specifically focuses on recruiting minority students interested in sciences. And it was quite instructive what they do. They actually engage a lot of the Harvard faculty to spend a couple of days with these students working in small groups and they recruit from high school on up. And some of them come back every year. But in essence, they're giving them a sense of possibilities, what it would look like. And I will say picking up on Elias' earlier point, they're fairly cautious. I mean, they're encouraging them. But they're also letting them know that the road ahead is going to be pretty tough. But they're also creating a built-in network for these students. They all leave with cards that say, you know, BSCP and their name on it. So they have the sense that they're part of a larger entity. This is funded entirely privately, not from governments or foundations. So it struck me as sort of one step or one piece of a potential strategy here. Because we're way, way behind. DR. ARDEN BEMENT: The down side is the reason why it may appear that we're not making broad progress in public school or even private school education is that the fastest growing segment of our population are underrepresented minorities. And yet, the highest dropout rate is in that segment. So it sort of balances out. On the other hand, there's great hope. There are school systems that are predominately Hispanic, as much as 87 percent Hispanic, that have now achieved 95 percent efficiency in both math and science at elementary, middle school and high school ranks. Incredible. A week ago, I met 200 students in our Lewis Stokes Alliance for Minority Participation from around the country, 200 that are in graduate work. Maybe 25 years ago, that would have been the whole national cohort. This is just one program. These students are hopeful. They're energetic. They're bright. They have a great future ahead of them. Many of them want to go into university teaching. Some want to go into industry. And they represent a broad spectrum of fields, many of which are represented here. So many will go into medicine. Many will go into the biosciences. Some will go into engineering. Some will go into computer science as well. We need to build on these successes. We need to exchange best practices. And we have a long way to go. But on the other hand, this is not the time to get discouraged. MR. DAVID GERGEN: Dr. Bement, could you tell us about a couple of the Hispanic schools that have made this part of ... are they public schools? DR. ARDEN BEMENT: Yes, the school district that I'm familiar with I believe is District 9 which is El Paso, Texas. The other school district is the one the President visited. I believe it was ... I want to say Dallas. But I could be wrong. I think it was Dallas, Texas. But I visited a similar school in Greenville, South Carolina just about three weeks ago. I'm not sure their proficiency is quite that high. But I only visited the fifth grade and that was dynamite. You talk about doing an experiment in the fifth grade. They were building cars with propulsion systems made with renewable materials. They did test data. They changed ... they optimized their propulsion system. They understood friction. They understood alignment. And they were taking data in the metric system. That was in fifth grade. MR. DAVID GERGEN: That's very helpful. Thank you. Yes, Dr. Cicerone. DR. RALPH CICERONE: The National Science Foundation has been great here. Sixteen years ago, I helped to start a program, the California Alliance for Minority Participation at U.C. Irvine focused on the Hispanic population in the area. And one of the early failures we had is that we traced difficulties in freshman and sophomore year chemistry and biology to calculus. And then that failure was traced back to the middle schools. And I'm proud to say that the people out there with NSF support have dug in. I've been working with middle schools in algebra in seventh and eighth grade. And the success rate now in those programs is stunning. On a typical Saturday session, which goes on all year that involves the families of the children and middle schools, we now have returning M.D.'s and Ph.D.'s of kids who went through the program, Hispanics in the area. And this never would have happened without not only NSF support, but people who feel optimistic and positive and who are making good things happening. And tremendous family support. MR. DAVID GERGEN: Good. That's good. Thank you, very much. Now. DR. JAY GERSHEN, UNIVERISTY OF COLORADO AT DENVER AND HEALTH SCIENCES CENTER: I'm Jay Gershen, Executive Vice Chancellor at the University of Colorado at Denver and Health Sciences Center. And I have the privilege of being on the board of Research!America and chair the Membership Committee. And I would like to drill down a little bit on the business side of this and business advocacy and getting the bio and non-bio business community involved in advocating for medical research. And I'd like to start with a very short anecdote story. Since storytelling is a good thing you said. Then ask a question. And the story is a local story. There's a military base in Colorado that was closed. The University of Colorado Health Sciences Center is moving out there. It will be done in two years. And one of the main reasons for that is the cooperation of the business community. And sitting behind me is Wendy Mitchell, who is president of the Aurora Economic Development Council, who has 100 businesses that pay $10,000 a year to be an investor in that council. And the University was stalled at about 14 votes in the state senate. You need 18. And Wendy and her coalition delivered 23 votes for $200 million in construction money to complete the campus. And my question is, if you look at Research!America and its main advocacy message, which is better health for Americans and also improving the economic health of America if you will, how do we get the business community more involved in what Research!America is doing and this coalition you were talking about? Going beyond that we need leadership. How do we get more bio and non-bio businesses to participate in Research!America and to carry this message? So that we move from 125 million people in this country who support this to 200 million? MR. DAVID GERGEN: Good question. Let's see, Helen, do you want to respond to that? MS. HELEN DARLING: Well, I would say they're a lot like politicians. If it's something they can understand and if they have the facts. For example, if you're a business that requires math and science experts for your business, then you can argue with them that if they help in the following ways, they're going to be better off. Most large corporations, who are mainly my members, in fact are usually very active in their communities. And they usually are active in two situations. They care about education. So it's partly a function of maybe redirecting how much of their interest in education also focuses on math and science. And second, where they have people in the company who are active. So, for example, most corporate foundations have a requirement that they put money in activities that they have employees or sometimes retirees who are working in them. Because they see it. They know they're going to get more for their money. And they also know that there's going to be added value there for everybody. So it would be again like politicians at the local and state level where they're headquartered. MR. DAVID GERGEN: All right. Well, this has been a long, sometimes complex, but always vital conversation. Mary Woolley and John Porter, do you have any final words? MS. MARY WOOLLEY: John. MR. DAVID GERGEN: All right. Fine. Good. MR. JOHN EDWARD PORTER: Well, I don't know about anyone else ... yes, I do. For this non-scientist, I have learned more and gotten more insights in the last two hours than any other time perhaps in my life about the subjects that we've discussed today. And I think all of us are greatly in debt to our nine very distinguished panel members and to our wonderful moderator, David Gergen, for making all this possible. [applause] Now, before you jump up, one of the things that I leave with ... and by the way, I think it's also been helpful for the panelists to hear each other, by the way as well. Maybe you don't have as many opportunities as there should be to interact with one another for such a long timeframe and talk about the things that we talked about today? But the message I get for everyone is that we have to go out and be the leaders that carry the message. Every one of us in this room has to go out there and lead and carry the message of the importance of working to put the priority of science and technology and research at the forefront of the thinking of the American people, our policymakers and our administration. And David, we're going to take you up on helping us tell that story. Because you are good at it. And I think that we add the right way to tell it. We can capture that imagination and bring our passion to the table to make it happen. Mary tells me we all need to do "friend-raising" before fundraising. And I think that's exactly right as well. Obviously, we need to do both. They work with each other. We need to go out though and provide the leadership and take the message home and make this happen. And David, we're going to pass that legislation in this Congress. But that isn't the end of the story. We have a lot more to do after that. Thank you all for being here. [applause]

###