[Joint House and Senate Hearing, 118 Congress]
[From the U.S. Government Publishing Office]


                                                        S. Hrg. 118-365

               ARTIFICIAL INTELLIGENCE AND ITS POTENTIAL
                  TO FUEL ECONOMIC GROWTH AND IMPROVE
                               GOVERNANCE

=======================================================================

                                HEARING

                               BEFORE THE

                        JOINT ECONOMIC COMMITTEE

                                 OF THE

                     CONGRESS OF THE UNITED STATES

                    ONE HUNDRED EIGHTEENTH CONGRESS

                             SECOND SESSION

                               __________

                              JUNE 4, 2024

                               __________

          Printed for the use of the Joint Economic Committee
          
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                     Available via www.govinfo.gov
                     
                               __________

                   U.S. GOVERNMENT PUBLISHING OFFICE                    
56-240                    WASHINGTON : 2024                    
          
-----------------------------------------------------------------------------------                          
                    
                        JOINT ECONOMIC COMMITTEE

    [Created pursuant to Sec. 5(a) of Public Law 304, 79th Congress]

      SENATE                               HOUSE OF REPRESENTATIVES

Martin Heinrich, New Mexico,         David Schweikert, Arizona, Vice 
    Chairman                             Chairman
Amy Klobuchar, Minnesota             Jodey C. Arrington, Texas
Margaret Wood Hassan, New Hampshire  Ron Estes, Kansas
Mark Kelly, Arizona                  A. Drew Ferguson IV, Georgia
Peter Welch, Vermont                 Lloyd K. Smucker, Pennsylvania
John Fetterman, Pennsylvania         Nicole Malliotakis, New York
Mike Lee, Utah                       Donald S. Beyer Jr., Virginia
Tom Cotton, Arkansas                 David Trone, Maryland
Eric Schmitt, Missouri               Gwen Moore, Wisconsin
J.D. Vance, Ohio                     Katie Porter, California

                  Jessica Martinez, Executive Director
                 Ron Donado, Republican Staff Director
                            
                            C O N T E N T S

                              ----------                              

                     Opening Statements of Members

                                                                   Page
Hon. Martin Heinrich, Chairman, a U.S. Senator from New Mexico...     1

                               Witnesses

Brian J. Miller, M.D., American Enterprise Institute, Washington, 
  DC.............................................................     2
Mr. Adam Thierer, Resident Senior Fellow, Technology and 
  Innovation, R Street Institute, Washington, DC.................     4
Dr. Ayanna Howard, Dean of Engineering, The Ohio State 
  University, Columbus, OH.......................................     6
Dr. Jennifer Gaudioso, Director, Center for Computing Research, 
  Sandia National Laboratory Albuquerque, NM.....................     7

                       Submissions for the Record

Prepared Statement of Hon. Martin Heinrich, a U.S. Senator from 
  New Mexico.....................................................    26
Prepared Statement of Brian J. Miller, M.D., American Enterprise 
  Institute, Washington, DC......................................    29
Prepared Statement of Mr. Adam Thierer, Resident Senior Fellow, 
  Technology and Innovation, R Street Institute, Washington, DC..    39
Prepared Statement of Dr. Ayanna Howard, Dean of Engineering, The 
  Ohio State University, Columbus, OH............................    65
Prepared Statement of Dr. Jennifer Gaudioso, Director, Center for 
  Computing Research, Sandia National Laboratory, Albuquerque, NM    69
Questions for the Record Submitted to Brian Miller, M.D. from 
  Vice Chairman David Schweikert and Dr. Miller's response.......    78
Questions for the Record Submitted to Adam Thierer from Vice 
  Chairman David Schweikert......................................    89
Questions for the Record Submitted to Dr. Howard from Senator 
  Mark Kelly and Dr. Howard's response...........................    90
Questions for the Record Submitted to Dr. Gaudioso from Senator 
  Mark Kelly and Dr. Gaudioso's response.........................    94

 
 ARTIFICIAL INTELLIGENCE AND ITS POTENTIAL TO FUEL ECONOMIC GROWTH AND 
                           IMPROVE GOVERNANCE

                              ----------                              


                         TUESDAY, JUNE 4, 2024

                                            United States Congress,
                                          Joint Economic Committee,
                                                    Washington, DC.
    The hearing was convened, pursuant to notice, at 2:30 p.m., 
in 216 Hart Senate Office Building, before the Joint Economic 
Committee, Vice Chairman, David Schweikert, presiding.
    Senators: Heinrich, Klobuchar, Schmitt, Hassan.
    Representatives: Schweikert, Beyer.
    Staff: Alexander Schunk, Kole Nichols, Tess Carter, Lia 
Stefanovich, Ron Donado, Colleen Healy, Jeremy Johnson, and 
Jessica Martinez.
    Vice Chairman Schweikert. (off mic)--out there as we sort 
of build the record of how do we do policy in the future. All 
right.
    I would like to introduce our four distinguished witnesses. 
Dr. Brian J. Miller is a practicing hospitalist and Professor 
of Medicine and Business at Johns Hopkins University. Dr. 
Miller is also a non-resident fellow at the American Enterprise 
Institute, where his research focuses on health care 
competition, FDA public policy, health policy and the 
integration of AI in the health care sector.
    Then there is Mr. Adams. Mr. Adams here? Thierer. Mr. 
Thierer is a senior fellow for the Technology and Innovation 
Team at the R Street Institute. Mr. Thierer also serves as a 
commissioner on the U.S. Chamber of Commerce's Artificial 
Intelligence Commission on Competitiveness, Inclusion and 
Innovation, where he advises on a variety of issues, including 
Internet, government telecommunication policy and AI. Senator 
Heinrich.
    Chairman Heinrich. Thank you for pulling this hearing 
together. It should be really interesting. A number of folks 
know that I have been heavily involved in these conversations, 
and we have been able to really put together a surprising 
amount of sort of bipartisan interest in where we think we need 
to, you know, where we really think the benefits are going to 
accrue from artificial intelligence and where are the places 
where we have to be careful and minimize some of the risks.
    So I am very much looking forward to continuing that 
conversation today, and I am going to introduce our other two 
distinguished witnesses. Dr. Ayanna Howard is the Dean of 
Engineering at Ohio State University. Previously, she was chair 
of the Georgia Institute of Technology School of Interactive 
Computing in the College of Computing, as well as the founder 
and director of the Human Automation Systems Lab.
    Her career spans higher education, NASA's Jet Propulsion 
Laboratory and the private sector. Dr. Howard is the founder 
and president of the Board of Directors of Zyrobotics, a 
Georgia Tech spinoff company that develops mobile therapy and 
educational products for children with special needs.
    She is also a fellow of the American Association for the 
Advancement of Science and the National Academy of Inventors, 
and was appointed to the National Artificial Intelligence 
Advisory Committee.
    Dr. Jennifer Gaudioso is Director of the Center for 
Computing Research at Sandia National Laboratories, where she 
stewards the Center's portfolio of research from fundamental 
science to state-of-the-art applications. She is also the 
program executive for the National Nuclear Security 
Administration's Advanced Simulation and Computing Program 
there at Sandia.
    Previously, she served as the director of the Center for 
Computation and Analysis for National Security, where she 
oversaw the use of systems analysis, cybersecurity and data 
science capabilities to tackle complex national security 
challenges.
    [The prepared statement of Chairman Heinrich appears in the 
Submissions for the Record.]
    Vice Chairman Schweikert. Thank you, Senator Heinrich. Let 
us go ahead and hear from our witnesses and Dr. Miller, 
everyone gets five minutes and then hopefully we can follow up 
with questions. Dr. Miller.

     STATEMENT OF BRIAN J. MILLER, MD, AMERICAN ENTERPRISE 
                  INSTITUTE, WASHINGTON, D.C.

