I offer this. I'm don't know much about the American Constitution, so bear with me.
Quote:
The phrase ["General Welfare"] is as comprehensive as any that could have been used; because it was not fit that the constitutional authority of the Union, to appropriate its revenues shou'd have been restricted within narrower limits than the "General Welfare" and because this necessarily embraces a vast variety of particulars, which are susceptible neither of specification nor of definition.
It is therefore of necessity left to the discretion of the National Legislature, to pronounce, upon the objects, which concern the general Welfare, and for which under that description, an appropriation of money is requisite and proper. And there seems to be no room for a doubt that whatever concerns the general Interests of learning of Agriculture of Manufactures and of Commerce are within the sphere of the national Councils as far as regards an application of Money.
The only qualification of the generallity of the Phrase in question, which seems to be admissible, is this--That the object to which an appropriation of money is to be made be General and not local; its operation extending in fact, or by possibility, throughout the Union, and not being confined to a particular spot.
No objection ought to arise to this construction from a supposition that it would imply a power to do whatever else should appear to Congress conducive to the General Welfare. A power to appropriate money with this latitude which is granted too in express terms would not carry a power to do any other thing, not authorised in the constitution, either expressly or by fair implication.
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Article 1, Section 8, Clause 1: Alexander Hamilton, Report on Manufactures
From what I gather, this is Hamilton on the subject of commerce (i.e. manufacturing) and the need to spend tax money within it for the "General Welfare" of the U.S. There is reference to the interest of "learning of Agriculture of Manufactures and of Commerce." So, generally, he is in favour of defining the "General Welfare" as spending money to support agriculture and commerce.
But the issue he takes is that it cannot be used locally. The money must be spent generally (i.e. nationally).
Could it not be argued that a national health care system is for the "General Welfare" in that it offers a basic need to Americans nationally? That without access to this basic need it could impede the productive capacity of the country as a whole?
Finally, he writes that "General Welfare" is a good term because it doesn't impose limits on its definition, which is good for a Union that faces "a vast variety of particulars." It's hard to say he could foresee America as it is today, so maybe it was a good thing he was in that mindset.