The biggest problem is that the republicans throw in so much hate-propaganda that it's hard to maintain a pertinent debate.
A prime example being the Stephen Hawking affair:
http://www.washingtonmonthly.com/arc..._08/019457.php
Basically an American newspaper editorial claimed that if Hawking had lived in the UK, he wouldn't be alive today (because the NHS doesn't bother to keep ill elderly alive there).
The had failed to realize that Hawking is a British resident, he has been treated by the NHS throughout his life and he is in fact alive.