Angela Braly, CEO of the largest health insurance provider in the country in Indianapolis-based WellPoint, wanted to make two things clear during her Economic Club of Indiana speech today. At some point, the debate that is taking place in Washington and around the country has shifted from health care reform to health insurance reform — and it needs to shift back. Braly, in her remarks before a sellout crowd, said:

• Inefficiencies in health care are driving up costs at an unsustainable rate
• Current incentives are wrong in the traditional Medicare system with payment for quantity instead of quality — and she fears the same cost shifting that takes place now would occur in a public option plan
• "We won’t solve the problem by only focusing on the insurance side of the equation."

Braly notes that Massachusetts has made progress in reducing the number of uninsured in its state, but that system costs have increased from $630 million in 2007 to an estimated $1.3 billion this year. The lesson for the federal level, she adds, is that coverage and costs must be tackled together.

An important topic that has been lost in the shuffle, Braly says, is malpractice reform. The fears of legal action "prevent more disclosure and communication about what might have went wrong. There are tests that are probably unnecessary and diagnostic tools used excessively because of the fears of medical malpractice." The arguments, however, have "fallen on deaf ears" on Capitol Hill.

The WellPoint leader opened her remarks by stating she is an advocate for reform, that all people should have insurance coverage and that insurers should offer coverage to all, including those with pre-existing conditions. But to make all of that possible, that shift in focus must take place. In answering questions, she defended her company’s 4.1% profit margin, said that WellPoint and the industry were prepared to continue to innovate and closed with her thoughts on one action item if she were leading the way in Congress.

"Focus on what is driving costs and how we can affect that. There are great discussions happening, but it doesn’t always make it to the bill." Earlier, she had ended her prepared remarks by saying about reform: "It won’t be easy, and it should not be quick."

Braly’s speech is available here and on the Economic Club of Indiana site. John Stossel of ABC News’ "20/20" is up next on October 6.