For many issues, the GOP doesn't just have no plan to fix them; they see them as ideological successes. Employees are supposed to be disposable. Things like healthcare are supposed to be dramatically different for the rich and poor.

Spending money and time making and maintaining a functional system for anyone but the rich is antithetical to the fundamentals of conservatism. Material wealth is directly correlated with human worth to the GOP. The hospital that makes the most money, the argument goes, must therefore be the best hospital. If people aren't recieving adequate care then it's either because they're undeserving OR it's that healthcare quite literally cannot be improved further. They're wrong, of course, but when has simply being wrong ever mattered in politics?