Another day, another ghastly shooting in America.

So far this year, the United States has averaged more than one mass shooting a day, according to the ShootingTracker website, counting cases of four or more people shot. And now we have the attack on Wednesday in San Bernardino, Calif., that killed at least 14 people.

It’s too soon to know exactly what happened in San Bernardino, but just in the last four years, more people have died in the United States from guns (including suicides and accidents) than Americans have died in the wars in Korea, Vietnam, Afghanistan and Iraq combined. When one person dies in America every 16 minutes from a gun, we urgently need to talk about remedies.

Democrats, including President Obama, emphasize the need to address America’s problems with guns. Republicans talk about the need to address mental health. Both are right.

First, guns, the central issue: We need a new public health approach based not on eliminating guns (that simply won’t happen in a land awash with 300 million guns) but on reducing the carnage they cause.

We routinely construct policies that reduce the toll of deadly products around us. That’s what we do with cars (driver’s licenses, seatbelts, guardrails). It’s what we do with swimming pools (fences, childproof gates, pool covers). It’s what we do with toy guns (orange tips).

It’s what we should do with real guns.

We can improve public safety without eliminating guns. Switzerland has guns everywhere because nearly all men spend many years as part-time members of the armed forces (it’s said that Switzerland doesn’t have an army; it is an army). Yet while military weapons are ubiquitous, crime is low.

What we should focus on is curbing access to guns among people who present the greatest risk. An imperative first step is universal background checks to acquire a gun. New Harvard research suggests that about 40 percent of guns in America are acquired without a background check — which is just unconscionable.

Astonishingly, it’s perfectly legal even for people on the terrorism watch list to buy guns in the United States. More than 2,000 terrorism suspects did indeed purchase guns in the United States between 2004 and 2014, according to the Government Accountability Office and The Washington Post’s Wonkblog. Democrats have repeatedly proposed closing that loophole, but the National Rifle Association and its Republican allies have blocked those efforts, so it’s still legal.

While Republicans in Congress resist the most basic steps to curb gun access by violent offenders, the public is much more reasonable. Even among gun owners, 85 percent approve of universal background checks, according to a poll this year.

Likewise, an overwhelming share of gun owners support cracking down on firearms dealers who are careless or lose track of guns. Majorities of gun owners also favor banning people under 21 from having a handgun and requiring that guns be locked up at home.

These are reasonable steps that are, tragically, blocked by the N.R.A. and its allies. The N.R.A. used to be a reasonable organization. It supported the first major federal gun law in 1934 and ultimately backed the 1968 Gun Control Act. As a farm kid growing up in rural Oregon, I received a .22 rifle for my 12th birthday and took an N.R.A. safety course that, as I recall, came with a one-year membership. But the N.R.A. has turned into an extremist lobby that vehemently opposes even steps overwhelmingly backed by gun owners.

As for mental health, Republicans are right that it is sometimes related to gun violence. But it’s also true that in some cases their budget cuts have reduced mental health services. To his credit, Representative Tim Murphy, a Pennsylvania Republican, has introduced a bill that would improve our disastrous mental health system, perhaps reducing the number of people who snap and turn to violence. Yet some Democrats are wary of the bill because Republicans like it. That’s absurd: We need better mental health services just as we need universal background checks.

It’s not clear what policy, if any, could have prevented the killings in San Bernardino. Not every shooting is preventable. But we’re not even trying.

When we tackled drunken driving, we took steps like raising the drinking age to 21 and cracking down on offenders. That didn’t eliminate drunken driving, but it saved thousands of lives.

For similar reasons, Ronald Reagan, hailed by Republicans in every other context, favored gun regulations, including mandatory waiting periods for purchases.

“Every year, an average of 9,200 Americans are murdered by handguns,” Reagan wrote in a New York Times op-ed in 1991 backing gun restrictions. “This level of violence must be stopped.”

He added that if tighter gun regulations “were to result in a reduction of only 10 or 15 percent of those numbers (and it could be a good deal greater), it would be well worth making it the law of the land.”

Republicans, listen to your sainted leader.