WASHINGTON – Wednesday night, President Barack Obama is scheduled to try one more time to persuade Congress and the country to change health care.

It's an opportunity to once more focus attention on the importance of slowing down the ballooning cost – a concern that's recognized among some who have fought the president to a standstill.

"All of us agree that health care costs are out of control and we have to bring them under control," Republican Sen. John McCain told ABC News.

After a long and difficult summer debate, what's left of the administration's approach is a plan to extend health insurance to most Americans who don't have it, paid for with tax hikes and cuts in Medicare spending.

Republicans attacked this outline for promoting government health insurance at the expense of private policies, and for cutting the money seniors spend on their health needs.

John Goodman, president of the Dallas-based National Center for Policy Analysis, expects to deliver to Congress this week a petition with 1.2 million names on it opposing any overhaul plan that limits patient choice for physicians and insurance.

Goodman agrees that costs must be reined in and argues that the government should offer incentives to hospitals and physicians that can demonstrate cost savings. He also supports letting consumers shop for health insurance among lots of suppliers.

The biggest care provider in North Texas is Texas Health Resources. Doug Hawthorne, the company's president, said earlier this summer that "health care is way too expensive."

He blamed it on uncoordinated patient care and urged the federal government to let hospitals act as coordinators. He called on Medicare and private insurers to offer bundled payments that allow doctors, hospitals, nursing homes and other caregivers to work with one budget.

Darren Rodgers, president of BlueCross BlueShield of Texas, also worries about costs and says Texas has a spotty record on quality as well. He has urged the federal government to increase reimbursements for hospitals and physicians who treat Medicare patients.

That doesn't sound like a cost-cutting move. But under the current system of paying a fee for each procedure, payment cuts cause doctors to generate more procedures and cause hospitals to shift more of their costs from Medicare patients to patients with private insurance.

Mark McClellan, a physician and health economist who's spent the year urging Congress and the Obama administration to break with the fee-for-service model, last week rolled out a reform plan written by academics and policy wonks from the political left and right.

The plan includes a bundled payment approach. It opposes cutting Medicare payments across the board. It urges more investment in electronic medical records to serve as a foundation for coordinated care delivery. It calls for insurance exchanges where consumers have lots of choices regulated in a manner that pushes insurers to compete on cost and quality. And it includes incentives for consumers to take better care of their own health in return for lower insurance premiums.

Given the deep splits across the country caused by this debate, it may not be possible for all of these local actors to agree on something like McClellan's plan.

But it's a start.