The strategists, many of whom saw healthcare reform fail in the Clinton administration, contend that President Obama has advanced too many rationales for his plan, leaving people confused.

For example, Obama has argued that a new healthcare system is necessary to spur an economic recovery. He also has offered up healthcare as an antidote to rising deficits. Earlier this week in a conference call with religious leaders, Obama laid out a “moral” imperative for revamping the nation’s healthcare system.

At other points, Obama has portrayed “meddling” insurers as a reason for scrapping the existing system.

“One of the difficulties has been that the explanation has changed,” said Howard Paster, a legislative liaison in the Clinton administration. “Originally it was keyed very much to the economy. More recently, emphasis has been placed on issues of fairness and equity. We need to have a consistent set of reasons for doing this.”

Conservative opponents of the overhaul increasingly use a simple, understandable message: Government-forced cost reductions will restrict treatments, imperiling the ill and elderly.