But Republican leaders argued instead for ditching the plans and starting again from scratch, calling for more discussions on the issue and saying that America cannot afford Obama's bill as it stands.

That idea was firmly rejected by Obama at the end of the meeting, as he suggested that Democrats will try to pass the sweeping overhauls without Republican support.

"We cannot have another yearlong debate about this," Obama said.

Earlier, Obama cast health care as "one of the biggest drags on our economy", tying the health debate to an issue that is seen as even more pressing to many Americans.

Beginning Thursday's summit of 40 key Republicans and Democrats, he had urged both sides to avoid "political theatre" and focus instead on areas of agreement.

But early on he acknowledged that agreement may not be possible.

"I don't know that those gaps can be bridged," Obama said. "If not, at least we will have better clarified for the American people what the debate is all about."

'Clean sheet'

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Lamar Alexander, a Republican senator, argued at the debate that the new healthcare bill would mean higher taxes, more regulations, and ultimately less choice for the US public.

"We have to start by taking the current bill and putting it on the shelf and starting with a clean sheet of paper," Alexander said.

"This is a car that can't be recalled and fixed."

Passing a version of the health care bill is critical to the president's political future and that of his Democratic party ahead of congressional elections in November.

Both chambers of Congress passed separate bills late last year after months of wrangling.

But before the two versions could be reconciled, Republicans captured the Massachusetts Senate seat in a special election following the death of Edward Kennedy.

That loss cost Democrats their 60-vote supermajority needed to overcome Republican procedural obstacles and pass major legislation.

With little sign of a bipartisan consensus being within reach the White House has now indicated it may end up forcing through a bill using a procedure known as budget reconciliation, which requires only a simple majority of 51 Senate votes.

Compromise

In video


Patty Culhane reports on the US government's failure to reach a deal on healthcare

Democrats have been reluctant to use that process so far because of concerns that it would enrage Republicans and likely further worsen the partisan divide.

Earlier this week, the White House unveiled what it considers to be a compromise bill to break the deadlock over the issue. The new bill would provide healthcare coverage to 31 million Americans without adding to the national deficit.

The proposal would require most Americans to carry health insurance coverage, with federal subsidies to help many afford the premiums.

Under the planned legislation, insurance companies would be barred from denying coverage to people with medical problems or charging them more.

It also grants the federal government greater power to block hikes in insurance premiums and envisages the creation of a new monitoring body of health industry experts.

Estimated to cost about $1 trillion over 10 years, Obama's plan would be paid for by a mix of tax increases, new fees on health care industries and cost cutting in an existing government health care programme for the elderly. 

Speaking after Thursday's health summit, Mitch McConnell, the Republican Senate minority leader, said he was "discouraged by the outcome" of the talks.

He said it was "pretty clear" that Obama and the Democrats wanted to revive the healthcare bill passed by the Senate last December, but said he did not believe there would be any Republican support.