One thing that’s been really striking about the long-running (too-long-running?) series of Democratic presidential debates is how many hours have been spent jawboning about universal health care plans like Medicare for All and how little time has been spent debating something else that could save tens of thousands of American lives.

That thing is universal higher education, which — unfortunately — is often simplified by friend and foe alike into “free college.”

OK, so most people agree that it should be easier and less expensive to attend college, in an economy where a diploma is frequently demanded as the price of admission. But not going to college in today’s America could kill you? To a lot of folks, that’s going to sound a little crazy.

But that’s the explosive premise of a new book called Deaths of Despair and the Future of Capitalism, which was written by the married Princeton University academics Anne Case and Angus Deaton and comes out on March 17, right in the middle of the 2020 primary season. Based on the advance write-ups, the perfectly timed tome could reshape America’s political debate much as another academic work, Thomas Piketty’s Capital in the Twenty-First Century, altered the way we looked at income inequality.

Case and Deaton first broke into the political conversation about three years ago when they reported that a lot of things that were happening in 2010s’ America — including the crisis of opioid abuse and overdoses and a sharply rising suicide rate among middle-aged, middle-class men — were part of a broader trend they dubbed “deaths of despair.”

Their initial research dovetailed with the startling statistic, that — contrary to just about every other developed nation — the United States had seen its life expectancy decline for three consecutive years for the first time since a story that’s been getting rehashed a lot in the news lately, the years surrounding the global influenza outbreak of 1918.

Yet the jarring term of “deaths of despair” gave the conversation a better grasp of “what” but not so much “why.” Clearly the rapid deindustrialization of America during the latter 20th century, most intense in those inland Rust Belt counties that also swung dramatically to the right-wing populism of Donald Trump in the 2016 election, seemed to be a factor, as well as the lack of social bonds in an atomized society.

Now, the years of additional research by Case and Deaton has brought the No. 1 factor into clearer focus. They found that rates of death by suicide, drug overdoses and alcohol-related illnesses were relatively low among older white men without college degrees as recently as the late 1990s but have skyrocketed since then. What’s more, death rates are also spiking for younger men without diplomas. The authors blame both working conditions for the millions who’ve been shut out of the so-called knowledge economy, the frayed institutions that make so many feel alone, and a uniquely American sense that failure isn’t because of “the system,” that instead it’s your fault.

“European countries have faced the same kind of technological change we have, and they’re not seeing the people killing themselves with guns or drugs or alcohol,” Case told the New York Times’ David Leonhardt and Stuart A. Thompson in a major op-ed announcing the book. “There is something unique about the way the U.S. is handling this.” They note that in the past, working-class people were part of both stable companies and, often, labor unions that offered not just better working conditions and a sense of self-worth that’s not easily found in oppressive warehouse or fast-food jobs with erratic hours or a lack of access to health care. This results not only in early death but divorce, social isolation, or even, they note, struggling just to walk up the stairs.

But rising despair among even younger people isn’t breaking news to people who live in historically working-class areas like lower Bucks County just north of Philadelphia; in 2018 I wrote in this space about the Pennsbury school board president who lost one 20-something child to heroin and another to suicide, and who looked at one high school graduating class from the late 2000s and found about 100 out of 890 had died, most from drugs or suicide.

I don’t know how many of those 100 didn’t attend college, or dropped out because of the cost in a state like Pennsylvania, which has some of the highest public university tuition in America. I suspect the number was high. In recent days, I’ve become fascinated with the idea that the warped way that American higher education had developed in the 75 years since the end of World War II has more to do with why we’re so divided, angry, and pessimistic about the future than people realize.

Think about it. In the middle of the 20th century, only 5 percent of Americans, from the most elite families, earned four-year degrees. Starting with the GI Bill in 1944, we defined college first as the aspirational American Dream and later as a requirement for the only jobs worth having in a “knowledge economy.” Yet, incredibly, after opening the post-war spigot of college for the average American, we shut it down at close to the 50 percent mark. And yet somehow we’re surprised that the other 50 percent are so angry and resentful.

It’s become conventional wisdom that Trump and the GOP recaptured the White House in 2016 with massive support from the white, not-college-educated classes, including many who hadn’t voted in past elections but were energized by a demagogue who seemed to hate the elites in academia or journalism as much as they did. Less well understood is that working-class contempt specifically for college was the secret sauce of Trumpism.

According to one survey after the 2016 election, 61 percent of white working-class men had a negative view of college education as “a risky gamble,” and those voters were twice more likely to vote for Trump. That report’s author called this “economic fatalism” and explained: “The enduring narrative of the American dream is that if you study and get a college education and work hard, you can get ahead. The survey shows that many white working-class Americans, especially men, no longer see that path available to them."

Dig deeper and you’ll find that college is the thing that broke America in two, although these days it’s really more a case of dividing us into three. It’s not surprising that the three remaining major presidential candidates represent each of these classes — and their increasingly warring cultures.

Trump is clearly the candidate of what he calls “the forgotten Americans,” especially those over 50 who came of age when blue-collar work was still a path to a vacation cottage or a motorboat, and who now wonder what the hell went wrong. Sen. Bernie Sanders is fighting for the under-35 voters who so internalized college as the only path to the American Dream they took on crushing debts in the quest to get there. And while Joe Biden’s support is more diverse and more complicated, a chunk of it comes from boomers in affluent bedroom communities like Northern Virginia who benefited from college before the system was broken, who don’t see what the Bernie fuss is all about, and who want to return to their mimosa-fueled Sunday brunches without Trump’s rude tweets.

» READ MORE: Suicide, drugs, despair: America’s biggest crisis is the one we don’t talk about | Will Bunch

Here’s the deal. No one would ever create a system the way that American higher education has devolved —with insane runaway tuition, private universities that serve as country clubs for the children of the 1 Percent, a worsening mismatch between college coursework and the jobs that actually exist, and predatory lenders and for-profit scamsters — starting from scratch. A radical rethinking should be the top campaign issue in 2020.

Two things need to happen. The first is to stop defining the American Dream strictly as a four-year college diploma, but instead with a greater role for vocational schools, community college or even less traditional post-high school paths like internships or public service. That’s to be followed by the political will to make all of these options not just accessible but essentially universal to our young people in the 18-22 age group, which will require a big increase in government spending.

We can’t afford that, you say? First of all, you never asked if we could afford $1 trillion for a nearly 19-year war in Afghanistan that has accomplished absolutely nothing, And now, knowing that the current rigged system is literally killing people who ought to be happy and productive citizens, how can we afford not to?

» READ MORE: What Pete Buttigieg doesn’t get about how college has ripped America in two | Will Bunch

And yet no one is quite there. Sen. Elizabeth Warren, who, regrettably, left the presidential race last week, had maybe the most detailed higher-ed plan that was heavily focused on eliminating most of America’s staggering $1.4 trillion college debt but arguably less attentive to the needs of the half who’ve been shut out.

Among those still in the hunt, the Biden plan that focuses on free community college is arguably way too narrow, while Sanders — who deserves a lot of praise for injecting the idea of free public-university education into mainstream politics — can do a better job making the average voter understand how he’d finance this. And Trump scores far too many political points bashing egghead-y elites to actually care about breaking down barriers.

We need to do a lot better. All but a few crackpots think that free universal public education in America up to age 18 is a basic human right, so it’s time to widen our definitions and expand those ideals into the 21st century. A country that holds out college as the only route to the American Dream and then makes it either unattainable or unaffordable to all but the children of multimillionaires is instead creating a nightmare. Let’s mark 2020 on the calendar as the year we turned that around — and even saved a few lives in the process.