On Wednesday President Barack Obama is going to address Congress in an attempt to regain control of health care reform, which is one of his top legislative priorities.
Obama's speech comes after many legislators were heckled by irate health insurance reform opponents over the summer at public forums on health care, dubbed "town hall meetings."
The speech is seen as crucial test for Obama, who also faces a drop in support for the war in Afghanistan as security deteriorates and casualties rise in the eight year-old conflict.
Obama's health care reform plans -- a key plank of his 2008 presidential campaign -- face trouble especially over "public option" plans, which supporters say are necessary to keep the insurance industry honest and help cover the 46 million uninsured Americans.
The debate has dented Obama's popularity: a Pew Research Center poll released Friday has the president's approval rating dropping 10 points, to 52 percent, since his 100-day mark in April.
The economy however was giving some encouraging signs, with the number of job losses decreasing in August.
On Monday, Labor Day in the United States, Obama told union workers in Cincinnati, in the northern state of Ohio, that the country is on the "road to recovery" after a year of financial turmoil, AFP reports.
AFP quoted Obama as saying, "We're also going to build an America where health reform delivers more stability and security to every American."
It was also reported, health care may swallow efforts to address climate change, while the weak economy and shocking deficits fuel public fears about the government's capacity to launch costly new social programs.
Obama, who for months has left details of health reform to Congress, will become "the decider" Wednesday evening, laying out specifically what he wants in health reform and setting the contours of the battlefield.
Nothing will loom larger than his endorsement or abandonment of a public option.
Liberal Democrats are terrified that he will jettison their Holy Grail, while conservatives fear that a vote for a public option - characterized by opponents as leading to government-run health care - could doom them in tough re-election fights, San Francisco Chronicle reports.
In the meantime, Medicare was enacted in 1965 under President Lyndon B. Johnson as a national health care plan for the disabled and for people 65 and older. Those enrolled in the program may generally visit doctors and other providers they choose, and the federal government repays the provider through a negotiated fee-for-service rate.
Over 43 million people were part of the program last year and the number is expected to swell to 77 million by 2031. Medicare's costs have skyrocketed and regulators have warned that the program is headed for insolvency if changes aren't made. Driving the costs are rapidly rising enrollment, a new prescription drug benefit that was never financed and the reality that the payroll tax rate that pays for the program has not gone up since 1986.
Conservatives for years have called Medicare a government takeover of a huge part of the economy, the Associated Press reports.