President Obama on Thursday gathered the people and interest groups with the most at stake in fixing the nation’s health care system and promised reform within a year.

“Health care reform is no longer just a moral imperative, it’s a fiscal imperative,” Obama told the gathering of about 150. “If we want to create jobs and rebuild our economy and get our federal budget under control, then we have to address the crushing cost of health care this year, in this administration.”

Obama spoke in the White House East Room before the participants broke into smaller groups to talk about the problems of quality, accessibility and affordability of health care. Clinic leaders sat with hospital administrators, social service professionals conferred with with conservative lawmakers, business and labor interests rubbed shoulders. The crowd even included one doctor in a white lab coat carrying a medical bag.

Any major change, including the $634-billion fund Obama has proposed as a down payment on reform, would affect a range of groups from hospitals to drugmakers to wealthy seniors, who might be called on to pay more for drug coverage under Medicare. The Obama team gathered them all under the East Room chandeliers.

“This was the hottest ticket in town,” Obama said at the start of the afternoon.

Travis Ulerick introduced Obama. Ulerick is a 24-year-old firefighter and emergency medical technician in Dublin, Ind., and one of 30,000 people around the country who hosted health care discussions in their towns late last year at Obama’s invitation.

“The most common theme was Americans don’t believe the current health care system works for them,” Ulerick said.

Obama is banking on the fact that “exploding” costs and his efforts to gather diverse viewpoints together will lead to a major reform of the nation’s health care system, the likes of which has not been seen in decades.

Every 30 seconds, Obama said, someone files for bankruptcy because of health care costs. Forty-six million Americans have no insurance. And skyrocketing costs are weighing down businesses, hurting families already rocked by recession, burdening state Medicare budgets and straining the federal Medicare program for the elderly.

With health care costs the biggest threat to the nation’s fiscal health, the country can’t afford not to act, he said. He blamed special interests for sabotaging reform in the past and he had a warning to the people in the room, many of them representing special interests.

“The status quo is the one option that's not on the table, and those who seek to block any reform at all at any cost will not prevail this time around,” he said.

During a question and answer period at the end of the summit, Obama reached out to both sides of the debate. If there is a way to get reform done relying on market-based approaches—as many Republicans favor—Obama said he would be happy to do it. If there is a way to do it with more government involvement—as some Democrats want—he said he would be happy to do it.

But Obama gave a friendly warning to the “liberal bleeding hearts” in the room that increasing the number of people covered without fixing the spiraling costs will not work.

Fixing those costs also is the only way to solve the balance sheet problems of Medicare and Medicaid, according to AARP CEO Bill Novelli. “While many are quick to focus on the problem of unsustainable costs in Medicare and Medicaid, this is actually a symptom of dysfunction throughout our health care system,” Novelli says. “We need fundamental reform to strengthen these programs and use them to drive change throughout the health care system." Novelli added that reform is especially important to the 7 million Americans in the 50-64 age group who lack insurance, the fastest-growing segment of the uninsured population.

Annie Hill, executive vice president of the labor group Communications Workers of America, said she was heartened to hear the National Federation of Independent Businesses, a past opponent of reform, stand up and say change is needed. “We have this window of opportunity and we have to make it happen,” Hill says.

U. S. Chamber of Commerce President and CEO Tom Donohue also said the landscape has changed and past opponents of health reform have come around.  “We know where everyone stood. But they don’t stand there anymore,” he says. "We’re going to play in this deal. We’re going to get some kind of an agreement here, whether it’s two-thirds of what everybody wants or three-quarters of what everybody wants or who knows. If you don’t get in this game, then … you’re on the menu.”

To get there, Obama and others stressed, everyone may have to accept some pain. “All of us have to be willing to kind of give a little,” says Rep. Jo Ann Emerson, R-Mo.

Karen Ignagni, head of America’s Health Insurance Plans, said insurance companies are committed to working on reform. “We hear the American people about what’s not working,” she said during the closing session.

White House Press Secretary Robert Gibbs likened the summit to a first pitch—or maybe even a ceremonial pitch—in a baseball game. “The legislative road is going to be … long and winding,” he said during a briefing as he fended off reporters’ questions about what types of compromises Obama is willing to make. 

Obama alluded to the fine line he will need to walk between dictating to Congress what should pass and leaving the reform in the legislators' court. But with Congress committed to taking action, the nation must leave aside fears that it would be too difficult to do right now.

Next year, he asked the summit participants, didn’t they want to tell their constituents, “We finally got something done on health care”?