Obama urges action on healthcare
US President Barack Obama has made one of the most critical speeches of his presidency, as he faced Congress over his plans for healthcare reform.
Mr Obama said that failure to introduce reform had led the country to breaking point and it was now time to act.
He said he planned to improve health insurance for those who have it and to create an insurance exchange to extend cover to those who do not.
Members of Congress are preparing to fight over details of the reforms.
Mr Obama told Congress that the US was the only rich country that allowed millions of its people to endure the hardship of going without healthcare.
"Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy," he said.
"These are not primarily people on welfare. These are middle-class Americans."
“ It seemed to go down pretty well in the chamber, but it's how Americans receive it over the next few hours and days that really counts ”
Mark Mardell BBC North America editor
But Mr Obama said the current system did not serve those Americans who do have health insurance well either.
"Those who do have insurance have never had less security and stability than they do today.
"More and more Americans worry that if you move, lose your job, or change your job, you'll lose your health insurance too."
He said the US spent one-and-half times more on health insurance than any other country but Americans were no healthier than other people.
Insurance exchange
Mr Obama set out details of his plan to reform the system.
He said that nothing in his proposal would require Americans who already have health insurance to change their coverage or doctor.
But he said he would make the insurance work better for individuals by prohibiting insurers from dropping coverage for sick patients or by capping it.
HEALTHCARE IN THE US
<li class="bull"> 46 million uninsured, 25 million under-insured <li class="bull"> Healthcare costs represent 16% of GDP, almost twice OECD average <li class="bull"> Reform plans would require all Americans to get insurance <li class="bull"> Some propose public insurance option to compete with private insurers
He would also require insurers to cover the cost of routine check-ups and preventative care.
For the millions of uninsured Americans, he said he would create an insurance exchange - a market place where individuals and small business will be able to shop for health insurance at competitive prices.
Public insurance option
Mr Obama said a public insurance option could help keep the private health insurance companies honest and competitive.
But he said it would not be subsidised by the government, so would not form unfair competition for them.
He added that the public option was only a means to an end, and he remained open to other ideas if they had the same effect.
Healthcare reform has been the central issue of his change agenda but has divided both the US public and the country's political establishment.
President Obama said that Congress agreed on about 80% of the reforms that are needed.
But he said months of partisan bickering had only hardened the disdain many Americans have towards their own government.
He is facing almost unanimous opposition from Republicans, who are uneasy about the idea of government-run healthcare and who have accused Mr Obama of attempting to introduce a "socialist" policy.
There are, in theory, enough Democrats in Congress to approve the changes.
But in practice, the party is deeply divided between those that want a publicly-run insurance scheme and those alarmed by the borrowing necessary to fund it.
US MEDIA REACTION TO OBAMA'S SPEECH
The complaints about Republicans at the end also didn't sound, to me, like they'll play well. Right now, more voters are on their side than yours. Don't tell them they're gullible dupes, and/or mean-spirited obstructionists. The Atlantic Monthly's Megan McArdle
The majority of the speech was proddingly practical, in a dutiful debater kind of way... But then, at the end, came the rousing defense of liberalism I was waiting for. For a speech in which he was trying to forge a consensus this was a brave and risky move. Hanna Rosin, of DoubleX,
[It] was nearly an hour of snake-oil salesmanship, promises that cannot possibly be kept, and false invocations of bipartisan civility even as he was trying to deliver partisan roundhouses of his own. John Podhoretz, of Commentary magazine,
If Obama hasn't created the perfect plan, he's created something arguably more impressive: a plan that actually might pass. That plan might not do enough to change the system, and it may not spend enough to protect everybody, but there is plenty in the proposal that will better the lives, health coverage, and financial security for millions of real people. The Washington Post's Ezra Klein
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