Enlarge By Saul Loeb, AFP/Getty Images President Obama listens as Republican congressional leaders speak during health care talks Thursday at Blair House, across the street from the White House.  JOIN THE CONVERSATION   Track the latest news about President Obama's administration with The Oval  READ THE LATEST POSTS After the Obama summit: Still a stalemate Posted on Feb 25 2010 6:59PM Obama spokesman Gibbs loses bet on U.S.-Canada hockey game Posted on Feb 25 2010 6:27PM Obama, GOP, health care: Agreement on details, not on approach Posted on Feb 25 2010 3:49PM Obama, Biden say health care plan will cut deficit; GOP skeptical Posted on Feb 25 2010 2:45PM Our live-stream of the health summit continues Posted on Feb 25 2010 2:08PM Read all posts  Enlarge By Pablo Martinez Monsivais, AP Senate Majority Leader Harry Reid of Nev., left, walks past Senate Minority Leader Mitch McConnell of Ky., at the Blair House in Washington on Thursday.

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Republicans said Democrats should "scrap this bill … and start over again on a clean sheet of paper," as House GOP leader John Boehner put it, adopting a "step-by-step" approach that would cost less and prescribe a smaller government role.

Democrats said it was imperative to act, and quickly. Some Americans "don't have time for us to start over," House Speaker Nancy Pelosi said as the session started. "Many of them are at the end of the line."

LONG DAY: Health summit shows divergent views COMMON GROUND: Summit settled little but showed a lot THE OVAL: Agreement on health care details, not on approach TIMELINE: The road to health care legislation

Seven hours and thousands of words later, Obama made it clear that unless Republicans made significant and unexpected compromises, Democrats would press ahead on something akin to the $950 billion, 10-year health care plan he outlined Monday — presumably by using a parliamentary maneuver that would bypass a Republican filibuster in the Senate.

"Baby steps don't get you to the place where people need to go," Obama said, noting efforts by presidents back to Harry Truman to provide insurance coverage for Americans who lack it. "They can't afford another five decades" for a health care overhaul.

If the cold morning began with any hope that common ground might be found — always a long shot — the mood by the end of the day was testy and unyielding.

The likely use of the procedure known as reconciliation seems sure to spark another wave of partisan recrimination. The tactic — used by Republicans to enact President George W. Bush's tax cuts in 2001, for example — allows the Senate to pass a budget-related measure by a 51-vote majority rather than having to muster 60 votes to end debate.

Sen. John McCain, R-Ariz., said he was "very disturbed" by the prospect. Reconciliation could have "very significant long-term damage to the way that Congress does business," he cautioned.

There was no evidence that the appeals for bipartisanship, warnings about perils ahead, talk of polls and arguments about policy by both sides succeeded in changing the views of anyone in the room.

"Throughout the day, participants talked past each other to such an extent that the summit was closer to a molehill of familiar stump speeches," said Robert Schmuhl, a political scientist at Notre Dame and author of Statecraft and Stagecraft. He called it "a Kabuki dance" as both sides sought political advantage.

Winning passage of his signature domestic issue, one on which he has expended enormous political capital, is crucial to Obama delivering on a campaign promise and demonstrating political clout. "To fail would be devastating," says William Galston of the Brookings Institution, a domestic-policy aide to President Bill Clinton when his health care plan was defeated. "I know what I'm talking about."

For Republicans, opposition to the Democrats' health care proposal has fueled the emerging anti-tax, small-government Tea Party movement and boosted GOP prospects in November's congressional elections.

At the summit, Republicans cited GOP upsets in the Massachusetts Senate race last month and gubernatorial contests in New Jersey and Virginia last fall as evidence the public agrees with them on the health care bill. "Put it on the shelf," Senate Republican leader Mitch McConnell of Kentucky urged.

Though summits on difficult issues have been held before between congressional leaders and administration officials, historians and political scientists weren't able to think of a precedent for one being open to televised coverage for all to see. The closest parallel may be an economic forum President-elect Bill Clinton held in Little Rock before his inauguration.

Aside from an hour break for lunch, the president, vice president, congressional leadership and key committee chairmen spent much of the day squeezed together around tables arranged in a hollow square in an elegant reception room with a pastoral mural on the wall.

There were discussions of fundamental philosophical disagreements on the role of government as well as political jockeying.

Obama displayed flashes of annoyance as he accused Republicans of reciting talking points rather than engaging on issues.

McCain, Obama's opponent in the 2008 presidential election, blasted "special deals for the special interests and favored few" in the Democrats' bill. "Both of us during the campaign promised change in Washington," he said to Obama.

"We're not campaigning anymore," the president replied. "The election's over."

"I am reminded of that every day," McCain said.

Afterward, in a conference call with reporters from his Senate office, he said, "I thought it would be well to joke a little bit because it was a little tense."

At times, the debate was wonkish; at times, rambling. It became a battle of the local anecdote: Harry Reid, the Senate's Democratic leader, talked about the plight of a restaurant owner in his home state of Nevada. Democratic Sen. Tom Harkin read a letter from a farmer in his home state of Iowa. Republican Sen. Mike Enzi described his wife's search for affordable health coverage when they ran a shoe business in Wyoming.

When it was over, Reid told reporters Obama had proved himself to be "the most patient man in the world."