'Time for Bickering Is Over'

WASHINGTON - Shaking off a summer of setbacks, President Obama summoned Congress to enact sweeping health-care legislation last night, declaring the "time for bickering is over" and the moment has arrived to protect millions who have unreliable insurance or no coverage at all.

Obama said the changes he wanted would cost about $900 billion over a decade, "less than we have spent on the Iraq and Afghanistan wars, and less than the tax cuts for the wealthiest few Americans" passed during the George W. Bush administration.

In a televised speech to a joint session of Congress, Obama spoke in favor of a provision for the federal government to sell insurance in competition with private industry. But in a remark certain to displease liberals, he did not insist on it, and said he was open to alternatives that create choices for consumers.

Obama said he remained ready to listen to all ideas but added in a clear reference to Republicans, "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."

In an unusual outburst from the Republican side of the House chamber, Rep. Joe Wilson of South Carolina shouted out "You lie!" when the president said that illegal immigrants would not benefit from his proposals. The president paused briefly and smiled, but from her seat in the visitor's gallery, Michelle Obama shook her head in disapproval of the interruption. Wilson later apologized for his "lack of civility."

Obama's tone was professorial through much of the speech, but he was assertive and firm in making his points.

In general, the president shied away from providing lawmakers with a list of particulars he wanted to see included in the legislation, and there was nothing in the speech to invite comparisons with President Bill Clinton's pen-waving veto threat of health care more than a decade ago.

Obama's speech came as the president and his allies in Congress readied an autumn campaign. Republican opposition, contentious town-hall meetings, and drooping polls have contributed to their woes.

An AP-GfK survey released hours before the speech showed public disapproval of Obama's handling of health care has jumped to 52 percent, an increase of 9 percentage points since July. The survey had a margin of error of plus or minus 3.1 percentage points.

While Democrats command strong majorities in the House and Senate, neither chamber has acted on Obama's top domestic priority, missing numerous deadlines leaders had set for themselves.

In a fresh sign of urgency, Sen. Max Baucus (D., Mont.) announced that his Senate Finance Committee would meet in two weeks to begin drafting legislation, whether or not a handful of Democrats and Republicans have come to an agreement.

The panel is the last of five to act in Congress, and while the outcome is uncertain, it is the only one where bipartisanship has been given a chance to flourish.

Obama said there was widespread agreement on about 80 percent of what must be included in legislation. And yet, criticizing Republicans without saying so, he added: "Instead of honest debate, we have seen scare tactics" and ideological warfare that offers no hope for compromise.

"Well, the time for bickering is over," he said. "The time for games has passed. Now is the season for action."

"I am not the first president to take up this cause, but I am determined to be the last," he added.

The president was alternately bipartisan and tough on his Republican critics. He singled out Sen. John McCain (R., Ariz.) for praise at one point. Yet, moments later, in a line apparently aimed at McCain's former running mate, Sarah Palin, Obama accused Republicans of spreading the "cynical and irresponsible" claim that the legislation would include "death panels" with the power to hasten the deaths of senior citizens.

In one gesture to Republicans, Obama said his administration would authorize a series of test programs in some states to check the impact of medical malpractice changes on health-insurance costs.

Responding on behalf of Republicans, Rep. Charles Boustany of Louisiana said the country wanted Obama to instruct Democratic congressional leaders that "it's time to start over on a commonsense, bipartisan plan focused on lowering the cost of health care while improving quality."

In a reflection of the stakes, White House aides mustered all the traditional pomp they could for a president who took office vowing to change Washington. The setting was a State of the Union-like joint session of Congress, attended by lawmakers, members of the cabinet, and diplomats.

The House was packed, and loud applause greeted the president when he walked down the center aisle of the House chamber.

Additionally, the White House invited as guests men and women who have suffered from high costs and insurance practices, seating them near Michelle Obama.

Obama intends to follow up the speech with a public rally Saturday at the Target Center in Minneapolis, the White House announced.

Despite deep-seated differences among lawmakers, Obama drew a standing ovation when he recounted stories of Americans whose coverage was denied or delayed by their insurers with catastrophic results.

"That is heartbreaking, it is wrong, and no one should be treated that way in the United States of America," he said.

The president sought to cast his plan as being in the political middle, rejecting both the government-run system that some liberals favor and the Republican-backed approach under which all consumers buy health insurance.

Obama said the legislation he sought would guarantee insurance to consumers, regardless of preexisting medical conditions, as well as other protections. "As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most," he added.

The president assured those with insurance that "nothing in this plan will require you or your employer to change the coverage or the doctor you have."

Obama also said the legislation he sought would help those who lack insurance to afford it. "These are not primarily people on welfare," he said. "These are middle-class Americans."

The president also said he wanted legislation that "will slow the growth of health-care costs for our families."

Obama said that a collective failure to meet the challenge of overhauling health care for decades had "led us to a breaking point."

Watch or read the speech at the White House Web site via http://go.philly.com/obama EndText