We are living in an odd span of time—caught between the past and the future. On one hand, the Supreme Court has ruled that PPACA is constitutional, and health care reform is proceeding full speed ahead. Yet it seems it will take a miracle for many states to be in compliance by 2014 when state-operated exchanges will be mandated.

At the same time, an important election looms. If voted into office, Republican candidates have vowed to use their power to change what the highest court in the land did not. Regardless, it is a time of transformation. And it presents a window of opportunity.

I'm reminded of a series of events that vividly capture the possibilities created by change. Last year, I called Domino's to order pizza. When my call was answered, before I uttered a word, the person on the other end of the phone knew my name, address and exactly what our family typically requests.