    Dr. Miller. Thank you, Chairman Heinrich, Vice Chairman and 
Schweikert and distinguished members of the Committee for 
allowing me to share my views on AI and its potential to fuel 
economic growth and governance. I am a pragmatist, so I am 
going to focus on pragmatic applications and policy questions 
for the fifth of the economy that comprises health care.
    As mentioned, I'm a practicing hospitalist at Hopkins, non-
resident fellow at AEI. I actually work for four regulatory 
agencies, including the FDA and CMS and the FTC and FCC, and I 
also serve on MEDPAC. I should note that today I am here in my 
personal capacity, and my views are my own and do not represent 
those of Johns Hopkins, AEI or MEDPAC.
    So I just actually finished a week working in the hospital 
on the night shift. It is an interesting experience. It is 
seven days in a row of flying a 747 with analog controls and no 
autopilot. It is not good thing for us to have systems focused 
this way across the country.
    I would say actually since I first rounded in the hospitals 
as a medical student 15 years ago, things have not really 
changed. I do not really see a lot of change in clinical 
operations and what we do, and the broader economic data 
support this assertion. The Bureau of Labor Statistics tells us 
that for around 25 years, the hospital industry has had flat or 
declining labor productivity most years.
    And demand is going up, right? People are getting sicker. 
We have more elderly patients, and we have a labor shortage as 
a consequence. So we are missing 78,000 registered nurses, 
68,000 primary care physicians, amongst others, and also the 
spending is breaking the budget, right?
    So Medicare and Medicaid are $1.7 trillion or more 
annually, and that crowds out other sort of transformative 
investments that we want to make in things like transportation, 
education, my personal favorite, space exploration.
    So we have got to think differently. And so AI and 
automation can help solve our productivity problem in my 
industry and let us clinicians do what clinicians do best, 
which is focus on the patients instead of paperwork. Patients 
today face delays in diagnosis, clinical errors and tired and 
fatigued clinical staff who are focused on admin tasks.
    So AI is not really Terminator 3. It is also not really 
Star Trek. It is an inherently practical and technical issue 
for implementing it in health care. We can use it to automate 
mundane administrative tasks like physician charting with 
ambient AI, coding and billing. Imagine if AI were summarizing 
your clinic visit as you were actually talking with the 
physician, instead of them staring at the computer.
    And imagine if that physician could save time from the six 
hours a day spent in charting. This is actually being tested 
today and my colleagues at other hospitals are part of these 
pilots. It can also augment clinical labor. It could assist 
with mammography interpretation, melanoma diagnosis, improving 
efficiency and accuracy, identifying areas of concern in 
advance of physician review.
    It can automate other elements of clinical practice, 
reading pathology slides, looking at EEGs to check for seizures 
and other neurologic problems. And then a lot of folks are 
really worried about the labor impact, and I have to say that 
with the average day for a primary care physician estimated at 
26.7 hours if they complete all the tasks they are supposed to, 
there is plenty of room for us to have software and automation 
pick this up.
    For consumers, the win is huge. So if you are a consumer 
and you have a chronic disease, the burden is significant. 
Being a diabetic, you have to check your sugars, you have to 
give yourself a bunch of shots, you have to catch your carbs, 
watch what you eat.
    It is not easy. Imagine if we could create integrated 
systems with glucometers to check glucose, insulin pumps and we 
could take that burden away from the patient, so they could 
just focus on going about their life? From a policy 
perspective, we have to be careful not to over-regulate. So 
right now, this is--and I am a car guy. This is like putting 
airbags in cars in 1920 if we go too far.
    We should be practical and use existing authorities that we 
have at agencies like the FDA and the Office of National 
Coordinator for Health IT, and we want sort of to facilitate 
permissive bottom-up innovation from clinicians, nurses, 
engineers and others, and we want that to come from the 
bedside.
    We should also aim to pay for and drive competition amongst 
new and old care models, between humans and technology, and we 
want rapid cycles stacked incremental innovation to transform 
health care. We cannot tax and spend our way out of this, so we 
must innovate and instead remember why America is great. Thank 
you.
    [The prepared statement of Dr. Miller appears in the 
Submissions for the Record.]

 STATEMENT OF ADAM THIERER, RESIDENT SENIOR FELLOW, TECHNOLOGY 
      AND INNOVATION, R STREET INSTITUTE, WASHINGTON, D.C.

    Mr. Thierer. Chairman Heinrich, Vice Chairman Schweikert, 
members of the Committee, thank you for the invitation to 
participate in this important hearing on artificial 
intelligence and its potential to fuel economic growth and 
improve governance.
    My name is Adam Thierer, and I'm a senior fellow at the R 
Street Institute, where I focus on emerging technology issues. 
I also recently served as a commissioner on the U.S. Chamber of 
Commerce Commission on Artificial Intelligence, 
Competitiveness, Inclusion and Innovation.
    Today I will discuss three points relevant to this hearing. 
First, AI and advanced computational technologies can help fuel 
broad-based economic growth and sectoral productivity, while 
also improving consumer health and welfare in important ways.
    Second, to unlock these benefits, the United States needs 
to pursue a pro-innovation AI policy vision that can help 
bolster global competitive advantage and geopolitical security. 
Third, we can advance these goals through an AI opportunity 
agenda that includes a learning period moratorium on burdensome 
new forms of AI regulations. I will address each point briefly, 
but I have included three appendices to my testimony for more 
details.
    AI is set to become the most important general purpose 
technology of our era, and AI could revolutionize every segment 
of the economy in some fashion. The potential exists for AI to 
drive explosive economic growth and productivity enhancements.
    While predictions vary, analysts forecast that AI could 
deliver trillions in additional global economic activity, and 
significantly boost annual GDP growth. This would be over and 
above the four trillion of gross output that the U.S. Bureau of 
Economic Analysis says that the digital economy already 
accounted for in 2022.
    But what really matters is what AI means to every American 
personally. AI is poised to revolutionize health outcomes in 
particular. AI is already helping with early detection and 
treatment of cancers, strokes, heart disease, brain disease, 
sepsis and other ailments. AI is also helping address organ 
failure, paralysis, vision impairments and much more. The age 
of personalized medicine will be driven by AI advancements.
    AI can help make government more efficient as well. Ohio 
Lieutenant Governor John Husted recently used an AI tool to 
help sift through the state's Code of Regulations and eliminate 
2.2 million words of unnecessary and outdated regulations. 
California Governor Gavin Newsome just announced an effort to 
use generative AI tools to improve public services and cut 
eight percent from the state's government operations budget.
    And regulators are already using AI to facilitate 
compliance with existing policies, such as post-market medical 
device surveillance. AI also holds the potential to achieve 
administrative savings for federal health insurance programs, 
or better yet, reduce the number of people dependent on them by 
identifying and treating ailments earlier.
    There is an important connection as well between AI and 
broader national objectives. A strong technology base is a key 
source of strength and prosperity, so it is essential we do not 
undermine innovation and investment as the next great 
technology race gets underway with China and the rest of the 
world.
    Luckily, U.S. innovators are still in the lead. Had a 
Chinese operator launched a major generative AI model first, it 
would have been a veritable Sputnik moment for America. Still, 
China has made imperial ambitions clear, its imperial ambitions 
clear to become a global leader in advanced computation by 
2030, and it has considerable talent, data and resources to 
power those innovations.
    Experts argue that China's whole of society approach is 
challenging America's traditional advantages in advanced 
technology. We therefore need an innovation policy for AI that 
will not only strengthen our economy and provide better 
products and jobs, but also bolster national security and allow 
our values of pluralism, personal liberty, individual rights 
and free speech to shape global information markets and 
platforms. If by contrast fear-based policies impede America's 
AI developments, then China wins.
    To achieve these benefits that AI offers and meet the 
rising global competition, America needs what I call an AI 
Opportunity Agenda. An AI Opportunity Agenda begins with 
reiterating the freedom to innovate as a cornerstone of 
American technology policy, and the key to unlocking the 
enormous potential of our nation's entrepreneurs and workers.
    As part of this agenda, Congress should craft a learning 
period moratorium on new AI proposals, such as AI-specific 
bureaucracies, licensing systems or liability schemes, all of 
which would be counterproductive and undermine our nation's 
computational capabilities.
    In addition, this moratorium should consider preempting 
burdensome state and local regulatory enactments that conflict 
with our National AI Policy Framework. Next, Congress should 
require our government's existing 439 federal departments and 
sub-departments to evaluate their current policies towards AI 
systems, with two purposes in mind. First, to ensure that they 
are not overburdening algorithmic systems with outdated 
policies and second, to determine how existing rules and 
regulations are capable of addressing the concerns that some 
have raised about AI.
    Taking inventory of existing rules and regulations can then 
allow policymakers to identify any gaps that Congress should 
address using targeted remedies. Finally, an AI Opportunity 
Agenda requires openness to new talent and competition. Experts 
providing that with a talent war brewing between the U.S. and 
China, China is moving ahead in some important ways, and we 
must take steps to attract and retain the world's best and 
brightest.
    In sum, America's AI policy should be rooted in patience 
and humility, instead of a rush to over-regulate based on 
hypothetical worse case thinking. We are still very early in 
the life cycle. There is still no consensus on even how to 
define the term, let alone legislate beyond establishing 
definitions.
    I thank you for holding this hearing and for your 
consideration of my views. I look forward to any questions you 
may have.
    [The prepared statement of Mr. Thierer appears in the 
Submissions for the Record.]

