If Obamacare goes down, and millions lose medical coverage, it will be in large part because its defenders didn’t fight for it like lives were at stake.

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Headline: “Harborview to lose $627 million under Republican health-care bill, officials said Friday.”

That’s Friday, as in the day after Thursday. Thursday being the day Congress passed this Medicaid-slashing bill that, entirely predictably, would rain red ink down on Harborview, our state’s largest public hospital.

“You can only imagine the dramatic impact it will have in the health of those we serve,” the head of Harborview added in critiquing the bill.

Again, he said that about 20 hours after Republicans had played “Eye of the Tiger” to get themselves good and psyched up to cancel medical coverage for tens of millions of Americans.

Now, I don’t mean to beat up just on poor Harborview. It’s got far more important things to do on a typical day than tilt at a know-nothing Congress. Saving lives, for example.

But if the historic gains of Obamacare eventually are lost, it will be in no small part because its backers never fought for it like people’s lives were on the line.

This standing down from the fight has been going on for years, especially with the Democratic politicians who passed Obamacare. Because it was a conservative compromise, they have always sounded more apologetic about it than proud.

More important, the people in the trenches of health care — patients, doctors and hospitals — also haven’t spoken up much. They were certainly missing-in-action these past few weeks as House Republicans careened to take the country back to the bad ol’ days of 2008.

As a reminder, here’s a Seattle Times headline from that year: “No Money, No Insurance, No Mercy.” It was about the plague of medical bankruptcy then sweeping our state.

You don’t see headlines like that anymore, for one reason: Obamacare. Harborview itself is the epicenter of a huge success story that bafflingly doesn’t get talked about much.

In 2013, the last year before the Affordable Care Act started up, Harborview delivered $219 million in free charity care to indigent, uninsured patients. The hospital also booked $48 million in “bad debts” — bills that patients couldn’t pay and so defaulted on. This was all at one hospital.

Today, Harborview’s charity care has been cut by 73 percent, to $60 million. And patients’ bad debts have been slashed nearly in half, to $25 million. The simple reason is there are far fewer uninsured folks heading into the emergency room, burdening the taxpayer-backed hospital or later filing for bankruptcy.

The financial savings are sizable. Statewide, total charity care plus bad debts in 2013, before Obamacare, was $2.5 billion. After just two years of Obamacare, it fell to $900 million, a 64 percent reduction. The emotional savings to folks who finally have medical insurance and aren’t bankrupt is incalculable.

Yet every day the president or some ideologue in the U.S. House says Obamacare is “disastrous.” How come that’s so seldom countered with how it has succeeded?

Right, I know, Obamacare has its flaws. In a rational political environment, its problems, which are mostly in the individual insurance market, could be easily fixed (either by relaxing the insurance standards a bit, or increasing the subsidies, or both).

But national politics is no longer rational. Maybe you’ve noticed? The Republican-led House just voted to strip insurance from 24 million Americans, and then held a pep rally! The president, who promised to never cut Medicaid, stood there blithely cheering the gutting of that same program as a “beautiful, beautiful” thing. It’s bizarro world.

I get a sense that people who have devoted their lives to medical care are dumbstruck. The quiet in the weeks leading up to the House vote was telling. People must have figured there’s no way they’d throw millions off health care, not just to give tax cuts to the rich. Surely saner heads would prevail?

This waiting for saner heads has become the new insanity. They aren’t coming. They didn’t ride to the rescue in the 2016 election, and they aren’t, alone, going to save Obamacare in the U.S. Senate. It’s past time to fight.