WASHINGTON (AP) – Now for the hard part.

Even if the national credit card is maxed out and partisanship remains the rule for Washington’s political tribes, President Barack Obama and Congress are plunging ahead with a health care overhaul.

In the week ahead, Obama will start the dialogue on how to increase coverage, restrain costs and improve quality.

Whether a bill can get through Congress and to Obama this year is uncertain.

Obama plans to stress the need for major changes in his address to Congress on Tuesday, administration officials say. He quickly will follow up with a budget that includes a commitment to expand coverage for the uninsured.

Spending $7,900 a year

“They don’t intend to blink. They intend to plow ahead,” said health economist Len Nichols of the nonpartisan New America Foundation.

People in the U.S. spend $2.4 trillion a year on health care, or about $7,900 per person. That’s more than twice as much per capita as in other advanced countries. But few would claim those dollars are buying good value.

Polls show most people support coverage for all and believe government should help guarantee it. But what looks like consensus starts to break down once thorny details such as costs and the government’s influence on the doctor-patient relationship come into the picture.

Overhaul the market

The plan laid out in Obama’s campaign calls for government, employers, families and individuals to keep sharing financial responsibility for health care. The approach would overhaul the health insurance market, particularly for self-employed people and small businesses. It would set up a national insurance purchasing “exchange” through which people would be guaranteed access to private health insurance or the choice of a new public plan.

Obama sees coverage for all as a goal to be reached in steps. His plan would not require every individual to purchase insurance. The estimated cost is about $90 billion a year, to start with.

The initial work has fallen to the Senate, where Democratic Sens. Max Baucus of Montana and Edward Kennedy of Massachusetts want to present a bill by the summer.

Baucus is chairman of the Senate Finance Committee, which oversees Medicare and taxes. Kennedy, who is under treatment for brain cancer, leads the Senate health committee. He has pursued the goal of coverage for all his entire career and doesn’t want this opportunity to slip away.

It takes 60 votes to get a bill through the Senate, and Democrats don’t have them.

In the House, the effort seems to be moving more slowly.

Senior aides from leadership offices and committees are talking. Rep. Henry Waxman, D-Calif., is expected to take a leading role.

Some experts believe the issue is too complicated to try to accomplish in one year and one bill.

Watching and waiting are people such as Robyn Perry, 56, of Lake Worth, Fla., who recently lost a job with health benefits. She has struggled to find coverage now that she is self-employed. Private plans are either too expensive or won’t take her because she had a ministroke several years ago. A plan sponsored by local government accepted her, but won’t cover her outside her county.

“Something has to be done,” said Perry. “I work. I make decent money. But I still can’t get coverage. I would really like to find a normal health insurance plan that would cover me wherever I get sick, not just in Palm Beach county.”