The paper begins with an overview of the legal, institutional, and public policy bases of the U.S. patent granting system and subsequently examines major deficiencies acknowledged in the existing U.S. patent system. The paper then catalogs the essence of four patent reform proposals of the Federal Trade Commission, the National Research Council, and academic economists (Jaffe/Lerner and Maskus), all of which focus on ameliorating alleged major weaknesses in the U.S. patent system. The paper concludes with an analysis of the above cited patent reform proposals, arguing for a proposed set of workable policy recommendations (reflecting recent changes in public policy) focused on patent cost controls, patent quality, patent uncertainty, and patent reform legislation, all designed to contribute to a globally competitive 21st century patent policy for the U.S. economy.