Days after being diagnosed with brain cancer, Sen. John McCain (R-AZ) flew back to Washington, DC, and cast what proved to be a deciding vote to begin debate on the Republican health bill.

And immediately afterward, he gave a lengthy speech on the Senate floor in which he excoriated the process used to craft the bill, said he wouldn’t support the current version, predicted it would fail, and called for a bipartisan solution.

It was ... strange. McCain’s speech gave the impression that he loathed everything surrounding this bill. Yet though he had the power to block it, just minutes earlier he chose not to. His speech suggested he wanted a bipartisan process through regular order. Yet though he had the power to kick-start that process, just minutes earlier he chose not to.

His said his vote Tuesday was merely a vote “to allow debate to continue and amendments to be offered,” and claimed he “will not vote for this bill as it is today.” So he did indeed leave the door open to potentially vote no on the final product.

But unless he does end up eventually banding together with two other Republican senators to actually block GOP leaders’ bill, all his inspiring words about how the Senate should work won’t actually mean anything.

McCain’s speech on the health bill was brutal. And yet he hasn’t done anything to back up his words.

McCain began his address by generally praising the Senate as an institution. “Our arcane rules and customs are deliberately intended to require broad cooperation,” he said, referring to the “necessity of compromise” and praising the “incremental progress” such a process can create.

Then he criticized the current state of the institution, calling its workings “more partisan” and “more tribal” than “at any time than I can remember.” He blamed both sides for wanting too much and resorting to overly partisan tactics, saying:

Incremental progress, compromises that each side criticized but also accept, just plain muddling through to chip away at problems and keep our enemies from doing their worst isn't glamorous or exciting. It doesn't feel like a political triumph. But it's usually the most we can expect from our system of government, operating in a country as diverse and quarrelsome and free as ours.

He chided extremists in the media: “Stop listening to the bombastic loudmouths on the radio, television, and internet. To hell with them! They don't want anything done for the public good.” He continued, “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.”

And then he pivoted to the health bill itself, and offered a similarly harsh assessment:

We Republicans have looked for a way to end [Obamacare] and replace it with something else without paying a terrible political price. We haven't found it yet, and I'm not sure we will. All we've managed to do is make more popular a policy that wasn't very popular when we started trying to get rid of it. I voted for the motion to proceed to allow debate to continue and amendments to be offered. I will — not — vote — for this bill as it is today. It's a shell of a bill right now. We all know that. I have changes urged by my state governor that will have to be included for my support of final passage of any bill. ... ... We try to do this by coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them that it's better than nothing. That it's better than nothing? Asking us to swallow our doubts and force it past a unified opposition. I don't think that's going to work in the end, and it probably shouldn't. The administration and congressional Democrats shouldn't have forced through Congress without any opposition or support a socioeconomic change as massive as Obamacare. And we shouldn't do the same.

McCain went on to predict that this process would “likely” fail, and that if it does, the Senate should “return to regular order” — a process that would involve committee consideration, hearings, and contributions from Democrats. “What have we to lose by trying to work together to find those solutions?” he asked.

And yet he voted to advance the health bill anyway, when he could have killed it — the vote was 50-50, and Vice President Mike Pence had to break a tie to move it forward.

So ... what’s going on?

What was that all about, then?

One possibility is that McCain could stick to the logic of his speech and vote down the health bill if, at the end of this process, he still thinks it’s a mess. (Though he also seemed to suggest he’d be willing to support the bill if some Medicaid-related changes Arizona’s governor wants were included.)

It’s also worth noting that a “motion to proceed” vote has often been treated as a procedural matter for which senators are expected to back their party — not as the decisive final vote determining passage. There really is precedent for treating it as merely a vote to begin a debate, as Adam Jentleson, a former aide to Harry Reid, says:

Agree 100%. McCain's procedural vote today was consistent with regular order.



At the end, "no" would be consistent., "yes" = capitulation. https://t.co/R62FRu7Jwg — Adam Jentleson (@AJentleson) July 25, 2017

But McCain also has his reasons to try to stay on the good side of Senate leadership. His main policy interests are the military and foreign policy, not health care. He chairs the powerful Senate Armed Services Committee, and Senate leaders have given him a lot of freedom to run things as he sees fit.

Indeed, those issues — and not the health care vote — may well be the real reason he flew back to Washington this week, since the Senate is also considering a defense spending authorization bill he is championing. His paeans to how senators should compromise might also imply that he’s willing to compromise on health care to get a freer hand on issues he cares about far more.

Whatever the case, if McCain truly does want a better and more bipartisan Senate, it’s not enough to give speeches saying he wishes it would be so. He needs to go about trying to make it happen.