President Obama offered a wonkish defense of his embattled health-care reform effort during an hour-long town hall meeting in Northern Virginia yesterday that featured seven questions, including one sent via Twitter and several from a handpicked audience of supporters.

With the president's health-care ambitions meeting a cool reception on Capitol Hill, the administration is increasingly seeking to pressure lawmakers with evidence of the public's desire for action as well as proof that the health-care industry is a stakeholder in -- not an opponent of -- the effort.

"The naysayers are already lining up," he said in remarks before taking questions. The challenge for opponents, he said, is: "What's your alternative? Is your alternative just to stand pat and watch more and more families lose their health care?"

Obama made his pitch before an audience of about 200 people at Northern Virginia Community College's Annandale campus, including students, administrators, professors and local residents. But the real targets of the message were far beyond Annandale, and the White House is hoping to use social media sites such as Twitter and Facebook to reach constituents across the country.

"This is a moral imperative, and it is an economic imperative," he told the live and online audience as he waded through health-care financing statistics.

Even as he spoke, the Republican Party live-blogged its opposition. "Obama says our economy is in crisis because of health care costs," wrote Matt Moon, deputy research director at the Republican National Committee. "But his government-run plan will make it even worse, putting our country further into debt."

In the stage-managed event, questions for Obama came from a live audience selected by the White House and the college, and from Internet questions chosen by the administration's new-media team. Of the seven questions the president answered, four were selected by his staff from videos submitted to the White House Web site or from those responding to a request for "tweets."

The president called randomly on three audience members. All turned out to be members of groups with close ties to his administration: the Service Employees International Union, Health Care for America Now, and Organizing for America, which is a part of the Democratic National Committee. White House officials said that was a coincidence.

The most dramatic moment came from Debby Smith, 53, of Appalachia, Va., who was near tears as she described for Obama her fragile health, including a recently discovered tumor for which she cannot get treatment.

Obama waved her over and hugged her, saying, "I don't want you to feel like you're all alone." He promised to "find out what we can do within existing law" and called Smith the "perfect example" of the kind of person his health plan is intended to help.

Afterward, Smith seemed less than satisfied with Obama's reassurances, telling reporters that it was still unclear how she would get the treatment she needs before she becomes eligible for government aid in nine years.

Obama's other audience questions came from a union worker who asked what she could do to help him, and another from a health-care activist who urged him to talk about how to make health care more affordable.

One Twitter user asked whether it makes sense to tax people's health-care coverage as a way to pay for reform. That led Obama to offer a long explanation of the various financing proposals, including his own for limiting deductions for the wealthy.

"This is something that's going to be debated in the House and the Senate," he said.

A Texas physician -- later proudly identified by the White House as Rep. Michael C. Burgess (R) -- challenged Obama to support caps on medical malpractice awards, something the president has refused to do.

Another video question came from someone named Steve, who wondered why the president does not simply advocate a "single-payer" plan that would involve the government insuring all Americans.

Obama was ready for the question. He launched into an explanation of the evolution of the American health-care system, calmly describing how difficult he thinks it would be to shift it to one based on a European model.

"For us to transition completely from an employer-based [system] . . . could be hugely disruptive," he said. "We should be able to find a way to create a uniquely American solution to this problem."


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