This wouldn’t be popular, nor would the radical change that Medicare for All would entail. President Barack Obama had to promise that if you like your health care you can keep it because any change to private insurance is so toxic. Medicare for All would replace the employer-based system entirely for more 150 million people. It wouldn’t matter how much they liked their insurance — it would be gone as a matter of definition.

It’s hard to see Medicare for All as a plausible health care agenda even if Democrats swept all elected branches of government in Washington in 2020. But the first step toward achieving any policy goal is creating a national debate over it and swinging one of the major political parties behind it. Bernie Sanders has had considerable success in that effort, and the allure of “free” health care — like free anything — can’t be discounted.

Republicans need to continue to develop and push their own ideas to reduce health-care costs, and adjust to the new reality where socialism doesn’t simply represent a laugh line, but a battle that needs to be won.