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“Just show me. If you can show me that something is going to work, I will welcome it.”

But Republicans say all but one of those 160 amendments were technical in nature. The one substantive amendment that was included requires all members of Congress to enroll in a government-run “public option.” It is unlikely that even this provision will make it into the final Senate bill that Senate Majority Leader Harry Reid could bring to the floor as early as this week.

Meanwhile, a number of Republican-backed health care ideas ended up on the cutting-room floor.

Conservatives want insurers to focus on catastrophic care. Reform, they say, should encourage Americans to purchase tax-preferred health savings accounts, with matching contributions from employers, where workers contribute money out of every paycheck to help build a fund to pay for their individual medical needs.

These ideas have barely entered the debate, however, and Mr. Obama has never seriously addressed them in public. The White House declined to comment on why the president has ignored these ideas, despite numerous requests by The Washington Times.

But White House communications director Anita Dunn argued in a public appearance Friday that Mr. Obama “has really gone to extraordinary lengths to reach out to people who don’t agree with him and to make sure the people who don’t agree with him have their voices heard.”

The House GOP leadership this month introduced its official alternative bill. But by that point, lawmakers like Mr. Ryan had already made up their minds that there was no point to doing anything but try to defeat the president’s plan.

“The best outcome is if we stop this - then the Democrats will have a failed presidency on their hands, and then they’ll have to work with Republicans to get something done that’s bipartisan,” Mr. Ryan said.

The White House, prior to the passage of the House bill, had also concluded that bipartisanship on health care reform was a lost cause.

Secretary of Transportation Ray LaHood, a former Republican congressman from Illinois who was given the job of contacting key GOP lawmakers before major votes earlier in the year, was given a list by the White House made up entirely of Democrats.

“The White House realized that no Republicans were going to vote for the bill, and so they didn’t expend their energy on calling them,” said an administration official, who spoke on the condition of anonymity to talk more freely about White House thinking and communications strategy.

In the end, just one House Republican - freshman Rep. Anh “Joseph” Cao of Louisiana - joined 219 Democrats in pushing the bill narrowly through the House. Handicappers expect none of the 40 GOP senators to support the bill Mr. Reid produces.

Mr. Ryan now sees the passage of the Democrats’ bill as a possibly irreversible change in the structure of American governance and the social contract between the government and the people.

“They won’t call it this, but they believe that a social welfare state is right. They believe that is what America morally should become,” Mr. Ryan said. “I believe that is completely antithetical to the American idea, the American project, and what America is about.”