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Use a microplane or the smallest sides of a box grater to grate the ginger. If you don't have a microplane or box grater, the ginger can be minced instead. Measure out 1 teaspoon of ginger and set aside.
Heat a large tall-wall skillet or wide-bottomed pot over medium heat. Add the butter. Once melted, add the onion. Saute until golden.
Stir in the tomato paste and ginger, sauteing until the ginger is golden. Stir in the sage, thyme, salt, pepper, and orzo and toast for about a minute, stirring frequently.
Add the vegetable broth (or water and vegetable bouillon) and pumpkin puree. Stir well. Bring to a rapid simmer over medium-high to high heat. Once simmering, reduce to a gentle simmer over medium-low to low heat.
Cover with a lid and cook for 10-12 minutes, removing the lid every 3-4 minutes to stir the orzo.
When the orzo is cooked through, remove the lid and stir in balsamic vinegar, then ¼ cup of half and half. Add Parmesan cheese and additional half and half, if desired. Taste for seasonings and enjoy!