Raleigh, N.C. — Business people inside and outside the health care industry continue to debate health care reform as Congress prepares to hammer out a final list of changes to the nation's health care system.

"Often times, what we do in government is we do a better job of reacting to a crisis than we do of planning ahead and preparing. To a great degree, health care reform is a reaction to crisis," North Carolina Secretary of Health and Human Services Lanier Cansler said Monday.

Cansler was among several participants in a round-table discussion that preceded the annual economic forecast event sponsored by the North Carolina Bankers Association and the North Carolina Chamber.

Some participants quickly expressed concern about the 2,000 pages of proposed legislation before Congress.

"There are a lot of unanswered questions that will come from this first piece of legislation, and I think there are some very strong unintended consequences to the business community and to employers that could come from it," said Billie Redmond, a member of WakeMed's board of directors.

Jack Bailey, a senior vice president of drug maker GlaxoSmithKline, said there's not enough emphasis on wellness and disease prevention in the reform effort.

"Obesity tripled in the last 25 years. There aren't strong enough prevention actions in this bill," Bailey said.

Panelists agreed that health care costs need to be contained or cut.

"Where's the incentive to do the best work, not necessarily more work, and to stop doing piecemeal work that we do? I think the opportunity for cost-containment has to come from improvement in the way health care is delivered," Redmond said.

Dr. William Roper, dean of the University of North Carolina School of Medicine and chief executive of the UNC Health Care System, said rationing of health care services might be one answer. He acknowledged that that would be a tough sell.

"Are we ready ever to have health care in America that is a communal activity with limits placed that allow us to make better use of dollars so that we can care for everybody? I'm a little worried about that," Roper said.

Despite doubts over the final reform package that will be presented to President Obama, Dr. Victor Dzau, president and chief executive of the Duke University Health System, said he likes what he sees so far.

"I'm optimistic, and I do believe that by introducing the changes we see today – not blowing up the system – we'll be able to have the first step toward the right direction," Dzau said.