PORTSMOUTH, N.H., - President Obama, taking center stage in an increasingly contentious national debate over health care, told a packed town-hall meeting here yesterday "I need your help" to overcome what he called "wild misrepresentations" about the program by special-interest groups.

In a campaign-style speech, Obama called health-insurance reform one of the pillars of a 21st-century economy and vowed to change a system in which he said insurance companies routinely denied coverage to people with preexisting conditions.

"I believe it is wrong," he declared to applause. "It is bankrupting families and businesses, and that's why we are going to pass health-insurance reform in 2009."

Answering questions in the first of three town-hall meetings on the subject scheduled for this week, Obama encountered none of the hostility that has erupted at similar events held by Democratic lawmakers in recent days.

He answered polite questions from one man who identified himself as a Republican and another who professed to be a "skeptic," using the opportunity to pitch his proposals, blast some practices of private insurance companies, and knock down what he called the "scare tactics" of critics.

"What is truly scary, what is truly risky, is if we do nothing," Obama said. In that case, he warned, people's health-insurance premiums will continue to skyrocket and the national deficit will continue to grow because Medicare and Medicaid "are on an unsustainable path."

America's health-care system often works better for the health-insurance industry than it does for the American people, Obama said, "and we've got to change it."

Over the last three years, more than 12 million Americans were discriminated against because of a preexisting condition, he said. He cited the case years ago of his mother, who died of cancer in 1995.

'Mean things'

"That is wrong, and that will change when we have health-care reform," Obama said.

He said that he welcomed a "vigorous debate" on the issue but that "I do hope we talk with each other and not over each other."

In response to a question from a young girl who said she had seen signs outside "saying mean things about health-care reform," Obama cited "the rumor" of "death panels that will basically pull the plug on Grandma."

He said the rumor grew out of a House provision that would allow Medicare to reimburse people for consultations they receive about end-of-life care, such as hospices. The intention, he said, was to give people information to help them handle such situations.

Obama also disputed the view that offering people a "public option" for health-care coverage would drive private insurance companies out of business.

"UPS and FedEx are doing just fine," he said. "It's the Post Office that's always having problems."

Thousands of raucous demonstrators - both for and against health-care changes - converged on the site of the town-hall meeting at a high school here.

The event drew 1,800 people, and 70 percent of the tickets to the auditorium were given to people who signed up online, and distributed at random, according to a White House aide. The rest went to the school community and to local lawmakers' offices.

One woman said she relied on Medicare for numerous medications and procedures and wondered how his plan would affect her.

He responded: "AARP would not be endorsing a bill if it was undermining Medicare, OK?"

After the event, AARP chief operating officer Tom Nelson issued a clarification.

"While the President was correct that AARP will not endorse a health care reform bill that would reduce Medicare benefits, indications that we have endorsed any of the major health care reform bills currently under consideration in Congress are inaccurate," the statement by Nelson said.

The Democratic National Committee is launching advertisements in the states Obama is visiting to bolster his message, and the White House has launched a Web site devoted to correcting what it says are falsehoods about the bills now working their way through Congress.

Obama's goal this week, advisers said, is to address the concerns of people who already have health care and to illustrate how those people would benefit from adjustments to the current system.

In Portsmouth, he spoke about people who are denied coverage because of preexisting conditions.

On Friday, he is scheduled to hold a town-hall meeting in Bozeman, Mont., to discuss the plight of people dropped from their health-insurance plans because of an illness. At the third session, on Saturday in Grand Junction, Colo., Obama intends to raise the subject of high out-of-pocket costs, such as co-payments and deductibles.

Adjusting message

The Democratic National Committee and Organizing for America, an advocacy group set up as a successor to Obama's campaign apparatus, are encouraging volunteers to fan out across the country to sway reluctant lawmakers to support the proposals on Capitol Hill.

Obama's top advisers said they were adjusting their tactics and message to confront head-on the often caustic public debate.

"We've definitely made some changes in the last week or so to be more aggressive," one senior adviser said.

They said the angry outbursts at town halls across the country recall the strident language that erupted at former Alaska Gov. Sarah Palin's rallies in the waning days of the presidential campaign last year.

Internal polling during the campaign reassured Obama's staff that independent voters were "turned off" by the tone of some of Palin's supporters, an adviser said.

Read a transcript of

the town hall via http:// go.philly.com/obama.nh EndText