Rising from the grave to which many pundits had consigned it, the Senate effort to reform health care reform showed new signs of life. The Senate voted 51 to 50 to proceed with debate on the bill, with no Democrats voting in favor, two Republicans, Susan Collins of Maine and Lisa Murkowski voting against, and Vice President Mike Pence making the tie breaking vote. If any one man, besides Senate Majority Leader Mitch McConnell whose reputation for political wizardry has been restored, it is Senator John McCain. R-Arizona, a man who has terminal brain cancer.

John McCain may have shamed some of the holdouts to vote for the motion to proceed

The drama of a man who has been given what is likely a death sentence coming back to the Senate to vote on the motion to proceed cannot be overrated. The act showed a level of commitment that lesser men may not have been able to muster. However, McCain has a distinct honor, one that he would likely want to do without, of having been tortured for his country. He knows that Obamacare is a scourge for many millions of Americans. He had to participate, as long as he was able, in its dismantling.

Makes an impassioned appeal for bipartisanship

After the vote had been taken, Sen. McCain made an impassioned plea for bipartisanship going forward.

The speech was high minded, statesmanlike, and likely divorced from political reality. Democrats find themselves both embarrassed and in denial about the manifest failure of the Affordable Care Act. Millions of people are being driven to the point of financial ruin by being forced to buy overpriced insurance policies that they don’t need and, because of high deductibles, they cannot use.

For any Democrat participate in the repeal of the law or even substantial changes that would repair it would be to admit they made a mistake by passing it, to begin with. Many adults find admitting a mistake to be hard, not to mention politicians with oversized egos. Anything that does not involve the imposition of single payer, government run health care would be unacceptable for many Democrats.

What happens now?

Now the hard part begins to pass a repeal and replace or repeal or not repeal and reform bill that 50 or more senators can vote for. Will the hold outs on the conservative and moderate wings of the Republican Party come to terms with a compromise? Will one or a few Democrats listen to McCain’s appeal and cross the aisle? Most conventional wisdom thinks either is not very likely. However, a lot of things that have happened have also not been foreseen.