President Barack Obama on Wednesday night appealed for bipartisan reform of the US healthcare system, recasting the debate as a moral one and saying it was "part of the American character" to ensure that people who needed help did not go without.
After a summer of acrimonious disputes - during which some Republicans accused him of planning a government takeover of medicine - the president used a prime-time address to both houses of Congress to emphasise the benefits of healthcare reform to all Americans.
While he signalled flexibility on a public insurance plan and offered to address Republican concerns about medical malpractice laws, the president used his toughest language yet to refute critics who had spread "lies" about his intentions.
"The time for bickering is over. The time for games has passed. Now is the season for action," Mr Obama told lawmakers in a speech that resembled a State of the Union address.
"Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do. Now is the time to deliver on healthcare," he said.
With the economic recovery remaining fragile at best, Mr Obama pledged that his plan - which he estimated would cost about $900bn over a decade - would not add "one dime to our deficits - either now or in the future".
Mr Obama was betting the credibility of his administration on the address, and some analysts said he delivered the best speech of his presidency.
"This conversation had become so ridiculous so it was refreshing to hear an eloquent and passionate address on this serious issue," said Dr Rick Mayes, who advised presidents George HW Bush and Bill Clinton on healthcare. "It's unlikely to sway Republicans but I thought he did a very good job of conveying that [Republicans and Democrats] agree on quite a bit."
Passing new healthcare legislation nevertheless faces many hurdles, with Republicans still broadly opposed.
With his address, Mr Obama on Wednesday presented a plan that he said would meet three basic goals: to provide more security and stability to those who have health insurance; to provide insurance to those who do not have it; and to slow the growth of healthcare costs.
Mr Obama said that under his plan, it would be against the law for insurance companies to deny coverage because of a pre-existing condition or cancel coverage due to sickness, and he said insurance companies would be required to cover routine check-ups and preventive care.
The president said he wanted "affordable choices" for those without insurance, including a new "insurance exchange". While reiterating his support for a public healthcare option, Mr Obama said he could be flexible if other ways to lower overall costs could be found.
Saying "there remain some significant details to be ironed out" - to widespread Republican laughter - Mr Obama said a broad consensus could be formulated around such a plan.
The president also delivered a strong rebuttal to opponents who had claimed that Mr Obama planned to "pull the plug on grandma" by denying old people life-saving treatment and to allow government funding of abortions.
"Know this: I will not waste time with those who have made the calculation that it's better politics to kill this plan than to improve it," Mr Obama said. "If you misrepresent what is in the plan, we will call you out."
"You lie," yelled one Republican lawmaker when Mr Obama denied accusations his administration was planning to insure illegal immigrants.
Republicans and centrist Democrats had voiced concern about the high cost of reform - especially at a time when the US economy is in such a fragile state - but Mr Obama said his $900bn plan would cost "less than we have spent on the Iraq and Afghanistan wars".
"If we are able to slow the growth of health care costs by just one-tenth of 1 per cent each year, it will actually reduce the deficit by $4,000bn over the long term," Mr Obama said.
Displaying the kind of oratorical flair he exhibited on the campaign trail, the president invoked the memory of Ted Kennedy, the veteran Democratic senator and healthcare reform advocate who died last month, to make a moral case for reforming the healthcare system.
"[Kennedy's] large-heartedness - that concern and regard for the plight of others - is not a partisan feeling. It is not a Republican or a Democratic feeling. It, too, is part of the American character," he said.
Delivering the Republican response, Charles Boustany, a Louisiana representative and heart surgeon, criticised the president's refusal to rule out a public option and the high cost of reform.
"It's clear the American people want health care reform, but they want their elected leaders to get it right," Dr Boustany said. "It's time to start over on a commonsense, bipartisan plan focused on lowering the cost of healthcare while improving quality."
Earlier on Wednesday, Max Baucus, the Democratic chairman of the Senate's powerful finance committee, which may prove the final arbiter of the reforms, vowed to push through a healthcare reform bill with or without Republican support.
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