Obama's last stand for health care reform

After a year of several blown self-imposed deadlines, unexpected setbacks and incremental victories, the president is taking his final stand to get a health care bill passed -- a push likely to last for the next few weeks.

When President Obama first began his push for health care reform a year ago, he was full of optimism and brimming with bipartisan brio.

Now, after a year of several blown self-imposed deadlines, unexpected setbacks and incremental victories, the president is taking his final stand to get a health care bill passed -- a push likely to last for the next few weeks.

A senior White official described the latest push to Fox News as a one-shot deal -- and if it doesn't work, it doesn't work. Obama underscored that he's stepping up his efforts with an eye to the finish line.

"I will do everything in my power to make the case for reform," he said Wednesday.

But Republicans remain united in their opposition despite Obama's bipartisan overtures.

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"It's most likely the end of bipartisanship on health care," said Matt Dallek, a historian and visiting scholar with the Bipartisan Policy Centre, a think-tank created by moderate former lawmakers in Washington. Dallek said a mix of political calculations and ideology had doomed the chances of passing a bill with broad support.

Supporters argued it was about time - Republicans were never going to be brought on board. Critics warned Democrats will rue the day come mid-term congressional elections in November, when one-third of the Senate and the entire House of Representatives is up for grabs.

"History is clear: Big legislation always requires big majorities," Mitch McConnell, the Senate's top Republican, said Wednesday. "And this latest scheme to lure Democrats into switching their votes ... will be met with outrage."

Obama said he had done his best to meet Republicans half-way, but there clearly remained irreconcilable differences between the two parties. He challenged Republicans to vote against his reform proposals as he sounded the final battle cry on Wednesday.

"I urge every American who wants this reform to make their voice heard," Obama said. "Every family, every business, every patient, every doctor, every nurse, every physician's assistant. Make your voice heard."

Both sides recognize a problem with the current health care system, which gobbles up about 17 per cent of the US economy and yet leaves more than 30 million Americans without any form of health insurance coverage.

Yet the divide over solutions is as large as ever. Obama's reforms would for the first time require all Americans to purchase basic insurance coverage, expand subsidies for those who can't afford the cost, impose new regulations on insurance industry practices and create state insurance exchanges to help lower premiums for families.

Republicans have fiercely opposed most of Obama's initiatives as too costly and too much government infringement on a largely private health sector. They argued for a much stronger focus on boosting private competition and less regulation of the insurance industry.