US president Barack Obama insisted today "the time is now" for healthcare reform as he geared up for a major address to Congress this week aimed at getting his top domestic policy priority back on track.
Taking his case for a healthcare overhaul to America's economically hard-hit heartland, Mr Obama sought to seize back the initiative on the divisive issue after losing ground to critics during a turbulent summer.
"It's time to do what's right for America's working families, to put aside the partisanship, to come together as a nation, to pass health insurance reform now - this year," Mr Obama told a wildly cheering crowd at a Labor Day picnic held by the AFL-CIO union coalition in Cincinnati, Ohio.
Mr Obama's holiday visit to the Midwest was a preview of a prime time speech he will deliver to a joint session of Congress on Wednesday when he will lay out his proposed revamp of the healthcare system to wary lawmakers and a skeptical public.
With his poll numbers down from once-lofty heights, Mr Obama's effort to reclaim control of the debate is seen as a key test of his leadership that could define his young presidency.
Overhauling the troubled $2.5 trillion US healthcare system, by cutting costs and expanding coverage to the estimated 46 million Americans without health insurance, is Mr Obama's top domestic initiative.
But Mr Obama's fellow Democrats who control Congress have struggled to craft a reform bill and most Republicans have fought it.
The debate is now reaching a make-or-break point.
After a summer of sometimes bitter words, White House spokesman Robert Gibbs said yesterday that the president will "draw some lines in the sand" in his speech on Wednesday.
Mr Obama's top aides said he still wants a government insurance option in healthcare legislation but they left room for a compromise that could disappoint his liberal backers.
Weighing in on issue in Cincinnati, Mr Obama said, "I continue to believe that a public option within the basket of insurance choices would help improve quality and bring down costs."
Despite polls showing Americans increasingly concerned about his healthcare strategy, Mr Obama's reform message appeared to resonate with union members, who gave him an enthusiastic reception at Cincinnati's Coney Island Park.
Signs that read "Health care can't wait" dotted the crowd of several thousand people. Labour was a key base of support for Mr Obama in his campaign for the presidency.
"In every debate there comes a time to decide, a time to act," Mr Obama said. "That time is now.
With government spending and deficits soaring as the Obama administration fights the worst economic crisis since the Great Depression and inherited wars in Iraq and Afghanistan, critics say the healthcare reforms under consideration are too costly.
A key question is whether Obama is ready to drop his support for the "public option" - a government insurance plan designed to compete with private insurance companies that has been a major feature of a proposed $1 trillion overhaul.
The insurance industry strongly opposes the public option and has spent millions of dollars lobbying against it, while conservative commentators have fanned fears of a government takeover of healthcare akin to socialism.
A group of moderate Democratic and Republican senators - known as the "Gang of Six" - have been engaged in closed-door negotiations searching for a way to avoid to bridge the gap.
Congress reconvenes tomorrow after a monthlong recess, with no sign the healthcare fight will abate any time soon.
A CBS News poll last week said most Americans found the healthcare proposals discussed in Congress confusing and thought Mr Obama had not clearly explained his plans.
Mr Obama coupled his visit to Ohio, an industrial state especially hurt by recession, with the formal announcement he has named Ron Bloom, senior adviser to his auto task force, to lead an effort to revitalise America's manufacturing sector.
Mr Bloom, a prominent figure in the labour movement before joining the administration, appeared with Mr Obama in Cincinnati.
Reuters