It is with more than a little trepidation that I even embark on this column about health care reform, knowing that whatever I write today could be obsolete by, oh, let's say tomorrow, shall we? And, because publishing cycles are what they are, it will be weeks before you're actually reading this.

So, let's focus on the things that are unlikely to be any different today than they will be next week, next month or next year.

There may be some who feel that our system is fine just the way it is, thank you very much, and doesn't need any fixing. However, I think most would agree that some measure of reform is needed, even though there's much disagreement on just how much.

The problem

Our system is fragmented, inefficient and wasteful.

We spend 16% of our GDP on health care, by far the most of any of the 30 member countries in the Organization for Economic Cooperation and Development, and yet have 46 million people with no health insurance.

Life expectancy is increasing, but not by as much as in other developed countries. We lag behind many countries that spend far less on health care than we do on many key medical benchmarks.

But, for all of its flaws, our largely employer-based system has its merits, and all of the stakeholders in it - employers, their employees and their advisers - need to be attuned to the opportunities it affords them.

The stakes

Because of the huge financial investment they have in providing health care for their employees, large employers have a significant vested interest in improving the results of our health care system.

Initiatives like Leapfrog and Bridges to Excellence have been designed to improve the quality of health care and the efficiency of the health care system. These programs are the result of cooperative efforts by many large employers, but anyone using the health care system will benefit from their improvements.

Indeed, some employers might want to get out of the business of providing health care coverage, but many others would much prefer to decide for themselves how their health care dollars are being spent, rather than give them to someone else - in the form of taxes - and let others decide what benefits to provide employees.

In a 2009 Mercer survey on recession and health reform, only 16% of employers said they favored a single-payer arrangement.

Benefits are a major competitive advantage in the fight to attract and retain talent. Advisers will always have a role with their clients in helping them structure and deliver competitive benefit packages, with or without health insurance.

The consequences

The health care debate has served to heighten awareness of wellness issues. The 2009 Mercer National Survey of Employer-Sponsored Health Plans shows that large employers have stepped up their efforts here.

Creating programs designed to improve employees' health can not only reduce costs, but also create a stronger employer-employee bond that can lead to a more committed, productive workforce.

There are as many ways to offer wellness programs as there are employers to offer them. But the compliance landscape around wellness programs can be complex. Advisers can be an invaluable resource to their clients in helping them design and implement these important programs.

Health care reform may not be what anyone imagined it to be.

But, the challenges still remain and smart advisers will seek out the numerous opportunities that exist for them to help their clients have a positive impact in contributing to a solution.