The compromise announced last week among the Baldacci administration, health insurers and hospitals was a tentative bit of good news in what will be a long process of negotiation and compromise to find a solution to the rising cost of health care. Even with the announcement of an agreement, however, the deal is not done and will not be done, not this year and not even when the first phases of it go into place next year.

That’s because passing health care legislation is not like choosing the state bird or renaming a highway. It never is finished because conditions change, programs thought worthwhile turn out to be stinkers, new information and experiences arrive to direct policy. The Dirigo health plan from the Baldacci administration should be seen in this light – as a reaction to the changed conditions of intolerably high costs, inefficient delivery of care, a hodgepodge of public and private health care funding streams and a large number of people with no insurance.

The intensity of the attacks on his plan and the tactics used to frighten Mainers into opposing it during the last few weeks are evidence of how pleased a minority of people are to see the status quo of high cost and limited access continue. Nevertheless, the current direction of health care cannot continue: The health care cost burden is needlessly high in Maine, it is higher than most other places and it is rising faster here than in most other states.

All sides in the debate say they want to control costs and extend access, but the debate comes down to Dirigo’s details, and the 4 percent assessment that would be charged to insurers to finance the uninsured is a good example of where the agreement can fall apart. As first drafted, Dirigo prevented insurance companies from passing the assessment onto premium payers because insuring those previously without insurance would save the companies the costs of bad debt and charity care.

Under the new agreement insurance companies can, as a last resort, pass this fee on to the insured. The extent to which the bottom lines of large insurance companies are protected compared with those of Maine’s small businesses, which may have to pay this fee, is a measure both of the effectiveness of lobbyists and a lack of data to combat them. The second reason, at least, will fade with time.

The state’s commitment to universal access and restraining costs remain the most important goals of Dirigo Health and reaching them will take many attempts over several years. That means advocates for affordable health care should not be discouraged by the recent compromises; there will be opportunity for negotiation and renegotiation for years to come.