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President Barack Obama said Wednesday night
that Medicare and Medicaid are the "biggest driving force behind"
massive federal deficits, and must be tamed as part of any health
care legislation.

      At a prime-time news conference marking six months in office,
Obama said health care legislation was key to a strong economic
recovery, and he added, "If we do not control these costs, we will
not be able to control our deficit."

      The president noted he took office with the economy in the worst
recession in half a century. "As a result of the action we took in
those first weeks, we have been able to pull our economy back from
the brink," he said.

      The president stepped to the microphone as Congress labored over
his call for sweeping legislation to expand health care to millions
who lack it, as well as control the costs of medical care
generally.

      In his opening statement, he stressed the second of those two
goals.

      "In the past eight year, we saw the enactment of two tax cuts,
primarily for the wealthiest Americans, and a Medicare prescription
program, none of which were paid for."

      He vowed anew that he wouldn't sign health care legislation that
wasn't paid for, although his administration has exempted from that
pledge an estimated $245 billion to raise Medicare fees for
doctors.

      "This debate is not a game for these Americans, and they cannot
afford to wait for reform any longer," Obama said. "They are
looking to us for leadership. And we must not let them down."

      The stakes are huge not just for everyday Americans, but also
for Obama, who is putting much of his credibility on the line to
gain passage of congressional legislation. His stepped-up public
role comes as he faces rising criticism from Republicans, sliding
public approval ratings and divisions within his party.

      Holding his 10th extended news conference, Obama was renewing a
message that the White House says he cannot pound enough: making
health coverage affordable and sustainable is so vital that
anything less will erode the economic stability of families,
businesses and even the government.

      The complex work of getting bills through the House and Senate
is proving difficult. Republican leaders contend Obama's effort and
the emerging bills are rushed and risky, and members of Obama's own
Democratic Party are split on how to structure and pay for a
daunting overhaul.

      Obama sought to get beyond that and connect with Americans -
and, in turn, the White House hopes, to pressure Congress. "I
understand how easy it is for this town to become consumed in the
game of politics, to turn every issue into a running tally of who's
up or who's down," he said.

      His words came as House Speaker Nancy Pelosi said Democrats have
the votes to pass a massive health care bill in that chamber,
prompting surprise and some criticism from conservatives within her
party.

      Congress is struggling to figure out how to pay for adding
millions to the ranks of the insured and slowing the long-term
costs of health care in the U.S.

      In his comments, Obama reiterated his pledge that any bill he
signs will not add to the nation's soaring deficit. "And I mean
it," he said.

      Meanwhile, a nervous public is being hit by TV ads and claims
from all sides.


      And other issues haven't gone away as Obama steps before the
cameras. Still looming are an economy that keeps losing jobs, wars
in Iraq and Afghanistan and Obama's January deadline to shut down
the Guantanamo Bay detention facility.


      The timing is critical as Obama appeals Wednesday night to a
national viewing audience.

      He wants the House and Senate to vote on comprehensive health
care bills before they break for the summer, a window that is
scheduled to shut by the first week in August. That timetable is
growing tenuous, though, with up-and-down developments by the day.

      So Obama is everywhere on health care: giving Rose Garden
statements, visiting health clinics, talking to bloggers, granting
interviews.


      "He's prepared to do this as many times as he has to," said
Michael Traugott, a University of Michigan professor who
specializes in political communications. "The president has a
special advantage because he's readily identifiable. The Congress
is a less well known institution, and less popular in the public's
eye."


      Obama's approval rating stands at 55 percent, according to a new
Associated Press-GfK poll, down from 64 percent in late May and
early June. Some 50 percent approve of his handling of health care,
but 43 percent disapprove, and that number has risen sharply since
April.

      With public opinion still waiting to be shaped on health care,
and with the legislative details in flux, what's clear is that
people care.


      Nearly 80 percent of those polled say health care is an
important issue to them. Obama is seeking to extend coverage to
millions who don't have it and to hold down the long-term costs of
health care. How to pay remain a complex political question.

      It didn't help the White House when the Congressional Budget
Office last week said the bills moving through Congress would add
to the nation's long-term costs, not reduce them. Obama has been
emphatic that he will not sign a bill that adds to the government's
deficit.

      Meanwhile, unemployment is at 9.5 percent and rising.

      Talk of Obama inheriting an economic mess from George W. Bush is
fading, and the American public is now grading the new president.
His approval rating on handling the economy has been slipping as
impatience grows.

      Obama says the country is moving in the right direction, and he
points to legislation from his first half-year in office: a massive
economic stimulus bill that is ultimately designed to work over two
years, a law to overhaul the credit card industry, and another to
keep tobacco companies from marketing to kids.


      Still, he told CBS News on Tuesday: "As long as the economy is
still shedding jobs and people don't feel confident about a
recovery, then, you know, I think there's going to continue to be
frustration. And rightfully so."


      White House spokesman Josh Earnest said Wednesday that Obama is
"feeling optimistic that he's on track, after his first six months
in office, to fulfill his promise to sign a health care reform bill
before the end of the year."

Gallery

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McCollum, Paulsen concerned about inequities in health care reform plan

Health

President Barack Obama said Wednesday night
that Medicare and Medicaid are the "biggest driving force behind" massive federal deficits, and must be tamed as part of any health
care legislation.

Obama on health revamp: Debate is `not a game'

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