Undertaking an aggressive new effort to push a major health-care measure through Congress by August, Obama rebuked critics from both the right and left - conservatives who say his support for creating a government-sponsored insurance option alongside private coverage would send the country toward an unsustainable nationalized plan, as well as liberals who are concerned he won't go far enough to mandate universal coverage.
Obama said the question of what to do about health coverage, which has vexed Washington for decades, has reached near-emergency status.
"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."
There is emerging bipartisan consensus around many big isssues of health reform, including a need to move all Americans toward coverage and to prohibit insurance industry practices that deny coverage to people with health problems.
But there remain major disagreements over how to pay the $1.5 trillion it will cost over the next decade to cover the 50 million Americans who lack coverage, as well as whether employers should be required to offer coverage and whether government-sponsored insurance should be one option.
Obama has detailed few specifics that he is for and against, and he did not break any new ground on Thursday.
But his steadfast support for a public insurance component in any plan is a major obstacle to bipartisan agreement on a final bill.
The American Medical Association, the nation's largest doctors group, to which Obama speaks in Chicago on Monday, is wary of the idea. Republicans are campaigning hard against it.
"We see that as a slippery slope to having the government run everything," Sen. Mike Enzi, R-Wyo., said at a news conference in Washington.
Conservative activists appear to be mobilizing. Several hundred protesters lined the president's brief motorcade from the airport to a suburban high school, holding signs such as "NObama" and "No to Socialism" - a rare occurrence for the popular new president.
Obama says creating the option of a government-sponsored health plan alongside private insurers would increase competition and lower costs. But in answering a question on Thursday, he also said that no one - "certainly not me" - is interested in a nationalized health care system like that in Britain. The president said the government is not going to force any change upon people who are pleased with the plans they already have with their employers.
"When you hear people saying socialized medicine, understand, I don't know anybody in Washington who is proposing that," he said. Aiming to sell his ideas directly to Americans in hopes they will pressure lawmakers, he said his opponents had better think of what to tell struggling Americans.
"To those who criticize our efforts, I ask them, `What's the alternative?"' Obama said.
Republicans acknowledge the majority Democrats may be able to push some version of Obama's plan through Congress with few or no GOP votes. But if they do, the No. 2 House Republican said in an Associated Press interview Thursday, "it will be at a huge political cost."
"My sense is by November of 2010, (there will be) an electorate that really wants to see a check and a balance on unfettered power," said House Whip Eric Cantor of Virginia.
The president 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 federal deficit, and said he will propose new savings beyond those already outlined.
He 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 to pay for Obama's measure that has Republicans unified in general opposition.
"This next 6-8 weeks is going to be critical," Obama 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."
He said he won't run roughshod over Congress with a "my way or the highway" approach.
For that, he'll turn to his political arm, Organizing for America. The president's re-election-campaign-in-waiting has organized coast-to-coast events to promote Obama's broad principles, thank friendly members of Congress and pressure opponents.
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Associated Press writers Ricardo Alonso-Zaldivar and Erica Werner in Washington contributed to this report.
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