Washington  - US President Barack Obama aimed to claw back some control of the health-care debate with a major speech to Congress Wednesday night, a day after lawmakers returned from a month-long summer recess.

Obama's plans to overhaul the country's health insurance system have stalled in recent weeks. Many of his Democratic Party lawmakers endured harsh attacks from constituents during unruly public meetings.

Obama hopes the rare address to a joint session of Congress may offer a fresh start.

Lawmakers have spent months thrashing out the details, and a final bill could still be months in the making. Obama has said he wants a finished product by the end of the year.

Reforming health insurance in the United States, which has the costliest system in the world, is considered an early test for Obama that could shape the rest of his four-year term and political clout in future legislative battles.

Lawmakers have so far been left largely to their own devices - five different bills are being developed in Congress - and Obama has drawn criticism for not getting more involved in the legislative process.

The White House has so far only laid out the broad strokes of what it hopes will be included in the overhaul, but spokesman Robert Gibbs suggested Obama's speech Wednesday will include "more."

Obama met Tuesday at the White House with the top two Democratic legislators - House of Representatives Speaker Nancy Pelosi and Senate Majority Leader Harry Reid.

"We think we're up to 90 per cent of things that are agreed upon. We have 10 per cent that we need to work on, and we can do that," Reid told reporters after the meeting.

Though Obama has not attached himself to any specific proposals, he has been fending off sharp criticism from centre-right minority Republicans, who are firmly opposed to creating new government programmes that would increase federal spending.

But Obama has also angered some left-wing Democrats by downplaying the importance of the so-called public option, a programme designed to provide government-run medical insurance to some of the nation's 46 million people who are without coverage.

History is not on Obama's side, as many predecessors have failed to enact major health care reforms in the last four decades. Opinion polls suggest the country is sharply divided.

A Gallup Poll issued Tuesday found 39 per cent of Americans would advise their legislator to vote against any health-care reform bill, while 37 per cent want their lawmaker to vote in favour.

An inability to pass significant health reforms could sap Obama of the political muscle he needs to push through other key measures on issues like climate change, financial regulation and closing the prison for terrorist suspects at Guantanamo Bay.

Meanwhile, a compromise effort continues among a bipartisan group of senators. Legislators in the Senate Finance Committee are currently working on a deal that could create government-backed co- operatives in lieu of the public plan.

The United States has the costliest health system in the industrialized world, consuming about 16 per cent of economic output. (dpa)