One of the more important arguments between Bernie Sanders and Hillary Clinton during their recent Democratic debate occurred over whether to push for “Medicare for all,” as Sanders insisted, or to build more slowly on the limited success of President Obama’s health care law.

Clinton said: “I do not to want see the Republicans repeal it, and I don’t to want see us start over again with a contentious debate. I want us to defend and build on the Affordable Care Act and improve it.”

Sanders retorted: “I voted for it, but right now, what we have to deal with is the fact that 29 million people still have no health insurance.”

For Europeans, that staggering fact is impossible to understand. There are debates there about national health care systems, but not this one. All the big economies there have universal health-care systems under which everyone is insured. Even the most conservative politicians support them.

Sanders’s critics say that expanding Medicare would cost too much and require much higher taxes. Without big changes in the structure of U.S. health care, that would be true. But that’s also a fact that sounds strange to European ears because European countries tend to deliver high-quality care while effectively controlling the cost.

During the Democratic debate, NBC anchor Andrea Mitchell questioned the feasibility of Sanders’s approach to health care, reminding him that his home state, Vermont, had rejected such a scheme because “by some estimates, it would double the budget.” Yet Europe’s example shows that universal health care doesn’t have to be about burdening people with more taxes.

According to the OECD, the U.S. already spends a bigger share of its economic output on health care than any of the other advanced nations. It might help, of course, if some more of the country’s unusually high defense spending and higher- than-average public safety outlay were shifted toward health. That wouldn’t bring the U.S. into line with the European societies, though. It would need to simplify the funding systems for health care and education, and it would need to drive down costs in both sectors.

Prescription drugs, for example, are far more expensive in the U.S. than in Europe, and the most important reason for that is that European countries regulate them and force pharmaceutical companies to accept thinner margins, and the U.S. doesn’t. European governments don’t give much credence to big pharma’s argument that higher prices help consumers by paying for more research and development: These companies spend more on marketing than they do on R&D, and big European drugmakers haven’t given up on research because they are more tightly regulated in their home markets.

Sanders sounds like a rabble-rousing socialist to Americans when he says: “What this is really about is not the rational way to go forward — it’s Medicare for all — it is whether we have the guts to stand up to the private insurance companies and all of their money, and the pharmaceutical industry.”

Sure, his approach is not as business-friendly as the current U.S. policies that Clinton wants to change only incrementally. But in Europe there’s nothing remotely radical-sounding about Sanders’s ideas because Germany, Britain and Spain, among others, provide certain basic services to their residents on roughly the same amount of per-capita tax dollars that the U.S. collects.

Europeans often complain about the quality of their comprehensive health care. Yet the residents of Europeans countries are generally in better health.

What Sanders suggests is mainstream policy for any European center-right party. It’s not clear why Americans should settle for less.

Leonid Bershidsky, a Bloomberg View contributor, is a Berlin-based writer.