US president Barack Obama began a final push for healthcare reform today, urging Congress to vote on the plan in the next few weeks even if it means passing the measure with a narrow Democratic majority and no Republican support.
Although much uncertainty remains on the path to passage of the legislation, Mr Obama opposed Republican calls to throw out broad bills passed by the House of Representatives and Senate last year and begin again with a more step-by-step approach.
"For us to start over now could simply lead to delay that could last for another decade or even more," Mr Obama said.
Americans are waiting for the administration to lead, Mr Obama said in remarks at the White House backing a muscle tactic known as "reconciliation" as a way of overcoming rock-solid Republican opposition.
Republicans dismissed Mr Obama's remarks and said Democrats risked paying a price in mid-term congressional elections in November.
"Every election in America this fall will be a referendum on this issue," Senate Republican leader Mitch McConnell said after the speech.
"Now is the time to make a decision about how to finally reform health care so that it works, not just for the insurance companies, but for America's families and businesses," Mr Obama said in his speech.
He said his plan included ideas from both his fellow Democrats and rival Republicans, who staunchly oppose the idea of a large-scale overhaul of the $2.5 trillion healthcare industry that accounts for one-sixth of the US economy.
Republicans say such a plan is too expensive for a government running huge budget deficits.
Mr Obama renewed his effort to win Republican backing with a healthcare summit last week and a letter yesterday outlining some of their ideas he was willing to adopt.
With those efforts, he can now say he gave bipartisanship another chance - even as he and Democrats move ahead with a procedure that bypasses them.
"Given these honest and substantial differences between the parties ... I do not see how another year of negotiations would help," Mr Obama said.
Democrats have been preparing to pass a final measure in the Senate without opposition support through reconciliation, which requires only simple majority approval instead of the usual 60 votes that are needed in the 100-member chamber to overcome procedural hurdles.
The Democrats lost their "supermajority" with the loss of a Senate seat in a special election in January.
Mr Obama did not use the word reconciliation, a term not understood by many Americans, but made clear he supported that process with his comments urging Congress to vote.
"No matter which approach you favour, I believe the United States Congress owes the American people a final vote on health care reform," he said.
The political stakes are enormous. Mr Obama's approval ratings have dropped during the healthcare fight amid public worries about an unemployment rate hovering around 10 per cent.
Reuters