The industries with the most to lose from proposed changes to the nation’s health care system vowed Monday to work with the White House — and each other — to strip out at least $2 trillion in unnecessary medical spending in the next decade.

Trade groups representing doctors, device makers, insurers, hospitals, organized labor and drug makers signed a letter to President Barack Obama on Monday pledging to “work together to provide quality, affordable coverage and access for every American.—

“We, as stakeholder representatives, are committed to doing our part to make reform a reality in order to make the system more affordable and effective for patients and purchasers,— the letter concluded. “We stand ready to work with you to accomplish this goal.—

The letter was signed by executives from the Advanced Medical Technology Association, the American Medical Association, America’s Health Insurance Plans, the Pharmaceutical Research and Manufacturers of America, the American Hospital Association, and Service Employees International Union.

While light on specifics, industry insiders say the letter — which followed a White House announcement earlier in the day on the proposed savings — represents a significant milestone in the debate: The primary stakeholders now are unlikely to poison the well.

Christopher Jennings, a pharmaceutical lobbyist and former Clinton White House health care adviser, likened Monday’s letter to a “first leap off a diving board.—

Once you are at the edge, “if you turn around, it’s very embarrassing,— he said.

“It basically sends a message to the Hill that the traditional opponents are sending signals that they want to be constructive participants,— Jennings said.

“And by dedicating themselves to specific savings to be reinvested into health care, they’re providing important assistance in achieving affordable, quality coverage for all,— he added.

Pharmaceutical lobbyist John Michael Gonzalez agreed, saying the new letter “reinforces the fact that it is a very different climate than 1994.—

During President Bill Clinton’s first term, insurance companies are credited with dealing a death knell to proposed health care changes through a now-legendary ad campaign featuring “Harry and Louise.—

“The same players that opposed health care reform are taking a very different position today. This doesn’t mean they like everything that’s being talked about,— Gonzalez said. “There are concerns about a public plan, there are concerns about certain pay-fors … but this is a significant step forward.—

But initial reaction from lawmakers on the plan was mixed. House Majority Leader Steny Hoyer (D-Md.) agreed that curbing costs was essential and applauded the joint announcement.

“Containing rising health care costs that are an increasing burden on families, businesses and the federal budget is one of the critical goals of enacting health care reform this year,— Hoyer said. “The fact that this diverse group of stakeholders has voluntarily pledged to work together to slow the growth rate of these costs underscores the broad commitment to making health reform a reality.—

But House Republicans said they aren’t holding their breath on the cost-cutting proposal, which Obama said on Monday would cut the rate of growth of national health care spending by 1.5 percent each year during the next decade.

Former Minority Whip Roy Blunt (R-Mo.) warned that the proposal “doesn’t save the federal government any money,— while Minority Leader John Boehner (R-Ohio) said in a statement that the plan was short on details.

“Today’s announcement promises savings with no concrete plan to achieve them and no enforcement mechanism if they don’t.

“The administration has yet to answer the fundamental question of how to pay for its massive multitrillion-dollar health care plan,— he said.