Except in a few instances, since World War II no American soldier or sailor has been attacked by enemy air power. Conversely, no enemy soldier orsailor has acted in combat without being attacked or at least threatened by American air power. Aviators have brought the air weapon to bear against enemies while denying them the same prerogative. This is the legacy of the U.S. AirForce, purchased at great cost in both human and material resources.More often than not, aerial pioneers had to fight technological ignorance, bureaucratic opposition, public apathy, and disagreement over purpose.Every step in the evolution of air power led into new and untrodden territory, driven by humanitarian impulses; by the search for higher, faster, and farther flight; or by the conviction that the air way was the best way. Warriors have always coveted the high ground. If technology permitted them to reach it, men, women andan air force held and exploited it-from Thomas Selfridge, first among so many who gave that "last full measure of devotion"; to Women's Airforce Service Pilot Ann Baumgartner, who broke social barriers to become the first Americanwoman to pilot a jet; to Benjamin Davis, who broke racial barriers to become the first African American to command a flying group; to Chuck Yeager, a one-time non-commissioned flight officer who was the first to exceed the speed of sound; to John Levitow, who earned the Medal of Honor by throwing himself over a live flare to save his gunship crew; to John Warden, who began a revolution in air power thought and strategy that was put to spectacular use in the Gulf War.Industrialization has brought total war and air power has brought the means to overfly an enemy's defenses and attack its sources of power directly. Americans have perceived air power from the start as a more efficient means of waging war and as a symbol of the nation's commitment to technology to master challenges, minimize casualties, and defeat adversaries.

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.