SHAKER HEIGHTS, Ohio - Conceding that passage probably won't happen on his timetable, President Obama yesterday urged middle-class America to turn up the heat on Congress to finally enact health-care reform.
An hour-long town-hall meeting for a ticket-only crowd of more than 2,000 in a suburban Cleveland high school was largely a sequel to Wednesday night's prime-time news conference in which the President hinged the nation's personal health and economic future on reform.
He downplayed his demand that a health-care bill reach him before lawmakers recess in August, a deadline congressional leaders said yesterday is too optimistic.
"I want to get it right, but I also want to get it done promptly," Mr. Obama said.
"As long as I see people working diligently and consistently, I am comfortable with moving a process forward that builds as much consensus as possible," he said. "What I don't want to see is delay for the sake of delay, delay because people are afraid of making tough votes."
He's now turned his attention to fall for passage of individual bills in both chambers with the goal of having something on his desk to sign into law by the end of the year.
"Our target date is to get this done by the fall. That's the bottom line," he said. "Even if it got done in the fall, most of these changes would be phased in over several years, phased in in an intelligent and deliberate way. This is not too much, too soon."
House Minority Leader John Boehner (R., Ohio) said Mr. Obama was using Ohio to promote a bill that will lead to the loss of jobs, health-care rationing, and a denial of services.
"Despite what President Obama is promoting, his bill would make health-care more expensive," he said. "It is a $1.6 trillion monstrosity. The Congressional Budget Office has estimated that it would add $240 billion to our deficit over the next 10 years. Beyond those 10 years we have an exploding deficit as a result of this proposal."
Mr. Obama insists reform could partially pay for itself through costs savings from better efficiency, preventive care that wards off more serious and expensive ailments, and decreased use of hospital emergency rooms for expensive nonemergency treatment.
He insisted again that he would not sign a bill that would add "even one dime" to the budget deficit, while also saying that any tax burden enacted to help pay for it should not be imposed on the middle class.
And the President had no problem laying the deficit at the feet of Republicans.
"If you are a taxpayer concerned about deficits, I want to reassure you, I am too. In the eight years before we came to office, Washington enacted two large tax cuts, primarily for the wealthiest Americans, added a prescription drug benefit to Medicare, and funded two wars, without paying for any of it," he told the gathering. "The national debt doubled, and we were handed a $1.3 trillion deficit when we walked in the door."
The meeting followed a quick tour of the cardiac unit at the nearby Cleveland Clinic, which Mr. Obama said epitomizes his goal of providing the best care at lower cost.
The clinic has not endorsed his health-care proposal.
"Cleveland Clinic has one of the best health-information technology systems in the country," he said. "This means that they can track patients and their progress. This means that they can see what treatments work and what treatments are unnecessary. It means they don't have to duplicate test after test because it's all online. They actually have some of the lowest costs for the best care."
He also praised the clinic's emphasis on preventive care.
"It's exciting that, in addition to a big fancy hospital with big fancy equipment, they're also linked up with family clinics throughout the area," he said. "They're making sure that someone is helped with a nutritionist to keep their weight down before they get diabetes as opposed to paying for surgery for a foot amputation."
Concerns over the health reform's price tag and how to pay for it have dampened prospects for quick congressional passage. Although he's won general endorsements for reform from the likes of the American Medical Association, which eluded the last major attempt at reform under President Bill Clinton in the early 1990s, Mr. Obama's plan seems to be hitting some of the same roadblocks that ultimately defeated Mr. Clinton's plan.
The reform would allow people who are happy with the private insurance they have now to keep it while creating a public alternative for those who can't afford coverage on their own.
Unlike its national counterpart, the Ohio State Medical Association has not endorsed Mr. Obama's proposal.
"One thing that concerns us is the idea that a so-called public option might be another Medicare-like program," said Dr. Roy Thomas, an Elyria eye surgeon and president of the 20,000-member organization.
He met with Mr. Obama shortly before the meeting.
"We've had a lot of experience with Medicare, and we feel that that is not the direction we should go," he said.
"We would rather see what the President talked about today, a health-insurance exchange where individuals have access to private markets, possibly by some means-tested subsidy if necessary," Dr. Thomas said.
State Sen. Sue Morano (D., Lorain) - a registered nurse who represents Huron County, eastern Seneca County, and part of Lorain County - praised Mr. Obama's commitment not to pay for the program on the backs of the middle class.
"I read letters and talk to constituents on a daily basis who have lost their health-care coverage after losing a job or simply because they can't afford to pay skyrocketing insurance premiums and co-pays," she said. "More often than not they must choose between buying health insurance or putting food on the table."
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Conceding that passage probably won't happen on his timetable, President Obama on Thursday urged middle-class America to turn up the heat on Congress to finally enact health-care reform. An hour-long town-hall meeting for a ticket-only crowd of more than 2,000 in a suburban Cleveland high school was largely a sequel to Wednesday night's prime-time news conference.