The Democracy of the founding fathers was Greek Democracy, predicated upon a slave society, and restricted to only the elite. This is the society we live in today, even with our reforms towards direct representation. The system is inherently biased towards the election of elites and against the representation of the masses. Hamilton called it “faction” when the working class got together and demanded better conditions, and mechanisms were built in (which still exist to this day) that serve to ensure the continued dominance of the elite over the masses. The suffering of the many is intentional. The opulence of the wealthy is also. This is the intended outcome.
That is not public healthcare. That would be like the US only allowing Mayo Clinic to operate. Public healthcare is provided by the government.