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WASHINGTON (AP) -- President Barack Obama is having better luck with the health industry than with his former colleagues in Congress in his push to overhaul the U.S. health care system.
On Wednesday, the nation's hospitals agreed to give up $155 billion in future payments to help defray the cost of Obama's plan, the latest major concession exacted by the White House. In recent weeks, U.S. pharmaceutical companies have agreed to cut costs for the elderly and help pay for the health care overhaul. Concessions from doctors could be next.
"Reform is coming. It is on track; it is coming. We have tried for decades to fix a broken system, and we have never, in my entire tenure in public life, been this close," Vice President Joe Biden said at the White House in announcing the hospital deal.
But details of the health care overhaul are being worked out by Congress, and lawmakers are far from united on how to overhaul the health care system and cover a cost expected to exceed $1 trillion over 10 years.
Timing is critical for Obama, who has made health care his top domestic priority. He has argued that medical costs rising into the trillions threaten to overwhelm the U.S. economy. Nearly 50 million Americans lack health insurance. Even for those with coverage, the rising price of health care takes a large chunk out of their monthly budgets.
Obama needs Congress to act quickly, knowing that lawmakers might be reluctant to vote on such a charged issue as health care closer to next year's midterm congressional elections.
He wants to sign a bill into law in October. That would leave lawmakers with a tough five-week stretch to draft legislation and vote on it before they leave for a one-month recess.
It also leaves little time to resolve differences not only between parties, but among the Democrats who control both chambers of Congress.
In the Senate, where Obama served before becoming president, Democrats have rebelled against a proposed new tax on generous health insurance benefits provided by some employers. Republicans favor the tax as a brake on cost increases. Without it, prospects for a bipartisan deal appear to be in jeopardy.
"I don't see it as having any viability," Sen. Christopher Dodd, a Democrat, said Wednesday of the proposed tax.
"We're not there yet," said another Democratic senator, Max Baucus. As chairman of the Senate Finance Committee, Baucus has spent countless hours seeking a compromise with Republican colleagues. "I'm trying the best I can to get there soon."
Obama and Democrats would prefer a bipartisan bill, not only to ensure broader public support but to make it easier to get votes. While Democrats have a significant majority in the House, the defection of a few moderate Democrats in the Senate could doom the outlook for health care.
Unlike most developed countries, the United States lacks a taxpayer-funded health care system that covers most of its citizens. Americans rely on private insurance, often provided by their workplace.
Baucus has long championed a tax on health benefits to pay for health care while simultaneously restraining the growth of the cost of coverage. But the idea has drawn strong opposition from organized labor, a core Democratic constituency. Democrats in the House of Representatives have been highly resistant, too, and Obama campaigned hard against it in last year's run for the White House.
Obama has largely let Congress work out specifics of the bill, but he has offered general guidelines. He favors creation of a government-run plan to compete with private insurers, which Republican lawmakers maintain would drive private companies out of business. The president would provide subsidies to low-income people to help them get insurance.
In courting the health care industry, Obama is trying to avoid the conflicts that doomed President Bill Clinton's attempt to overhaul health care in the 1990s.
The administration has reached out to various groups -- drug makers, major employers, doctors and the hospitals -- not only to get their backing, but to persuade them to give up some of the fees they are likely to receive.
The administration's argument is simple: The millions of uninsured Americans who would get coverage in the next few years would add up to a huge new group of customers, possible sources of income for the industry.
Last week, Wal-Mart, the world's largest private employer, broke with other big firms and said it supports a requirement in the proposal for many companies to offer health care to their workers.
Yet the deal with hospitals announced Wednesday also may be on shaky ground. Officials said it is pegged to the Senate Finance Committee legislation that Baucus is negotiating, and whose prospects are uncertain.
Even though Obama was traveling overseas in Europe, his top aides were making his intentions clear in congressional offices. White House Chief of Staff Rahm Emanuel did not make the trip with Obama and instead met with lawmakers trying to write health care legislation.
Associated Press writers David Espo, Erica Werner and Ricardo Alonso-Zaldivar contributed to this report.