My colleague Jonathan Chait has a terrific summary of the philosophical divide separating Democrats and Republicans on health care:
When you consider the differences between Democrats and Republicans on health care, you probably think in terms of scale. Democrats want to enact a big reform, while Republicans favor incremental progress. House Minority Whip Eric Cantor coos, “We want to take a much more commonsense, modest, incremental approach, trying to address the first issue first, which is cost, and then go on to try to deal with some of the things that the president and Speaker Pelosi want to do.” Within a recent six-month span, Republicans on the Senate floor used the phrase “step-by-step” to describe their approach to health care an astonishing 173 times.
The reality is quite different. What separates the two parties is not how far to go, but in which direction to go. The divide is simple. Democrats propose to shift resources from the rich and the healthy to the poor and the sick. Republicans want to do just the opposite. Republican health care plans reflect the party’s increasingly widespread belief that good health, like other forms of prosperity, is a matter of personal responsibility. Democratic plans to help the sick at the expense of the healthy therefore amount to socialism.
The whole thing is worth a read if you haven't read it already.