Diagnosis for the future: more North Carolina companies want health coverage crafted to give employees incentives to make better choices.

• Position: HEALTH CARE ROUND TABLE - Interview

Health-care reform remains confusing, with many of its provisions still unwritten. But one thing is clear. Employers and insurers want the plans that arise out of it to give incentives to the people covered to stay healthier. That was the consensus of a group of health-care experts at a recent round table on the health-care industry and its impact on the economy. Participating were William K, Atkinson, CEO of Raleigh-based Wake Med Health & Hospitals in Raleigh; Greg Griggs, executive vice president of the North Carolina Academy of Family Physicians in Raleigh; Edward H. Stall Jr., principal at Dixon Hughes PLLC accounting firm; Sam. Taylor, president of North Carolina Biosciences Organization (NCBIO) in Research Triangle Park; and Brad Wilson, CEO of Chapel Hill-based Blue Cross and Blue Shield of North Carolina. BUSINESS North Carolina publisher Ben Kinney moderated the discussion, held at Raleigh-based Capstrat and sponsored by Dixon Hughes and Blue Cross. Following is a transcript, edited for brevity and clarity.

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What's the economic impact of the health-care industry in the state?

Taylor: The life-sciences, manufacturing and service-provider diagnostic-testing companies represented by NCBIO contribute about $45 billion a year in economic output. Total employment is about 57,000. Indirect employment is about 180,000 at more than 500 companies. They contribute about $1.4 billion in annual state and local taxes.

Wilson: Think about it in its broadest terms. We have faculty and staff at universities and community colleges who directly train practitioners. Think about the medical practices that essentially are small businesses. Scale that up to an organization such as the one that Bill Atkinson leads. Then you think about the allied industries. Think about Blue Cross and Blue Shield of North Carolina and our at least 12 competitors in the state. We employ slightly fewer than 4,500 and are a $5 billion company. It's a pretty big deal to the economy.

Griggs: Every new family physician in North Carolina generates almost $1 million in economic development. We have 2,700 family doctors in the state. The average practice has three or four administrative and nursing staff jobs for every doctor. That's a lot of jobs.

Atkinson: Just after World War II, the state looked at the growth of health care, especially in the rural areas, and a conscientious effort was made to increase the availability of physicians and hospitals and nurses. In this down economy, the number of persons employed in health care is still growing.

Stall: Health care goes through all sizes and shapes and flavors of our communities, but usually is the number one, two, or three employer. Then you have to add the real estate and the medical office buildings to house that.

Atkinson: Then there's the research work at Research Triangle Park, Charlotte and across the state. There's even work at places that you don't traditionally think about as health care such as the School of Public Health at UNC Chapel Hill.

Taylor: Not only are we generating direct economic impact, we're improving quality of life. That's critically important to productivity. If you're adding another day of productive work to a factory floor or another productive day at a research or government institution, you're really adding to the economy.

Wilson: All of us who care about North Carolina need to think about medical tourism as an economic-development opportunity. We need to decide that North Carolina wants to be the destination rather than the exporter. We need to figure out how to put our wonderful facilities, highly trained physicians, innovation...