The debate over health care, long simmering on the backburner as the White House tackled other issues, is now coming to a boil.

"After decades of inaction, we have finally decided to fix what's broken about health care in America," President Obama said in Green Bay, Wisc., Thursday.

It was a campaign-style kickoff in the effort to pass a health care bill this summer, signaling that after a largely hands-off approach, Obama himself was ready to dedicate the political capital ready to achieve historic legislation.

Despite the sudden public focus, Obama went out of his way Thursday to assure the audience that health care reform wasn't "something I just cooked up." To be sure, aides have been working with the principles in Congress behind the scenes through the first five months of the new administration.

A significant part of the stimulus package, signed in February, was what Obama calls a "down payment" changes to the system. An Office of Health Care Reform was created in April, after the delayed confirmation of Kathleen Sebelius as Health and Human Services Secretary. And just weeks ago, Obama heralded what he called a historic agreement of health care stakeholders to decrease costs in the next decade.

But as to specific legislation, the White House has been content thus far to leave most of the deliberations to lawmakers, as was the case with the stimulus bill.

"One of the approaches that I've tried to take is to not just put down my plan and say, ‘It's my way or the highway,'" Obama said Thursday. "It turns out is Congress doesn't really like you to just tell them exactly what to do."

It's been a wise strategy so far, especially on considering past efforts on the issue.

"They're climbing up the mountain in a very quiet way," David Gergen said in a recent interview, comparing it to the Clinton administration's "full court press" to sell legislation it largely authored itself. "In a Democratic Congress the [Clinton] bill never got out of committee, [but] they're going to get a bill out of committee here," Gergen said.

But as the issue has percolated in the past week, fissures within the Democratic Party on the proper approach have widened. At this point, there are several competing frameworks coming from different sources. Just this week, Sen. Kent Conrad (D-N.D.) called for a series of "co-op" health care plans as a potential compromise on the public option. House Speaker Nancy Pelosi said Thursday, however, that such a plan wouldn't pass muster among the House Democratic caucus.

Obama has yet to weigh in on some of the most contentious issues, and the White House to date simply points to a letter the president sent weeks ago outlining general principles he wanted included.

"He's not a senator," press secretary Robert Gibbs said Wednesday, as reporters asked for the administration's reaction to specific proposals.

Republicans, meanwhile, wonder if there is not an ulterior motive at play by the White House here.

"I think they're making far more politically tactical moves these days by not releasing legislation," said Rep. Paul Ryan (R-Wisc.), a member of the House Ways and Means Committee. "Their plan is to put that stuff out at the very last minute, rush it through the committee, rush it off the floor, and get it into law. ... That's not being honest with the American people. That's not at transparent legislative system."

The president signaled otherwise, saying he was "open minded."

"This debate is going to evolve over the next eight weeks," he said. "If people can show me, here's a good idea and here's how we can get it done and it's not something I've thought of -- I'm happy to steal people's ideas."

That would be hard, Ryan said, when very few Republicans, save perhaps for Sen. Chuck Grassley (R-Iowa), ranking member of the Senate Finance Committee, have been invited to participate in meetings with the White House.

One thing Obama has staked out clearly, though, is his desire for a public health care option, pleasing Democrats who say it is the only true mechanism to guarantee competition and drive down costs. Most Republicans oppose such a plan, with some calling it a deal-breaker.

"Government can't match consumers and markets when it comes to lowering cost, improving quality and boosting productivity," former Massachusetts Gov. Mitt Romney wrote in Newsweek last month. "The right answer for health care is to apply more market force, not less."

As governor, Romney signed a first-of-its kind health care bill at the state level. Though not perfect, Romney aide Eric Fehrnstrom said it's working today, and that with thoughtful compromise, passed with broad support.

"Liberals attack it because it's not single-payer and there's no government insurance option. Some conservatives object to it because of the individual mandate. But the people of Massachusetts like what Romney did," he said. "The overall lesson for President Obama and national health care reformers is that strengthening the private market is the way to go."

Former President Clinton told the New York Times in a story published Thursday that a compromise could be reached nationally, because the set of proposals, contentious as they may be, are "more politically saleable" today than they were when he pushed for reform.

"He's got a better Congress, a more receptive climate," he said.