ms. mcgiffert? >> i do think the va is a good example, for example, a number of years ago they started screening incoming patients for mr sa, antibiotic resistance, a bug that people might carry on their skin. so they are mrsa infections have gone significantly down. the va put out a directive saying we're going to do this all over the country. in the private sector we cannot do that. we cannot, the only way to do it is through medicare. medicare is the big dog. they make things happen. and so i would say one of the most important things that can happen is medicare, keep pushing of public reporting, keep pushing on these incentive payments. and i do think there probably are ways they can standardize and coordinate them a little better. but this needs to keep going and i think you're going to hear from a lot of hospitals who say, stop this. but from the consumer perspective, we want to see accountability for these kinds of events, and payment incentives are one way to do it. >> dr. pronovost, getting