Is this all just the typical government program, bloated, inefficient, and financially unsound? Or is it by design, doomed to fail, paving the way for a replacement such as single-payer? Regardless of motives, the "Affordable" Care Act is anything but.

Obamacare is dying, afflicted with a terminal illness not curable by current medical technology. The system is plagued with ever rising premiums and deductibles, reduced choice of physicians and hospitals, and fewer options for insurance. Adverse selection is chasing healthy individuals away, who choose to have no insurance rather than paying for coverage they don't want or need – and can't afford.

Now in the intensive care unit, doctors from Congress are deciding what to do with their moribund patient. In this case, I favor the approach of Charlie Gard's doctors: letting Obamacare "die with dignity." How ironic that bureaucrats and judges are happy to let a little boy "die with dignity" without the opportunity for a last-ditch effort at life-saving therapy but are hell-bent on continuing CPR on the pulseless corpse of Obamacare.

The House passed a lousy replacement bill. It was like moving an ICU patient to another room with a better window view, thinking that will cure the patient. The Senate couldn't even do that, instead fretting over how much dextrose to add to the IV, believing that will change the disease course of a patient suffering from multiple organ system failure.

Next week is the Charlie Gard decision for the Senate. Let Obamacare "die with dignity" via repeal, or continue the tube feedings via insurance company subsidies and bailouts, prolonging the inevitable?

It's not looking promising in the Senate. The "we know better than you" men and women of the "world's greatest deliberative body" will likely choose life, unlike the E.U. judges choosing death for Charlie. Maybe we could swap a few U.S. senators for E.U. judges as a solution. Charlie would get a chance at life, and Obamacare could sail off to the afterlife.

Next week, Senate majority leader Mitch McConnell is throwing down the gauntlet: a simple up-or-down vote on repealing Obamacare. About time.

Remember the endless campaign promises from Congress to repeal Obamacare? They told us they needed the House. Delivered. But we need the Senate, too. Also delivered. But President Obama will just veto what we send him, including the 50-plus attempts by Congress to repeal or defund Obamacare in some manner. We need the White House, too. Guess what: you have it. Now there's Republican control of Washington, D.C. not seen in generations.

The stars aligned, the weather perfect, no more excuses. Time to perform. And the Senate choked – big league, as the president might describe it.

Next week, Senators demonstrate whether or not their talk of the past eight years was cheap and empty. As it stands now, Senators Murkowski, Collins, and Capito will not vote for repeal. What a difference a couple of years and now a real vote make.

In 2015, Senators Murkowski and Capito were among 48 GOP senators who voted "yes" to repeal Obamacare – a much easier vote then, since it faced a veto. Not so much now. When the vote matters, integrity and honesty are thrown out the window.

It's much like standing in front of the bathroom mirror, telling off your boss or asking someone out on a date. It sounds so clever when the recipient is just a reflection in the mirror. But then when facing a real person, nothing of substance comes out – just some tongue-tied jibber-jabber.

Other senators may vote no, too. My local senator, Cory Gardner, voted for repeal in 2015, but now he is spinning like a weathervane in a tornado, deciding which way to vote. Focus groups, polls, the Denver Post opinion page...all far more influential than what he promised Colorado voters.

No more hiding behind the skirts of Senate rules and procedures. Time to take a position. Draw that line in the sand. They wanted to be senators. So now they can do their jobs. Take a stand, and be prepared to defend it.

Is it their voters they are afraid of? Or their campaign donors? It seems more like the latter, else Obamacare would have been repealed last January, consistent with their endless campaign promises. Republican senators can enrage their voters, assured that most would never vote for a Democrat. But don't forget primaries, and don't rule out voters staying home in 2018 under the assumption that their votes don't matter. All votes are for the uni-party, beholden to the establishment and donors, not the voters.

Repeal won't pass the Senate. Those senators up for re-election who were "for repeal before they were against it" can seek guidance from former senators John Kerry and Hillary Clinton on how to tap-dance around their shifting votes, as those two did for their Iraq War votes.

The media will blame Trump for the failed vote, as will NeverTrumps. Voters will not. They will rightly blame Congress for their ineptitude and dishonesty. Don't be surprised if Trump calls Schumer and tries to work with Democrats, since Republicans can only chase their tails.

Congress abdicated taking tough votes when Obama was in the White House. No oversight. No checks and balances. No power of the purse. Instead, they sat in the bleachers, occasionally clapping or booing but doing little else. Now they are on the field. It's their turn to play.

Talking out of both sides of your mouth is fine for Sunday talk shows and speeches to campaign donors. But let's see how it plays out on a national stage.

Everyone is watching, just as they are with the Charlie Gard case. Death with dignity or continued life support? What will senators choose for Obamacare?

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