In this Ninth Annual Lundberg Institute Lecture, Kenneth Kizer will provide an overview of the state of health care quality in the United States after taking a historical look at improvement strategies over the past 4,000 years. He will especially focus on the forces and strategies driving health care quality improvement in the past 20 years following several landmark events in the late 1990s. Despite these efforts, receiving high-quality health care remains illusory for many Americans. As the co-chair of the National Quality Task Force, he will then discuss the likely strategies to normalize high-quality health care over the next 10 years.