Undertaking a new and aggressive push to enact health reform this year, President Barack Obama bluntly challenged Republican critics on Thursday to put forward their own plan to expand coverage to the uninsured and help struggling families afford care.
"To those who criticize our efforts, I ask them, `What's the alternative?'" Obama said at a town hall-style meeting, surrounded by supportive citizens in the heartland.
"What else do we say to all those families who spend more on health care than on housing or on food? What do we tell those businesses that are choosing between closing their doors and letting their workers go?"
A dispute over Obama's desire to create a new government-sponsored health plan to compete with private insurers is forming a major obstacle to bipartisan consensus on a sweeping overhaul of the nation's health care system. So the president is stepping up his personal efforts, a key part of which is selling his ideas directly to Americans, in hopes they will pressure lawmakers directly and create momentum through a groundswell of public support.
He described his critics as naysayers.
"I know there are some who believe that reform is too expensive, but I can assure you that doing nothing will cost us far more in the coming years," Obama said. "Our deficits will be higher. Our premiums will go up. Our wages will be lower, our jobs will be fewer, and our businesses will suffer."
The president's warnings come as reservations have been expressed by health care providers, Congress — led by Obama's fellow Democrats — and the public. The brief ride from the airport to the high school where he spoke featured a rare sight for the new president: a large gathering of protesters.
Signs held among the several hundred demonstrators lining his route said "NObama" and "No to Socialism."
Back in Washington, Republicans assailed any inclusion of a public insurance option in a new system of expanded health care.
"We see that as a slippery slope to having the government run everything," Sen. Mike Enzi, R-Wy., said at a news conference.
But Obama, answering a question, said no one — "certainly not me" — is interested in a nationalized health care system, like that in Great Britain. The president said the government is not going to force any change upon people who are pleased with the plan they already have with their employer.
"When you hear people saying socialized medicine, understand, I don't know anybody in Washington who is proposing that," he said.
For his goal of reshaping the nation's health care system to bring down costs and extend coverage to 50 million uninsured Americans — an overhaul that has vexed Washington for decades — Obama has set an August deadline.
"This next 6-8 weeks is going to be critical," he said, asking the audience to lobby Congress to get it done. If the country puts off health care reform, he said, "it's never going to happen."
Senators of both parties agree on many big issues, including getting all Americans covered and prohibiting insurance industry practices that deny coverage to people with health problems. But there remain major disagreements over how to pay for the $1.5 trillion it will cost over the next decade to cover uninsured Americans, whether to require employers to offer coverage and whether government-sponsored insurance should be one option.
Obama has detailed few specifics that he is for and against, and did not break any new ground at the event. He said he won't run roughshod over Congress with a "my way or the highway" approach and is "happy to steal other people's ideas."
The president also acknowledged that extending coverage will cost "a good deal of money at a time where we don't have extra to spend." He promised anew that he will not allow reform to add to the deficit, and said he will propose new savings "in the days to come" beyond those already outlined to help explain how reform will be financed.
But, he said, that won't be enough.
"I'll be honest, even with these savings, reform will require additional sources of revenue," Obama said.
The president proposes raising taxes on the highest-earning Americans by limiting the value of deductions they can claim, including charitable donations. This idea has little backing on Capitol Hill.
Green Bay resident Laura Klitzka, a 35-year-old, married mother of two who has breast cancer that has now spread to her bones, introduced Obama. She carries about $12,000 in unpaid medical bills that continue to pile up as treatment continues that she said her family cannot afford.
The White House considers such emotional pleas critical to selling reform. Obama's political arm, the grass-roots machine known as Organizing for America, has collected hundreds of thousands of similar stories that could shame lawmakers who don't sign on.
"What we're doing right now is we're really priming the pump. I mean, we will ramp this activity up, we'll make more explicit calls for people to call members of Congress — every member of Congress that we can get a call into — as we approach key votes," said Dan Grandone, a political aide who runs Obama's re-election campaign-in-waiting in Wisconsin.