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But he did hammer critics and implied they have no ideas.

“So to those who criticize our efforts, I ask them, ‘What is the alternative?’” Mr. Obama said.

“We have reached a point where doing nothing about the cost of health care is no longer an option,” he said.

But Rep. Paul Ryan, Wisconsin Republican, did propose an alternative last month, along with a handful of other Republicans, called the Patients’ Choice Act.

“The difference between the presidents rhetoric and the substance of his plans is nothing short of astounding,” Mr. Ryan said in an editorial placed on the website of a Wisconsin newspaper shortly after the president’s town hall event concluded.

“He knows that there are alternatives, better alternatives where the patient, not the government, is at the center of health care in America. He knows that we have introduced the Patients Choice Act of 2009. He knows this, and is simply hoping that the American people dont know it,” Mr. Ryan said.

The PCA would do away with the system of employer-based insurance plans and give tax credits of $2,300 per individual and $5,700 per family to pay for insurance that is portable between jobs.

The president said that much of the increasing costs of health care has been driven by a business mentality among health providers rather than having patient health as the top priority.

“But the real cost savings will come from changing the incentives of a system that automatically equates expensive care with better care,” he said.

“We should change the warped incentives that reward doctors and hospitals based on how many tests or procedures they do, even if those tests and procedures aren’t necessary or result from medical mistakes,” Mr. Obama said.

“Doctors didn’t get into the medical profession to be bean-counters or paper-pushers; they’re not interested in spending all their time acting like lawyers or business executives. They became doctors to heal people. And that’s what we must free them to do.”