WASHINGTON (AP)

President Barack Obama picked up the pace on the health-care sales job yesterday, travelling to the industrial Midwestern city of Cleveland in his continuing push for a massive overhaul of a system he says is bankrupting America.

Facing partisan opposition to an issue he has made central to his young administration, Obama sought, in a Wednesday White House news conference, to make his case with American families, urging them to ignore political opportunists and naysayers in order to achieve sweeping changes that have eluded United States presidents dating back to Harry Truman.

"If we do not reform health care, your premiums and out-of-pocket costs will continue to skyrocket," Obama said in his nationally broadcast appearance in the East Room of the Executive Mansion.

He looked past the dozens of assembled reporters and peered straight into the TV cameras. "If we do not act, 14,000 Americans will continue to lose their health insurance every single day."The United States is the only major industrialised nation that lacks a comprehensive health-care plan.

Most Americans with health insurance receive it through their employers, though those who do not, or who are unemployed, must either buy costly insurance or pay medical bills out of pocket. The elderly and indigent receive coverage from the government.

Economy still suffering

Yesterday in Ohio, the president was scheduled to undertake two more events focused on health care, the issue dominating his administration even as the economy still suffers and wars continue in Iraq and Afghanistan. For his supporters, Obama's stepped-up pace is coming not a second too soon.

For all his efforts, which have included public statements each weekday for the past few weeks, Republican lawmakers and other critics sense momentum building against Obama's plan. They particularly cite non-partisan cost projections that have not predicted the savings the White House promises.

"What I heard last night was a president that seems somewhat frustrated that people do not understand what this government health-care plan is all about," Republican Eric Cantor, one of the top House Republicans, said yesterday on NBC television. "I think people still have a lot of questions about what a (new) health-care plan means for them and their families."

Louisiana Governor Bobby Jindal, another leading Republican, said on CBS that he "liked a lot of what he (Obama) had to say last night."

"I think he's actually ... his marketing is the best part of this," Jindal added. "You listen to what the president said. He said he does not want to increase the deficit, does not want government control of health care. He wants people to keep their insurance. He wants to crack down on the abuse, the over-utilisation. All that's great. The problem is, that's not what's in the House Democrat bill."

Despite the many problems gripping the country, the health-care debate has seized the US political debate. The United States is the only major industrialised nation that lacks a comprehensive health-care plan.

The stakes are huge for Obama, who is putting much of his credibility on the line to gain passage of the legislation. At least one Republican said it could prove to be the president's Waterloo if the drive collapses.

But Obama said: "This isn't about me."

He cited examples of Americans whose insurance would not cover cancer treatment or who went into debt after emergency surgery.