Chait lays out well how over and over movement conservative ideology and “principle” makes them unfit to lead:

“In truth, it was never possible to reconcile public standards for a humane health-care system with conservative ideology. In a pure market system, access to medical care will be unaffordable for a huge share of the public. Giving them access to quality care means mobilizing government power to redistribute resources, either through direct tax and transfers or through regulations that raise costs for the healthy and lower them for the sick. Obamacare uses both methods, and both are utterly repugnant and unacceptable to movement conservatives. That commitment to abstract anti-government dogma, without any concern for the practical impact, is the quality that makes the Republican Party unlike right-of-center governing parties in any other democracy. In no other country would a conservative party develop a plan for health care that every major industry stakeholder calls completely unworkable.”

nymag.com