Bahy-Dole Act and DoD Federal Acquisition Regs. are the answer to your question about "who gets access to these patents" and should be the focus of reform if you find them inadequate. Outside my area of the law, but my understanding is prior to Bahy-Dole, it was common for the Gov. to take title to patents arising from Gov. funded research, and that this was seen as a disincentive to commercializing the technology. So Bahy-Dole adjusted the balance, with certain lesser rights (like march in rights and a license) going to the government to try to drive more commercialization of the technology that was invented under Gov. contracts.