 STATEMENT OF DR. AYANNA HOWARD, DEAN OF ENGINEERING, THE OHIO 
                STATE UNIVERSITY, COLUMBUS, OHIO

    Dr. Howard. Chairman Heinrich, Vice Chairman Schweikert and 
members of the Joint Economic Committee, thank you for this 
opportunity to participate in today's hearing on artificial 
intelligence, and its potential for job growth and improved 
governance. It is an honor to be with you today.
    My comments in this testimony are focused on the national 
importance of AI literacy, and its role in augmenting the 
current and future workforce talent pool, as well as the 
government's role enabling this to happen. While demographics 
of the U.S. are changing, these changes are not reflected in 
the diversity of students pursuing degrees related to AI, 
engineering and computer science.
    According to the 2023 World Economic Forum Future of Jobs 
report, AI continues to shift the skills that are needed within 
the workforce, in some cases creating new jobs, augmenting old 
jobs and eliminating other jobs. AI talent shortage is thus not 
just a U.S. problem. Buying outside talent is thus no longer a 
viable option to solve this issue.
    Too often though, we disregard our untapped talent pools. 
Organizations tend to over-index on hiring new talent with 
needed skills versus upskilling their current workforce. As an 
educator, I have witnessed bright students who, because of gaps 
in their high school curricula, leave the engineering major 
because they struggle when they take their first discipline-
specific engineering course.
    Yet when we have instituted enrichment programs such as 
Preface and Accelerate in the College of Engineering at Ohio 
State, we have seen quantifiable growth in student retention 
and graduation rates in engineering. There is thus no reason 
beyond intentionality and resources why organizations, 
government agencies and educational institutions cannot 
institute similar AI training and literacy programs within 
their own organizational borders.
    There has been some movement in Congress to expand the 
Digital Equity Act into an AI Literacy Act, but there needs to 
be more. As a technology researcher and college dean, I also 
dabble a bit in policy with respect to AI and regulations. I 
think policy would be critical to building trust.
    Policies and regulations allow for equal footing by 
establishing expectations and ramifications if companies or 
other governments violate them. Now some companies will 
disregard the policies and just pay the fines, but there is 
still some concept of a consequence.
    Right now, there is a lot of activity around AI 
regulations. There is the European Union AI Act, which 
Parliament just adopted in March 2024. There are draft AI 
guidelines that were released by the Japanese government, and 
slightly different proposals in the U.S., including President 
Biden's AI executive order.
    There is state-specific activity too. Over the past five 
years, it has been documented that 17 states have enacted 29 
bills that focus on some aspect of AI regulations. In fact, on 
June 11th his month, I will be participating in an AI symposium 
at the Ohio State House, which brings academic leaders, 
policymakers and industry experts to talk about the challenges 
and opportunities that AI poses for Ohio's universities.
    But this practice of each state coming up with their own 
rules for regulating AI, it will continue to happen if AI bills 
are not being passed at a federal level, and that is a problem. 
I believe we have a lot of room for improvement and making sure 
that people not only understand technology and the 
opportunities it provides, but also the risks that it creates.
    With new federal regulations, more accurate systems and 
increased AI literacy training and upskilling for the untapped 
labor market, this can happen. The intersection of the 
country's growing dependence on advanced AI technologies, 
coupled with the clear shortage of AI talent, is fast becoming 
a national security issue that must be addressed urgently. In 
2001, Secretary of Defense Lloyd Austin emphasized in a speech 
that sophisticated information technologies, including 
artificial intelligence, will be key differentiators in future 
conflicts.
    In the U.S. though, we have our risk and we don't have 
enough talent trained with sufficient AI literacy that is 
needed for advancing emerging technologies, critical to 
maintaining American leadership. If we are not careful, we 
might be living another 1957 Sputnik moment.
    Today, with nearly every aspect of life evolving to being 
coupled to AI, the U.S. cannot afford to sit back and wait for 
an AI-based crisis to hit. We are at a crossroads. The U.S. 
must make an equivalently bold investment in growing the AI 
talent pool, to help protect democracy, citizens' quality of 
life and the overall health of the nation.
    I want to thank you for this opportunity to participate in 
this important hearing, and I appreciate the Committee's 
attention to this topic, and look forward to answering your 
questions. Thank you.
    [The prepared statement of Dr. Howard appears in the 
Submissions for the Record.]

   STATEMENT OF DR. JENNIFER GAUDIOSO, DIRECTOR, CENTER FOR 
 COMPUTING RESEARCH, SANDIA NATIONAL LABORATORY, ALBUQUERQUE, 
                           NEW MEXICO

