In business, Trump's strategy of completely ditching a failed venture makes sense.
If he launches a product that is complete rubbish (Trump Vodka? Trump mortgages?) after a blaze of publicity he can just walk away if it doesn't work out. If the market needs Vodka, or mortgages and somebody else has a better product, they will provide. If nobody wants Vodka, who cares? If the Smirnoff brand falls apart, maybe there will be more vodka opportunities in the future.
However, Trump's administration is responsible for US government healthcare policy for the next 4 years.
If he allows Obamacare to 'fail' without coming up with a better plan people will suffer. Will Americans really allow him to do nothing and blame Democrats?