For Halloween, I was thinking of going out as the public option, but I didn’t want to scare conservatives that much.

I tried to come up with a bipartisan or independent costume, but it turned out to be a hideous blend of Senators Bernie Sanders, Olympia Snowe and Joe Lieberman. (The jowls scared the kids.)

So I decided to stay home and read “Sick: The Untold Story of America’s Health Care Crisis and the People Who Pay the Price.” That cheered me up.

Naturally, I was curious to hear what the author, Jonathan Cohn, had to say when he spoke at Brown University on Nov. 10. Cohn, a senior editor for the New Republic magazine, began by asking the audience how many people had been following the health-care debate closely. Most had.

He asked how many people would describe themselves as “left of center.” Most people raised their hands. “Shocking,” he said. “Those of you who said ‘left of center’ keep your hands up. How many of you are really excited and enthusiastic about the way health-care reform is turning out?”

Most people put their hands down. “Yeah, that’s what I thought,” he said. “Well, I know how you feel.”

Cohn noted that the House of Representatives narrowly approved an overhaul of the nation’s health-care system on Nov. 7. “We’ve never done that before,” he said. “Never, in the nearly 100 years that we have been working on health-care reform, has a full health-care reform bill passed a house of Congress. It’s an amazing accomplishment.”

But, he said, “This is not necessarily everything we talked about, everything we wanted.”

For one thing, the bill would not provide “universal” health care because it wouldn’t cover everyone, he said. The number of uninsured Americans is projected to reach between 50 million and 60 million by 2019, and the House bill would cover about 36 million of those people, he said. So the bill would do nothing to help one-third of the uninsured.

Also, the House bill would leave some of those who do have coverage with large out-of-pocket expenses, Cohn said. When combined with the premiums they’d pay, “you’ll find there are people who are going to be paying 20 percent of their income on health care, which is a lot of money,” he said.

But isn’t the bill going to achieve other goals for improving the health-care system and curtailing costs? “Are we going to shrink our spending down to close to what they spend in other countries? Are we going to ring out these inefficiencies?” Cohn asked. “As they like to say in the Hertz commercials, ‘Not exactly.’ ”

The legislation would slow health-care spending, but not by a lot, he said. And if you got the top 10 experts to agree on the top 10 changes that need to be made, you’d find that some of those goals are not in the bill and others are pursued “in a halfway fashion,” he said.

Cohn said the presidential election produced a lot of talk about changing the way things are done in Washington, yet a few months ago President Obama appeared with leaders of the insurance and drug industries, saying they were working together. “In the weeks that ensued, we learned that working together meant cutting some deals — some very favorable deals, at least from the standpoint of the industry.”

For example, the drug industry talked about the sacrifices it would make as part of the health-care overhaul, but a new industry forecast projects that “annual growth for the next five years will be 3 percent higher than it would otherwise be because of health-care reform,” Cohn said. “So, far from making a sacrifice, the drug industry is actually making a killing.”

Cohn said other countries — such as France, the Netherlands, Japan and Taiwan — have excellent health-care systems, but we are not going to end up with those types of systems. “We are not going to tear anything down,” he said. “Instead, we are going to build on the system we have here, which is a complicated mess.”

He noted that Dr. Marcia Angell, a former editor in chief of the New England Journal of Medicine, wrote a Nov. 8 article for The Huffington Post, saying, “Is the House bill better than nothing? I don’t think so.”

Cohn said, “If Marcia Angell could get her way and have a single-payer system tomorrow, I’d be right there behind her.” But since that’s not going to happen, Cohn said he thinks about what the bill would have meant for the people he wrote about in his book.

Cohn thinks of the Rotzler family from upstate New York. After Gary Rotzler lost his job in the defense industry, the family found a way to get by but lacked health insurance when his wife, Betsy, started experiencing the first signs of what turned out to be breast cancer. She might have died anyway, but if she’d had insurance there’s a good chance she would have had more time with her children, she wouldn’t have experienced so much pain for so long, and the family wouldn’t have had to declare bankruptcy because of medical bills.

Cohn thinks of Janice Ramsey, who ran a real-estate company in Florida. She was diagnosed with diabetes soon after switching insurance companies, and that company promptly dumped her. She spent months trying to buy insurance before falling victim to a scam by a company that wasn’t licensed in Florida. Like thousands of other victims, she wound up on the hook for thousands of dollars in medical bills.

For Ramsey and the Rotzlers, the House bill would have meant a lot, Cohn said.

“Say what you will about the bills going through Congress right now,” he said, “they will put an end to the exclusion of insurance for preexisting conditions.”

The bill would “put an end on Day 1 to the practice of rescission, which is the yanking away of insurance like happened in Janice Ramsey’s case,” he said. “So right off the top of the bat, you have transformed the insurance market for people who are presently locked out of it or worry about getting locked out of it.”

Cohn said the legislation would end lifetime caps on medical coverage.

And the House bill would launch some pilot programs. “They don’t go as far as they should,” Cohn said. “I don’t see why we need to go slowly on paying more for drugs that work well and less for drugs that work less well. But moving in that direction will make a difference. There is a reason that the [Congressional Budget Office] believes that both the bills in the House and the Senate now will actually lower expenditures for federal programs and, we think, the health-care system as a whole. They are not optimistic they’ll make a huge difference, but they’ll make a difference.”

The bill also would provide subsidies, Cohn said. “They will come in the form of some kind of tax credit or some form of assistance,” he said. “These subsidies are not as big as they should be. I think that particularly when you get to some parts of the income spectrum, there are people left on the hook for some pretty big expenses.”

Still, Cohn emphasized, the projections show the House bill would provide insurance for 36 million more people. “Now think about it,” he said. “When was the last time in this country where overnight — or in this case, over five years — we were able to say we are going to make life better for 36 million people, just like that? That’s a pretty good deal.”

The bottom line is the House bill is better than nothing. In Halloween terms, the health-care system might remain a Frankenstein monster. But as Cohn points out, the bill contains some things we can be grateful for as we approach Thanksgiving.

efitzpat@projo.com