A lot of the hospitals were surprised to learn how many of their patients had died because they often don't follow up. They didn't know.

I would certainly want to grill them, to ask if results in 2003 are being repeated today.

This is not a flip of the coin.

The whole idea is to get to the point where we can issue a reliable broad-based report on care.

Hospitals are institutions, bureaucracies that don't change quickly, though some of them are capable of doing that.