You know those signs in gift shops, "You break, You pay?" Medicare has adopted that philosophy in refusing to pay hospitals for "never events"—things that just shouldn't happen to patients. Now the agency has proposed adding to its list.

Last year Medicare announced it would not pay for certain medical errors and conditions acquired in hospitals. Starting October 1, several private insurers followed suit. Now Medicare wants to add nine more avoidable conditions and complications, if acquired in the hospital. The goal, which we like, is to put some financial teeth in efforts to improve care of patients, including infection control. Hospitals should not be dangerous to our health.

According to the AP, the new list includes deep vein thrombosis, or a blood clot within the vascular system, which occurred in 140,010 cases for the fiscal year ending September 30, ventilator-associated pneumonia, which occurred in 30,867 cases, bloodstream infections with the staph aureus bacteria, 27,737 cases, and Legionnaire's disease, which occurred in 351 cases.

The focus on hospital-acquired infection has been slowly building since the Institute of Medicine in 1999 concluded that medical errors, including hospital-acquired conditions, caused up to 98,000 deaths annually. Congress in 2006 gave the Centers for Medicare and Medicaid Services the ability to deny payment for extra treatment costs arising from preventable conditions during a hospital stay.

Hospitals now have to report on 30 measures designed to assess quality of care. Medicare is proposing to add 43 new measures to the list. Payment increases are linked to quality reports, and the information is also shared with consumers on the Medicare web site. So maybe the slogan should be updated— "You Break, You Pay. We Tell."