    Dr. Gaudioso. Chairman Heinrich, Vice Chairman Schweikert 
and distinguished members of the Committee, thank you for the 
opportunity to testify today on the crucial role of the 
national labs in driving AI innovations.
    Doing AI at the frontier and at scale is crucial for 
maintaining competitiveness and solving complex global 
challenges. Today, I want to emphasize two key points about the 
national labs can and should contribute to Frontier AI at 
scale.
    First, the role of the national labs in accelerating 
computing innovations through partnerships, and two, the role 
of the national labs in critical AI advances aligned with our 
national interest to date and going forward. But first, let me 
provide a brief overview of Sandia National Labs to provide 
context for the rest of my testimony.
    Sandia is one of three research and development labs of the 
U.S. Department of Energy, National Nuclear Security 
Administration. Our roots go back to World War II and the 
Manhattan Project. Throughout its 75 year history as a multi-
disciplinary national security engineering laboratory, Sandia's 
primary mission has been to ensure the U.S. nuclear arsenal is 
safe, secure and reliable, and can fully support our nuclear 
deterrence policy.
    Importantly, there is strategic synergy and interdependence 
between Sandia's core mission and its capabilities-based 
science and engineering foundations, because breakthroughs in 
one area beget discoveries in others in a cycle that pushes 
breakthroughs and fuels advancements.
    For decades, the Department of Energy National Labs have 
been pioneering breakthroughs in high performance computing 
through strong public-private partnerships. This collaborative 
approach has greatly enhanced America's overall 
competitiveness.
    As Mike Schulte from AMD Research said, ``One of the key 
take-aways is how impactful the forward programs were on our 
overall high performance computing, plus AI competitiveness. We 
not only created great systems for the Department of Energy, 
but in general it greatly enhanced U.S. overall competitiveness 
in high performance computing AI, and energy efficient 
computing.''
    Another powerful example is our recent tri-lab partnership 
with Cerebras Systems that I discussed in my written testimony. 
Let me expand upon that impact of that partnership by sharing 
the latest results.
    Funded by NNAS, the team achieved a major breakthrough 
using the Cerebras wafer scale engine to run molecular dynamic 
simulations 179 times faster than the world's leading 
supercomputer. This required innovations in both hardware and 
software. This remarkable advancement has the potential to 
revolutionize material science and drive scientific discoveries 
across various domains.
    For example, renewable energy experts will now be able to 
optimized catalytic reactions and design more efficient energy 
storage systems by simulating atomic scale processes over 
extended durations. This partnership exemplifies how to open up 
new frontiers in scientific research, potentially transform 
industries and address critical global challenges while pushing 
the boundaries of AI and computing technologies.
    The DOE National Labs have also researched AI for decades, 
with a focus on addressing critical challenges for the nation. 
Recently, ten of these laboratories, including Sandia, 
showcased their work at the AI Expo for National 
Competitiveness in Washington, D.C. At the Expo, the labs 
highlighted their contributions to AI research and their 
ability to contribute to the frontiers of science and solve 
national energy and security challenges.
    The labs are developing reliable and trust for the AI-based 
solutions for critical areas such as nuclear deterrence 
engineering, national security programs, non-proliferation, 
energy and homeland security needs and advanced science and 
technology. Pushing AI to the frontier and scaling it through 
the Department of Energy's Frontiers of AI for Science, 
Security and Technology initiative known as FASST, will 
maintain U.S. competitiveness and solve global challenges.
    The national labs' long history driving computing 
innovations, coupled with our strategic AI research focused on 
key applications, makes DOE and the labs invaluable partners 
for realizing AI's full potential through secure, trustworthy 
and high performance systems.
    In New Mexico, we are working with our premier institutions 
and industrial partners in the state to finalize the New Mexico 
AI Consortium. This consortium seeks to transform the landscape 
of AI research, cultivate a skilled workforce, and build a 
robust infrastructure to support cutting edge AI research, 
education and commercialization in the state.
    By harnessing the lab's capabilities through academic and 
industry partnerships, we can lead the world in AI while 
safeguarding our national interests. I welcome the discussions 
on how we can work together on this critical imperative. Thank 
you for convening the hearing, and I look forward to your 
questions.
    [The prepared statement of Dr. Gaudioso appears in the 
Submissions for the Record.]
    Vice Chairman Schweikert. (off mic)
    Chairman Heinrich. Thank you, Vice Chairman Schweikert. Dr. 
Gaudioso, as you talk in your testimony, national labs like 
Sandia have historically played an important role in innovation 
and technology development. How has that prepared them to 
steward AI development?
    Dr. Gaudioso. The national labs when it comes to AI 
development one, we have a history of working in AI, in the 
algorithms. Our work in advancing computing technologies has 
been focused on supporting the simulation missions and the 
science the labs have, but we can also have been using that 
computing power to start pushing large-scale AI.
    We also in the national labs actually have the world's 
largest--the free world's largest scientific workforce, and the 
unique data sets that science has. So for instance, ChatGPT and 
other types of large language models are built on the corpus of 
knowledge that is in the Internet.
    We know that we can build much more exquisite and impactful 
models if we train them on the exquisite science data that we 
have in the Department of Energy, and we look forward to using 
that data to build models that can transform how we do science 
to solve our challenges.
    Chairman Heinrich. Can you explain a little bit of that, 
because you know, there is a tendency among some of our 
colleagues to think of AI now just as a really elegant chatbot, 
you know, something that can respond back with, you know, with 
language that you would be hard-pressed to know whether it was 
a human or not on the other side.
    But when you take a large language model and you put in on 
top of some of these foundational science models, so that you 
can use language as the--basically to coach new science, new 
alloys, new molecules, new pharmaceuticals, out of these 
foundational models, you get really powerful combinations.
    Can you talk about the opportunities there a little bit?
    Dr. Gaudioso. I would be happy to discuss those 
opportunities, because I think, you know, we have the large 
language models that are trained on language, visual arts, 
other popular media. We now need to train physics models. We 
need to train them on chemistry data and these models will help 
us be able to make connections in the science data that today, 
you know, I am a chemist by training.
    I was trained to read the scientific literature, comb 
through the data, spend years trying to make sense of the world 
around me, make a hypothesis, design experiments to test my 
hypothesis and iterate. Well, if we can train a chemistry AI 
model, I have my own student intern right there with all of the 
world's chemistry knowledge, or at least the trust chemistry 
knowledge included in it, and we can use that to make science 
go much faster and to make connections that no human is ever 
going to make, right?
    And so we're already seeing this in materials discovery.
    Chairman Heinrich. Yeah, material science in particular I 
just an incredibly slow, painful like long-term endeavor in the 
normal course of how we do science. I think it is really going 
to change that dramatically. We heard a little bit about the 
importance of labor and workforce in having, maintaining our 
advantages in AI.
    But you mentioned something else, which is data. Talk a 
little bit about what the unique data sets that we have at 
places like our national labs, within our agencies, and how 
some of that--and for that matter data curation, the importance 
of data curation, how that gives us a leg up over some of our 
competitors as well.
    Dr. Gaudioso. Yeah. The data is really at the heart of AI, 
right, and we have data both open science data, the Office of 
Science Laboratories. The national labs broadly do science to 
advance the public interest. So most of the science data we 
have is public.
    But we as the scientists that discover and produce that 
data know how to interpret it and how to curate it to make it 
AI-ready, and to be able to use it to build these models. But 
we also have access--as federally funded research and 
development centers, we have trusted partnerships with the U.S. 
government, and we have access to national security science 
data that we use, as Sandia does, in designing hypersonic 
reentry bodies or nuclear weapons.
    And that data, which of course we do not want to make 
public, can be used to train closed foundation models that will 
help us change the design life cycles and respond to--at the 
speed of the national security threats we are facing today.
    Chairman Heinrich. Great. I am going yield back the rest of 
my time, Vice Chairman.
    Vice Chairman Schweikert. Thank you, Chairman Heinrich. Dr. 
Miller, first you already know I am a bit of a fan what you do 
and the way you think. Can you play a game with me instead of 
just reading a written question here? I come to you, you get to 
use the full power of what you believe exists today and is 
going to exist over the next year.
    How could you revolutionize medicine? How could you 
revolutionize the cost? How could you revolutionize making 
people well and the morality of ending and providing cures?
    Dr. Miller. A couple of answers. One, if you had high blood 
pressure, we have software that could titrate the medications 
for you. You could do that home, you could send me a message. I 
could talk with you about exercise, and in fact software in 
theory could titrate lots of medications for lots of common 
conditions.
    You would not even have to necessarily leave your house to 
see me. In fact, a lot of the time you might not even need to 
see me, and then see me for acute concerns. You could 
automatically have your clinical preventive services ordered, 
right? You could have your colonoscopy, if relevant a PSA to 
check for prostate cancer.
    So a lot of care could occur not just outside the walls of 
the clinic, but also even outside needing to see a physician. 
And then let us say you had a condition and you had to do a 
prior authorization, which my colleagues and I do not 
particularly enjoy doing.
    Imagine if the first layer of approval or review and then 
approval were automated and in near-real time?
    Vice Chairman Schweikert. You know, we have that piece of 
legislation. So Doctor, within that scope, you have the data of 
my wearables, my breath biopsy, whatever it may be. Do you see 
a world at least at the basic level, the AI and then the 
