President Barack Obama fiercely defended his embattled campaign to overhaul US healthcare, calling it vital to nursing the economy to long-term vigor after a "full-blown crisis."
Facing a defining moment six months into his presidency, Obama warned at his fourth prime-time press conference that a political stalemate must not be allowed to kill what he has described as a central plank of his domestic platform.
"As we rescue this economy from a full-blown crisis, we must rebuild it stronger than before. And health insurance reform is central to that effort," the president said in the White House's ornate East Room.
The US Congress has been groping its way forward on overhauling a healthcare system that leaves some 47 million Americans uninsured, but it is unclear when or even whether the Senate and House of Representatives will act.
Recent public opinion polls suggest growing unease about Obama's approach, with his own approval ratings still healthy but showing some signs of weakness in the face of a relentless onslaught by his Republican critics.
The president was undaunted, declaring: "We will pass reform that lowers cost, promotes choice and provides coverage that every American can count on. And we will do it this year."
And Obama tied the bid, including plans to revamp the government's Medicaid program for the poor and Medicare program for the elderly, to efforts to deflate the budget deficit, which has ballooned to historic girth.
"Let me be clear: If we do not control these costs, we will not be able to control our deficit," he said, warning the price of inaction will be skyrocketing insurance premiums and out-of-pocket costs for the US public, as well as more and more uninsured Americans.
"These are the consequences of inaction. These are the stakes of the debate we're having right now," he warned.
But "the American people are understandably queasy about the huge deficits and debt that we're facing right now," said Obama, calling both problems "deep concerns of mine."
"We have been able to pull our economy back from the brink," he said, adding that "we still have a long way to go" and cautioning that historically high unemployment will likely be "one of the last things to bounce back."
The president said he had "inherited" a 1.3-trillion-dollar deficit upon taking office in January -- but Republicans quickly shot back that Obama's economic stimulus and an emergency war spending bill had sent current estimates for the year's deficit to about 1.8 trillion dollars.
Healthcare reform has bedeviled many administrations, including that of former president Bill Clinton who tried, and very publicly failed, to change the system.
And Republicans are loudly fretting over the cost of Obama's plans, with some branding it "socialism" and warning the deficit will only grow if the popular president has his way.
"Republicans look forward to being able to move a healthcare proposal this year on a truly bipartisan basis and one that doesn't increase the deficit," said Senate Republican Minority Leader Mitch McConnell.
But Republicans want reform "that doesn't put the government in charge of our healthcare, one that doesn't produce a system that in the end delays cares, in many instances denies care," he added.
Obama has received support in some Republican quarters however, including from California Governor Arnold Schwarzenegger, who said reform was needed "right away."
"I would support him 100 percent in healthcare reform, because I think it's necessary," Schwarzenegger told ABC television, adding it was "inexcusable" that so many people remained uninsured.