(OfficialWire) – You can agree to reform the U.S. health insurance system or you don’t; you can’t have it both ways, Vice President Joe Biden said Thursday.

During a bipartisan summit about healthcare reform, including changes to the health insurance industry that were in Democratic bills and an outline offered by President Barack Obama, Republicans said they endorsed reforms such as language that would end yearly and lifetime caps, bar companies from dropping people, and allow increasing the age children could remain on a parent’s policy.

But, several Republicans said, they have an issue with mandated insurance minimums and a non-elected panel that would review how health insurance companies spend premium money and how much it returns to medical coverage.

“If you agree that you can’t be dropped, there has to be dependent coverage, if there’s no annual or lifetime cap, then, in fact, you’ve acknowledged that is the government’s role,” Biden said. “The question is how far to go. So … you’re either in or you’re out. (Either) the government can’t do it — none of it — or they can do some.”

Democrats and Republicans agree in theory about the issue of barring insurers from denying coverage for pre-existing conditions.

Republicans, several speakers said, favor state-level risk pools for people who are chronically ill or have pre-existing conditions.

Health and Human Services Secretary Kathleen Sebelius outlined the issues of rate reviews and establishing benchmark standards that insurance companies must abide by.

Sen. Jay Rockefeller, D-W.Va., said insurance companies need to be regulated because “this is a rapacious industry that does what it wants.”

“If you don’t put the restriction on them, they’re going to go on doing this,” Rockefeller said. “And so, you know, the public option was, I liked that a lot, but that’s not going to probably be possible. So you have to go at them to clip their wings in every way that you can.”

Blue-dog Rep. Jim Cooper, D-Tenn., threw down the gauntlet to both Republicans and Democrats to stop the talk and walk the walk. “(So) far we’ve heard a lot of folks trying to outdo each other in deficit reduction,” he said. “I welcome that competition, especially if it’s backed up votes, because it’s easy to talk tough on this. It’s harder to deliver. For all the folks who want to talk tough and not vote tough, that’s not good enough. It means that for all the folks who want to do this next year or next decade or leave it to their successor, that’s not good enough.”