An Interview with Congressman Bill Foster – STEM for Social Good

The Acronym recently interviewed the congressman from Illinois’s 11th District, Bill Foster. Mr. Foster is an exceptional individual — he has found significant success as a legislator, as a scientist, and as an entrepreneur. Incredibly, he has been exploring applications of AI in various fields for more than ten years (before the term “AI ” became popular). He is keenly interested in the latest and greatest in the fields of Physics, Technology, Medicine, Healthcare, and Education.

Given his background at the intersection of science and public service, the second part of the interview (this article) focuses on applications of STEM in improving our society. Part 1 of the interview is covered here.  

Part 2’s discussion begins here:

The Acronym: How do you think STEM education can be used to address challenges such as climate change or public health issues?

Rep. Foster: Well, if we’re going to address climate change effectively, we need to consider two main aspects. The first is decarbonizing within the United States. This can be achieved with today’s technology, costing a few trillion dollars. We have the financial capability in our economy to undertake this. However, the United States accounts for only 5% of the global population, and there isn’t enough money here or anywhere else to address this issue globally unless we make the technologies more affordable. Consider the significant reductions in the cost of solar cells; the technology itself hasn’t changed much. I remember playing with a small silicon solar cell in fifth grade, which is fundamentally similar to the material used in today’s large solar panels, yet the cost of solar power has decreased dramatically. This reduction is due to thousands of incremental improvements by engineers and scientists at every stage. 

Therefore, it’s these cost-reducing technologies that will fundamentally change how we address the climate crisis. For instance, a few years ago we reached a crossover point where the total cost of owning an electric car became lower than that of a fossil fuel car. And that’s now true in most areas of the world. Consequently, developing countries are more likely to opt for electric vehicles because they are less expensive. This underscores the real value of STEM education: it’s the myriad small enhancements that make life more affordable and efficient. 

The Acronym: What about the health crisis we face, like obesity, epidemics or even diabetes running rampant? How can the government help in ensuring all the advancements benefit the society at large?  

Rep. Foster: Once again, we find our hope in technology. In the last five years, we’ve witnessed the emergence of a new class of drugs known as GLP-1 receptor agonists, such as Ozempic and Wegovy. When these were proving their effectiveness in clinical trials several years ago, I started receiving messages from medical researchers I know, urging me to pay attention because these drugs could be transformative. One-third of our healthcare costs stem from diabetes, and another 10 to 15% from obesity. These drugs have shown that if you are pre-diabetic and take them, you’re unlikely to develop diabetes. They have been remarkably successful. Moreover, for individuals who are obese but not diabetic, taking these drugs has led to an immediate 20% reduction in the rate of heart attacks and strokes, according to data released last summer.

From a congressional policy perspective, my aim is to make these drugs accessible to those who need them as soon as possible. However, the primary obstacle is the cost. In the U.S., without any subsidies, these drugs cost about $10,000 a year, which is prohibitive for many people. There are actions the government can take to address this, including negotiating lower prices with the manufacturers and recognizing the substantial savings in healthcare costs when preventing diabetes. This makes it economically viable and beneficial for the government to subsidize these drugs and ensure they reach the people who need them.

The Acronym: I have some background in congressional debate. Based on my debate experience, can we completely trust this one study because we don’t know some of the longer term impacts of these drugs. So is it viable for us to already start thinking about and passing legislation until we actually are 100% certain that these drugs will be safe?

Rep. Foster: Well, first of all, as a scientist, I know that nothing is 100% certain. I mean, it’s possible that the laws of gravity are almost right, but not exactly, and there might be a correction needed. Even more so in medicine, with any new drug, you don’t really know it’s safe until it’s been through a 70-year experiment to ensure that there isn’t some downside. So, there’s a lot of very evolved federal policy trying to understand when the risks are acceptable compared to the anticipated benefits.

