Marc Thiessen, the George W. Bush speechwriter who now writes a column for the Washington Post op-ed page, is aghast at the Senate GOP’s health care bill. “Paying for a massive tax cut for the wealthy with cuts to health care for the most vulnerable Americans is morally reprehensible,” he says.

“If Republicans want to confirm every liberal caricature of conservatism in a single piece of legislation, they could do no better than vote on the GOP bill in its current form.”

But at what point do we admit that this isn’t the liberal caricature of conservatism? It’s just ... conservatism.

Though Republicans had long promised the country a repeal-and-replace plan that offered better coverage at lower cost, the House GOP’s health care bill cut hundreds of billions of dollars in taxes for the rich and paid for it by gutting health care spending on the poor. It was widely criticized and polled terribly.

Senate Republicans responded by releasing a revised health care bill that also cut hundreds of billions of dollars in taxes for the rich and paid for it by gutting health care spending on the poor. It has also been widely criticized, and it also is polling terribly.

Donald Trump, who ran on a platform of covering everyone with better health insurance than they get now, has endorsed both bills.

Republicans, in other words, have repeatedly broken their promises and defied public opinion in order to release health care bills that cut spending on the poorest Americans to fund massive tax cuts for the richest Americans. (The Tax Policy Center estimates that 44.6 percent of the Senate bill’s tax cuts go to households making more than $875,000.)

If they would simply stop doing that, their health care problems would vanish: They could craft a bill that would rebuild the health care system around more conservative principles and do so without triggering massive coverage losses. But at some point, we need to take them at their word: This is what they believe, and they are willing to risk everything — their reputations, their congressional majorities, and Donald Trump’s presidency — to get it done.

And it’s not just health policy. Though Trump said he would raise taxes on people like himself during the campaign, the tax reform plan he released amounted to a massive tax cut for the richest Americans. That cut will ultimately have to be paid for, and because Republicans refuse to increase taxes to close deficits, and because they support increasing spending on the military, the only plausible way to pay for their tax cuts will be by slashing programs that serve the poor and/or the elderly. (This isn’t just hypothetical: Trump’s budget relies on massive cuts to programs that serve the poor.)

Like Thiessen, I want to see a better, more decent conservatism drive the Republican Party. I don’t want to believe that this is the bottom line of GOP policy thinking. But this is clearly the bottom line of GOP policy thinking.