Mr. Obama, the Democratic presidential candidate, in a long-awaited speech on a signature issue for his party, acknowledged that similar efforts to create universal coverage had failed in the past,
?crushed under the weight of Washington politics and drug and insurance industry lobbying.
But he added,
?This cannot be one of those years.
Mr. Obama would pay for his plan by allowing President Bush?
?s tax cuts for the most affluent Americans
?? those making over $250,000 a year
?? to expire. Officials estimated that the net cost of the plan to the federal government would be $50 billion to $65 billion a year, when fully phased in.