In the case of GLP-1 receptor agonists, fortunately, they have been in clinical trials for more than 20 years because they were originally developed as an anti-diabetes drug. It was only later that people understood how effective they were for weight loss and all the secondary effects from weight loss, like strokes and heart attacks. As a result, in this case, there is a lot more clinical data with a longstanding record to examine, compared to newly invented drugs. That’s a very fortunate thing when you conduct the risk-benefit analysis. On the other side of the coin, we know that if you don’t take these drugs, and if you do become diabetic, it is really bad, and we have more data than we ever need to understand that downside. That allows for a higher risk tolerance in the market where you know it works and you know that the alternative is a bad outcome. In that respect, it’s similar to oncology. Actually, when a new cancer drug comes forward, we can be very risk-tolerant regarding possible side effects because we know the side effect of not taking the drug is to have your cancer progress.

This is something where it’s important to have really high-quality statistical and STEM knowledge among the government workers who make those decisions, such as when there is enough data to approve a drug or to understand statistically the risks that are avoided by taking that drug. That’s something where the people who, after learning STEM, choose to spend their lives working in the federal government, there’s a special place in heaven for them, because they have really saved so many lives by getting our policies on new medical treatments as correct as they can.

The Acronym: What can Congress do to ensure that the ethical considerations of STEM advancements are integrated into policy?

Rep. Foster: Well, that’s a challenge. We saw this, for example, during all the vaccine debates during COVID. One of the problems is that politicians, and to some extent, people want simple answers. However, often there isn’t a simple, absolutely correct answer. During the debates on how rapidly and extensively to roll out the COVID vaccines, people and politicians wanted to wait until it could be absolutely proven safe. Well, guess what, no drug is ever absolutely proven to be safe. Even those that have been taken for generations can have adverse effects. So we have to consider this among all the other risks in life and do a good job with the quantitative analysis to determine if there’s a net benefit from deploying the drug to different patient populations. In the case of vaccines, the mortality rate varies significantly between young people and the elderly, so the policy needs to be very different. This should be driven by science and statistics, but it’s very hard to discuss these statistical concepts with the voting public. And that’s definitely one of the big challenges that I face.

The Acronym: What can we do when STEM reinforces already existing views? Or, how can incorporating STEM skills into government institutions help improve public trust and reduce misinformation in society?  

Rep. Foster: When you figure that one out, let me know! We operate under the model that we are all independent agents with free will, making our own decisions. This works when you have time to think about a specific issue in detail and discuss it appropriately with your fellow countrymen. For example, in the time of our founding fathers, the question might have been whether to join an alliance with France. There was time to discuss this because wars progressed over years, and the economy changed over decades.

Now, things are changing so rapidly, and there is so much information that I’ve become acutely aware of how overwhelmed my brain is with all the incoming information. I know that for any one policy decision, if I studied it and nothing else, I could form a pretty solid opinion. However, it’s very difficult to maintain a well-considered opinion on all the tens of thousands of issues we must decide as a society. So, what we need is to establish a set of trusted institutions, deciding which issues will be handled by Congress, which will be decided by federal agencies, and which will be resolved in the courts. We must set up systems we trust to appoint the right people and find a way to trust them. Incorporating STEM skills in all branches of government is essential, though it’s not the entire solution. Certainly, we don’t want AI deciding court cases, but we do want to make our processes as efficient and fact-based as possible.

The Acronym: How do you advise that we and our government look beyond the political noise and misinformation, especially on partisan issues? Because nowadays, it seems like everything’s becoming partisan. How do you stay focused on the long term?

Rep. Foster: Well, it’s a challenge because, you know, the way we have our government (House of Representatives) set up, there’s an every two-year survival imperative. So every member of Congress has part of his or her brain thinking, ‘How am I going to survive the next election?’ two years before it happens. So we spend way too much time worrying about political things instead of thinking deeply about the long-term best interests of those we represent. One thing that would make a huge difference is simply moving from two-year terms to four-year terms for members of the House of Representatives, so that they wouldn’t constantly be thinking about their next election.

Interestingly, Lyndon Baines Johnson (LBJ), who had served both in the House and the Senate, when he became president, one of the first things he did was to send out high-priority communication to Congress and the House of Representatives, saying, ‘You guys need to have four-year terms.’ It was a well-reasoned explanation for why the world is different than it was at the time of the founding fathers and why the two-year terms may have made sense then.

But it’s a very different world that we live in right now. Longer terms for Congress, I think, would make a huge difference in terms of giving more thoughtful men and women more time to think about the real long-term stress that our civilization is under.