The Republican majority in Congress has voted to kill the Affordable Care Act dozens of times. It's done this knowing that President Obama would veto the bill, thus sparing members from the consequences.
So obviously, it was always a game. It was posturing before a public that largely didn't know what Obamacare did for them.
Still, Republicans could have thrown the American people a crumb of respect by saying, "When the day comes, this is what we're going to replace it with." Or, "There's no replacement. We're just going back to the world before Obamacare."
Either response would have been honest. Republicans would have put their cards on the table, exposing their ideas to scrutiny. And importantly, they would have let patients, doctors, hospitals and insurers know what was up and plan for the future.
But that would have ended their game — which has been politics, not governing. Politics is telling people they can get what they want without paying for it. Governing is specifying where the money will come from. Governing, in short, requires work, much of it unpleasant.
In a matter of days, Donald Trump takes over the presidency. He's demanded a repeal of Obamacare on "day one" of his administration. Congressional Republicans still don't have a replacement, so they've designed a new game called "Repeal and Delay."
This game operates under the dubious assumption that you can vote to repeal Obamacare but leave the benefits in place while you come up with a new plan. Or not. Many Republicans back passing a budget bill that strips Obamacare of funding, at which point it all would be over. Some are having second thoughts. Who knows what they'll do.
The uncertainly, meanwhile, is traumatizing the health care system. Insurers are being jolted by a possible meltdown of their markets. Doctors happily adjusted to Obamacare are rattled, while hospitals are already laying off people as a precaution.
A "slow-moving tsunami" is how Heidi Gartland, spokeswoman for University Hospitals in Cleveland, has described an Obamacare repeal. "In the aftermath of the tsunami," she told Politico, "there's devastating loss that we never could have planned for."
And what about the American people? Some 20 million are at risk of losing their health coverage. The group includes large numbers for whom the stakes are extraordinarily high. They're wondering whether they'll be able to contain their chemo treatments or get heart surgery.
If Republicans came out and said that "Obamacare is over, period," the medically needy would at least be able to make their own arrangements — sell the house, file for bankruptcy, rewrite their will. But Republicans haven't done them that minimal courtesy.
Republicans have floated a few vague ideas for replacing Obamacare — that's true — but they've agreed on nothing. The most coherent plan, released earlier this year by House Speaker Paul Ryan, didn't have a price tag on it, so why even bother?
It happens that Obamacare is overall a big success. It has slashed the number of uninsured and moderated health care spending. There are problems, but they are fixable problems. So this "downward spiral" talk is pure propaganda. But take the money away and the downward spiral becomes real.
One of the saddest scenes was thousands of Americans signing up for Obamacare right after Trump won the election. They were like refugees trying to get the last plane out of a war zone.
Every other modern nation guarantees health care as a right of citizenship. Even their conservative leaders don't touch benefits that beat ours by a mile.
This Obamacare repeal game is, at bottom, an insult to the dignity of the American people. Actually, it's a disgrace.
(A member of the Providence Journal editorial board, Froma Harrop writes a nationally syndicated column from that city. She has written for such diverse publications as The New York Times, Harper's Bazaar and Institutional Investor.)