algorithm that's attached to it could write the scrip?
    Dr. Miller. Absolutely.
    Vice Chairman Schweikert. Okay. That was clean without a 
whole lot of struggle. Dr. Howard, this is a little bit 
different, but in--and you need to correct me, because I was 
listening to your discussion about okay, we need more people, a 
variety who are writing AI and code. But in some ways, maybe I 
have the utopian vision of it provides access for more people 
to be able to do technology.
    Most people have no idea of how to write an app, but they 
can use the app to do technical jobs. Is there some ways that 
yes, there may be this hierarchy of here is over here, my 
people writing code, doing those things. But over here, is not 
this an empowerment for almost every American to do things that 
are much more complex?
    Dr. Howard. Yeah, it is. So when I define AI literacy, it 
is not about creating computer scientists or coders. It is 
about making every citizen understand how to interact with AI 
to do their jobs better. So it is allowing doctors to basically 
talk in their phone and then transcribe it into the actual 
records that can then be shared with other doctors. So that is 
really about it.
    Vice Chairman Schweikert. Okay. That is much more elegant 
way to phrase it. Mr. Thierer, what is my GDP growth? What is 
my--I have a personal fixation on where we are demographically 
as a country. We are getting old very fast. We often do not 
want to talk about it.
    We have to be brutally honest. 100 percent of calculated 
future debt for the next 30 years, interest, health care costs 
and if a decade from now we backfill Social Security. It is 
demographics. What is your vision of AI, the growth, the labor 
substitution? Does it save us?
    Mr. Thierer. Yeah. Well, nothing can save us, but it can 
certainly make a major contribution towards the betterment of 
our government processes and potentially our debt. There has 
been various estimates, Congressman, on exactly how much AI 
could contribute to overall gross domestic product, the low end 
being somewhere like at least 1.2 percent annually, but it goes 
up from there, with one forecast for 15----
    Vice Chairman Schweikert. I beg of you to be slightly 
louder.
    Mr. Thierer. 1.2 percent annually GDP boost and 15.7 
trillion potential contribution to the global economy by 2020, 
according to another report. I have all this data in a 
supplement to my testimony. And again, the estimates vary 
widely.
    But the bottom line is almost all economists, political 
scientists and consultancies realize that this is a great, you 
know, opportunity for the United States to once again build on 
the success of our past technological, you know, success story 
of the Internet and digital economy, you know.
    We look at the data that our government has put out, the 
Bureau of Economic Analysis. I mentioned one data point in my 
testimony. $4 trillion in gross output from digital economy in 
2022. Nine million jobs, a huge amount of compensation. 18 of 
the 25 largest digital technology companies in the world by 
market capitalization are U.S.-headquartered companies. Fully 
50 percent of the largest digital technology employers in the 
world are American technology companies. That happened because 
we got policy right.
    Vice Chairman Schweikert. Thank you, Mr. Thierer. All 
right. To our true AI expert, Mr. Beyer.
    Congressman Beyer. First of all Mr. Vice Chairman, thank 
you very much for convening this, and I am very excited to be 
here. Thank you very much for coming. I am a huge AI optimist, 
especially on the health care side.
    So Dr. Miller, in fact I just got off a Zoom a couple of 
minutes ago with Dr. George Church at Harvard, who was 
explaining to me that he and his colleagues have built new 
microorganisms with DNA completely different from all the other 
DNA on the planet.
    And because of that, the viruses do not work. They are 
completely, completely immune for viruses. Within these are the 
idea of making replacement organs that will not be rejected, 
because there will be nothing to reject. They will be 
unrecognizable. Just extraordinarily exciting.
    So Dr. Miller, you talked about how agencies like ARC have 
been at the forefront, but we have seen in the past that to 
introduce the new technologies to medicine has not necessarily 
improved things. He specifically talked about the absence of 
labor productivity growth in health care. The best example I 
can think of is how EHR, electronic health records and the lack 
of interoperability.
    Veterans Affairs and DoD have been fighting for years about 
how to bring them together. How do we take--how do we 
acknowledge the 17 to 19 percent GDP on health care, like 
double the highest of any other place in the world, and use AI 
to bring down those costs and bring labor products in the deal?
    Dr. Miller. Thank you. I think a lot of this is practical, 
right? So one, one of the many things that gets in the way of 
actually us using it in a productive and proactive fashion is 
state and federal regulation. There is a role for state and 
federal regulation, but we do not want to go to town to prevent 
people from innovating at the bedside and getting it into 
practice.
    Think about a radiologist, right, reading CT scans, 
mammograms. Imagine if software automatically went through all 
the images and I pre-identified the areas of concern. That 
could massively speed up the efficiency at which that 
radiologist reads those CT scans. Instead of reading ten an 
hour, maybe they read 12 or 14.
    So if we direct payment and FTA policy to support this, for 
example, if a tech company is providing a service, why not let 
them bill, right? If they can provide that service cheaper than 
I as a physician or a nurse practitioner or a pharmacist, they 
should have the opportunity to bill for that and compete.
    And if you have that competition within a population-based 
payment system like Medicare Advantage or Medicaid Managed 
Care, you can potentially drive service delivery and innovation 
for consumers to then have a choice.
    They could have a choice of whether they want human in-
person service; they could have remote human service, maybe 
with a blue tooth exam; they could have remote service like 
audio video only; they could have automated service, right, 
from software, or they could even have a phone visit or maybe 
an email visit.
    And so if we drive policy to give consumers that choice, 
then that will improve labor productivity, because the 
consumers will choose.
    Congressman Beyer. Thank you, Dr. Miller, very much. Mr. 
Thierer, your ten principles to guide AI policy, you said 
``It's equally important that lawmakers not demand that all AI 
systems be perfectly explainable in how they operated.'' We had 
Secretary Becerra in here recently over at Ways and Means. I 
asked him about that, and he said that HHS does not have enough 
authority to see behind the curtain. But we also, every doctor 
I talk to, is worried about prior authorization decisions being 
made by AI.
    What are the limits of explainability? What can we as 
lawmakers really demand in terms of explainability?
    Mr. Thierer. Yeah, well transparency is a good principle, 
but the question about how to mandate it by law is always 
tricky. And when you get specifically into algorithmic 
explainability, the question of exactly how do you explain all 
the inner workings of a model before it gets to market, right?
    That is very difficult, and what I have articulated in the 
ten principles to the AI Task Force that I sent out were 
basically the need to, on the back end, look at how we can 
regulate the outputs or outcomes associated with algorithms, as 
opposed to trying to micromanage all the inputs and figure out 
how ``explainable'' they are, quote-unquote.
    Because I think that is a fool's errand. I do not think 
that can be done efficiently without stopping a lot of that 
innovation from happening altogether. That does not mean again 
we do not regulate; we just regulate it as we look at the 
outputs or outcomes to see did it actually work as billed, 
right? That is the most important thing. Did it actually hurt 
anyone? Is there any actually consumer harm, and then we 
address it with targeted policies.
    Congressman Beyer. Great, thanks. We do have a wonderful AI 
Foundation Model Transparency Act, bipartisan, two Dems, two 
Republicans in the House side, I think many on the Senate side, 
trying to find that right balance. But thank you for the 
principles, and Mr. Chairman, I will yield back.
    Vice Chairman Schweikert. Mr. Schmitt.
    Senator Schmitt. Thank you. Just a few comments, then I 
have a couple of questions. America's poised to enter the next 
decades of the 21st century hand in hand with the technology 
that could possibly define it: artificial intelligence.
    Decades of innovation and entrepreneurship have led to this 
point, from industry titans of NVIDIA to innovation centers 
like St. Louis' own geospatial hub. America is ahead in the AI 
race and has the resources to double down on its unique 
advantages.
    Yet America's position in AI is under constant pressure. 
China is investing billions and billions into its own AI 
industry. Some of this investment is for AI surveillance 
technology, to export their malignant surveillance state 
abroad. There is no telling what could happen if China became 
the dominant player in the 21st century. I am sure China is 
watching us; Europe is too, hoping that we bury our burgeoning 
AI industry in unnecessary regulation and lose sight of what 
got us in this position in the first place.
    The worse thing we could do in this race towards AI is 
stifle innovation by unleashing the bureaucrats and putting 
crippling regulations onto innovators. The EU has done this and 
now Europe will now most likely be watching this race from the 
sidelines.
    Yet there have been rumblings here on Capitol Hill and 
fancy summits all over the world that the U.S. should over-
regulate this industry. This would only serve to hamstring our 
innovation and give the China the keys to this amazing 
technology.
    I want to zero in on this because we--I think this is a 
common theme that we hear about as far as over-regulating, and 
I think the American way here is a--we are concerned about 
this. But I want to drill down on that a little bit, and maybe 
Mr. Thierer I will start with you.
    What do we mean by that? Like how would you define that? 
Colorado has passed some regulations that even their governor 
has questioned. I am just using that as one example. What is it 
that we should be concerned about in this framework?
    Mr. Thierer. Certainly. Thank you for the question. So 
first of all, as of noon today, there are 754 AI bills pending 
across the United States of America. 642 of those bills are at 
the state level. That does not include all the city-based 
bills.
    Probably the most important AI bill that has passed so far 
is New York City. Not New York state, New York City. And so 
there is patchworks and then there is patchworks, right? And so 
the cumbersome nature of all those compliance rules added on 
top of each other, even if well-intentioned, can be enormously 
burdensome to AI innovators and entrepreneurs. So that is just 
one thing to note.
    The other thing to note is that there has been discussions 
about the idea of like overarching new bureaucracies or, you 
know, certain types of licensing schemes. I have no problem 
with existing license schemes as applied in the narrow focused 
