Another problem with the Republican party's apparent belief that the Same Old Tunes are just as popular as they ever were, if, that is, they're played properly is that, just as the United States is changing demographically, so its political centre-of-gravity has moved to the left. As Ross Douthat says, persuasively to my mind, what seemed radical 15 years ago now seems possible and much less scary. Thus, the rising cost - and insecurity - of health coverage has helped persuade voters that the government must be a larger part of the solution. Thus too, the rising cost of college education helps persuade families that more needs to be done to help their kids be able to afford a proper education.
Republicans talk about how the market will provide better, cheaper, more efficient healthcare than anything the government might be able to devise. They may well be right about that (though it's worth noting that just as no country would copy the NHS if it were building a healthcare system from scratch now, so no-one would copy the American way of doing things either) but it's quite clear that there are plenty of working, lower-middle and middle-class voters who, facing rising bills and struggling along on stagnant wages, don't believe that the GOP has answers here. That is, the Republicans are not doing well enough at persuading voters that the party "cares about people like me." Policy details matter, but so too does that perception. That is, the GOP needs to show that it gets it. There may well be good criticisms to be made of Obama's healthcare proposals but shrieking "Socialism!" doesn't seem the response most likely to persuade an already sceptical electorate.