STRONGSVILLE, Ohio — Speaking to a boisterous crowd of 800 in suburban Cleveland here, President Barack Obama made an impassioned appeal for health care reform.

Even before he entered the gym at the Ehrnfelt Recreation Center in Strongsville, the audience was chanting repeatedly “What do we want? – Health Care! When do we want it? – Now!” and “Yes, we can!”

The crowd erupted enthusiastically when Obama was announced and continuously interrupted his 30 minute speech with applause and supportive comments.

The speech had a special significance since Strongsville is in the district of Rep. Dennis Kucinich, who has threatened to vote against Obama’s plan on grounds that it does not go far enough to reduce costs to consumers. Kucinich and Obama sat next to each other on Air Force One from Washington and the two reportedly spent the entire trip discussing health care reform.

The speech also had special meaning because of a letter Obama had received from Natoma Canfield of nearby Medina which he had read to a recent meeting he had with insurance company executives.

Obama had hoped Canfield, a self-employed cleaning woman, would be at his side but two weeks ago she collapsed and had to be hospitalized where she received two blood transfusions and was diagnosed with leukemia.

Canfield lost her insurance in January after paying premiums for 16 years. Her insurance company kept hiking the premiums because she had been diagnosed with a treatable form of cancer. Last year she paid $6,000 in premiums plus $4,000 out of pocket for co-pays and prescriptions. Since she didn’t reach her deductible, her policy only paid $900.

Then the company hiked her premium 40% and she would not have been able to make the mortgage payment on her home, so she cancelled her insurance and wrote the President.

“Natoma is in the hospital and that’s why I’m here,” Obama said.

With anger rising in his voice and the crowd continually cheering, Obama went on:

“I’m here because I remember my own mother, in the last six months of her life, on the phone in her hospital room arguing with insurance companies when she should have been spending time with her family.

“I’m here because of the millions denied coverage because of pre-existing conditions – or dropped from coverage when they get sick.

“I’m here because of the small businesses forced to choose between health care and hiring.

“I’m here because of the seniors unable to afford the prescriptions they need.

“I’m here because of the folks seeing premiums going up by thirty, forty, fifty percent in a year.

“I am here because this is not the America I believe in – and it’s not the America you believe in.

“And so when you hear people say ‘start over’ – I want you to think of Natoma. When you hear people saying that this isn’t the ‘right time’ – think of what she’s going through. When you hear people talk about who’s up and who’s down in the polls – instead of what’s right or what’s wrong for the country – think of her and the millions of responsible people – working people – being hurt by today’s system of health insurance. And I want you to remember: There but for the grace of God go I.”

The status quo is unsustainable, Obama said. “We can’t have a system that works better for insurance companies than it does for the American people.”

As the audience shouted, “No, No, No,” Obama blasted “those who believe the answer is to simply unleash the insurance industry, by providing less oversight and fewer rules. I call this the ‘putting the foxes in charge of the hen house’ approach. It would only give insurance companies more leeway to raise premiums and deny care.”

Obama said his plan would “end the worst practices of insurance companies” would guarantee everyone coverage regardless of pre-existing conditions or length of illness. It would provide free preventive care and let young adults stay on the parents plans until they are 26. It would provide tax credits for middle income people and pay for it by cutting the subsidies to insurance companies which are draining Medicare. The plan would also close the “donut hole” in prescription drug coverage for seniors.

Obama blasted his Republican opponents who claim his plan is “a government takeover of health care,” that it sets up “death panels” deciding if someone lives or dies and harms Medicare. The plan in fact “adds almost a decade of solvency to Medicare,” he said.

“I believe Congress owes the American people a final up or down vote,” he said and someone in the crowd shouted, “we need courage.”

“Yes,” Obama said, “we need courage,” as the crowd erupted in cheers.

“Because in the end, this debate is about far more than the politics. It’s about what kind of country we want to be. It’s about the millions of lives that would be touched and, in some cases, saved by making private health insurance more secure and more affordable. It’s about a woman, lying in a hospital bed, who wants nothing more than to be able to pay for the care she needs.

“And the truth is, what is at stake in this debate is not just our ability to solve this problem, but our ability to solve any problem. The American people want to know if it’s still possible for Washington to look out for their interests and their future. They are waiting for us to act. They are waiting for us to lead. And as long as I hold this office, I intend to provide that leadership. I don’t know about the politics. But I know what’s right. So I am calling on Congress to pass these reforms – and I look forward to signing them into law.”