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This past weekend I went to the eye doctor. I had tried to order new contact lenses online. You can order all kinds of abominable things online without any hassle but for some reason buying contact lenses online requires that the seller contact your eye doctor. Well my eye doctor said that my prescription was expired and I had to have another eye exam.

My eye exam went well enough. The people there dilated my pupils to run some of the usual tests and did another special “contact lens test” that cost another $40 on top of a $50 deductible. After an hour and a half, I was released back into the world wearing a pair of oversized disposable sunglasses that made me look like a Florida retiree shuffling to an early bird special. And my eyeglass and contact lens prescription did not change one bit. I spent $90 just for the honor of getting permission to buy contact lenses online. I can’t apply that to the purchase of any new glasses or contact lenses. That’s an expensive two-year rubber stamp.

I’m lucky enough that I can afford to pay off the doctors to let me buy my contact lenses. I have good health insurance and I’m gainfully employed. Someone who is unemployed or under-employed or not paid as well at their job would be shit out of luck if they didn’t have the cash for this.

Even with the good health insurance we have, for-profit health insurance companies have earned their bad reputation for their treatment of consumers. When our youngest daughter was born, we sent in all the paperwork on time to have her added to our insurance policy, but for some reason the insurer didn’t process this in time and for several months we got letters from doctors and collection agencies looking for the money that the insurance company was supposed to pay. When my wife was in the hospital, she was being charged $1.50 per Tylenol pill. Why?

These experiences illustrate some of the inadequacies of our current healthcare system and they are MILD in comparison to some of what goes on. The Affordable Care Act (A.C.A. a.k.a. “Obamacare”) curtailed some of the most blatant insurance company abuses, but there are so many bad actors in the healthcare system that piecemeal reform hasn’t worked to fix things. For example, one of the first efforts of the Obama administration to pass its health plan was to make price guarantees to pharmaceutical companies and insurance companies.

The Trump administration’s effort to repeal Obamacare only accomplished in proving that the Republicans have had no real healthcare plan from day one. For all the meaningless votes to repeal the A.C.A. that the Republicans held in the intervening years, the half-assed effort to pass “Trumpcare” showed that this was all silly games. They have no real plan. Democrats would prefer to have socialized medicine but few establishment Democrats will come out and say that.

Socialized medicine doesn’t sound good to Americans because socialism in general has a deservedly bad reputation. Venezuela’s ongoing collapse is a lesson in how “progressive” authoritarians are best at running their countries into the ground. But socialized medicine does pretty well in capitalist countries. The Japan, Ireland, Sweden, the U.K., France, Germany, the list goes on– these are all civilized democracies with healthy business communities. This doesn’t mean they are immune from recession or fiscal difficulties, but it means that healthcare is not a confusing patchwork of providers trying to grab what they can from every consumer.

But socialized medicine is not the imposition of socialism and not a stepping-stone to a Stalinist state. And the most recent political debacle of Congressional Republicans calling off a vote because they knew they would lose was pathetic. There was no real reason to bring this vote within the first 100 days of the Trump administration, but Congressional Republicans still think it’s 2009.

The latest political shifts have given us an opening to resolve this issue once and for all. There are calls for a single-payer system in the populist right as well as the populist left. The cultural wars that have been using the healthcare debate as a proxy are now out in the open. We can have those discussions instead of hiding behind the skirts of medical policy.

Let’s have the healthcare debate we ought to have. Doctors in France get paid and people in Denmark don’t go bankrupt when a loved one gets cancer. Canadians don’t have to launch a GoFundMe campaign when they sprain their knee.

America is a great enough nation to establish and manage socialized medicine. Let’s go for it.

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