Is there a vision of society underlying those choices? Not really. Most political parties define their vision of the role of government around their vision of the sort of country they would like to create. The current Republican Party has iron, dogmatic rules about the role of government, but no vision about America.

Because Republicans have no governing vision, they can’t really replace the Obama vision with some alternative. They just accept the basic structure of Obamacare and cut it back some.

Because Republicans have no governing vision, they can’t argue for their plans. Health and Human Services Secretary Tom Price came to the Aspen Ideas Festival to make the case for the G.O.P. approach. It’s not that he had bad arguments; he had no arguments, no vision for the sort of health care system these bills would usher in. He filled his time by rising to a level of vapid generality that was utterly detached from the choices in the actual legislation.

Because Republicans have no national vision, they seem largely uninterested in the actual effects their legislation would have on the country at large. This Senate bill would be completely unworkable because anybody with half a brain would get insurance only when they got sick.

Worse, this bill takes all of the devastating trends afflicting the middle and working classes — all the instability, all the struggle and pain — and it makes them worse. As the C.B.O. indicated, the Senate plan would throw 22 million people off the insurance rolls. It would send them to private insurance plans that they could not afford to buy. Under the Senate bill, deductibles for poor families would be more than half of their annual income. The plans are so incompetently and cruelly designed that as the C.B.O. put it, “few low-income people would purchase any plan.”

This is not a conservative vision of American society. It’s a vision rendered cruel by its obliviousness. I have been trying to think about the underlying mentality that now governs the Republican political class. The best I can do is the atomistic mentality described by Alexis de Tocqueville long ago:

“They owe nothing to any man, they expect nothing from any man; they acquire the habit of always considering themselves as standing alone, and they are apt to imagine that their whole destiny is in their own hands. Thus not only does democracy make every man forget his ancestors, but it hides his descendants and separates his contemporaries from him; it throws him back forever upon himself alone and threatens in the end to confine him entirely within the solitude of his own heart.”