It wasn't meant to have content. It was meant to be appropriately dismissive of a bad analogy. Using the same format, I would suggest this one. I see a major difference between being ass raped nightly for four years, and being inappropriately touched once in a while.
So do I think Republicans are perfect, or even very good, of course not. They aren't. But I don't think that means there is no difference. I think that a four year pause in bad legislation really is worth something, even if it is not as good as repeal. But I am pragmatic in that way.
To your other points, Romneycare in MA is different from Obamacare for two reasons. First, I believe that the proper reading of the Constitution gives states much more leeway than the federal government for various laws and programs, and second I think that in MA it served as a moderate alternative to what the population wanted vs in the US it was not at all what the population wanted and far too radical. In the same vein, take Susan Collins and Lisa Murkowski. While they vote almost identically, Collins is an outstanding senator and Murkowski is a joke. Why? Because Collins is far better than anybody else we could get from Maine, and Murkowski is far worse than anybody else we could get from Alaska. It is similar to the idea in baseball of wins above replacement value. The MA example vs Obamacare can be seen similarly.
I agree about the Patriot Act. I have written that many times. I was the only Republican I knew who thought it was a bad idea back then, and was generally called a commie for that just as I am in here for some opinions. Plus ca change.
I am not sure strict scrutiny was even a glimmer in the founders eye. I think they believed that these rights were not negotiable, but it is undeniably true that, at least since Marbury v Madison, which included signers on every level of the case, the courts have self arrogated powers not granted to them in the text. That makes it pretty difficult to argue that it is obvious what the general expectations were. Remember strict scrutiny refers to rights and not to the rest of the document. I think they would be horrified at the idea of multiple levels of scrutiny.
I hope that even if you disagree you see this as less content free.