US President Barack Obama has begun public consultations on how to reform the country's health care system. More than 120 health experts have gathered at the White House to discuss possible ways forward.
The US spends more than $2 trillion a year on health care, although nearly 50m people have no medical insurance.
Mr Obama made public health a key part of his election campaign and has pledged to make quality and affordable care available to everyone in the US.
He told the experts at the health forum - including doctors, nurses, insurance professionals and lawmakers - there would be no "sacred cows" in the discussions.
"In this effort, every voice must be heard. Every idea must be considered. Every option must be on the table," he said. Mr Obama said there could be "no debate" about whether all Americans should have access to decent, affordable health care: "The only question is, how?"
Attempts by previous administrations to reform the massively expensive system have collapsed in disagreements.
But Mr Obama said America's soaring health care costs were now "the biggest threat to our nation's balance sheet" and that anyone seeking to block reforms would "not prevail this time".