By all accounts, Robert Pear of the New York Times was one of the most relentlessly probing journalists on the health-care beat, enlightening readers and rankling partisans with the clarity of his reportage and his savantlike understanding of the federal government and its arcana. With a seemingly ever-present byline on Page One of the Times, Mr. Pear was a constant and authoritative presence in Washington for four decades.

He died May 7 at 69 at a hospice center in Rockville, Md. The cause was complications from a severe stroke that he suffered April 29, said his brother, Doug Pear.

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Mr. Pear joined the Times’s Washington bureau in 1979 and specialized in untangling the thicket of legislation and regulations that govern domestic policy, including the federal budget, welfare and Social Security, the food stamp program, civil rights, and immigration. But he was best known for his coverage of health care.

“He was almost certainly the best health-policy reporter we’ve ever had,” Drew Altman, the president and chief executive of the Henry J. Kaiser Family Foundation and founding publisher of Kaiser Health News, said in an interview. Such was Mr. Pear’s commitment to detail, Altman said, that he toted around fact sheets and would call at “2, 3 and 4 a.m., working a story literally to death to get it exactly right.”

“Because of his knack for finding just the right story at just the right moment, he became almost a referee of these great health-policy debates,” Altman continued, “and also an indispensable provider of the facts just when the country needed the facts.”

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An erudite, private man with degrees from Harvard and Oxford, Mr. Pear declined to join the bantering on Sunday-morning television talk programs. He left sources who knew him only by his whispery voice on the phone — colleagues said he always answered on the first ring — wondering what he looked like.

He was over 6 feet tall and favored the color gray in his wardrobe — “dark gray,” according to a profile published years ago in the Times’s internal newsletter, Times Talk, “except between Memorial Day and Labor Day, when he wears light gray.”

Mr. Pear was vastly more comfortable reporting news rather than making it. But his prolific front-page bylines made him a supporting character in the Clinton health-care saga of the 1990s, in which the administration, with leadership from then-first lady Hillary Clinton, failed dramatically in its quest to enact universal health-care coverage.

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Critics charged that Mr. Pear’s stories often overplayed leaks from interest groups and exaggerated the importance of internal draft memos. They accused him and other members of the media of contributing to public confusion, even exhaustion, that helped doom the Clinton plan. On at least one occasion, White House officials convened a Sunday briefing to challenge Mr. Pear’s reportage.

“Change, far from being what everyone wants, is virtually impossible in our political culture,” journalist Michael Kinsley wrote in a commentary published in the New Republic in 1993. “Whose fault is this? I blame Robert Pear of the New York Times. Mr. Pear . . . is a legendarily scrupulous reporter. But his stories of recent weeks, since Mr. Clinton’s big health-care speech, form a pageant of political paralysis.”

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“The longer Bob Pear and his ilk are allowed to roam the landscape kicking interest groups until they bark, the more it will seem as if Mr. Clinton’s reform plan is full of terrible disadvantages that rival plans somehow magically avoid,” Kinsley continued. “Cut a deal, Mr. President. Quick. Before Robert Pear strikes again.”

Kinsley, who often injected humor into his analysis, later walked back his criticism, telling The Washington Post that he “thought it was humorous to portray this mild-mannered, legendarily scrupulous reporter as some kind of monster.”

“I certainly don’t have any problem with his journalism,” Kinsley said. “I thought it would be funny to blame the whole mess on Bob Pear.”

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Reflecting on Mr. Pear’s coverage of the Clinton health-care debacle, Altman cited with particular admiration a special report by Mr. Pear and two colleagues, Adam Clymer and Robin Toner, that ran on page one of the Times on Aug. 29, 1994, under the headline “For Health Care, Time Was a Killer.” At nearly 7,000 words, the article chronicled the “lost time, lost opportunities, lost confidence,” as well as “many mistakes and misjudgments,” that led to the legislation’s demise.

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At the time, the article noted, officials in the White House and on Capitol Hill “all but” conceded that there was “no chance of passing universal health insurance legislation” that year. But the legislation was not yet officially dead, and Altman described the article, with its unvarnished portrayal of a “collapse,” as “a brave story,” one that “other journalists at other newspapers were immediately under pressure to follow.”

Timothy Stoltzfus Jost, a professor emeritus at Washington and Lee University School of Law, wrote in an email that “sometimes it seemed like health policy developments didn’t really happen until Robert Pear wrote about them, and people took notice.”

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Robert Lawrence Pear was born in Washington on June 12, 1949. His father was a tax lawyer and accountant. His mother, a linguist who had worked for the Office of Strategic Services, the World War II-era espionage agency, was a homemaker.

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As an adolescent, Mr. Pear created a newspaper, the Pear Press, using calligraphy pens to mimic the style of the Times’s masthead, his brother recalled. The Pear Press covered historical events as if they were happening in the present day, but Mr. Pear was also a precocious consumer of current affairs. He amassed a library of articles about the assassination of President John F. Kennedy in 1963.

Mr. Pear grew up in Bethesda, Md., where he graduated from Walter Johnson High School in 1967 and wrote for the Montgomery County Sentinel. He received a bachelor’s degree in English history and literature from Harvard University in 1971 before continuing his studies at Balliol College at the University of Oxford, where he received a master of philosophy degree in 1973.

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He received a second master’s degree, from the Columbia School of Journalism, in 1974. That year, he was hired by the now-defunct Washington Star, where he remained until he joined the Times.

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Mr. Pear, a Bethesda resident, had no immediate survivors besides his brother. His last byline, an analysis of protections for preexisting conditions under Republican proposals to “repeal and replace” the 2010 legislation known as Obamacare, appeared in the Times just over a week before his stroke.

When he was not working, which was not often, Mr. Pear could be found exercising — “although he was usually seen reading papers at the gym rather than working out,” John Rother, the president and chief executive of the National Coalition on Health Care, recalled in an email. He described Mr. Pear as “the single most important journalist covering health-care policy in Washington for a generation.”

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Bill Kovach, who led the Washington bureau during Mr. Pear’s early years with the Times, recalled a frequent need to order him home at the end of the day.

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“I finally paid for a week-long stay in Nassau in the Bahamas and carried him to the airport and put him on the plane,” Kovach wrote in an email. “He may have stayed there a day but the next thing I knew he had slipped back into town and into the office when my back was turned.”