Ezra Klein makes a good point here that there appears to be a split between businesses, who basically are trying to cut their best deal with the Democrats on health care, and Republicans following a rejectionist strategy. Similar situations during the last few years included immigration reform (big business wants cheap immigrant labor, contrary to the populist impulses of GOP politicians) and bailout politics last year (and most likely stimulus politics this year).
One way to look at conflicts within parties is to look for interest groups that oppose each other (Democrats, for example, have problems with immigration if it sets Latino organizations against labor). Another way, however, is to pay attention to different components of the party. Parties are made up of several different components: interest groups, activists, campaign and governing professionals, party bureaucrats, and of course politicians. One might say that for healthy parties, the interests of all of these groups tend to run together, but that doesn't always happen. For example, it is not unusual for activists to be "purists" who would rather lose with an ideologically perfect candidate than to win with a moderate, while most candidates and governing professionals tend to place a very high value on winning office.
The obvious and much-noted problem for Republicans right now is that a large and apparently very influential component of the party has a financial incentive for the Democrats to hold the Presidency and Congress, so that they can make money by riling up a small but apparently very lucrative market. It may also be true that some GOP pols believe that rejectionist policies are good electoral strategies...and, perhaps, that might be the case, but at the same time empowering those groups within the party makes it hard to then nominate candidates who can win. And hard to govern when they do win.
(The challenge for Democrats is to avoid duplicating the problem on their own side. Many liberals believe that there's something inherent in conservatives that makes them easily exploited sheep, but there's plenty of evidence that liberals produce sheep, too).