The politics of fear began to dominate the health care reform debate Monday — much as it did in 1993 and 1994 during the fight over President Bill Clinton’s plan — as both sides raged about the dire consequence of each other’s approach.

President Barack Obama sought to take the offensive during a speech to the American Medical Association in Chicago, in part by listing a cascade of calamities he predicted would befall the nation if his proposals are rejected. But he also repeatedly accused opponents of seeking to scare people with charges that he wants to socialize medicine.

Republicans were sounding like a “Harry and Louise— echo chamber, reviving the tone of the TV ads that portrayed the Clinton health care proposal as a threat to people’s existing coverage. Those ads famously helped sink the Clinton initiative.

Obama made clear that he understands the central role that fear has assumed in the health debate.

“We also know that there are those who will try and scuttle this opportunity no matter what — who will use the same scare tactics and fear-mongering that’s worked in the past, who will give warnings about socialized medicine and government takeovers, long lines and rationed care, decisions made by bureaucrats and not doctors,— he said.

Congressional Republicans spent the day charging that Obama’s reform plans would lead to a government takeover of the health care industry, in turn resulting in medical rationing and diminishing quality of care. And they added a new twist: charging Obama with rushing the process in order to dupe the American people.

Republicans suggested Obama is fully aware his reform plans are likely to be met with public resistance and is pushing Congress to approve legislation before voters can figure out what he is doing.

“There’s a reason why the president says: If we don’t get this done soon, it’s not going to happen.’ Why? Why does he say that?— Senate Minority Whip Jon Kyl (R-Ariz.) asked rhetorically during a briefing with reporters.

[IMGCAP(1)]“Because,— Kyl said, “he knows that momentum will inevitably slow for something that will be extraordinarily costly, will deny people the coverage that they already have, will ration their health care and could provide some kind of government insurance company that’s going to drive out the private insurance companies.—

Republicans are almost unanimous in their opposition. They argue that inclusion of a government-run insurance option would financially undercut private insurers. Without the pressure to make a profit, advertise and engage in other normal business practices, the public plan would drive private insurers out of business, they say, creating a health care system with fewer choices and causing Americans who like their insurance to lose their coverage.

“That’s unacceptable to the physicians of America; that’s unacceptable to the patients of America,— Rep. Tom Price (R-Ga.) said to reporters by telephone from the American Medical Association’s convention in Chicago. Price, a practicing physician, is an AMA member.

Obama dismissed such talk.

“We have heard this all before,— he said. “And because these fear tactics have worked, things have kept getting worse.—

But the president himself eagerly waded into the politics of fear.

“Make no mistake: The cost of our health care is a threat to our economy,— Obama said at the outset of his Chicago remarks. “It’s an escalating burden on our families and businesses. It’s a ticking time bomb for the federal budget. And it is unsustainable for the United States of America.—

Obama described a country in crisis, where “Americans of all ages go without the checkups or the prescriptions they need,— and “a single illness can wipe out a lifetime of savings.— It’s a place where doctors fill out forms instead of seeing patients and businesses lay off workers because they can’t afford their insurance. Health care costs are even part of what ailed bankrupt General Motors.

“If we do not fix our health care system, America may go the way of GM — paying more, getting less and going broke,— Obama warned.

“It’s a scenario that will swamp our federal and state budgets and impose a vicious choice of either unprecedented tax hikes, or overwhelming deficits, or drastic cuts in our federal and state budgets,— Obama said.

As his remarks made clear, Obama is determined to erase fears that his plan could ruin the insurance of those with coverage, as was suggested in the “Harry and Louise— ads a decade and a half ago.

“If you like your doctor, you will be able to keep your doctor, period,— he said. “If you like your health care plan, you’ll be able to keep your health care plan, period. No one will take it away, no matter what.—

Despite the rising rhetoric, both Obama and Republicans declared their intention to work together.

Senate Republican Conference Chairman Lamar Alexander (Tenn.) said his GOP colleagues are committed to working in a bipartisan fashion and hope to be given the opportunity to contribute to and improve the forthcoming legislation.

But Alexander indicated that the GOP would not budge from its opposition to the public plan, nor would Republican Senators support a bill that was not funded in an acceptable manner.

“We’re being public advocates,— Alexander said, explaining that GOP strategy calls for leveraging public opinion to compensate for a lack of votes. On health care, Alexander said, Republicans hope to repeat the success they had in raising a public firestorm over Obama’s proposal to move Guantánamo Bay detainees to the United States.

“I think we’re beginning to see the same thing about the so-called government-run health insurance option that would amount to a Washington takeover,— Alexander told reporters.

Republicans said Monday that Members should be given the monthlong August recess to discuss the details of health care reform with their constituents, although they still claimed to be in favor of approving a reform bill this year. Obama contends opponents of reform generally are seeking to delay as a tactic to deny passage of an overhaul altogether.

In the House, there’s virtually nothing the Republicans can do to slow the process or stop the Democratic leadership from passing a health care bill that meets its philosophical specifications.

But in the Senate, Republicans are angling to influence the outcome by using the extensive parliamentary powers afforded to individual Members — and leveraging the desire of some key Democrats to craft a bill that can garner significant bipartisan support, possibly by attenuating or eliminating the public option.

“The Democrats are scrambling to try to come up with a different option,— Alexander said. “So, we intend to be players.—