Sen. John McCain (R-Ariz.) departs the Capitol after returning to the Senate to vote on health-care legislation on Tuesday. (Oliver Contreras/For The Washington Post)

Sen. John McCain was greeted by applause from both sides of the aisle Tuesday as he walked onto the Senate floor, delivering Republicans a crucial vote to begin debate on an unknown plan to overhaul the health-care industry.

Then the Arizona Republican, done with the niceties, delivered a 15-minute excoriation of the modern Senate. A Senate riven by partisan infighting and almost no effort to work across the aisle. A Senate that has abandoned the principle that legislative committees had ownership of the process.

A Senate so broken that the only way to even begin a health-care debate was to drag an 80-year-old man, diagnosed last week with brain cancer, 2,300 miles across the nation from Phoenix to cast that critical vote.

“Let’s trust each other. Let’s return to regular order. 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,” McCain told his colleagues, who gave him the floor for an unusual address usually reserved for a retiring senator. “We’re getting nothing done, my friends. We’re getting nothing done.”

His mere presence gave Senate Majority Leader Mitch McConnell (R-Ky.) his biggest victory since the April confirmation of Supreme Court Justice Neil M. Gorsuch, allowing debate on a still unformed legislative package designed to replace the Affordable Care Act. McConnell joined a long line of senators embracing McCain upon his arrival.

(U.S. Senate)

While McCain cast blame far and wide for the Senate’s shrunken status, he left no hint of subtlety in singling out the GOP leader’s secretive, zigzagging effort to draft the health-care bill.

“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,” McCain said, noting rising support for the 2010 Affordable Care Act. “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.”

Despite this warning, McCain’s vote on Tuesday helped enable the broken process on health care that he came to the floor to decry. It allows McConnell to continue to circumvent the committee work and bipartisan negotiations McCain said represent the best of the Senate. A no vote would have forced leaders back to the drawing board, possibly into a bipartisan negotiation, but now, they will barrel ahead, possibly for weeks or months, on the Republican-only effort.

There was nothing new about a defiant McCain speech. On July 12, two days before his surgery to remove a blood clot that led to the diagnosis of a brain tumor, McCain delivered a fiery speech with the same themes — it was delivered to an almost empty chamber. Just McCain being McCain.

But Tuesday, McCain wasn’t just being McCain.

He spoke for more than 225 years of Senate history, trying to force his colleagues to break free of this era’s political spell. No one quite knew where he would end, almost sounding as if he were about to announce his retirement.

Almost every senator sat in his or her seat, hanging on every word. McConnell and Senate Minority Leader Charles E. Schumer (D-N.Y.) twisted themselves sideways so they could look directly at McCain, his left eye still deeply swollen from the surgery.

Both leaders grew visibly emotional at times, McConnell’s face bright red as Schumer’s eyes glistened.

Whether his words will have any lasting impact remains to be seen and, frankly, is not very likely. When McCain concluded, Vice President Pence cast the tiebreaking vote, and both sides marched out to partisan news conferences blaming one another for the gridlock in Washington.

“This legislation is open for amendment, not just by Republicans but by Democrats as well,” Sen. John Cornyn (R-Tex.), the majority whip, told reporters. “Should our Democratic colleagues, in the spirit of Senator McCain’s remarks, decide to participate in the process and build a bipartisan piece of legislation, this could well be the beginning of that healing process for this institution.”

Yet Cornyn knows full well that is not going to happen, that the process being used now is a fast-track effort under rules that allow budgetary measures to pass on a simple majority without having to clear a 60-vote threshold to defeat a filibuster. Long ago, Democrats said they wanted no part of the work on an Affordable Care Act repeal, and McConnell was more than happy to take them up on that non-offer.

McCain now finds himself among the last of a generation in the Senate. He is venerated across the nation for surviving more than five years of captivity and torture during the Vietnam War. But he is worshiped inside the Senate for the latter half of his 30 years here, when he took on the role of bipartisan elder statesman.

McCain acknowledged that he has not always lived up to his own ideal. His temper legendary, his clashes with some colleagues have been incendiary. “Sometimes I’ve let my passion rule my reason. Sometimes I made it harder to find common ground because of something I said to a colleague,” he said.

He and McConnell have had an on-again-off-again relationship. Its rockiest patch came 15 to 20 years ago as they clashed over campaign finance legislation restricting large donations to political parties. McCain beat McConnell on the Senate floor, but McConnell won in court, leading the legal battle that gutted McCain’s eponymous bill.

When McCain returned to the Senate following his loss in the 2008 presidential election, McConnell effectively deputized him to lead the GOP caucus on national security issues. In recent years, McConnell has sometimes relied on McCain as an emissary to Democrats, particularly Schumer, who grew close to McCain during the 2013 effort to overhaul immigration and border laws.

But in recent weeks, McCain has grown increasingly angry with the way McConnell abandoned any hint of regular order, working with an ad hoc group of Republicans in his office and then drafting the legislation on his own, reworking it each time he ran out of support from within the GOP caucus.

“I don’t think that’s going to work in the end and probably shouldn’t,” McCain said.

Democrats applauded the call for bipartisan effort, prompting McCain to remind them that Democrats passed the Affordable Care Act with only their votes eight years ago.

As Republicans cheered at those remarks, Schumer made a bowing gesture toward McCain, acknowledging the point.

“We’re not getting much done apart,” McCain told his colleagues. “I don’t think any of us feels very proud of our incapacity. Merely preventing your political opponents from doing what they want isn’t the most inspiring work. There’s greater satisfaction in respecting our differences but not letting them prevent agreements.”

Read more from Paul Kane’s archive, follow him on Twitter or subscribe to his updates on Facebook.