Why, for example, have even Democratic senators been resistant on health-care reform? It might be because so many of the key players represent so few of the voters who carried Obama to victory — and so few of the nation’s uninsured. The Senate Finance Committee’s “Gang of Six” that is drafting health-care legislation that may shape the final deal — without a public insurance option — represents six states that are among the least populous in the country: Montana, Wyoming, North Dakota, Maine, New Mexico and Iowa.

Between them, those six states hold 8.4 million people — less than New Jersey — and represent 3 percent of the U.S. population. North Dakota and Wyoming each have fewer than 80,000 uninsured people, in a country where about 47 million lack insurance. In the House, those six states have 13 seats out of 435, 3 percent of the whole. In the Senate, those six members are crafting what may well be the blueprint for reform…

“You have this automatic disequilibrium,” said Donald Ritchie, the official Senate historian. “It’s clearly inequal. There’s no sense of equality except in the sense that the states are equal.” Was this what the founders wanted? “I think they would have a hard time imagining how big the country got,” he said. “I’m not sure they knew the full ramification of that decision.”