Home remedies: while North Carolina's health care industry awaits potential changes to the Affordable Care Act, it is empowering businesses and their workers to cut costs.

• Position: HEALTH CARE ROUND TABLE

LAWMAKERS, PROVIDERS AND PATIENTS HAVE COME TO THE SAME DIAGNOSIS: The nation's health care system is in an unsustainable condition. Improving it will require changing the Affordable Care Act, deploying technology and emphasizing wellness across the board. Business North Carolina magazine and Lynchburg, Va.-based James A. Scott & Son Inc.'s Scott Benefit Services recently assembled a panel of experts to discuss the status of health care in North Carolina and changes that would make it better.

The discussion was moderated by Ben Kinney, Business North Carolina publisher. Support was provided by Blue Cross and Blue Shield of North Carolina, East Carolina University, Morganton-based Carolinas HealthCare System Blue Ridge, and Scott Benefit Services, which hosted the round table at its Greensboro office. The transcript was edited for brevity and clarity.

THE RECENTLY PROPOSED AFFORDABLE CARE ACT REPLACEMENT WAS SCUTTLED BEFORE ITS VOTE. WHAT CHALLENGES HAS THE ACA CREATED, AND HOW COULD IT BE IMPROVED?

WILLOGUHBY-RAY We're in Round 2 of health care reform, and my clients know the drill--wait and see. While they have less anxiety and trepidation this time around, they're still dealing with uncertainty and instability. That slows risk taking and entrepreneurship. I recently visited a client who is a large furniture manufacturer. Its human-resources department spent two weeks preparing Internal Revenue Service health-insurance reports, which were necessitated by ACA. That's a lot of lost productivity, and it would cost more to have a third-party vendor handle them. Situations that include risk and reward produce better outcomes. Health care costs are dramatically different in Texas, for example, than in North Carolina. So it makes sense to give states the opportunity to innovate on a local level. My clients are frustrated that coverage receives the most attention. There are many livelihoods tied to the health care industry, so misinformation is preventing an honest conversation about actual solutions. No matter what happens to ACA down the pike. North Carolina will continue to have great health care. Its great minds and vibrant and diversified industry will hit a double or triple off whatever curveball Washington throws. I'd rather be living here than anywhere.

DELIA Businesses--including providers, health systems and doctors--want certainty so they can plan and invest. But the health care industry is in the middle of large changes, some driven by the ACA and others by the industry's evolution. They're told to hold off and plan while the world marches forward. Their businesses are being affected by decisions not of their making.

EDWARDS Coverage is the challenge. Waiting to see what's going to happen could become a disadvantage for a health system or clinician. Some people won't invest time to learn a new physician payment model, for example, because they claim ACA will be repealed. That's wrong: Not everything is tied to ACA. We're encouraging members to move...