The Republicans at this point have become irrelevant. The real argument within the Democratic Party between the “Rubin Democrats” and the “Nader Democrats.” Right now you have the White House for the most part run by “Rubin Democrats” and the “Nader Democrats” are the opposition party. Ronald Reagan created a coalition of the religious right, corporate and financial interests, and Cold War hawks. Obama destroyed that coalition.
The big shift in the last election was that corporate and financial interests basically gave up on the Republican Party and voted Democratic in a big way, which means that the only people left in the Republican Party are fanatics, which can make a lot of noise, but are otherwise irrelevant.
The big debates in health care are between various groups of people within the Democratic Party. The Republicans aren’t part of the equation at all.