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Next week, Iowans will caucus to choose a Democratic candidate for president. But an observer might be forgiven for thinking that the future of U.S. health care was the real choice on the ballot.

Health care has been the most discussed topic at the Democratic Party debates, to the dismay of commentators who would like the conversation to expand beyond Medicare and its financing to highlight the candidates’ other policy differences with President Donald Trump. Yet politicians and debate moderators are merely responding to recent polls: health care is the only issue that a majority of Americans agrees is extremely important in the 2020 presidential election.

The public’s concern is warranted. The United States now suffers from twin pathologies—one afflicting the health of its citizens and the other the health of its political system. Reversing the simultaneous declines in U.S. health and U.S. democracy depends on

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