Other bills are expected to follow from a trio of senior House Democrats, including Rep. Henry A. Waxman (D-Beverly Hills), and Senate Finance Committee Chairman Max Baucus (D-Mont.), whose bill may offer the best hope for gaining Republican support.
In addition, a phone-book-size catalog of amendments and less-detailed alternatives -- including many from Republicans seeking to shape the debate themselves -- are expected to compete for attention.
Though they differ on important details, the Democrats' plans all focus on three broad goals, each of which has contributed to stalemate in the past:
* Improving the quality of care for everyone by encouraging doctors, hospitals and others to adopt the best, most effective courses of treatment. Research shows that many doctors fail to adopt advances in treatment and that more than 25% of all treatment may be medically ineffective or unnecessary.
Achieving this goal moves the government into the sensitive area of relations between individual patients and their doctors.
But many health policy experts say such changes could do the most to reduce medical costs and improve care.
"At the end of the day, that may be the most important thing we end up doing," said Ken Thorpe, a healthcare economist at Emory University.
* Curbing the explosive growth in costs by prodding the medical system to make more cost-effective decisions and to increase efficiency by moving to computerized medical records.
The public and employers are staggering under the cost of the present system -- rising at more than twice the rate of inflation and expected to surpass $2.2 trillion this year. But reining in prices can narrow freedom of choice and impose changes on providers.
* Making health insurance readily available to the 46 million people who don't have it, as well as more affordable and less burdensome to those who do, and to the employers who still deliver the bulk of medical insurance to workers.
In one of their most controversial proposals, Obama and congressional Democrats want to create an optional government insurance plan that individuals could choose instead of a private plan. Supporters argue that such a plan would curb costs and improve quality by creating competition for the handful of private insurance companies now dominating the market.
Few proposals ignite hotter partisan passions.
