He told his audience reassuringly, "For all the chatter and the yelling and the shouting and the noise, what you need to know is this ... if you do have health insurance, we will make sure that no insurance company or government bureaucrat gets between you and the care you need."
Retooling his message amid sliding support, he addressed some of his remarks to a vital and skeptical audience: the tens of millions of people who already have health insurance and are generally satisfied with the care they get.
He said the overhaul is essential to them, too, contending it is the way to keep control in their hands. Obama said while government bureaucrats should not meddle with people's care, bureaucrats at insurance companies should not, either.
The president accused critics of creating "boogeymen."
"Spread the facts. Let's get this done," Obama implored the crowd
He reiterated his determination that the plan be paid for without adding to the nation's soaring deficit.
He singled out the charge that the Democratic health care legislation would create "death panels" to deny care to frail seniors. Former Republican vice-presidential candidate Sarah Palin has said the Democrats' legislation includes "death panels" that could deny care.
Obama declared that a provision that he said had caused the uproar would only authorize Medicare to pay doctors for counseling patients about end-of-life care, living wills, hospice care and other issues, if the patients wanted it. It would not "basically pull the plug on grandma because we decided that it's too expensive to let her live anymore," as Obama put it.
Obama sought to dispel talk that his ultimate goal is a single-payer federal health care system, like that in countries such as Canada.
In 1996, when he was running for the state Senate in Illinois, he was asked on a questionnaire whether he supported a single-payer health plan. The response was, "Yes in principle." During Tuesday's town hall, he said, in answer to a question from a self-described Republican, that he doesn't believe such a system would be workable for the United States. "For us to transition to a system like that I think would be too disruptive," Obama said.
He also disputed the notion that adding a government-run insurance plan into a menu of options from which people could pick would drive private insurers out of business, in effect making the system single-payer by default.
As long as they have a good product and the government plan has to sustain itself through premiums and other non-tax revenue, private insurers should be able to compete with the government plan, Obama said.
"They do it all the time," he said. "UPS and FedEx are doing just fine. ... It's the Post Office that's always having problems."
