Barack Obama's bid to overhaul the US health care system reaches a dramatic climax Thursday as the president gathers Democratic and Republican leaders for a last-gasp televised debate.
Almost nine months after proposals were first tabled in Congress, Obama is challenging opposition Republicans to stop obstructing his top domestic priority and come on board a plan to cover 31 million uninsured Americans.
The president has invested too much political capital to delay further and faces a pivotal moment in his presidency as he makes one final effort to win over lingering Democrats and a skeptical, recession-battered American public.
Obama, Vice President Joe Biden and other leading Democrats will square off with top Republicans such as Senate Minority Leader Mitch McConnell and Arizona senator John McCain for a live debate around the same table.
The unusual event, which promises to be a classic piece of Washington political theater, will play out over six hours from 1500 GMT at Blair House, a former presidential residence across the road from the White House.
Republicans have dismissed the so-called "summit" as a sham, accusing the White House of having already decided to force a bill through the Senate using a process called reconciliation to bypass their delaying tactics.
"It seems to me the president's already made up his mind," McConnell told reporters on Tuesday.
The White House said Obama would open Thursday's debate followed by Republican and Democratic leaders speaking on four talking points: controlling costs, insurance reforms, reducing the deficit, and expanding coverage.
A sign of its knife-edge importance, Republicans insisted on a table set-up after coming off second best at a recent annual party retreat in Baltimore when a professorial Obama appeared to be lecturing them from a podium.
Obama unveiled his own plan on Monday in what was seen as a last-ditch effort to break the deadlock in Congress and prevent Republicans from further stalling his agenda ahead of crucial mid-term elections in November.
After months of wrangling, the House and the Senate adopted different versions of a reform bill late last year but they must be combined into a single piece of legislation for Obama to sign into law.
Republicans derailed that process last month by capturing a crucial Massachusetts Senate seat that gave them the power to delay final votes with endless debate using a legislative tactic called a filibuster.
If Thursday yields no sway, Obama is increasingly expected to try to use reconciliation, a procedure reserved for budget-related legislation, to drive a bill through with a simple Senate majority of 51 votes, which he should have.
Criticized last year for failing to get personally involved in framing the legislation, Monday's announcement saw Obama take full ownership of the Democrats' health care bill for the first time.
He had reason to be wary as a similar move by former president Bill Clinton ended in a spectacular failure that saw the Democrats lose control of both the House and the Senate in mid-term elections in 1994.
The Obama plan sticks largely to the Senate version of the legislation while embracing certain aspects from the House bill and a few proposals put forward by the Republicans.Facts:Main points of Obama health care plan
Tapping into popular anger at recent premium hikes by leading insurers, it would grant the federal government greater power to block such moves and create a new monitoring body of health industry experts.
The 950-billion-dollar proposal claims it could reduce the US budget deficit by 100 billion dollars over the next 10 years and by one trillion dollars over the second decade by reining in waste, fraud and abuse.
In a boost to Obama's chances of passing a bill, key Democrats expressed willingness ahead of the summit to use reconciliation to force legislation through the Senate due to what they said was blatant Republican obstructionism.
The United States is the world's richest nation but the only industrialized democracy that does not provide health care coverage to all its citizens.
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