There were plenty of sparks, even though the president started out by saying he wanted to accentuate the positive.
"Let us focus on where we agree," said the president. "Because there is actually is some significant agreement on a host of issues."
But Senator John McCain, D-Arizona, said Republicans and the American people have been shut out.
"In fact, eight times you said that negotiations on healthcare reform would be conducted with the C-SPAN cameras. I'm glad that more than a year later they are here," said McCain.
"Let me just make this point, John, because we're not campaigning anymore. The election's over," said Obama.
"I'm reminded of that every day," said McCain.
"We can spend the remainder of the time with our respective talking points, going back and forth. We were supposed to be talking about insurance," said Obama.
Throughout the day, the president and the Democratic leadership sparred with the Republican leaders that want to scrap the current bill and start over.
"The backbone of our country are the working middle class families in America," said Speaker of the House Nancy Pelosi, D-California. "And for them, they don't have time for us to start over."
For Congressman George Miller, D-Concord, getting rid of pre-existing condition clauses, got personal.
"You hate to admit this at my age, I sit here with two artificial hips, a little bit of arthritis, and I have a kidney stone. I'm dead in that insurance market, if I have to switch policies," said Miller. "But you can't shop in the market place for another insurance company. You can't go from Blue Shield to Kaiser because you have a pre-existing condition."
"In a perfect world, everyone would have everything they want. This government can't afford it, businesses can't afford it," said Eric Cantor, R-Virginia.
The non-partisan Congressional Budget Office has said premiums could rise between 10 and 13 percent because more conditions would be covered.
But for families making less than $88,000 a year, government subsidies would decrease their premiums by 56 to 59 percent. Businesses would pay a little less than they are now, anywhere between 0 to 3 percent lower.
The CBO adds, its estimates include a substantial degree of uncertainty. So the fact is it is very hard to quantify. Republican lawmakers repeated claimed the American people are on their side.
"The American people don't care for the bill and I think we've demonstrated in the polling that they don't," said Cantor.
But the polls have actually been split.
Outside the meeting, conservative protestors demonstrated against what they see as a government takeover, while in San Francisco, progressives protested that the plan does not go far enough.
Inside the summit the president had the last word. He told republican lawmakers they have got a month to six weeks to work with Democratic leaders and if they don't, the president said the Democrats and the White House will go ahead without them.
It sounded like he was laying the ground work for pushing the legislation through without Republican support.
