of these tools also have the advantage of directing cooperation to occur in
ways that are driven by top-down goals, purposefully and deliberately, rather
than opportunistically. Two different examples will illustrate some of the
institutional design options available on this issue.
One potential procedural mechanism draws heavily from a proposal first
advanced by Professors Arti Rai & Stuart Benjamin, who suggest the creation
of an innovation regulator within the executive branch.111 They consider the
advantages (and disadvantages) of centralizing an innovation office and
housing it within the Executive Branch, arguing quite rightly that the
decentralization we observe at present is a significant problem from an
innovation perspective.112 Interestingly, in keeping with my arguments
regarding transparency above, Rai & Benjamin would create a regulator with
both “an obligation and an incentive to operate transparently.”113 This
proposal is especially well-suited to innovation in mobile health, where
potential innovation concerns span multiple independent agencies.114
Creating a central innovation office within the White House or even within
an existing White House Office, such as the Office of Science and
Technology Policy, would be a particularly timely act. Over the past few
years, President Obama invested in a series of biomedical research initiatives
which all bring together different administrative agencies for innovation
purposes.115 The BRAIN Initiative, the Precision Medicine Initiative, and the
Cancer Moonshot are all centrally driven programs.116 Congress signaled its
111. Id. at 6.
112. Id. at 57.
113. Id. at 78.
114. Sachs, supra note 91. Concerning subagencies within HHS—such as CMS, FDA,
and NIH—I have elsewhere suggested that creating a separate officer within HHS may be
prudent. This proposal may strike a middle-ground between complete centralization and
complete decentralization, allowing the officer to develop deeper, more personal connections
with the material than would housing them within the executive branch, while at the same time
minimizing some of the difficulties of decentralization. Benjamin & Rai, supra note 88, at
56–58. Alternatively, creating individual subject matter officers within a more centralized
executive branch office may functionally replicate these concerns.
115. Fact Sheet: BRAIN Initiative, THE WHITE HOUSE OFF. OF PRESS SEC’Y (Apr. 2,
initiative [hereinafter Brain Initiative]; Fact Sheet: Vice President Biden Delivers Cancer
Moonshot Report, Announces Public and Private Sector Actions to Advance Cancer Moonshot
Goals, THE WHITE HOUSE OFF. OF VP. (Oct. 17, 2016), https://obamawhitehouse.archives.gov/
[hereinafter Vice President Biden Delivers Cancer Moonshot Report].
116. See The Precision Medicine Initiative, THE WHITE HOUSE (2015),
https://obamawhitehouse.archives.gov/precision-medicine (last visited Jan. 30, 2017); BRAIN
Initiative, supra note 115; Vice President Biden Delivers Cancer Moonshot Report, supra note