GREEN BAY, Wis. - Undertaking a new and aggressive push to enact health-care legislation this year, President Obama bluntly challenged Republican critics yesterday to put forward their own plan to expand coverage to the uninsured and help struggling families afford care.

"To those who criticize our efforts, I ask them: 'What's the alternative?' " Obama said at a town-hall-style meeting, surrounded by supportive citizens in the heartland.

"What else do we say to all those families who spend more on health care than on housing or on food? What do we tell those businesses that are choosing between closing their doors and letting their workers go?"

A dispute over Obama's desire to create a new government-sponsored health plan to compete with private insurers is forming a major obstacle to bipartisan consensus on a sweeping overhaul of the nation's health-care system. So the president is stepping up his personal efforts, a key part of which is selling his ideas directly to Americans, in hopes they will pressure lawmakers directly and create momentum through a groundswell of public support.

He described critics as naysayers.

"I know there are some who believe that reform is too expensive," Obama said, "but I can assure you that doing nothing will cost us far more in the coming years."

His warnings come as reservations have been expressed by health-care providers, Congress, and the public. The brief ride from the airport to the high school where he spoke featured a rare sight for him: a large gathering of protesters.

Signs held among the several hundred demonstrators on his route said "NObama" and "No to Socialism."

Back in Washington, Republicans assailed any inclusion of a public-insurance option in a new system of expanded health care.

"We see that as a slippery slope to having the government run everything," Sen. Mike Enzi (R., Wyo.) said at a news conference.

But Obama, answering a question, said no one - "certainly not me" - was interested in a nationalized health-care system such as that in Britain. The president said the government was not going to force any change upon people who are pleased with the plan they already have with their employer.

For his goal of reshaping the nation's health-care system to bring down costs and extend coverage to 50 million uninsured Americans - an overhaul that has vexed Washington for decades - Obama has set an August deadline.

"This next six to eight weeks is going to be critical," he said, asking the audience to lobby Congress to get it done. If the country puts off health-care reform, he said, "it's never going to happen."

Senators of both parties agree on many big issues, including getting all Americans covered and prohibiting insurance-industry practices that deny coverage to people with health problems. But there remain major disagreements on how to pay for the $1.5 trillion it will cost over the next decade to cover the uninsured.

Pelosi Confirms Public Health Plan

The U.S. House's health-care overhaul measure will include a government-run insurance plan that "will be paid for," Speaker Nancy Pelosi (D., Calif.) said.

"In our house there is great support for" the so-called public-option insurance program, Pelosi said yesterday at her weekly news conference in Washington.

In the Senate, Republican criticism of proposals for a government-run program has led lawmakers of both parties to consider instead creating nonprofit cooperatives that would provide coverage to the uninsured.

The cooperatives would be allowed to negotiate directly with health-care providers for low-cost rates.

Pelosi said that House members want a government-run plan to "be a real competitor, not something that has an overwhelming advantage" over private insurance plans.

Republicans have said a government-run program could endanger the insurance industry because of cost advantages the public option would enjoy.

House staff members "will have something on the table

in a week or two," perhaps with cost estimates for most of it, Pelosi said.

- Bloomberg News

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