VISION, OF COURSE, IS AN IDLE EXERCISE WITHOUT ACTION. One of my heroes, Eleanor Roosevelt, cautioned: “The things you refuse to meet today always come back to you later on, usually under circumstances which make the decision twice as difficult as it originally was.”(18) So, we are acting now, strategically investing to raise the quality of the country’s health care by (1) inspiring revolutionary and innovative approaches to health care excellence, (2) supporting a matrix of high-impact, systems-changing portfolios, and (3) turning what works into models for others to follow.

How our programs and grantees perform two jobs is what ultimately will determine how well we meet our goals:

• Job One is to reduce continually the affliction of illness, the suffering from injury and the burden of disability experienced by patients, their families, friends, co-workers and neighbors.
• Job Two is to improve continually the health status and function of all our people, no matter who they are or how much they make or where they live.

Tough jobs? Yes. Worth tackling? Absolutely. Attainable? They’re already being done. Programs we sponsor across the country right now are achieving strong, transforming outcomes, making us increasingly—and realistically—optimistic that the system can indeed become more patient-centered and knowledge-based, with leaders who are willing and able to spearhead wide-scale transforming change. Their results are verifiable and are making a positive difference not only in patient care but in systemic effectiveness and efficiency. For example: