Seven hours of discussion at Thursday’s health summit did produce some winners and losers on both sides of the table. The Republicans were winners because they were able to present themselves as having ideas, rather than just being naysayers. They had a wider audience for their versions of tort reform, expanding health savings accounts (nothing new in these) and allowing insurers to sell across state lines. They also scored by putting forth Senator Lamar Alexander to open their remarks, a more temperate voice that those ordinarily associated with the GOP brand, and gained credibility with two lawmakers who are also doctors.

President Obama was also a winner. Ever the law professor as well as leader, he managed the presentations in an even-handed and fairly open-minded way, keeping the group focused on key topic areas, and hinting at possible areas of compromise (tort reform, sales across state lines) and restating shared baseline goals (helping small businesses buy insurance as a group, routing out Medicare and Medicaid fraud and abuse, controlling costs, increasing prevention).

The American people also were winners in a couple of ways. First, they saw mostly respectful, civilized discourse, something increasingly rare in this “tea party” era. (As Congressman Joe Barton said, (I paraphrase) ‘never have so many politicians behaved so well for so long in front of television cameras.’

Second, the summit was an opportunity to learn more of the substance of the issue, to set aside some of the shibboleths (this is not a government take-over of health care). Then again, there was still a fair amount of posturing.

Which brings us to the losers. Top four: House Speaker Nancy Pelosi (strident, self-congratulatory and non-bending), Senate President Harry Reid (disingenuous), Senate Minority Leader John Boehner and House Minority Leader Mitch McConnell (both Republicans unwilling to say a single area in which they’d be willing to compromise).

So where to from here? It seems clear that fundamental differences (especially over pre-existing conditions and whether you can cover them without vastly expanding coverage to draw healthier individuals into the pool) may make a bipartisan solution all but impossible. If that is so, then having held the summit and having presented themselves as open to a bipartisan solution, the Democrats can then move to reconciliation, requiring a simple majority. What a radical idea!

The most laughable blather by a talking head was Mary Matalin’s assertion that passage by a 51-vote majority represents the “tyranny of the minority!”

Reconciliation has been used by both Democrats and Republicans more than 20 times in the last two decades, including the passage of welfare reform and tax cuts.

Of course, if the Democrats go for reconciliation and fail, you may see Barack Obama as a one-term President! And you may not see significant health reform legislation for another generation.

Please let me know your thoughts in the comments section below.