Since the dawn of the atomic age, the United States and every other nation that has chosen to use nuclear power have created hazardous substances that have the capacity to outlast human civilization, and possibly even the human species, and the potential to devastate the environment. The management of these substances that make up what has been termed high-level radioactive waste (HLRW) has presented a set of technical and socio-political challenges that are matched by few other science and technology policy issues. High-level radioactive waste consists of spent fuel from civilian and military reactors, as well as transuranic waste which comes primarily from the fabrication of nuclear weapons. U.S. policy for the management of HLRW has focused on long-term (permanent) containment which still has many technical and policy issues to overcome. This focus has been to the detriment of medium-term containment--in fact, existing U.S. law explicitly prohibits the federal government from developing an interim (e.g., medium-term) repository for HLRW before a permanent disposal facility is operational. Medium-term containment presents technical and policy challenges that are inherently much easier to address than permanent disposal. In this article, the author argues that without a coherent national policy for medium-term containment, the U.S. HLRW management system is compromised, and the risks to human health and the environment are made higher than they need be.