Seems the flip-flop may be on another foot this week as the Senate voted down a last-ditch effort at repealing Obamacare, the so-called "skinny repeal." Leaving aside the fat-shaming micro-aggression of calling the repeal "skinny," it really wasn't much of a repeal. It was much like someone weighing 300 pounds starting a diet, losing 20 pounds, and calling himself skinny.

John Kerry, during his ill fated presidential run in 2004, defined himself as a flip-flopper through this comment : "I actually did vote for the $87 billion before I voted against it." Incumbent President George W. Bush used Kerry's flip-flop against him, eking out an electoral victory.

Nonetheless, it was a reasonable start toward the long promised "repeal and replace" we have been hearing about for the past seven years. It was only a Senate bill, not a final law, as it still needs to go to the House for conference, with a very different bill finally emerging, then having to pass both the House and Senate before heading to the White House to be signed into law.

It wasn't the repeal we had been promised, but in the current political environment, perhaps it was the best we will get. So why didn't it pass? Was it a flip, or was it a flop?

The vote was close, failing by a 49-51 margin. Two more Republican votes would have reversed the outcome and the fortunes of the GOP Congress. Which two votes weren't there at 1:30 A.M., when the votes were tallied?

Republican senators John McCain and Lisa Murkowski, both voting no. Did one flip and the other one flop?

It turns out that both senators were for repeal before they were against it. It must be a Senate affliction, as John Kerry and Hillary Clinton, as senators, were both for the Iraq war before they were against it.

In 2015, Senator McCain voted to repeal Obamacare. In his press release, he explained, "It is clear that any serious attempt to improve our health care system must begin with a full repeal and replacement of Obamacare, and I will continue fighting on behalf of the people of Arizona to achieve it."

What happened? Has his brain tumor clouded his thinking? Or was this a chance to stick it to President Trump, who, as everyone remembers, as a candidate said about McCain, "He's not a war hero. He's a war hero because he was captured. I like people who weren't captured." Was this McCain's revenge?

Based on a tweet from political operative Jack Posobiec, "[m]ultiple Hill staffers confirm last night McCain was heard laughing w Dems and remarked, 'Lets see Donald make america great again now'." Mission accomplished. Revenge is best served cold, and here is one of Trump's signature campaign issues, served ice cold on the morgue slab, ready for the incinerator.

Never mind what McCain promised his constituents. He is now the darling of the left and the NeverTrumps. He will be invited on all the Sunday talk shows, basking in his "maverick" glow.

If McCain is "flip," then Murkowski is "flop." In 2015, she was also in favor of repealing Obamacare, telling Alaskans, "I will support the bill that repeals the ACA and wipes out its harmful impacts." Not so this week.

She too seems to have a bone to pick with President Trump. In typical Trump fashion, he called her out on Twitter after her no vote earlier in the week to proceed with debate, saying she "really let the Republicans, and our country, down."

Both were for repeal before they were against it. Flip and flop.

The reality is that the opportunity to stick it to President Trump was too great to resist. Their fragile egos were bruised by Trump's comments and tweets, and they had a score to settle. The heck with what they promised when campaigning or what they told their constituents. So what if they work in "the world's greatest deliberative body"? Seems these two, as well as many other senators, work in a playground, where any criticism requires a reciprocal attack. They must save face, preserve their honor.

What happened to deliberation? Or legislation?

Spite your constituents and America to get in the last word. These two would fit right in on an episode of Real Housewives or The Jersey Shore, where every slight is avenged, regardless of previous promises and assurances.

Could we be led by a more ineffectual and unserious group of legislators? This includes Senator McCain, who had the nerve to call some of his fellow GOP senators "wacko birds," at the same time squandering a once-in-a-lifetime electoral majority and opportunity to pass significant, long promised legislation. All because they don't like Donald Trump, his tweets, his mannerisms, his brusqueness, his personality.

They flipped, and they flopped. Meanwhile, Americans are forced to buy insurance they can't afford, both to purchase and to use – all for a few minutes of fame as Washington, D.C. establishment NeverTrump heroes. Hope they enjoy their summer recess and Sunday talk show appearances.

Brian C. Joondeph, M.D., MPS is a Denver-based physician and writer. Follow him on Facebook, LinkedIn, and Twitter.