While the health care debate is focused on how and who should be a recipient of health care insurance, it does nothing to the further the conversation on how to get people better. While an insurance conversation is a necessary conversation, it certainly shifts the focus away from health care. The focus on health insurance shifts the focus from away from what patients are getting better. It also removes the focus from and also what is happening internally with clinics, doctors, pharmacists and which therapies are covered. This may be the real heart of the issue, not entirely insurance and insurance carriers, but what is considered an effective treatment not by insurance companies, but doctors. Current systems do not cover diet and lifestyle medical interventions, which the research says is not only our most effective option, but also our most cost effective option. Currently we have a system where an insurance company can tell the doctor what they consider to be medically necessary and therefor what insurance reimburses. Consider the short comings of this approach. This means that someone with no medical training, who has never even spoken to the patient is making a decision about what is necessary for them. In addition to that, an insurance company can define certain testing and therapies to be the only things are covered, and other testing that may be part of the individualization of care for that patient will be excluded by insurance. Insurance companies even bonus doctors and pharmacists for using more medications, and they are actually penalize for getting people off medications and helping them to put conditions in remission. If there is no metric for patient outcome, then of course evaluation is missing the most basic question. A system of medicine that isn’t based on wellness is of course going to cost more, and deliver less. The focus should be on the patient first and what they and their doctor decide is the best course of action for them. The patient should dictate their care, not an insurance policy.