By Tine Hansen-Turton.   A recent Pew Research Center report on the nation’s mood concluded that two-thirds of the public is dissatisfied with the way things are going in the country. With consumer confidence plunging, the jobless rate rising, millions of people uninsured or under insured and the American economy faltering in a way most of us have never seen before, there appears to be little hope of good economic news anytime soon.

 A look back in history, though, tells us that hard times can produce innovation and invention.

We’re not talking about those businesses that thrive in tough times or entrepreneurs with products that sell when the economy is down. We’re talking about basic ideas that can improve the way we live. This past fall President Obama said, “It is time to tap into the spirit of innovation that has always succeeded in moving America forward.” He’s right. The spirit of innovation is what we are about as a people, and it will always prevail. We are a people and country with the creativity to solve complex issues. And our courage to adopt good ideas is what will get America back on its feet.

Now, the best ideas are those that are good for the average person. In health care, most people want accessible, affordable, and quality care. However, 70 percent of us report that we cannot see our doctor on the same day we feel sick, and over 30 percent of us don’t have a regular doctor in the first place. Yet 90% of our basic primary health care needs can be met by a nurse practitioner who functions similarly to a doctor.

In recent years, a series of so-called “disruptive innovations,” a term coined by Harvard professor Clayton Christensen, in the health care sector have capitalized on nurse practitioners and their ability to provide high-quality primary and preventive care in convenient care clinics located in retail settings such as pharmacies, big box stores and supermarket chains – and in community settings, such as nurse-managed health centers. Research has documented that both retail-based clinics and nurse-managed health clinics provide safe, accessible and affordable care to millions of Americans. In these settings, nurse practitioners already touch millions of people each year. What this tells us is that millions of Americans are not waiting for Congress to solve the health care problem. Instead, they have voted with their feet and are changing the rules on their own.

For healthcare reform to be successful, we need to embrace these disruptive innovations. Similarly in education, parents and children are not waiting around for government to fix the education system. Instead, millions of them are flocking to alternative schools that are able to adapt to the changing needs of the students who now live in a competitive global economy.

When our education systems do not adapt and there are no alternative options, our students are voicing their own opinion by choosing not to participate at all. Many of our urban districts are experiencing drop-out rates above 50%. More and more students and their families are flocking to any available public or private option that meets their needs, academically and financially. We know how to educate our students for the 21st Century and have documented successes across the country. For education reform to be successful, our public education districts need to demonstrate the ability to adapt, and our higher education institutions need to train educators to be student-centric.

If our systems cannot adapt, then the best hope will be the expansion of the alternative options. We have all heard the adage, “necessity is the mother of invention.” With the challenges we face as a society today, whether it be health care or education, the time for invention is now.

The best ideas are grounded in solving our basic challenges. And when we focus on those everyday challenges, our spirit of American innovation truly prevails.

This post, which appeared first in the Philadelphia Social Innovations Journal, a web-based journal that highlights regional innovators – www.philasocialinnovations.org, was co-written by Tine Hansen-Turton and Nick Torres.

Healthcare (insurance) reform has passed in the Senate and final negotiations are happening before it moves on to the President’s desk for signature. While the legislation is not perfect – in fact some would say far from perfect – it is a piece of legislation that is very much in keeping with our American philosophy, our constant pursuit of progress and change.

As the late Senator Kennedy’s career on Capitol Hill demonstrated, change is usually incremental, usually negotiated and usually compromised. But at the end of the day, change usually amounts to progress.

I see tremendous progress, too, as I look back on a decade’s worth of work to promote access to affordable quality health care using nurse practitioners in the role as primary care providers, thereby alleviating the burden on a strained primary care system.

We’ve come a long way regionally and nationally. The fact that we as a country are always striving to improve our path is what most invigorates me as a relatively new American. Our pursuit of progress is never ending, but it is what sets us apart from most countries in the world. We know our work is never done. As we enter a new year and decade, we always should remember that what makes us different from most people and countries in the world is that we have the freedom to purse progress and make change.

This health insurance reform bill is not the end all or be all, but it will help make affordable health insurance available to more than 30 million Americans who have been without it. Furthermore, the legislation contains many provisions for others who fall through the cracks and will need additional care and support.

That’s progress for individuals, families and America, as Walt Disney would have said. And not until you take a ride on the Magic Kingdom’s The Wheel of Progress will you truly appreciate how important it can be to take even a small step in the right direction.

Happy New Year! And a toast to a New Decade and our new Pursuits of Progress for individuals, families, and our country.

In the face of acute primary care physician shortages and steady reductions in the number of physicians who are willing to accept Medicaid and Medicare, it is unclear whether our existing primary care system will be able to meet the needs of a universally-insured nation, as President Obama has expressed as a priority for his Administration.

Health care delivery is strained under tremendous pressure from the demands of chronic health issues, downward trends in third party payments, and while insurance coverage will address some of these issues, many of these problems may persist even if universal insurance coverage is achieved in the United States. So what else needs to happen to make healthcare reform a success?

In recent years, a series of “disruptive innovations” in the health care sector have capitalized on non-physician providers, such as nurse practitioners, and their ability to provide high-quality primary and preventive care in retail-based settings such as Convenient Care Clinics (also known as retail-based clinics) and in community-settings, such as Nurse-Managed Health Centers. Research in Health Affairs and other peer-reviewed journals has documented that retail based clinics and Nurse-Managed Health Centers provide safe, accessible, affordable care to millions of Americans without threatening continuity of care. Nurse practitioners practicing in these independent settings already touch millions of people annually. Thanks to regulatory reforms that have taken place over decades, including those led by governors in Pennsylvania and Massachusetts, nurse practitioners are legally authorized to prescribe medications and provide care that is a comparable in scope to that of a primary care physician in all 50 states.

Consumers gravitate to both models because they are accessible, affordable, provide quality care but most importantly, they are convenient in their locations, hours and ease of use. For healthcare reform to be successful, we need to embrace these disruptive innovations. We also need to maximize the amazing, high-quality provider workforce we educate in our finest academic institutions across the country. Nurse practitioners and other non-physician providers (such as physician assistants, pharmacists, and psychologists) are eager to partner with their physician colleagues to expand access to care for all Americans and make the Administration’s healthcare reform effort the success it needs to be!