It is often assumed by most military and civilians, that flag-ranking officers and their families, enjoy priveleged health care, both accession and quality of care. As an experienced physician in charge of a major command's Executive Health Program, the author's experience is far from that perceived and ssumed. In fact, quite the opposite prevails. Although there are "Executive Wellness" and "Health" programs in existence in the USAF, there is clear lack of doctrine and awareness of such programs. The result is a less-than optimal health care delivery to flag-ranking officers and their families. In some instances, inferior to that provided to the lowest ranking individual in the service. The paper will go on to explore the origin of executive health care, case studies highlighting major medical errors commited with analyses that follow, a broad look at world-class executive establishments, and finally, a proposed executive establishments, and finally, a proposed executive health care system for the 21st century.