areas where AI might be applied, whether it is medicine, you 
know, drones, driver-less cars.
    But an overarching new licensing regime for all things AI 
is going to be incredibly burdensome. That is a European 
approach. We do not want that. And sir, let me just say 
something about your China point, because this is really 
important.
    You know, we are here on June 4th. This is the 35th 
anniversary of the Tiananmen Square Massacre. When we talk 
about like, you know, the importance of getting this right for 
America and our global competitiveness, it is important for 
exactly the reason you pointed out. Because if we do not and 
China succeeds, then they are exporting their values, their 
surveillance systems, their censorship.
    The very fact that I just uttered the term ``Tiananmen 
Square'' at this hearing means it will not--this hearing will 
not be seen in China. I apologize for that to everyone else 
here. But the bottom line means that that means what is at 
stake is geopolitical competitiveness and security and our 
values as a nation. So this is why we have to get it right.
    Senator Schmitt. So it is interesting, because when I was 
going to school the idea was that sort of the more literate a 
society became, the more educated it became, the more open it 
became, the more likely they were to become a democracy, right, 
and China was kind of always an example of maybe if there are 
fewer poor people there and they are more literate, that 
ultimately they will demand more.
    But interestingly, AI has uniquely, and very low tech AI as 
it relates to surveillance, has empowered Communist regimes, 
right? It empowers the totalitarian level of control that 30 
years ago I am not sure anybody could really foresee, and that 
is certainly what they have capitalized on to your point.
    If people think that that is a way to maintain power, which 
has been the way of the world in many places, you are right, 
you know--They become the dominant player in this. I do want to 
just shift with a little bit of the time I have left, and 
anybody please chime in on this point, but I will start with 
you, Mr. Thierer, again.
    Big tech versus little tech here. I think there is a--there 
is a concern, at least that I have, that a regulatory scheme or 
we are doing something that sort of protects the big players, 
but ultimately leaves out the innovation, again that got us to 
this point now.
    How would--how do you view this and what can we do to guard 
against that, because I do think there are some folks that want 
a more, sort of a protectionist view of the big players here, 
and they have all the answers. They are very important players, 
but not the only players. How do you guard against this 
shutting out little tech in this process?
    Mr. Thierer. Amen to that. So, let us take a look at 
Europe. I mean one of the things that I always ask my students 
or crowds that I talk to about AI policy or technology policy, 
as I say, name the leading digital technology innovator 
headquartered in the European Union today. Silence, right?
    That has everything to do with getting policy wrong, and 
what the European Union--the only thing they are exporting now 
is regulation. And basically that is all they have got left, 
and they are trying to regulate mostly large American tech 
companies.
    And so what is ironic that--is it was meant to sort of like 
keep things more in check and competitive, but there is only a 
handful of large technology companies that can comply with 
those rules and regulations. We do not want that to happen in 
the United States. We have thousands upon thousands of small 
entrepreneurial companies starting up in the AI space right 
now, and this is the hope for the future, especially open 
course technology.
    You know, right here in America that is happening on the 
ground. We have got to preserve that entrepreneurial, you know, 
freedom to innovate kind of model for the United States, so we 
do not become the innovation backwater that is the European 
Union.
    Senator Schmitt. Thank you. Thank you, Mr. Chairman.
    Vice Chairman Schweikert. Senator Klobuchar.
    Senator Klobuchar. Thank you very much. Thanks for doing 
this important hearing, and thank you to our witnesses. I come 
from a state that believes in innovation. We brought the world 
everything from the pacemaker to the post-it note, and I also 
think that we have to get ahead of this in a good way.
    We have to put guardrails in place. That is something that 
we really did not do with tech policy, and now there are all 
kinds of issues with privacy. I am not going to go into 
everything that we need to do, that I hope we can do 
differently with AI.
    I think David Brooks, a columnist, put it best when he said 
``The people in AI seem to be experiencing radically different 
brain states all at once. I found it incredibly hard to write 
about because it is literally unknowable whether this 
technology is leading us to heaven or hell.''
    We need guardrails that acknowledge that both are possible. 
So I will start with Senator Thune and I serve on the Commerce 
Committee, and we have introduced legislation that has gotten 
some positive feedback, the AI Research, Innovation and 
Accountability Act to increase transparency and accountability 
for non-defense applications, and sort of differentiating 
between some of the riskier applications like electric grids 
and then others, and directing the NIST, the Commerce 
Department to issue standards for critical impact systems.
    So I guess I will start with you, Mr. Thierer. The bill 
that I just mentioned takes a risk-based approach that 
recognizes different levels of regulation are appropriate for 
different uses of AI. Do you agree that risk-based approach to 
regulation is a good way to put in place some guardrails?
    Mr. Thierer. Yeah, absolutely. I wrote a paper about your 
bill, Senator, and I----
    Senator Klobuchar. Maybe I know that. It gets kind of a 
softball beginning.
    Mr. Thierer. Well, I love building on the NIST framework, 
right, because that exists and it was a multi-stakeholder, 
widely agreed to set of principles for AI risk management. And 
so it is really good utilize the sort of existing sort of 
regulatory infrastructure we already have, and build on that 
first.
    Senator Klobuchar. Uh-huh, very good. Do you want to add 
something Dr. Howard? I also noticed that your testimony 
emphasized the importance of AI literacy, training and we 
actually in that bill direct the Commerce Department to develop 
ways of educating consumers that this has got to be part of 
anything, including the work that Senator Heinrich, our leader 
here, as well as Senator Schumer and Senators Rounds and Young 
have done for the bigger base bill, and that we hope to be part 
of. Do you want to talk about literacy a bit?
    Dr. Howard. Yeah. I think even if you think about doing 
policy right, you have to have individuals understand that 
definition of right. If you do not understand AI and both the 
opportunities and the risks, there is no way that you can think 
about great policy.
    And so when I think about this, it is not just computer 
scientists and engineers; it is everyone that is touching any 
type of technology, to understand how to define it, understand 
data, understand parameters, understand outcomes, understand 
what the impacts are on different markets, different 
populations. So that is really important.
    Senator Klobuchar. Do you want to add anything, Dr. 
Gaudioso?
    Dr. Gaudioso. You know, I think, that there is the 
importance of the risk framework. There is also research that 
needs to be done to give us the technical underpinning, right? 
Trust is something that a human conveys, but we are still in 
the early stages of doing research to understand what makes a 
model trustworthy.
    When does it respond within the bounds of our data, what--
where is it reliable, where is it not? And so I think, you 
know, policy just needs to keep in mind where we are heading 
and what the technical basis is at any given point in time, 
because the technology to understand the trustworthiness, the 
mathematical underpinnings is something the national labs have 
researched for a long time and is moving quickly.
    Senator Klobuchar. Uh-huh, very good. One of the things 
that I am like hair on fire at the moment is just because I 
chair the Rules Committee, is the democracy piece of this, and 
I guess I will ask you. This is not the subject really. We are 
talking about innovation.
    But if our democracy is unstable because people do not know 
if it is the candidate they love or the candidate they do not 
like that is speaking, because you cannot tell, it is just 
something that we have to think about in terms of going forward 
as a nation. Something like over 15 states now have required 
bans or disclosures on deep fake ads.
    Senator Hawley and I, as well as Senator Collins and Coons 
and many others have put together a bill on actually banning 
deep fakes with exceptions for satire and the like. Senator 
Murkowski and I have the bill that we lead on disclaimers. And 
I am just really worried with federal elections, that while 
states are doing things, which is good, we do not preempt them 
on state ads, that we have to guardrail our democracy here so 
people know who they are hearing from.
    And I often get worried that some little disclaimer at the 
end, no one is going to really know. Do you want to answer 
that?
    Dr. Howard. That is true. It is just like with consent 
forms. Nobody actually reads them, and so one of the things is 
how do we provide individuals or how do we provide some 
transparency and trust on the information they are hearing, 
because we know it is very easy to manipulate individuals with 
advertisement and media.
    And so if those advertisements and media are very, very 
real or associated with a candidate that people resonate with 
or do not, that will influence them, guaranteed 100 percent.
    Senator Klobuchar. Uh-huh. And Dr. Miller, I think I am out 
of time, but I will put a question in writing to you on tech 
hubs. I know that you know a lot about this kind of--your 
testimony is on the importance of policies that promote 
development of new science and new innovation, and we have a 
lot of medical device in Minnesota and it served our country 
well.
    I just want to talk a little bit about that and tech hubs, 
and you can do it in writing, unless you want to add something 
and the Chair will let me ask you that. Is that okay? Do you 
want to add anything on that?
    Dr. Miller. Yeah. I guess one thought, I think, with tech 
hubs and also just tech innovation, is we often do not realize 
that the current status of purely human-driven care is actually 
frequently low quality and often highly unsafe.
    And so promoting innovation at universities, at small 
companies that change that and automate components of care 
delivery or assist nurses, doctors, pharmacists, whomever in 
making decisions, will actually massively raise the quality and 
safety and efficiency of care.
    I would add, I would say my greatest fear is actually that 
we do not take advantage of this opportunity, because the care 
delivery system is a mess.
    Senator Klobuchar. That is where you go to heaven or hell. 
We have got to make sure we have got it right. All right. Thank 
you very much, Dr. Miller. Thank you all.
    Chairman Heinrich. And Senator, that was a terrific 
question. It is sort of the--we sometimes have, are emotionally 
