09/17/2009 05:12 am ET Updated May 25, 2011

Health Care: The Founding Fathers Weigh In

"The founders did not look to the government as being the solution for the problems in this country. It doesn't say in the Constitution: give out free health care to people, bail out the auto companies, do all these things. The people of this country can be self-sufficient and take care of ourselves."
--Pennsylvania resident Katy Abram in an interview on CNN Aug. 12. Abram received wide media attention after she questioned Senator Arlen Specter at a town hall meeting.

September 1787

Madison: So I think we've got a good start here, fellas. We've established the three main branches of the government and included the stuff about the post office and the military and counterfeiting money...

Washington: And pirates.

Madison: Yes, George, for the last time, we got something in about pirates. Now let's see. This part about the Electoral College--I think we made that pretty foolproof. And you've all figured out how many Representatives you want for your states? What's that? Oh yeah, Rhode Island! Apparently they thought this was just any old Convention and didn't bother to show. Man, Rhode Island. We'll give them one guy. Okay, so what are we still missing?

Franklin: I think I've got something. All of us here have well-lined pockets, right? And if, for example, one of us decided to conduct fascinating electrical experiments and took a kite to the skies during a violent thunderstorm, if that didn't turn out so well for this one of us, then his dear ones would still be supported. But what if another person, perhaps not so established in the world, heard about this experiment and wanted to imitate it, but went out in more of a tornado type thing with, say, a large metal stick, in utter darkness so he couldn't see all the puddles or actually the small stream he was standing in, and something maybe happened to him, what would his family do? And say he didn't in fact die in the storm, but required round-the-clock care, and also had a wife who began sending very nasty letters to the originator of the experiments demanding that he pay for her husband's mending? Could we fit something in to deal with that?

Washington: Do you mean a kind of colony-wide-for-everybody system in which mending would be paid for by one--you could say a single--payer, and they would provide compensation to physicians and hospitals, apothecaries, botanists, leech breeders, and so on, for everyone equally?

Hamilton: OR, what if there were companies that pay the botanists and leech breeders FOR you, and the compensation would depend on your social class, income, how many duels you've survived, eye color...

Washington: That doesn't sound fair. I think what we're trying to do here, really, is make things very clear and equal for everyone.

Franklin: DEATH PANELS! Oh, I do apologize. RUSSIANS! I've been doing some time-travel experiments and I don't know where that came from or why I feel like shouting at you and not listening.

Washington: Okay, forget that other plan. How about something where groups of citizens get together, co-operate even, and figure it all out themselves?


Madison: It seems to me the best thing would just be to not get into too many specifics here. I mean, for all we know we could end up having 15, 17 states, eventually, and things could get a bit more complex than they are now. Plus, there could be great medical advances. Cleanliness and sanitation could be improved.

Hamilton: Yeah, and maybe someday Rhode Island will get its act together.

(Snickers around the room.)

Washington: Ha! And perhaps in the future people won't want to wear wigs, or breeches will extend all the way to the floor. Or maybe we'll all give up our horses and build giant mechanical carriages, and the people who make the mechanical carriages--mostly in some magical new state almost surrounded by water--will dominate the economy for years and years and then suddenly they won't and the government will have no choice but to give them financial assistance.

Hamilton: Well that's just crazy.


Madison: Here. I'm just going to stick this in after Article IV, Section 4, something about how Congress can, let's see, add? Change? Paste in? Ah yes, amend this Constitution as they see fit. Plus, we've given quite a bit of power to the Executive Branch, and since the people elect the president, I'm sure they'll listen to what he has to say when he wants to make some kind of change.

Washington: Indeed. But what will Tom think of that?

Madison: What? You want me to tell you what Tom Jefferson thinks? Tom is in PARIS. And Tom is not the principal author of the Constitution, I am. You ask my opinion? I'll tell you my opinion. I am not going to be channeling Tom.

Washington: Jeez. I just meant if he'd prefer the word "amend" over "change."

Hamilton: Here we go again.