If you're looking for a terse, tidy directive of what precisely your company should do to prepare for the health insurance changes coming down the pike with the Affordable Care Act, you aren't likely to find it.

There isn't a one-size-fits-all answer as to what to do when some of the major provisions in Obamacare—a once-derogatory term the President himself now embraces—kick in just over a year from now. As M+O Benefits principal Mark Patrick put it, we didn't get into this mess with simplicity; we aren't about to get out of it simply.

Moloney+O'Neill and the Journal of Business put on health care forum two weeks ago at the Davenport Hotel. Slightly less than 200 people filled the Marie Antoinette Room to hear Washington state Insurance Commissioner Michael Kreidler, Providence Health Care Chief Executive Michael Wilson, UnitedHealthcare Vice President Joy Higa, and Patrick talk about the looming changes.

To no one's surprise, the Affordable Care Act is complex, has moving parts, and includes language for which clarification is still pending. In simplest terms, every individual must have health insurance starting in 2014, and employers will have to look closely at whether to offer a health plan or drop it, making employees go to a state-run insurance exchange that is far along in its development.

The financial consequences go beyond those associated with the cost of a health plan. There are penalties that will be assessed to some employers for not offering plans. Then a few years down the road, there are penalties for offering plans that are too extravagant.

Individuals will have pay-or-play options as well. Generally, they'll be weighing whether the cost and benefit of a plan is worth more than the penalty charged for not having one.

For some businesses, the best option for employees in 2014 might be dramatically different from the best option for employees today.

Conventional wisdom would say offering health insurance is more beneficial to employees than not providing a plan. However, Patrick points out, employees making minimum wage or a little more than minimum wage might be better off going to the state exchange and taking advantage of available, heavy government subsidies.

Clearly, this is something that will take more study than an annual health-plan review and renewal.

For the most part, the speakers left politics out of the discussion, which is no easy feat. Kreidler, a Democrat, champions the changes as written and predicts the law will gain favor with the general public during the next five years. Others seemed more lukewarm about some of the particulars of the bill.

Regardless, all seemed to agree that the health system, while competent in providing quality care, has severe flaws. Those who can't afford care and don't have insurance sit in hospital emergency rooms until they receive the care they need. Emergency rooms are far more expensive than urgent care or doctor visits, yet they are the most accessible to the uninsured.

And those who have insurance end up picking up the tab. Providence's Wilson says patients with private insurance pay slightly more than 140 percent of the cost of care, and the primary reason is to make up for the Medicare, Medicaid, and uninsured patients whose payments don't cover the cost.

This dynamic alone suggests there's room for measurable improvement in care delivery, and it's only one part of the overall problem.

Overall, costs have increased at a rate that's three times the growth of the consumer price index, and it's done so for at least a decade, according to Patrick. Something needed to be done to "bend the curve" and slow the increases in cost.

But how the present solution affects each of us could vary dramatically.