President Obama on Thursday held his first health care-focused event outside Washington to push for a massive expansion of coverage for uninsured Americans, including a government-run "public option" which is vigorously opposed by Republicans and some industry groups, during a town hall meeting in Green Bay.
The president's trip to Wisconsin marks a new phase in the Obama administration's push for health care reform, as lawmakers on Capitol Hill move closer to hammering out the make-or-break details on how to provide care for the 46 million Americans who currently are without health insurance coverage.
Since taking office, Mr. Obama, who wants a bill finished by the end of this year, has deferred to Congress on the details of health care reform, allowing them to hash out and debate the most controversial items, such as whether or not there will be a government-run option and whether or not employer-provided benefits will be taxed.
The president came out in favor of a public plan last week for the first time in a letter to lawmakers, and stated his support for it at a public event for the first time Thursday.
"I also strongly believe that one of the options should be a public insurance option, because if the private insurance companies have to compete with a public option, it will keep them honest and it will help keep their prices down," Mr. Obama said, as the crowd inside Southwest High School cheered.
Republicans insist that a government option for insurance will actually drive private insurers out of the market because they will not be able to compete with the taxpayer-funded plan. The federally run plan, they say, will not necessarily have to be profitable, while private sector plans must make money to stay in business.
"It amounts to a government takeover of health care, and it would force millions of Americans off their own plans and into a government-sponsored plan," said House Minority Leader John Boehner, Ohio Republican.
Senate Minority Leader Mitch McConnell, Kentucky Republican, said that "one estimate suggests that 119 million Americans could lose the private coverage they have as a consequence of the government plan."
Mr. Obama took on his critics directly in Green Bay.
"I don't know how clearly I can say this: If you've got health insurance that you're happy with through the private sector, then we're not going to force you to do anything," he said. "It's not clear that [objections are] based on any evidence as much as it is their thinking, their fear that somehow once you have a public plan government will take over the entire health system.
"That's going to be a significant debate. All we're trying to make sure is there is an option out there where the free market fails. And we've got to admit that the free market has not worked perfectly when it comes to health care," he said.
The American Medical Association, the country's largest physician organization with about 250,000 members, on Thursday said they were opposed to a public option, which was first reported by the New York Times. Mr. Obama will address the group Monday in Chicago.
In Green Bay on Thursday, however, Mr. Obama did not mention the idea of taxing employer-provided health insurance, a proposal that he criticized during the presidential campaign but has since signaled he is open to.
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."