Too much focus on winning. Not enough attention on bipartisan problem-solving. That’s what ails the US Senate today, said Sen. John McCain (R) of Arizona in an impassioned speech that amounted to a dressing-down of his colleagues before a full Senate on Tuesday.

“We’ve been spinning our wheels on too many important issues because we keep trying to find a way to win without help from across the aisle,” said the politician respected and beloved by colleagues, after Republicans agreed in a tight party-line vote to debate a rejoinder to the Affordable Care Act.

He admitted that sometimes he, too, has “wanted to win, more for the sake of winning.”

It’s not the first time a senator has denounced one-sided lawmaking, and health care is not the first issue to illustrate this. Like Wall Street’s focus on quarterly profits, lawmakers from both sides look to the next election and satisfying their base, and this can be to the detriment of solving America’s biggest problems.

But a GOP that’s desperately trying to fulfill a campaign promise with variations on a Republican House bill that is broadly unpopular with the American public points to an acute case of winning-itis, as McCain’s speech implies.

Why health care is so partisan

Multiple factors account for this, says Matt Mackowiak, a GOP consultant in Austin, Texas: A campaign promise repeated for seven years which racked up impressive Republican electoral wins; GOP control of Washington that should allow Republicans to deliver on their promise; and the party-line Democratic vote that brought the nation Obamacare in the first place.

Then there’s the difficulty of taking away a benefit once it’s been dispensed and the very real philosophical divide over health care between the parties, with Democrats viewing it as a right to be guaranteed by the government while Republicans see it as a choice to be met by the private sector.

Republicans are trying to “save” the private health-care system and forestall a move to a “single payer,” government-run system advocated by Democrats, explains Mr. Mackowiak.

But in his view, “The die was cast on Republicans approaching this in a partisan manner once Democrats passed this in a partisan manner themselves.”

Senator McCain made this very point in his speech, calling out Democrats for their partisan passage of the Affordable Care Act, a point that Senate minority leader Sen. Charles Schumer (D) of New York readily admits.

“He’s right that both bills were partisan, and I wish that didn’t happen. But we tried,” Senator Schumer told reporters Tuesday. Democrats worked for months with Republicans to try to fashion a bipartisan bill, held public hearings on their legislation, and allowed for amendments on their bill, before they ultimately passed their bill without a single Republican.

In this case, no public hearings accompanied the GOP bill that passed the House in early May. Democrats did not participate in negotiations. And a Senate version to “repeal and replace” was hammered out behind closed doors by majority leader Mitch McConnell (R) of Kentucky.

But Senator McConnell was unable to bring enough Republicans behind a bill that would leave 22 million Americans without insurance and cut hundreds of billions of dollars from Medicaid, according to the independent Congressional Budget Office. Another idea, the reprisal of a “repeal only” bill, passed in 2015 but vetoed by President Obama, also could not get enough support.

And so Republicans have embarked on a path to the unknown, debating the House version as a vehicle for amendments that will produce a bill whose final shape is still to be determined. On Tuesday night, nine of the Senate’s 52 Republicans voted against an amendment to “repeal and replace,” and on Wednesday seven voted against an amendment for “repeal” only, and neither garnered a single vote from Democrats. Both amendments failed.

What happens next

The going theory is that after a massive amendment process known as “vote-a-rama,” the amendments that survive will amount to a “skinny” repeal – simply repealing the individual and employer insurance mandates and a tax or two – with a final vote on Friday. The GOP leadership wants to pass something – anything – so they can keep the process alive. (Republicans in both chambers would then have to confer on a bill that could pass both houses.)

Which brings up McCain’s point about winning being everything.

He urged his colleagues to return to “regular order” and tackle legislation through committees involving both parties. Senators on both sides of the aisle listened intently as he made his first appearance at the Capitol since he was diagnosed with cancer. It was a rare moment when a senator had the entire body as his audience – usually they are alone on the floor speaking to the C-SPAN television cameras.

A man of stature

In the history of the Senate, forceful speeches have at times changed people’s minds and determined policy, and leaders have successfully argued that certain issues are bigger than parties, says former Senate historian Don Ritchie. He cites Sen. Henry Clay of Kentucky (revered by McConnell) and the Compromise of 1850 over slave and free states, and also Sen. Arthur Vandenberg from Michigan, who helped turn Republicans from an isolationist to an internationalist view after World War II.

McCain certainly has stature. He is admired for his courage when he was tortured as a prisoner during the Vietnam War. And he is known as a senator who works across the aisle. He’s also known for his unvarnished speech. When he ran for president in 2008 and 2000, he named his campaign bus the Straight Talk Express.

But it’s unlikely that he’ll sway his colleagues to work together on this particular issue. The more realistic incentive will be if the GOP effort to change Obamacare fails.

“If this fails, McConnell is going to move to a bipartisan path,” Mackowiak says. Indeed, the majority leader has said there would be no other alternative but to work with Democrats if Republicans pass a health-care bill.

That negotiation, however, may well be just as difficult as the Republican process has been. As McConnell noted on Tuesday, “Some issues are just more partisan than others. I think we can all stipulate that health care has not been a subject of bipartisanship.”

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McCain also urged Republicans and Democrats to start over on health care if the GOP effort fails, which he thought would be the likely outcome.

“Let’s see if we can pass something that will be imperfect, full of compromises, and not very pleasing to implacable partisans on either side, but that might provide workable solutions to problems Americans are struggling with today.”