We've compromised way too much on health-care reform. It's time to get this thing done.

And here's a news flash: We're not going to get a perfect reform bill. Neither the House nor the Senate seems willing to clamp down hard on costs. The abortion restrictions in the House bill simply make me sick. And Representative Eric Massa's right, of course: What we really need is a single-payer, universal plan.

We're not going to get single-payer, though. The question is, can we get a bill that moves us in the right direction? If Congress passes a bill with a strong public option, we'll be much better off than we are now. It will bring the competition that the current system lacks. It will move us toward true universal coverage. And it has the potential to rein in costs.

It just mystifies me when reform opponents insist that most Americans are happy with the current health-care system. A recent study by the Commonwealth Fund estimated that 55 million Americans had no health insurance at some point during the past year and that 25 million more don't have enough insurance to cover them if they're hit with huge medical bills. "Seventy-two million adults under age 65," said the study, "have problems paying medical bills or are paying off accumulated medical debt; about 60 percent of these adults were insured at the time the expenses were incurred."

If you work for a small business, you pay an average of 18 percent more for comparable health insurance than big-business employees do, says Commonwealth.

In a special kind of hell: people who have to buy individual insurance because their employer doesn't offer it or they're out of work. Nearly three-quarters of those who tried within the past three years didn't get coverage, says the Commonwealth study. "They could not find the coverage they needed, could not afford the coverage they needed, or were turned down or charged a higher price because of a preexisting condition."

And because Medicaid pays health-care providers less than private insurance companies do, says the Commonwealth study, "fewer providers accept Medicaid patients, so low-income people have less choice and less access."

Also hurt by the current system: Elderly Medicare recipients, who spend "an average of 22 percent of their incomes on premiums and out-of-pocket health care costs," says the study. And that figure "is expected to grow to 30 percent by 2025."

Everybody's happy with the current system? How about the cancer patients whose insurance companies have canceled their policies? And workers who changed jobs and can't get new insurance because of pre-existing conditions. And laid-off workers who lost their insurance with their jobs. And the families of the millions (45 million, according to a recent Harvard study) who have died because they didn't have access to adequate care.

Unquestionably, controlling costs is crucial, and that won't be easy. People live longer, so more people are using health care. Medical advances help us live longer, more productive lives, but they cost money.

My hunch is that while we can save a good bit of money through health-care reform, it won't be as much as we hope. No matter what the reform, health-care costs in the US may continue to grow. We'll have to raise taxes, then, to pay for those costs. But if we don't pass reform, costs will escalate anyway, and we'll have many more people uninsured and under-insured.

And can we talk about priorities? The Bush administration pushed us into a senseless war that continues to cost us billions, but instead of raising taxes to pay for the war, Bush cut them. And now we're talking about escalating our commitment in Afghanistan.

"Doesn't it seem odd," the Times' Nicholas Kristof asked last week, "to hear hawks say that health reform is fiscally irresponsible, while in the next breath they cheer a larger deployment of troops in Afghanistan?"