What do London and New York have in common? The English language, world-class museums, other good things, and a hospital infection problem. The difference is that in London, infection rates are posted conspicuously at hospital entrances and in newspapers. In New York, the public is kept in the dark.

New York and some 20 other states require hospitals to report infections that are serious enough to cause permanent disability or death, but the requirement is seldom enforced and, worse still, states go along with the hospital industry’s demands to keep infection reports secret. If you need knee surgery or a bypass, or other hospital care, you should be able to choose a hospital with a low infection rate. Good luck trying to get that information.

It’s an outrage. Secrecy is allowing the infection problem to fester. Every year, more than 2 million hospital patients in America contract infections, and nearly 100,000 die from them. The death toll is higher than from AIDS, breast cancer, or auto accidents.

Many infections are preventable. The single most important factor is the failure of doctors and other caregivers to clean their hands in between treating patients, according to the federal Centers for Disease Control and Prevention. Research shows doctors clean their hands only 48% of the time.

Improvements in hand hygiene, cleaning of equipment in between patients, insertion and removal of intravenous catheters, and presurgical procedures can substantially lower infection rates. Latter Day Saints Hospital in Salt Lake City, Mercy Hospital in Oklahoma City, and hospitals in the Pittsburgh Regional Healthcare Initiative are proving it. No scientific breakthrough, no miracle cure, is needed. Yet the infection rate in America has persisted at the same level for more than 30 years. Why? Because most hospitals have not made fighting infection a high priority, and the public has not demanded it.

One of the deadliest infections is methicillinresistant staphylococcus aureus, or MRSA, because most antibiotics do not cure it. Some patients who contract it are forced to spend months in the hospital and endure repeated surgeries to cut out infected tissue. This is tragic because MRSA can be almost eradicated. Hospitals in Holland and Denmark have done it recently by insisting on hand hygiene, decontaminating equipment such as beds and wheelchairs in between patients, prohibiting nurses from wearing jewelry, and isolating patients who carry the germ to prevent transmission to other patients – precautions people assume are taken everywhere. In addition, in Denmark and Holland, nonemergency patients are tested for MRSA before coming into the hospital, and those who test positive are treated to eliminate the bacteria – a process that keeps new germs out of the hospital. Broomfield Hospital in England, which adopted similar procedures, lowered its infection rate by 67% and totally eliminated MRSA in its orthopedic wing.

Very few American hospitals take these precautions. The result? A frightening 57% of hospital staph infections in America are antibiotic resistant – up from 2% in 1974 – and the problem is increasing: Denmark and Holland have brought that figure down below 1%.

On July 8, the Infectious Diseases Society of America called on Congress to provide incentives for companies to develop new drugs against antibiotic-resistant infections. That’s the wrong tactic. It merely perpetuates a race between scientists and constantly morphing germs – a race we may not always win. Strict hygiene will curb the spread of infection, no matter how germs evolve. Hospitals are dirtier places now than 50 years ago, when doctors and nurses learned hygiene and practiced it rigorously. It’s time to make hygiene a central part of health care again.

Can we afford it? We can’t afford not to do it. A serious bloodstream infection adds, on average, $57,000 to the cost of treating a patient in intensive care. An infection after surgery more than doubles the cost of care. Hospitals in New York City alone spent hundreds of millions of dollars in one year treating one type of infection, staphylococcus aureus, according to a study by the healthcare researchers Lewin IV. The nation as a whole spends an estimated $20 billion a year extra on health-care because of hospital infections. That’s enough to fund two thirds of the annual cost of the Medicare drug benefit.

Who pays? We all do. Employers who foot the bill for workers’ health-care pay. Insurers pay. Taxpayers who fund Medicare, Medicaid, and other government health programs pay.

Infection prevention saves money. Shadyside Hospital in Pittsburgh spent $114,320 extra treating 12 patients because they became infected with MRSA. Then the hospital instituted rigorous infection-prevention procedures similar to those in Holland and Denmark. The result: no new MRSA infections in the next five months. The cost of prevention during that period: $9,984. Numerous similar studies prove infection prevention is cost-effective, but hospital administrators still claim they can’t afford it.

They also insist on secrecy, arguing that publicizing comparisons of hospitals’ infection rates would be unfair to hospitals treating AIDS, cancer, and organ transplant patients who succumb to infection quickly. Fair enough, but reports can be risk-adjusted to reflect these differences. What is unfair is keeping the public uninformed. Hospital won’t improve until their customers insist on it. To do that, we need hospital infection report cards. Secrecy will help hospitals save face, but it will not save lives or money.

Ms. McCaughey, the former lieutenant governor of New York and currently chairman of the Committee to Reduce Infection Deaths, is a health expert at the Hudson Institute.