It often seems that the most innovative programs develop out of the most hopeless seeming situations. The world of migrant health is full of examples of individuals who see a great need and then employ creative thinking and action to right a wrong. In a world where we too often run up against an intractable bureaucracy, these examples of creative problem solving are a breath of fresh air. Some of the most inspired thinking in migrant health comes out of the 22 Migrant Voucher Programs that exist nationwide. All of the voucher programs coordinate, facilitate, and provide access to primary health care for farmworkers by purchasing, rather than providing directly, some or all of the primary care services required. In many ways these voucher programs are one of the best models for public-private partnerships found in primary care for the underserved. As Susan Bauer, Executive Director for Community Health Partnerships of Illinois says, “When vouchers come to town, private providers become partners in our health systems and we gain extree into the wider community of support for migrants”. As economic times get more difficult, imagination in health care is even more important to reach out to the hardest to treat among us. You can find out more about these programs here [2].