Your misunderstanding appears to be some confusion between stoichiometry and equilibrium concentrations. The chemical equation describes the stoichiometry or the ratio of the species in the reaction. In other words, each time the reaction happens, the equation describes how many of each reactant are consumed and how many are produced. In your example:
$$\ce{HCO3- + H2O <=> H2CO3 + OH-}$$
Each time this reaction occurs in the forward direction, one bicarbonate anion and one water molecule react to form one carbonic acid molecule and one hydroxide anion. In the reverse direction, one carbonic acid molecule and one hydroxide anion react to form one bicarbonate anion and one water molecule.
Since this reaction is reversible, the equilibrium constant tells you something about the extent of the reaction. In other words, what portion of the overall system is sitting on the reactant side and what portion sis sitting on the product side. Put another way, the system is at equilibrium when the rates of the forward and reverse reactions are equal. These rates are dependent on the concentrations of the species on the reactant and product sides of the equation and on rate constants.
$$\mathrm{rate_{forward}=rate_{reverse}}\\
k_\mathrm{f}[\ce{HCO3-}][\ce{H2O}]=k_\mathrm{r}[\ce{H2CO3}][\ce{OH-}]$$
The equilibrium constant is the ratio of the rate constants:
$$K=\frac{k_\mathrm{r}}{k_\mathrm{f}}=\frac{[\ce{H2CO3}][\ce{OH-}]}{[\ce{HCO3-}][\ce{H2O}]}$$
The equilibrium constant is thus a law of mass action expression for the situation where the forward and reverse rates are equal. At this state, both forward and reverse reactions are occurring following the stoichiometric ratios, but the concentrations of each species has reached a steady state.