Health summit: The 5 key clashes

Despite yielding a few points of agreement, Thursday's health care summit primarily served to highlight major — likely unbridgeable — differences between the two parties' agendas. Though the overall tenor of the summit was collegial, the underlying tension spilled over at times into contentious exchanges, generally involving President Obama and Republican members of Congress. From charges of budgetary "gimmicks" to claims of partisan timekeeping, here is a look at the defining clashes from the historic Blair House pow-wow:

1. Wait, is this 2008?

When John McCain charged the Democratic bill was the product of "unsavory deal making," Obama shot back: "We're not campaigning anymore. The election's over." A flustered McCain responded, "Well, I'm reminded of that every day." A bit later though, the Arizona senator got revenge. Cornered by a question from McCain about why some Florida seniors got special treatment on Medicare, Obama conceded, "I think you make a legitimate point." McCain, looking as surprised as anyone in the room, didn't reply. (Watch Obama's putdown)

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2. Paul Ryan's budgetary smackdown

In a feisty speech, Rep. Paul Ryan (R, WI) described the Democratic bill as a "ponzi scheme" full of accounting "gimmicks and smoke and mirrors" and sought to discredit official projections showing it would reduce the deficit. Conservative critics jumped on the moment as a GOP victory. "The expression on the president's face as Ryan made his case was absolutely priceless," says Matthew Continetti in the Weekly Standard. "Simply put, he looked like someone who realizes he's met his match." (Watch Paul Ryan's critique)

3. The rift over reconciliation

Throughout the summit, Republicans pushed the Dems not to pass health care reform using reconciliation, a procedural technique that would allow them to sidestep the threat of a GOP filibuster in the Senate. Lamar Alexander asked Obama to "renounce this idea" of "jamming" the bill through Congress "using reconciliation." After all, he said, the process has "never been used for anything like this." But Obama kept the option open: "I think most Americans think that a majority vote makes sense." (Watch Lamar Alexander's comments on reconciliation)

4. Is there a fact-checker in the house?

While making the GOP's opening remarks, Sen. Lamar Alexander of Tennessee claimed that insurance premiums "will rise as a result of the Senate bill." Obama countered that this was "not factually accurate. The cost for families for the same type of coverage as they're currently receiving would go down 14 to 20 percent." Bloggers immediate scrambled to pick a winner, with most seeming to settle on Obama. "The record is tricky," says Brian Beutler in Talking Points Memo. But overall "Obama is correct." (Watch Obama smack down Alexander)

5. It's about time

In addition to serving as moderator and head debater for the Democrats, Obama was also the official timekeeper — much to the dissatisfaction of GOP members of Congress. Ninety minutes into the summit, Sen. Mitch McConnell (R-KY) noted that Democrats had spent 52 minutes talking compared to only 24 for Republicans. Obama shot back: "I don't count my time, because I'm the president." (Watch Mitch McConnell question the time)

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SEE MORE OF THE WEEK'S COVERAGE OF THE HEALTH CARE DEBATE:

• What's next for health care: 5 theories

• Obama's health care summit: Live first reactions

• Obama's 11th-hour health care play

• Health care summit: 6 ways to win