Two realities were evident during Wednesday’s town-hall gathering on health-care reform at Everett Memorial Stadium, hosted by U.S. Rep. Rick Larsen:

1. Partisanship, the I-can-yell-louder-than-you-can variety, is alive and well in Snohomish County. On both sides.

2. There are thoughtful people who want positive changes made to our health-care system, but who are honestly wary of too much government involvement, and how that might add to an already ballooning national debt.

Democrats who wrote the bills currently in the congressional pipeline may have thought they’d headed off the latter concern by shelving the idea of a single-payer system — one that would essentially expand Medicare, which currently covers those 65 and older, to cover everyone.

Now it’s the “public option” — a government-sponsored insurance plan that would compete with private insurance, ostensibly to drive down costs by guaranteeing consumers an affordable choice — that has become the target of healthy skepticism. Despite assurances that such a program would be sustained by premiums alone and not tax dollars, reasonable doubts persist. For if a public insurance plan ever did start receiving government subsidies, it really could drive private insurers out of business, leaving consumers with fewer choices.

And, quite likely, the nation with more debt.

This is why so many eyes are fixed on the Senate Finance Committee’s bipartisan negotiations, which could produce an alternative bill after Congress reconvenes next month. The negotiators — three Democrats and three Republicans — reportedly are considering nonprofit, member-owned insurance cooperatives rather than a government-run plan. Such a setup could ensure enough competition to keep costs down and encourage innovation, especially in markets where little or no real competition currently exists. If it didn’t do enough, a government-run option could still be considered down the road.

Rep. Larsen, who used a deft combination of patience, assertiveness, reason and humor to keep Wednesday’s discussion mostly on track, took pains to remind the crowd that while the health-care status quo is unacceptable, the solutions are works in progress.

Fully effective reform will be achieved incrementally, not in any one bill or in any one year. This year, Congress must seize the opportunity to make a good start. Democrats, who control Congress and the White House, should do so without overreaching, which risks achieving little or nothing.

An initial reform bill that has at least some Republican support will open the door to more progress, as Americans begin to see a system that’s more humane, cost-effective and stable. We’re confident those goals can be achieved, a few steps at a time.