Bill Cassidy, Lindsey Graham

In this July 13, 2017, file photo, Sen. Bill Cassidy, R-La., left, and Sen. Lindsey Graham, R-S.C., right, talk while walking to a meeting on Capitol Hill in Washington. Senate Republicans are planning a final, uphill push to erase President Barack Obama's health care law. But Democrats and their allies are going all-out to stop the drive. The initial Republican effort crashed in July in the GOP-run Senate. Majority Leader Mitch McConnell said after that defeat that he'd not revisit the issue without the votes to succeed. Graham and Cassidy are leading the new GOP charge and they'd transform much of Obama's law into block grants and let states decide how to spend the money. (AP Photo/Pablo Martinez Monsivais, File) ORG XMIT: WX111

Pablo Martinez Monsivais

U.S. Sen. John McCain, 81 years old, fighting cancer and nearing the end of a storied three-decade career in the upper chamber, is in legacy mode.

While McCain's votes haven't always conformed with his straight-shooting, independent image, he's embarking on quite a run of public gestures that put the country and the institution he serves ahead of partisan priorities.

That's what he did when he provided the dramatic, decisive vote to kill the last GOP attempt to ram through a massive upheaval of the nation's health care system by bypassing the normal hearings, fact-finding and other processes meant to produce sober-minded legislation. It's what he did when he signed a bipartisan legal brief aimed at reducing the toxic effects of partisan redistricting, even though Republicans have benefited far more than Democrats.

And it's what he did last week, when he came out against yet another last-ditch attempt, authored by his good friend Lindsey Graham of South Carolina and Louisiana's Bill Cassidy, to undo the signature accomplishment of the man who ended his presidential dreams, Barack Obama. McCain said he could not in good conscience support the latest repeal-and-replace bill, which proposes sending money to states and letting them come up with their own plans, leaving the bill on life support as the Sept. 30 deadline to pass it with just 51 votes looms.

So here's what I'm wondering: What about Cassidy's good conscience? And what about his legacy?

Compared to McCain, Cassidy is on the opposite end of the seniority spectrum. He turns 60 this week but has been in the Senate for less than three years following a relatively brief stint in the U.S. House. He has no major legislation to his name and, until recently, was unknown outside of Louisiana. His real career was as a gastroenterologist in the state's charity system, which he often cites as a credential for leading the health care fight.

Right now, all that's done is make him a public face of a bill that only 20 percent of Americans support, according to a new CBS poll; that's been shredded by every major patient, medical, insurance and hospital group; and that would take money away from his own state and many others that worked to insure the very patient population that Cassidy once treated.

It's put him in a losing battle with comedian Jimmy Kimmel, who has easily held the upper hand by focusing attention on Cassidy's earlier promise to preserve protections for people with pre-existing conditions and who require expensive care over the long haul. Cassidy had sought to capitalize on Kimmel's emotional monologue about his newborn son's heart surgery by inventing something he called the "Jimmy Kimmel test," but after he started promoting a bill that falls short of that, Kimmel called him a liar and demanded that he stop using his name.

Cassidy's push also has made him complicit in diverting a genuinely bipartisan effort to shore up the part of the current health care law that has caused the real problems Republicans campaigned on. Those are the high costs and deductibles associated with some private insurance policies for people who don't get coverage through an employer and don't qualify for government subsidies, and the limited options in some states. Instead, Graham-Cassidy undermines many of the law's popular provisions and takes aim at something that predated Obama — Medicaid's very existence as an entitlement program.

Cassidy campaigned to repeal the Affordable Care Act, and he's been a consistent critic of its mandate that individuals carry coverage. Still, until now, he's often been a voice of reason, arguing in favor of expanding coverage in other ways and for understanding the financial implications of any proposed change. Facing voters who were furious over the repeal drive at a series of town hall meetings this summer, he treated them respectfully. People who know him better than I do vouch for his caring and character.

All of which makes his insistence on pushing this universally panned proposal inexplicable. The New Yorker's medical writer, a surgeon named Atul Gawande, put it this way: "I find it baffling that a person with (Cassidy's) experience would not recognize the danger of this bill." He's far from the only one.

Because with everything Cassidy knows and all he's done, nobody's better positioned to be a productive force in the health care debate than he is. If there's shame in blowing things up and taking health care away from people who need it, there's honor in getting it right.

And it's never too soon to start thinking legacy.

Email Stephanie Grace at sgrace@theadvocate.com.

Follow Stephanie Grace on Twitter, @stephgracela.