Stop the presses: John Boehner admitted Thursday that the Republican Party’s long-awaited alternative to Obamacare needs a little more time in the oven. “You know, the discussions about Obamacare and what the replacement bill would look like continue. We’re trying to build consensus around one plan,” the Speaker told Hill reporters. “Not there yet.”

As if you even needed me to tell you, rest assured: It could be six months from now, a year from now, five years from now, or the day Bibi Netanyahu and Khaled Mashal share a Nobel Peace Prize—they aren’t going to have a plan. Oh, they might have a “plan.” They had a “plan” last year, or at least Oklahoma Sen. Tom Coburn and two others did. For about two days, they were really tooting its horn. Then it dawned on people that paying for it would involve a hefty middle-class tax increase, on higher-end insurance plans. You may have noticed since then that the Coburn “plan” has not exactly become a leading Republican talking point.

As conservatives continue to hail the Halbig decision, some historical context is called for. In my last column, I wrote that conservatives and Republicans are going to extraordinary lengths to see that more Americans die. Not every reader was won over by that opinion, as you might imagine. But I think it’s beyond dispute, as a little discussion of political history should show.

The problem of millions of uninsured has existed in this country since—well, since forever. But as a running news story that the media paid attention to, for the last 25 or 30 years. I remember when the then-horrifying number was 15 million uninsured. Then 20 million, then 30 million, on up to the 46 million figure we often saw bandied about before the Affordable Health Care was enacted (10 million new Americans are insured as a result of it—a very respectable dent, for just one year). So, 30 years, a full generation, tens of millions of people adversely affected. And what, in all that time, has the Grand Old Party proposed to do about it all?

Not. One. Thing. Republican presidents had (if we go back to 1984) 16 years to pass some kind of health-insurance law. But none of the three ever even proposed one. George W. Bush did pass his Medicare law, but that was about adding prescription-drug coverage for seniors; it didn’t insure any previously uninsured citizens. What the GOP did instead, of course, was to fight tooth-and-nail to stop the two Democratic attempts to insure more people, succeeding the first time, failing the second.

And “tooth-and-nail” hardly begins to describe the demented and nearly sociopathic reality of Republican and conservative opposition to trying to make health insurance affordable for working-class people. Opposition to doing so has been one of the four grand accomplishments of the Republican Party of our time, which I would rank as follows, one scratched on each side of the obelisk: one, start disastrous wars and commit torture; two, make people despise the government; three, nearly cause a new Depression; and four, deny health insurance to as many people as possible, as aggressively and nastily as possible. It’s a grim record generally, and with regard to health care specifically, inarguably one that has promoted insalubriousness and suffering and, indeed, deaths that might have been avoided or delayed if people had had insurance.

It is true that some conservative intellectuals have offered up some ideas—as we know, the same individual mandate that the right now calumniates was a conservative idea at first. And John McCain actually had a decent-ish health-care platform plank in 2008. But if McCain had been elected, it’s very unlikely that the constellation of interests and power centers in the GOP would have permitted him ever even thinking about pursuing it. It was just something he felt he had to say to have credibility with middle-of-the-road voters. And in any case he wasn’t elected, and those conservative intellectuals’ ideas were never seriously proposed by elected Republicans, so the historical record is what it is.

The 20-year war on health care—since their 1993 defeat of the Clinton plan—has been about Republicans’ hatred of government; their view of people who don’t have insurance as lazy or flawed and not worth lifting a finger for; and their fear that if a law is passed and succeeds in bringing health care to millions, they and their whole vision of society will be discredited in the eyes of millions. Of course, these days, all that is shot through with one more element: a heavy dose of Obama hatred.

I was on Hardball Wednesday evening with David Corn, and Chris Matthews showed poll numbers during our segment that surprised even me. The topic was “rooting for failure.” Back in 2006, he said, Democrats were asked in a Fox News poll whether they wanted President Bush’s policies to succeed or fail. Answers: 40 succeed, 51 fail. Not particularly generous. But earlier this year, he said, CNN asked Republicans the same question about President Obama. Answers: 14 succeed, 73 fail.

Think about that. Three-quarters of regular Republicans want Obama to fail. And just one in seven wants him to succeed. We pundits spend most of our time blaming politicians for inaction, but maybe it’s time to start blaming the people. If regular Republicans feel like this, there’s no way the elected officials who represent them are going to do anything that looks remotely like compromise or cooperation.

And no, they’re not going to offer a real health-care plan either. They first promised that in 2010, during the campaign season, so they could say “repeal and replace” instead of just “repeal” and sound like they had a positive side. Then they dropped “and replace,” and now that it’s election time again, it’s back. But it’s not in their DNA to do anything constructive about health care. Or—the VA crisis, the border crisis, the Middle East crisis, the wage-and-inequality crisis, et cetera—about much of anything.