tied and sometimes the disruption of the technology makes us 
nervous. But the math is the math.
    You know, we have seen a number of papers that talk about 
some of the ability for the AI to read the data coming off my 
watch or the wearable or the glucose meter or the thing you 
blow into, and being able to analyze that data actually is 
remarkably good and statistically much more accurate, you know, 
someone that went to postgraduate school for what, nine years?
    And I feel crappy saying that, because I cannot imagine 
what your student debt is.
    Senator Klobuchar. On that note----
    Vice Chairman Schweikert. Yeah, on that note. Thank you, 
Senator. And Congressman Beyer was actually--and he and I were 
sort of channeling each other. Where I am trying to get is a 
model where AI makes traffic better, where AI helps me attach 
an air quality monitor to these things, and we crowd source our 
environmental data, where AI is--and I accept some of that 
becomes technically an algorithm underlying. It is actually 
not, you know, crawling through a stack.
    But even where Congressman Beyer was, the ability to 
revolutionize the cost and delivery and efficacy of health 
care, of--what was it, about three weeks ago, a month ago, we 
had one of the first drugs solely designed by AI, a new 
molecule that looks like it has a remarkable efficacy.
    How do I get this to move fast, because I believe cures are 
moral? And it is an interesting--is the solution an environment 
as you and I think about policy, is it taking a look at the 
outcomes and making sure those outcomes are effective and in 
some ways moral, efficient?
    Because if we do not do something fairly dramatically on 
the cost of delivering services, I mean yesterday we borrowed 
$101,000 per second over the last 366 days. It is a leap year.
    You know, if I had come to you a few years ago and said we 
are going to be over $100,000 a second in borrowing, and almost 
all the growth of borrowing is interest. Interest now will be 
number two in our spending stack, and the growth of health 
care. Am I channeling you appropriately?
    Congressman Beyer. Totally, very much so. It is terrifying 
to think that interest on the debt is greater than Medicare, 
greater than Medicaid, greater than the Defense budget. Only 
has to catch up with this discretionary non-defense.
    Chairman Heinrich. Yeah, just Social Security.
    Congressman Beyer. And Social Security.
    Chairman Heinrich. So as I come to all of you, you have the 
ginormous computers and lots of technical data that is not 
public. You have the next generation students. You have the 
policy and you have the case of how we could revolutionize 
health care. How do I deal with the fact that when he and I 
have actually had conversations of telehealth, you know, 
digital health.
    The fact of the matter is in many ways you know this 
because you sat and we talked about it. If the pandemic had not 
happened, I do not know if I would have ever gotten our 
telehealth bill a single hearing. It only moved forward--and 
because apparently grandma would not know how to work FaceTime. 
Turns out she is really good at it.
    I do not believe the next generation is talking to someone 
on the phone. I think it is reading the data off my body. How 
do I sell this story, Dr. Miller? How do we sell the morality 
of doing it better, faster, cheaper and much more accurately?
    Dr. Miller. I think it is immoral not to do that, right? So 
if we do not give patients the choice of having cheaper, more 
efficient, more accessible, more personalized care, I think 
that we would be making a massive moral error. You mentioned 
telehealth. 20 years ago if we talked about telehealth, people 
would say that we were cuckoo for Cocoa Puffs, right, because 
no one is going to call their doctor, do Skype or FaceTime, and 
now it is the standard.
    It took a global pandemic where a million Americans died, 
for us to have telehealth. So I think the answer is one, 
hopefully we do not have another global pandemic, but we do not 
want to wait until there is some catastrophic event until we 
offer automated or autonomous care, right?
    If you are a poor American with chronic disease, autonomous 
and automated care or AI-assisted care is basically the best 
thing ever, because you will get more access, you will get 
higher quality and it is going to be cheaper. So I personally 
think that we have to do it. It is not a choice.
    Chairman Heinrich. Mr. Thierer, and if you--I know you are 
going to respond to that. Does it make a difference in our 
world that, what was it three weeks ago, Apple finally got its 
next generation a watch for cardiac arrhythmias, those things, 
essentially certified as a medical device.
    Is that what you were talking about, that the next 
generation disruption is coming?
    Mr. Thierer. Yeah, absolutely. And to answer your question, 
Congressman, about how we essentially sell these benefits, we 
talk about it in terms of opportunity cost. Like what would be 
losing, it is what kind of foregone innovation will we lose if 
we do not get this right?
    Well, we can put our numbers on this. Let us talk about 
some of the biggest killers in America today. 800,000 people 
lose their lives to heart disease. 600,000 people lose their 
lives to cancers every year now. I mean how about--how about 
cars? Let us talk about public health and vehicles.
    I mean every single day there are 6,500 people injured on 
the roads in America, 100 of them die. 94 percent of those are 
attributable to human error behind the wheel. I have to believe 
that if we had more autonomy in the automobiles sector, we 
could actually make a dent, excuse the pun, in that death toll.
    Yeah, and so I mean this is where we can talk to the public 
about like the real world trade-offs that work if we get this 
wrong, right? I mean we have had a 50 year war on cancer that 
goes back to the time when Richard Nixon was in office and, you 
know, we have made some strides, but we could make a lot more 
if we had serious, robust technological change to bring to bear 
on this through the form of computation and algorithmic 
learning. I mean this is where we can make the most efforts.
    Chairman Heinrich. Mr. Vice Chairman, if I can wonder for 
just 30 seconds?
    Vice Chairman Schweikert. (off mic)
    Chairman Heinrich. Okay, well I'm just--I just wanted to 
help you stay on message. But if I can go off message for a 
minute. I wanted to respond to one of the things that Senator 
Schmitt said about licensing. My dear friend Tom Wheeler, who 
chaired the FCC, a Democrat and clearly a left to center 
Democrat, called to tell me how important it was not to use 
licensing in AI.
    That when we did that, all we were doing was essentially 
embracing anti-competitiveness, and locking in the advantage of 
the incumbents. We need to be very careful about that. Senator 
Schmitt also started with two minutes on China. I also want to 
quote Martin Wolf, who is the editor-in-chief of Financial 
Times, saying please do not give up.
    That 20 years of liberalization is too soon to tell, that 
sooner or later, the state model of Virginia is sic semper 
tyrannis, that sooner or later the Chinese people are going to 
rise up. And we need to be worried about the Chinese Communist 
Party, not the Chinese people, that they will be demanding 
freedom sooner, hopefully rather than later.
    Dr. Howard, I have two Brunonian children. So it is 
wonderful to have you here, and I really appreciate your 
service on the National AI Advisory Council. I mean you really 
set the stage for the big executive order and all that.
    And I specifically understood your emphasis on digital 
literacy. We have been looking at what Finland has done with 
the multi-hour training in digital literacy. As we struggle 
with deep fakes, which are now coming more and more, that you 
start with the notion that we need to be teaching people what 
to be suspicious of, and let their own instincts kick in.
    But how--how can we develop digital literacy in a much more 
robust way that we have done so far?
    Dr. Howard. Well, I think this is an area where you have to 
bring in academics, industry, organizations, non-profits and 
government. I think about it as very similar to cybersecurity. 
Nowadays, people actually check to make sure is this really 
spam. I'm not going to click the link.
    But I will tell you five years ago, everyone was clicking. 
And so how do you get people to be aware that this is an issue? 
Half of the Americans have no clue that, you know, there might 
be a fake. It might be manipulation. Advertisement might by via 
chatbot. I mean so what it really is is ensuring that we have 
this conglomeration of everyone thinking about how do we train 
within the organization, outside the organization, from K to 12 
to gray.
    Chairman Heinrich. David, also before yielding back to you, 
because you did not shorten my----
    Vice Chairman Schweikert. This is a conversation. We are 
doing almost a colloquy question model.
    Chairman Heinrich. Well, in a colloquy thing, I want to 
thank you for bringing together----
    Vice Chairman Schweikert. And we are actually also 
stalling, because I have another member coming.
    Chairman Heinrich. Oh okay.
    Vice Chairman Schweikert. So keep going.
    Chairman Heinrich. Thank you for getting the Joint Economic 
Committee to focus on the challenges of diabetes, and end stage 
renal disease. We had the same type hearing a few months ago, 
and we have both been worried about the cost of dialysis. It 
took Mitch Daniels, former OMB Director, etcetera, to do the 
math while we were sitting here and say 31 percent of our 
Medicare budget right now is just dialysis.
    Vice Chairman Schweikert. Think about what he just said. 31 
percent is Medicare; 33 percent is all health care. It's 
functionally diabetes.
    Chairman Heinrich. $260 billion a year, and now we have 
GLP-1 antagonist. We have solutions. Not inexpensive, but so 
far----
    Vice Chairman Schweikert. Can you help me do some things on 
the farm bill?
    Chairman Heinrich. Oh, absolutely. Everything we can. But 
this, when we look at how to deal with the $100,000 a second 
and how we make the 19-18 percent of GDP on health care trim 
down, and not just GLP-1 but many other ways that we think are 
using technology and AI and better management to manage health 
care in America.
    Vice Chairman Schweikert. Dr. Howard, just a stick in the 
back of your head and it is a slightly non-sequitur as you were 
talking about teaching people technology literacy. What is our 
only success functionally in the last decade of getting 
Americans to actually exercise?
    We have spent hundreds of billions. This is somewhat of a 
trick question, and he may--he already knows the answer. It was 
gamification. It was Pokemon Go. I know that sounds absurd, but 
if you actually look at the data, Pokemon Go did more to get 
people out chasing their little--and we have often had this 
running discussion.
    What would happen if that type of technology, saying here 
is how I train you how to understand how to work ChatGPT. The 
gamification of even down to health care and maintaining--if 
drug adherence is 16 percent of all U.S. health care, when I 
forget to take my statin, when I do not do those things.
    How do I make it so my pill bottle cap beeps at me and 
those sorts of things. There are solutions that are genuinely 
ahead of us, and we are actually struggling, saying is there a 
unified theory of the ability to use this technology disruption 
