ST. CHARLES, Mo. (AP) -- President Barack Obama denounced waste, inefficiency and downright fraud in the government's health care system on Wednesday as he sought to rally public support for his revamped overhaul plan.
"Improper payments cost taxpayers almost $100 billion last year alone," Obama said at a rally in this St. Louis suburb.
He said such payments amounted to more than is spent on the Education Department and the Small Business Administration combined, and that if there was a "Department of Improper Payments" it would be "one of the largest agencies in the government."
Obama pressed Congress to act on the health care overhaul measure without further delay.
"I believe that Congress owes the American people a final up or down vote on health care reform. The time for talk is over. It's time to vote," he said, his voice rising.
The White House wants Congress to act on the legislation by March 18, when the president leaves on a trip to Indonesia and Australia, a timetable that may be hard for Congress to meet.
"What we're proposing is a common sense approach to protecting you from insurance company abuses and saving you money," Obama said in the campaign-style appearance, his second health care speech outside Washington in a week, with another one scheduled in Ohio on Monday.
Obama cited abuses in the government-run Medicare and Medicaid and in other federal health programs, noting "payments sent to the wrong person, sent for the wrong reason, sent in the wrong amount."
Sometimes "they're innocent errors" and other times deliberate fraud "by scam artists and fly-by-night" operators, Obama said.
He spoke after Health and Human Services Secretary Kathleen Sebelius, the nation's top health care official, challenged insurers to join Obama's push to overhaul the medical system, arguing that if the effort fails it will hurt them as well as other Americans.
She told insurers in a speech earlier Wednesday in Washington that if the overhaul fails, premiums will continue to rise and employers will cancel coverage. She said the industry may make money initially, but "this kind of short-term thinking won't work in the long run for the American people or our health care system. It won't work for you."
As part of the administration's campaign, she sketched out a stark choice for insurers: oppose reform and eventually lose customers, or work with the White House to improve the legislation. Sebelius called on insurers to take the millions they might spend on attack ads and give Americans relief from rising double-digit premium increases.
Groups that oppose the legislation are stepping up their criticism, with the U.S. Chamber of Commerce announcing a coordinated campaign to spend as much as $10 million on ads, starting Wednesday, saying, "Stop this health care bill we can't afford."
Leaders in the House and Senate are awaiting a final cost analysis from the Congressional Budget Office in the next day or so that will allow them to start counting votes -- and twisting arms -- in earnest. In the House, in particular, getting the needed majority will be touch and go.
Republicans are playing on House Democrats' suspicions of their Senate colleagues, arguing that Senate Democrats may not hold up their end of the bargain and the votes will be damaging politically for Democrats in November.
An Associated Press-GfK Poll released Tuesday found a widespread hunger for improvements to the health care system, but also found that Americans don't like the way the debate is playing out in Washington.
About four in five Americans say it's important that any health care plan have support from both parties.
After a year of off-and-on negotiations, Republicans adamantly oppose Obama's plans. The White House and Democratic leaders say it's now or never for the health care overhaul, which would cover an additional 30 million Americans, require almost everyone to buy health insurance and impose new restrictions on insurance companies.
Obama's message Wednesday was aimed at the political middle. The anti-fraud plan he's touting would bring in high-tech bounty hunters to help root out health care abuses, a populist idea with bipartisan backing.
Waste and fraud are pervasive problems for Medicare and Medicaid, the giant government health insurance programs for seniors and low-income people. They range from simple errors such as duplicate billing to elaborate schemes operated by fraudsters peddling everything from wheelchairs to hospice care.
The bounty hunters in this case would be private auditors armed with sophisticated computer programs to scan Medicare and Medicaid billing data for patterns of bogus claims. The auditors would get to keep part of any funds they recovered. The White House said a Medicare pilot program recouped $900 million for taxpayers from 2005-08.
Werner reported from Washington. Associated Press writers Ricardo Alonso-Zaldivar, Charles Babington and Donna Cassata contributed to this report.
(Copyright 2010 by The Associated Press. All Rights Reserved.)