Compromises on a health care reform appear to be creating a bill that is far short of what is needed, but one that has a real chance of being enacted.

For those opposed, this creates no dilemma. But for those who are convinced that U.S. health care is in dire need of reform, it raises a difficult question: Whether to embrace a reform bill that appears insufficient.

Improved prospects for a health care reform bill are reflected in polls that show the public evenly split on the subject. And from the Congressional Budget Office, more good news ”“ the health care reform envisioned by the Senate Finance Committee can be accomplished without any red ink.

After a close look at the numbers, the Congressional Budget Office estimated the 10-year cost of the bill at $829 billion. Expected savings and new tax revenue exceed that figure, and the CBO projects a reduction in the deficit by $81 billion over 10 years.

The Senate bill wouldn’t bring universal coverage, though. About 94 percent of Americans would be covered, the CBO estimates, compared to 83 percent today.

In the spirit of compromise, the Finance Committee dropped plans for a public option to compete with for-profit insurance plans. The bill relies almost entirely on the profit motive, offering subsidies to induce insurers to write policies for those with low and moderate incomes.

But insurers would no longer be allowed to deny coverage based on pre-existing conditions, or discriminate with high rates based on age or gender. The plan would set up a new insurance marketplace where consumers could compare plans’ costs and benefits.

The Finance Committee plan anticipates savings by eliminating private insurance plans from Medicare, and it calls for taxes on employer subsidies for high-cost health insurance plans. A tax on insurers and others in the health care industry is also under consideration. And by 2013, all Americans would be required to get health insurance or pay a penalty.

As unsatisfying as it may be, the Finance Committee bill appears to be a good opportunity to address unfairness, inequity and inefficiency in the American health care system. Supporting it does not mean giving up on goals for a better plan.

 — Questions? Comments? Contact Kristen Schulze Muszynski or Nick Cowenhoven at 282-1535 or kristenm@journaltribune.com or nickc@journaltribune.com.