Let’s get real. The big health insurance reform battle is all over but for the shouting. Yes, talk goes on about repealing the law after Republicans seize Congress and President Barack Obama leaves the White House. But you can bet major components of this legislation are all but set in stone.

Some polls even suggest Americans are ready for all the vitriol to end and for the rule of law to at last reign over the land. And the fact that Republicans didn’t really offer many viable alternatives during the yearlong struggle over health care reform only reaffirms that this issue is done and that the GOP must seriously reconsider its ill-advised strategy of late.

Is it all about winning elections, or is it about seeking ways to govern responsibly, even when in the minority? The past year has indicated that the GOP chose a disastrous course, effectively shutting itself out of a furious national debate over a critical issue. In doing so, it failed.

Worst of all, few of the concerns raised by Democrats were smartly addressed by Republicans. In my 33 years as a journalist, I’ve been to the homes of poor and middle-income folks devastated by illness, plunged into despair and poverty. I’ve seen the hopelessness of it. And for all the healthy arguments I heard in favor of free enterprise, few reflected Christian compassion — supposedly an all-American virtue.

Where did we go wrong?

Candidates stumped

Something of this arose at the Hispanic Republican Club of McLennan County debate for the two GOP congressional runoff candidates seeking a shot at U.S. Rep. Chet Edwards come fall. The best question came from Dr. Bradford Holland, a prominent Republican who admits he sometimes can’t get past his profession. He’s president of the McLennan County Medical Society.

His question was one of the best asked during the yearlong debate over health care reform. The heart of Holland’s hypothetical question for Bill Flores and Rob Curnock focused on the motorist without health insurance who gets drunk and gets into a bad wreck. Who takes care of him?

Currently, the hospital lucky or unlucky enough to receive him must often eat the costs of putting him back together again.

Curnock was clearly flummoxed. He gave a rambling answer about ours being a “compassionate nation,” that you can’t leave the errant, injured drunk driver unattended, bleeding to death. Nor can you regulate all risky or bad behavior, he said.

“That’s the price you pay for freedom,” Curnock said.

Which is not an answer that medical institutions would embrace, considering they have to swallow such costs — the whole point behind mandating that all Americans buy health insurance or face a punitive tax to help pay for the costs that they incur when they ultimately (and stupidly) wind up in the hospital without health insurance. Hillcrest Baptist Medical Center alone reportedly provides $72 million in uncompensated care annually.

Flores’ answer wasn’t much better. He talked about the “moral fiber” of our nation, with a digression into other matters that Holland wasn’t exactly pressing.

Holland told me his question stemmed from his experience in medicine and “a real problem that we face every day.”

Unfortunately, too many Republican leaders spent too much time working toward procedural obstruction and hurling insults and playing to fringe elements in the long national debate. Ordering that members refrain from working toward conciliation on policy with Democrats? That strategy sure worked out well.

Did groundless talk of Obama being a “foreigner” help? No, Americans scoffed at such unpatriotic nonsense, and Republicans who lowered themselves to such attacks undermined us all in the end. Did talk of socialism do the trick? No, because Americans know elements of it also exist in everything from veterans health care to Social Security.

Arguments that could have forged something ironclad for us all were almost never waged. That’s something Republicans must accept in the months and years ahead. And they should answer for it come November, right along with the Democrats.