WASHINGTON — President Barack Obama urged Congress on Wednesday to ignore "bogus” talk of death panels and a government takeover and approve a health care reform bill that would control spiraling costs and ensure coverage for the sick and uninsured.

"The time for bickering is over,” Obama told a joint session of the House and Senate in a nationally televised address. "The time for games has passed. Now is the season for action.”

Obama said he wants a public option, a government health insurance plan that would be available to small businesses and uninsured people who can’t afford to buy coverage in the private market.

However, he said, he was open to alternatives, including nonprofit cooperatives that also would compete against private insurers.

"I will not back down on the basic principle that if Americans can’t find affordable coverage, we will provide you with a choice,” Obama said. "And I will make sure that no government bureaucrat or insurance company bureaucrat gets between you and the care that you need.”

The president presented himself as open to negotiations but not "scare tactics.” And he declared himself ready to go back on the offensive.

"I will not waste time with those who have made the calculation that it’s better politics to kill this plan than improve it,” Obama said. "I will not stand by while the special interests use the same old tactics to keep things exactly the way they are. If you misrepresent what’s in the plan, we will call you out. And I will not accept the status quo as a solution. Not this time. Not now.

"Everyone in this room knows what will happen if we do nothing. Our deficit will grow. More families will go bankrupt. More businesses will close. More Americans will lose their coverage when they are sick and need it most. And more will die as a result. We know these things to be true.”

Lawmakers’ concerns

Obama went to Capitol Hill to make his plea to lawmakers after he and Democratic leaders lost control of the issue during an August congressional recess in which town hall meetings dominated media coverage. Many members of Congress were assailed by their constituents about the public option, which many see as a step toward a health care system operated totally by the federal government.

Lawmakers also were put on the defensive by former Alaska Gov. Sarah Palin’s claim that the House bill would allow government "death panels” to determine when medical care could be cut off.

Rep. Frank Lucas, R-Cheyenne, who conducted 18 town hall meetings in his western Oklahoma district, said in an interview Wednesday that he doesn’t see how any major bill could be approved by Congress this year.

"There’s just such a level of cynicism and suspicion about Congress and the administration out there — it’s just intense,” Lucas said.

Oklahomans are concerned about the same things as the president in regard to health care, Lucas said.

"The question is: How do you meet all these meritorious goals and not change the health care system beyond recognition?” he said.

Outlining goals

Obama said Wednesday that his plan has three main goals: ensuring that those who have insurance can keep it, providing coverage to the uninsured and slowing the growth of health care costs.
 
He said he wants to require individuals to carry basic health insurance "just as most states require you to carry auto insurance. Likewise, businesses will be required to either offer their workers health care or chip in to help cover the cost of their workers.”

"There will be a hardship waiver for those individuals who still cannot afford coverage, and 95 percent of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements.”

Insurance companies couldn’t deny coverage because of a pre-existing condition or drop coverage when a person gets sick, Obama said. Moreover, the companies would not be able to put annual or lifetime caps on coverage, and there would be limits on out-of-pocket costs, the president said.

He made brief mention of medical malpractice reform, saying it wasn’t a "silver bullet” but that he would move forward on some demonstration projects in states.
 
Obama promised that his plan wouldn’t add to the deficit and would use savings from reducing fraud and waste in Medicare and Medicaid to help pay for it.

A Republican lawmaker, Rep. Joe Wilson of South Carolina, shouted, "You lie,” after Obama said his plan wouldn’t cover illegal immigrants, giving the president some pause; Obama then reiterated that point. The president also promised that no federal funds would be used for abortion.

Moving forward

The White House has not sent its own legislation to Capitol Hill, leaving lawmakers to try to incorporate some of his principles in the bills they’re writing.

Some House and Senate committees already have approved portions of reform legislation. And one of the most powerful committees working on the issue could take action in the next couple of weeks.

Sen. Max Baucus, the Montana Democrat who heads the Finance Committee, said Wednesday he was ready to move on health care legislation even if no Republicans are willing to sign on. Baucus has been working with two other Democrats and three Republicans on the panel to find a bipartisan compromise.

Baucus has circulated a plan that would include an individual mandate to purchase insurance and impose fines on those who did not.