In traditional Chinese medicine, a key maxim is "Zhi Bing Yao Zhi Gen," which literally means, "To cure a disease one must cure the underlying cause." The author was reminded of this principle when she reflects on K-12 math education reform when the US. President Bush's 2006 State of the Union Address prompted yet another wave of debate on actions the government should take to improve math and science education to sustain U.S. economic competitiveness internationally. What has not been brought to the forefront, however, is that cultural beliefs about mathematics and how it should be taught will profoundly influence how reform efforts, such as new curricula or teaching methods, will work themselves out in practice. Drawing from her experiences in China, the author hopes that her observations can help highlight key issues identified in the mathematics reform literature and provide a lens for examining how mathematics instruction functions in the U.S. and China. The author also provides several suggestions for reforming and improving K-12 math education in the U.S.