With the latest figures from the Congressional Budget Office (CBO) pointing toward a largely limited public option, some national commentators are wondering what the big fuss about the public option was about. The truth is that having the public option as part of the health care reform serves two purposes. One purpose is practical, based on the idea of providing competition against private insurers. The other is ideological, the hope that a public option, much like Medicare and Medicaid, will eventually lead us to a nationalized healthcare system.

Political change is almost always a slow-moving process. It happens in small steps over large periods of time. While I many other Democrats hoped for a single-payer system to be a part of the discussion of health care reform, realistically it wasn’t going to happen. This isn’t because a single-payer system is a bad option for health care reform. In fact, it was probably a great option that should have been seriously considered. No, a single-payer system wasn’t realistic because it is very different than the current system we have, and it’s hard to convince the American public to embrace large-scale reform.

As the most powerful and wealthiest nation in the world, admitting that things in other countries sometimes work better than our own can be hard. That is something that we must come to grips with first if we are to really overhaul our healthcare system. Rising premiums, dropped coverage from insurance companies and thousands of people dying from no health insurance every year. These are the stakes today. What else needs to go wrong before we seriously consider overhauling our healthcare system?

I think it is now time to focus on passing this healthcare reform while public opinion is still strongly in favor of democratic health care proposals. The public option has been compromised over enough that its time to figure out who among the moderate democrats and republicans will support its passage. If these “moderates” can’t even get behind a health care reform bill that figures to reduce the deficit in the long term and provide some real change to health care reform in our nation, then they were never really interested in working on health care reform.

It’s time for the final push for health care reform. Hopefully the democratic leaders on the hill can create a good compromise between the House and Senate health care bills. Ideally this bill would create a strong public option that provides meaningful competition for private insurance companies and helps to slow the rising premiums faced by families today. This bill would also serve as a stepping stone for more reforms later in time if it can be as successful as its proponents hope it will be.

If this legislation becomes too weak or ineffective because of compromises that democratic leaders have made, it will probably be a while before we have a meaningful discussion about health care reform again. The most important thing is to make this current legislation the best it can possibly be so that future legislation can build on it. Americans want a good piece of legislation. A bill that makes neither liberals nor conservatives happy isn’t very likely to accomplish that objective.