Washington: US President Barack Obama has called for "courage" from Democratic lawmakers unnerved by looming final votes on his historic health care plan in a pivotal political week that may shape his presidency.
Obama made a lightning trip to Ohio to showcase the plight of a cancer-stricken woman deprived of health insurance, while a game of political brinkmanship unfolded in Washington as Democratic leaders hustled for votes.
"We need courage -- that`s what we need," Obama roared, at a raucous rally in Strongsville, Ohio, a state where people live in fear of losing health insurance when their jobs disappear in tough economic times.
"We need courage, that`s what we need... we need an up or down vote -- it`s time to vote," Obama said, before dashing back to Washington to rejoin the fray in what the White House says is the last week of a year-long struggle.
Democratic leaders are imposing intense pressure on wavering Democrats as they seek a 216-majority vote this week in the House of Representatives, part of a complex legislative minuet to enact reform also involving the Senate.
Some top Democrats have said the votes are still not assured, and a dramatic few days of arm twisting are expected on Capitol Hill.
But the President offered an upbeat prediction in an interview with ABC News.
"I believe we are going to get the votes, we`re going to make this happen," Obama said.
Failure to pass the plan, to expand access to more than 30 million Americans, cut costs and rein in insurance company abuses, would be a devastating blow to Obama`s authority and political ambitions.
But Republicans complain his plan would hike taxes, do little to stem runaway health costs, and further inflate the already bulging one-trillion dollar-plus federal budget deficit.
Democrats have thirsted for comprehensive health care reform for generations, but a year of fierce rows with Republicans has sapped public support for the bill, and many lawmakers fear casting a career-ending vote.
The President told the story of Ohio woman Natoma Canfield who survived cancer but was priced out of the health insurance market by rising premiums, and is now fighting for her life in hospital in a new bout with leukemia.
"You want to know why I am here Ohio? I`m here because of Natoma," Obama roared, in one of his most passionate attempts yet to convince lawmakers to back his reforms.
Canfield wrote to Obama about her story, after being forced to give up her health insurance after spending 10,000 dollars last year -- and he read her letter to chief executives of health insurance giants two weeks ago at the White House.
But she has since fallen ill again, being diagnosed with leukemia at the weekend, and now faces weeks of costly chemotherapy.
Intense politicking on health care meanwhile speeded up on Capitol Hill with a key House committee considering final legislation. Obama has delayed a trip to Asia by three days, until March 21, in hopes the plan could be voted on and reach his desk for signature before his departure.
The White House and allies devised an intricate plan that would have House Democrats pass a Senate version of health reform that is fervently disliked by many House lawmakers.
If his plan works, Obama would sign the bill into law and then both chambers would pass "fixes" to the legislation demanded by the House Democrats.
That process, known as "reconciliation," would let Democrats frustrate Republican filibuster obstruction tactics in the Senate and allow the health care overhaul to be finalized before Congress goes into recess on March 26.
But Republicans stepped up their rhetoric, complaining that the reconciliation process, normally used for budget bills, should not be used for a reform so sweeping as health care.
"Americans are watching what happens when it becomes necessary to push political kickbacks and bend the rules so perversely to give members of the majority party who wouldn`t otherwise support this legislation political cover," said Eric Cantor, the Republican whip in the House.
The House Budget Committee meanwhile voted to send the reconciliation bill to the full chamber, possibly opening the way for a final drama by the end of the week.