Has there ever been a more cynical surrender of Presidential authority? The editorial board of the Washington Post posed this question on Tuesday, after Donald Trump reacted to the collapse of the Senate health-care-reform bill by suggesting, in a tweet, that his fellow-Republicans should now “let Obamacare fail” and then look to build a new system out of the wreckage. Ignoring the turmoil that such a course of action would generate for tens of millions of Americans, Trump restated his support for it later in the day, saying, “I think we’re probably in that position where we’ll let Obamacare fail. We’re not going to own it. I’m not going to own it. I can tell you, the Republicans are not going to own it.”

The Post’s editorial called Trump’s suggestion “irresponsible,” which was too kind. The first duty of any President is to protect the welfare of the citizenry. In blithely threatening to allow the collapse of the Obamacare exchanges, through which some twelve million Americans have purchased health insurance, Trump was ignoring this duty. Arguably, he was violating his oath of office, in which he promised to “faithfully execute the office of the President of the United States.”

As President, Trump has continued to live by the one imperative that has propelled him for decades: furthering his personal interests and defending his bountiful amour propre. When virtues like consistency, practicality, and decency come into conflict with this overriding concern, they are invariably relegated to secondary status, or ignored completely.

This week, however, Trump’s reaction to his party’s political setback wasn’t just morally abysmal; it was also self-defeating. Thursday will mark the end of his first half year in the White House, and Trump’s Presidency is in crisis. He is facing record low approval ratings, his policy agenda is stalled, and every day seems to bring another damaging revelation about his relationship to Russia—the latest being the news that he had a second, undisclosed conversation with Vladimir Putin during the G-20 summit.

As the Wall Street Journal’s editorial page pointed out on Tuesday, Trump “somehow seems to believe that his outsize personality and social-media following make him larger than the Presidency,” but if he doesn’t change his approach the “brutal realities of Washington politics” will “destroy” him. The Journal was referring to Trump’s attitude toward the Russia investigation, but the point also applies to his approach to policy. By championing the agenda of the Republican right and making the repeal of Obamacare the first big project of his Presidency, he has hung a huge anchor around his own neck.

Over the past six months, Obamacare’s approval ratings have steadily increased and support for the Republican alternative has steadily declined. Last week, pollsters working for ABC News and the Washington Post asked Americans whose health-care plan they preferred: half said Obamacare, while just twenty-four per cent said the Republican plan. Even among self-identified Republicans, just six in ten respondents picked the G.O.P. plan.

A more seasoned and more engaged President would have sensed early on that repealing Obamacare was a potential disaster in the making. Now Trump has Republican politicians breaking ranks, such as Senator Shelley Moore Capito, of West Virginia—a state that Trump won handily in November—who raised concerns about reversing the Affordable Care Act’s expansion of Medicaid, which has enabled some fourteen million Americans to get health care. In Republican-run Arkansas, three hundred and thirty thousand people have been added to Medicaid’s rolls under the A.C.A. Speaking on NPR on Wednesday, Asa Hutchinson, the state’s Republican governor, rejected Trump’s call to let Obamacare collapse and argued instead that lawmakers would have to find a bipartisan solution.

In theory, at least, Trump could have anticipated some of this and responded to the collapse of the Senate bill by aligning himself with Capito and other repeal-skeptical Republicans. Rather than lashing out, he could have announced that he was now eager to work with members of both parties to do what he promised during the campaign—provide affordable health care for everybody, reduce drug prices, protect Medicare—and made it clear that, in the interim, he would support efforts to stabilize the Obamacare exchanges. Conservative Republicans would have accused him of betrayal, but so what?

On the campaign trail, Trump did promise to repeal Obamacare, but the pledge wasn’t central to his appeal as a candidate. He ran as an economic nationalist and an ethno-nationalist. His signature issues were protecting American jobs, keeping out undocumented Latino immigrants, and barring Muslim visitors from America’s shores: the underlying theme was a desire to promote the security of white, native-born Americans. Since becoming President, he hasn’t abandoned this illiberal but fairly popular agenda, and yet it has been overshadowed by the congressional effort to replace Obamacare.

The fact is that the Republican establishment’s desire to roll back the welfare state isn’t consistent with Trump’s stated wish to transform the G.O.P. into the the party “of the American worker.” Going all the way back to Bismarck, the most successful nationalist politicians of the right have supplemented nationalism and economic protectionism with a willingness to expand government programs that provide security for the masses in other areas, including health care. Many of Trump’s European counterparts, such as Marine Le Pen, of France’s far-right National Front, and Norbert Hofer, the head of the Freedom Party of Austria, are committed to universal health care, just as long as it is reserved for native citizens.

After the collapse of the Senate health-care bill, Trump could move in this direction—but that would mean breaking with the Republican leadership, many of its Washington-based activists, and the ultra-conservative big donors who bankroll the Party. It would also involve Trump demonstrating, counter to all the evidence, that he is more than a sham populist. Ever since he made it to the White House, he has been content to champion the G.O.P.’s deeply regressive agenda, despite the dire consequences it would have for many people who voted for him. On Wednesday, Trump changed his tune (again), telling Republican senators during a meeting at the White House that they should stay in town until they find a way to replace and repeal Obamacare. But, of course, he has no plan of his own, and no clue.

Trump is what he is: a self-obsessed carnival barker with authoritarian instincts and little grasp of policy or history. In the long run, his unwillingness (or inability) to change strategy means he is unlikely to go down in history as a transformative figure but, rather, one who exploited a unique set of conditions to win the Presidency. In the short run, Trump’s vacuousness means he has nothing to offer except a laughable effort to blame the Democrats for what has happened. “They’re responsible for passing Obamacare,” Trump’s spokeswoman, Sarah Huckabee Sanders, said on Tuesday. “They’re responsible for the mess we’re in.”