Stat! Clinton Readies Scalpel for Obamacare

“There was a tremendous amount of internal discussion about when Senator Clinton should release her plan,” he said. “There is certainly not universal agreement in the campaign even about when exactly the time of it should be. There were people that were saying, ‘You ought to be out there first to establish yourself.’ And Hillary’s call was: ‘I need to be ready when I go out there with this.’”

(When asked about Dr. Redlener’s account of dissension in the campaign, Clinton campaign spokesman Howard Wolfson said that he was unaware of any.)

Mr. Edwards had seemed to set the tone on the issue of universal coverage in February, when he announced a proposal to force private companies to compete with a government insurance provider to drive down prices. His plan also requires the purchase of insurance coverage by every American able to afford it.

“It’s truly universal,” said James Kvaal, the Edwards campaign’s policy director.

Three months later, Mrs. Clinton cautiously rolled out the first installment of a three-point plan with an address about cutting costs to the system, which some experts took as an indirect criticism of the estimated $120 billion price tag of the Edwards plan. In her speech, Mrs. Clinton also attempted to address the concerns of the 255 million people who pay insurance costs that they believe are too high.

“Here again, I think, is a good example of her having learned a very important lesson from her experiences in 1993 and 1994,” said Ron Pollack, the executive director of Families U.S.A., a nonprofit, non-partisan organization advocating universal health care. “She made a very smart decision to focus first on cost. While coverage is ultimately the moral issue in our health-care system, what most voters are concerned about is cost.”

But Mrs. Clinton’s speech amounted to more of a striptease than an unveiling. Whether by design or not, she withheld a comprehensive articulation of her plan until Mr. Obama had shown his.

The plan Mr. Obama duly put forth on May 29 took Mrs. Clinton’s campaign and health-care experts by surprise.

Paul Ginsburg, president of the Center for Studying Health System Change, a nonprofit, non-partisan research group, said he was “a little baffled” that Mr. Obama’s plan didn’t require universal coverage.

Jonathan Gruber, an M.I.T. economist who helped develop the health-care plans of Mr. Obama, Mr. Edwards and Mrs. Clinton, said that while the Obama proposal takes strides in making insurance more accessible and affordable, its lack of a requirement to make insurance obligatory for all Americans would mean that many of the people currently without coverage would stay that way.

“My estimates are, you can’t even get halfway to universal coverage without some mandate,” Mr. Gruber said. “Even when it’s affordable, healthy people won’t take it.”