when I call the IRS? The person I am talking to is actually 
ChatGPT.
    But it stays on the phone with me, and it helps me fill out 
my forms and then maybe texts me the form I need, instead of 
someone who has been dealing with crazy for seven hours and 
does not really want to be on the phone with me. That is 
actually going on right now and so far the early data of the 
IRS experiment of using a chatbot has been apparently early 
good.
    That is human, so if it be from the curers to the education 
to the, you know, miracles of producing new materials. We are 
trying-- help us sort of build the argument that, you know, 
many of us are not that bright, but we get to sit here and read 
things that smart people write for us.
    But how do we create a unified theory of let the technology 
run, because God forbid, none of us truly know what it is going 
to look like a few years from now. I mean am I being fair?
    Congressman Beyer. Mr. Chairman, will you yield for 
questions?
    Chairman Heinrich. I thought you were going to tell us it 
was a pickle ball, rather than----
    Vice Chairman Schweikert. You know I do not like you 
anymore. I tried one pickle ball and my eight year-old beat me. 
I mean----
    Mr. Thierer. Could I just wholeheartedly endorse what Dr. 
Howard had to say about digital literacy, AI literacy, because 
this is really important. First of all, Representative 
Rochester has a really nice bill on digital AI literacy that I 
think we should take a look at. It is really good stuff.
    And when we talk about this, you know, AI literacy/digital 
literacy, we are talking about, you know, learning for life. 
You know, no matter what kind of punches come out, if we can 
roll with those punches and figure out how to adapt when we 
know more about the technology.
    It is about building resiliency, societal and individual 
resiliency. And you know, people sometimes laugh at this. I was 
on a--I was a co-chair of an Obama administration Online Safety 
and Security Task Force, where like the only thing anybody in 
the room could agree on was the importance of digital etiquette 
and literacy.
    So there is a lot of agreement on this. This a good place 
to start. It is a good foundation for building that resiliency. 
And some people will say well, that is not enough. Okay fine. 
We will find other remedies. But it can go a long way.
    You know, I am old enough to remember the problems we had 
in this country with littering and forest fires back in the 
60's and 70's, and I remember well, I am sure some of you up 
there too as well, that you know ``give a hoot, don't 
pollute.'' We addressed that, right? We went after Woodsy, you 
know, Woodsy the Owl and things like that, with Smokey the Bear 
and forest fires.
    We made a huge difference just with societal education 
about the problems of littering and forest fires, right?
    That was not a law that passed. That was actual societal 
learning. It was wrong to throw things out the window of your 
car, right?
    So you apply that mentality to the world of like digital 
and AI policy, and we talk about again, AI etiquette, 
netiquette if you will, like proper behavior. Using algorithmic 
services and technologies, using LLMs, using, you know, these 
systems.
    Vice Chairman Schweikert. I want to go, and actually I also 
want to Mr. Beyer to come into this. And you know, you teach 
students. You already have--you have to deal with lots of 
freaky, smart people. Most of them bathe, I assume, because it 
is actually really funny if you know some of your scientists.
    How do I deal with my brothers and sisters here who are not 
Don Beyer, who are almost fearful of technology? I mean you 
know, what do we do to take away--I mean I swear they instantly 
think of a Terminator movie. I mean what do you do--I mean in 
health care.
    I cannot tell you the--and I'm forgive my elegance in my 
language, the crap I take when I basically say the same things 
you have at forums of here's my health care cost, here's things 
we could do to disrupt it using technology.
    And I will get administrators and this and that to come and 
say ``well, we can't do that. It might be against our state 
law.''
    Dr. Miller. Technology allows us to operate at a higher 
level. I have a terrible sense of direction, right? So I use 
Google Maps and Uber and Lyft to get places. I do not pick up a 
rotary phone and call my friends to ask for directions and 
write them down on a note pad, right?
    Vice Chairman Schweikert. Is that after you look it up in 
the phone book?
    Dr. Miller. Right, yeah. I do not even have a--do not even 
have a phone book in the house anymore, and you know my iPhone 
organizes my calendar and email and tells me where to go and 
what to do, because I am a little absent-minded. And that is 
the standard. Like that is the standard of my day.
    And I think if we make that an analogy over to health care, 
where right now we have the rotary phone and we actually 
single-handedly keep the fax machine lobby employed, we have an 
opportunity to totally transform that, so that the clinical 
example is like if your blood pressure is really low and you 
have septic shock and you are going to the ICU and you are 
getting pressers, have to stick some big IV in your neck, 30 
years ago if they did that they would just look at, you know, 
the topical landmarks and put the IV in and hope that, you 
know, they didn't hit your carotid artery, which would be bad.
    Now, you use ultrasound. You do ultrasound guided. You have 
a little probe and you take a look and if you try to do it the 
other way, the nurse would run screaming into the room, telling 
you that you are about to be negligent and doing something bad.
    And the answer here is that technology will allow us to do 
a safer, more effective job. It will become the standard and at 
some point to actually not use technology will be negligent.
    Vice Chairman Schweikert. You get the last.
    Congressman Beyer. Well first of all, on your comment on 
gamification, I wanted to show you, David, that I'm on Day 641 
on Duo Lingo.
    Vice Chairman Schweikert. I am so proud of you.
    Congressman Beyer. And that is only because of gamification 
and----
    Vice Chairman Schweikert. But it makes my point----
    Congressman Beyer. And it will ring at 11:30 at night if I 
forgot to do it.
    Chairman Heinrich. So that is what I want from pill bottle 
caps when you do not take your statin.
    Congressman Beyer. And Dr. Gaudioso, I was very impressed 
with all of your testimony, but especially the notion that 
scientific machine learning, Sandia's fusing machine learning 
with scientific principles to solve scientific and engineering 
problems.
    For me, that is maybe the most exciting part of AI. Not 
ChatGPT-4, 5 or 6 or 7, but the notion that everything from 
fusion energy to how our biology works, etcetera, etcetera, 
that you can use machine learning, the predictive parts of AI 
to figure things out. Can you expand on that as a scientist?
    Dr. Gaudioso. I would love to. Thank you for the question. 
You know, I think--to me, this is--this is the really exciting 
potential, right? I mean ChatGPT has shown us how it can change 
our daily interactions and, you know, I was able to put my 
written testimony into our internal chat engine and ask it if 
it was, you know, helping me make it a little less technical 
and more general, and it was great for providing me with a 
first draft and editing.
    But that is just been trained on the corpus of knowledge 
that is in the Internet. I think what I get really excited 
about is the transformative potential of training models on 
science data, so that I have my chemist intern with me that can 
help me discover new science properties, that can then help me 
think through the physics in thermal and mechanical stresses to 
design a part that can be manufactured today, right?
    We can just go from a new material to something that can be 
in our hands and usable, and transform not just how we do 
medicine and how we interact with patients, but how we make 
things in the country. And so AI has the potential if we do it 
and we can train it with science, so that these concepts of 
hallucination and statistically guessing what the next answer 
should be based on what it has learned, we can constrain that 
with physics and chemistry and science data.
    We can then do new manufacturing. We can make digital twins 
of the human body to take to drug discovery from decades down 
to months, maybe 100 days for the next vaccine.
    Vice Chairman Schweikert. Beyer, anything to follow-up.
    Congressman Beyer. No, but I am so glad that you are doing 
that and I--one of the things we do not talk about much is as 
somebody who ran a small business for many, many years, the 
notion that one of the most important technologies is 
management.
    We do not tend to think of it that way, but the way we 
can--the way we can explore the use of artificial intelligence, 
to make much better and management decisions much better. Once 
again to the issue of making our world much more efficient, 
dealing with the $100,000 per second that we borrow.
    Vice Chairman Schweikert. And if we are lucky we will 
replace members of Congress with something intelligent. Never 
mind.
    Congressman Beyer. Or raise our pay.
    Vice Chairman Schweikert. And they have called votes for us 
on the House side.
    Congressman Beyer. Oh no. Can I ask one more question?
    Vice Chairman Schweikert. Will it be short?
    Congressman Beyer. Yeah, yeah.
    Vice Chairman Schweikert. You sure?
    Congressman Beyer. I am positive.
    Vice Chairman Schweikert. Okay.
    Congressman Beyer. Dr. Howard, you started Zyrobotics, and 
you also made, what does it say, STEM tools and learning games 
for children with diverse learning needs.
    Dr. Howard. Yes.
    Congressman Beyer. I would love--you know, the chair of our 
AI Task Force, Jay Obernolte, Dr. Obernolte, machine learning, 
master's from Cal Tech, so sort of a smart guy, and he made his 
fortune in video games. I would love to get your insight into 
how we use gaming to help educate people, on not just 
artificial intelligence but on everything else in the science 
world?
    Dr. Howard. Well with Zyrobotics, I could get five year-
olds to learn how to code through gamification. And so--and it 
really is, is how do you provide small nuggets based on 
someone's knowledge, engaging with them, and bringing them 
along, scaffold them along til at the end they are like oh, I 
am actually putting code together to do simple things for a 
five year-old. I think that could be done with adults as well.
    Congressman Beyer. Yeah, I would love to work with you. I 
have a couple of ideas which we could go offline with. But 
David, thank you so much, Mr. Chairman.
    Vice Chairman Schweikert. And he knows that is actually one 
of my fixations. So you are--there is a reason I like you. 
Thank you for engaging in this hearing with us. You be 
prepared. You have--we are going to--for three days we may ask 
you questions.
    I am going to ask also to do something a little bit 
different for the public record. If you have articles that you 
think would be appropriate for us to try to absorb, in reality 
we are going to make our staff read it and then give us the 
highlighted copy, please send it our direction. And with that 
we are off the boats. This hearing is adjourned.
    [Whereupon at 3:40 p.m., the hearing was adjourned.]
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