The government of the United States today is deeply involved in activities that have significant scientific and technical (S&T) components that are vitally important for economic productivity and technological competitiveness, national security, an improved environment, better health, and many other purposes. Leadership of the government’s role in S&T is exercised by fewer than 100 positions, most of them presidentially appointed and Senate confirmed. Yet, there is considerable evidence of increasing difficulty in filling and keeping filled these seemingly prestigious positions. This book by a distinguished panel composed mostly of former presidential appointees delves into the reasons these federal S&T-related positions are vacant, identifies the serious consequences, and recommends a series of changes to reduce the hurdles and disincentives posed by the appointment and confirmation process and to make the positions more attractive to top candidates.