Barack Obama is determined to get healthcare reform moving in the USA by the end of the year, saying that it is morally and economically vital to start changing the system now.

The need for speedy reform was at the heart of the president’s address to members of Congress, doctors, insurers and leading lights in the pharmaceutical industry such as Pfizer chief executive Jeffrey Kindler. Opening up the White House Forum on Health Reform, Mr Obama said "our goal will be to enact comprehensive health reform by the end of this year," noting that "this time the call for reform is coming from the bottom-up, from all across the spectrum – from doctors, nurses and patients, unions and businesses, hospitals, health care providers and community groups”.

He went on to say that "this time there is no debate about whether all Americans should have quality, affordable health care - the only question is how?" Speaking about ‘this time”, the president was referring back to the failure by the Clinton Administration in the 90s to push through reforms, following objections by Republicans, drugmakers and insurers.

Moral and fiscal imperative to change
Moving slowly is not an option, Mr Obama said, as the present costly but inefficient system is damaging the economy even further. "Healthcare reform is no longer just a moral imperative, it is a fiscal imperative," he claimed.

"If we want to create jobs and rebuild our economy, then we must address the crushing cost of healthcare this year, in this administration." The president added that "by a wide margin, the biggest threat to our nation's balance sheet is the skyrocketing cost of healthcare”.

He called on those who opposed the Clinton plans to enter into an inclusive process, saying all stakeholders must not “give in to the same entrenched interests and arrive back at the same stalemate that we've been stuck in for decades". As to whether the Obama Administration is taking on too much so soon after coming to power, the president said when times were good, “when the economy was better and we were not at war, we failed to get it done”. He added that there is always a reason not to do it and he could think of no better time than now.

There was a general consensus from attendees on both sides of the political divide that the forum had been a positive move. The industry response was also reasonably enthusiastic.

Pharmaceutical Research and Manufacturers of America chief executive Billy Tauzin, who was at the White House, said the forum “provided an important opportunity for all stakeholders to openly discuss effective solutions to build on the strengths of our healthcare system and address its weaknesses”. He said that the nation’s drugmakers “are committed to making sure comprehensive health reform stays on the front burner”.

Mr Tauzin said “we recognise the fact that all stakeholders are going to have to step up to the plate and make sacrifices to accomplish our shared goals”. However he added that “in doing so, it is important that policymakers support the continuation of medical advances”.

As yet there is no meat on the bones of these planned reforms but once the discussions become more detailed, perhaps they will become less cordial