by Robert I. Field, Ph.D., J.D., M.P.H.

 Breaking news!! The House of Representative voted to repeal all of Obamacare – for the 33rd time.

In a recurring political ritual, Republicans in the chamber denounced the law as a government takeover and said that all of it has to go. Then they backed up their statements with a vote.

The action has virtually no chance of becoming law. The Democratic majority in the Senate is certain to block it. And if for some reason it does not, Obama has promised to veto it.

Many Republicans, aware that repeal is likely to go nowhere, acknowledge that the vote is largely symbolic. But symbolic of what?

They had based much of their opposition to health reform on the claim that it is unconstitutional. Attorneys allied with the party turned to the final arbiter of constitutionality, the Supreme Court, to prove their point.

The Court has now spoken, and it found, to the contrary, that most of the law passes constitutional muster.

Now, opponents contend that while health reform may be legally valid, it represents bad public policy. They assert that alternative approaches to fixing the health care system would work better.

But Republicans have yet to propose a substitute. And they don't plan to formulate one until after the November elections.

The closest thing to a Republican health care plan is a series of steps outlined by policy experts at two conservative think tanks. However, many of the steps they advocate are already part of Obamacare. It is less an alternative to Obama's plan than a reaffirmation of it.

Nevertheless, House Republicans express such outrage at Obamacare that they find no room for compromise. They claim that all of it must go.

But they have already voted to keep part of it – and done so twice.

That part is a series of cuts to Medicare that were included in health reform to help offset the cost. The budget plan formulated by Rep. Paul Ryan (R – Wisc.) had included all of those cuts (but without any expansion of health care coverage), and every Republican member of Congress voted for it.

And, in perhaps the biggest contradiction, the plan that so outrages Republicans is based almost entirely on their own ideas.

The notion of a mandate on individuals to maintain health insurance originated with Richard Nixon. It was developed in detail by the conservative Heritage Foundation in 1990, backed by a group of 20 Senate Republicans in the mid-1990s, and implemented by Mitt Romney in Massachusetts in 2006.

In fact, no prominent Republican expressed outrage with the idea until after Obama had adopted it in 2009.

The ritual of voting to repeal Obamacare is pure political theatre. It is clear that Republicans are not acting out of concern for the Constitution, do not envision better policy approaches, have no desire to replace it entirely, and do not even harbor true ideological objections.

Perhaps it's not fair to fault politicians for playing politics. That's their job.

But when it comes to health reform, the financial security, health, and even lives of millions of Americans are at stake. Is it too much to hope that they would take that into account?