By:  Jake Wagman, Blythe Bernhard, Mark Schlinkmann

President Barack Obama brought his health care road show to the St. Louis area Wednesday, announcing a crackdown on waste and fraud in hopes of persuading a gridlocked Congress to pass sweeping health insurance reform.

After delivering a speech in St. Charles, Obama appeared at a downtown St. Louis fundraiser for U.S. Sen. Claire McCaskill, D-Mo. Hundreds of protesters appeared in St. Charles and in downtown St. Louis, many to express opposition to the health care plan.

Obama’s speech in a stuffy gymnasium at St. Charles High School, his second health care address in three days, is part of a White House push to take the debate from the halls of Congress directly to voters, allowing the administration to frame the issue in its own terms.

Earlier in the week, Obama used the prospect of rising insurance premiums to make the case for health care reform. On Wednesday, in front of an invitation-only crowd in St. Charles, he offered a new angle, announcing additional oversight of federal programs.

Obama was joined on stage by McCaskill, a former state auditor whom the president praised as a person who “just pinches pennies.”

“Washington is a place where tax dollars are often treated like Monopoly money,” Obama said, “where waste — even billions of dollars in waste — is accepted as the price of doing business.”

Obama signed an executive memo Wednesday calling for greater use of “payment recapture audits,” which allows federal government departments to hire private auditors to find taxpayer funds paid in error or through fraud. The auditors can be paid based on the amount of improper payments they reclaim, providing incentive to root out waste.

The audits could be used to prevent overpayment in Medicare, Medicaid and, potentially, any new or expanded health care program.

The audit plan, which has bipartisan support, comes as Obama attempts to pick certain Republican ideas that could make his health care package more palatable across the aisle. Obama also expressed interest in a proposal from U.S. Sen. Tom Coburn, R-Okla., to use undercover investigations to combat fraud.

The White House says expanded use of payment recapture audits could return $2 billion in taxpayer money over the next three years.

Hours before Obama’s speech, as many as 2,000 people gathered for a Republican rally at the St. Charles Convention Center.

“I have a question that I respectfully ask of my president,” Missouri Lt. Gov. Peter Kinder said. “What part of ‘no’ don’t you understand?”

Kinder and several GOP state legislators spoke in person at the event, while others delivered remarks from Washington via videoconferencing, displayed by a large TV screen. All were well-received by the enthusiastic crowd.

“This is so much more fun than watching C-SPAN, isn’t it?” remarked the announcer, local radio host Jamie Allman.

Among the long-distance speakers was the event’s organizer, U.S. Rep. Todd Akin of Town and Country, whose 2nd District includes St. Charles, and U.S. Rep. John Shimkus of Collinsville.

Akin called Obama’s bill “a threat from within and a danger from Washington, D.C.” House Speaker Nancy Pelosi, D-Calif., also was taken to task by speakers.

“This is Pelosi versus the people, and we stand with the people,” Kinder said, adding that Democratic measures would turn the country “into something that is unrecognizable.”

“But we the people will have the final say,” he added.

Obama’s visit to St. Charles offered an opportunity to refocus attention on health care and attempt to blunt the opposition.

“The plan that I’ve put forward … incorporates the best ideas of Democrats and Republicans, even though the Republicans have a hard time acknowledging it,” he said, calling it a “common sense approach to protecting you from insurance company abuses and saving you money.”

He said the bill would force insurance companies to cover pre-existing conditions and ban insurers from dropping customers when they get sick. It would also offer a pool for individuals and small businesses that the president said would lead to lower premiums for many.

Obama — with sleeves rolled up and no jacket in the tightly packed gym — spoke with teachers and staff from the high school who were standing behind him. Most of his comments were met with applause from the invited audience of local officials and party activists.

Frank Scimo, 64, of Ballwin, said he helped organize a group of about 100 people outside the high school who came to support the president and health care reform.

“I believe the people should have health insurance,” he said. He pointed to his stepdaughter, who he said was denied insurance because of a pre-existing problem with her knees.

Amy Smoucha, an organizer with the nonprofit Jobs with Justice, said she left the speech feeling confident in the president and his plan. “I’m happy to see he is so sincere about fixing the health care system,” said Smoucha, 42.

Even those who don’t agree with Obama’s approach on health care came to catch a glimpse of the commander-in-chief.

“I am sincerely honored that the president of the United States has chosen to come to our county and my hometown,” said St. Charles County Executive Steve Ehlmann, a Republican. “I’m just not buying what he’s selling.”

Obama has asked Congress to deliver an “up or down” vote on health care by the end of next week. Each branch of Congress has approved its version of a health care reform bill, but, in order to take effect, lawmakers must agree to one identical bill.

If the administration musters the 216 House votes needed to pass Senate legislation, the next step would be the so-called reconciliation process, under which Congress hammers out a final version to submit to the Senate for an up-or-down vote requiring a simple majority.

Polls show split public opinion on the direction of health care. Outgoing U.S. Sen. Christopher “Kit” Bond, R-Mo., said the president’s speeches in St. Charles and elsewhere — he was in Philadelphia on Monday and will be in Ohio next week — are an attempt by Obama to use oratorical skills to sell a plan Americans don’t want.

“He is trying to cram it through. He has shown that he is not listening,” Bond, who is retiring when his term ends this year, said. “He thinks if he talks very slowly, we will understand.”

U.S. Rep. Roy Blunt, R-Mo., who is running for Bond’s seat, proffered a more measured approach to health care, endorsing incremental steps — such as limiting lawsuits and allowing patients to shop across state lines for insurance.

“Go back to the things that everybody believes would change the system. Do a handful of those in the next couple of years. Then see what needs to be done,” Blunt said.

This week’s visit was Obama’s third trip to the St. Louis area since he took office last year.

At Wednesday’s speech at St. Charles High, Obama was joined by several local Democratic officials. One noticeable absence was Democratic Senate hopeful and Missouri Secretary of State Robin Carnahan, who has attempted to distance herself from Obama. Carnahan, the state’s chief security regulator, was in Washington on Wednesday talking to lawmakers about financial reform.

A White House official said Wednesday that Carnahan’s visit to Washington was planned before the president’s trip here was scheduled, and that Carnahan has already asked to appear with the president at an event soon.

McCaskill, who flew to St. Louis with Obama on Air Force One, did not have to wait.

On Wednesday evening at the Renaissance Grand hotel downtown, Obama headlined a fundraiser for McCaskill, who is not up for re-election until 2012. Tickets ranged from $25 for standing room to $25,000 for dinner and a photo with the president.

Outside, several hundred protesters representing a wide spectrum of viewpoints stood on nearby street corners, chanting slogans and yelling at one another through bullhorns.

A large group of local Tea Party activists gathered on one corner, while a smaller group of Obama supporters set up shop on another corner. Across the street was a mixed bag of protesters and activists who seemed less vocal.

Rose Green, 70, had never seen a sitting president in person before watching Obama talk Wednesday downtown.

“A president, a black president. It’s history, and I’m a part of it,” Green said. “It was worth the wait.”

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