In his address to Congress on Wednesday night, President Barack Obama struck a bipartisan note, praising individual Republicans for their past work on health care and promising an open mind on constructive GOP proposals. "Now is when we must bring the best ideas of both parties together," he declared. It's an approach that could pay dividends in the form of a package that Republicans as well as Democrats could support — if the president would embrace it for real.

That seems less likely, given the recriminations prompted by Republican Rep. Joe Wilson's impudent outburst during Obama's speech.

The bewildering thing about the debate is that on many issues, the two sides are in basic agreement. The Patients' Choice Act drafted by House Republicans echoes the White House on things like guaranteeing access to insurance, assuring affordable premiums and giving tax subsidies to help lower-income people pay for coverage. Yet Obama and congressional Demo-crats have made little effort to structure their plan so as to bring Republicans on board.

That's a politically dangerous strategy. True, Democrats have enough votes in Congress to ram a program through almost entirely on their own. But that approach would alienate moderate and independent voters. Right now, only 53 percent of Americans think his plan would improve health care. This slim majority is an argument for incremental, bipartisan change.

The biggest sticking point is the "public option" — a government-run insurance plan to compete with private insurance coverage. Republicans fear that it will unfairly undercut private insurers by using the government's power to squeeze providers or by pricing below cost and making up the loss with tax revenues. They also worry that it would lead to a system in which the federal government is the only option.

This component is not necessary to stimulate competition: The same thing could be done by letting health insurance companies compete nationally, as auto and life insurers do. Keeping it in the bill only gets in the way of bipartisan compromise.

So the president should offer to give it up. What he should get in return is the individual mandate he seeks, an idea incorporated by GOP Gov. Mitt Romney in his Massachusetts health care reform and one endorsed by many conservative experts. Absent a mandate, many consumers would game the system by buying policies only when they get sick.

Republicans generally don't like the idea of requiring coverage. But in exchange for some administration concessions — give up the public option, agree to modest but genuine malpractice limits — some might be persuaded to go along. After all, the individual mandate rests on the impeccably conservative idea that each person should take responsibility for his or her own health care bills, rather than impose a burden on others by showing up uninsured at the emergency room.

There is a gulf between Democrats and Republicans on how to reform health care. But it's not so large that it can't be bridged. That can be done, if each side will focus on how to make it hard for the other to refuse.