The end of the legislative session is near, so it must be time for California lawmakers to fundamentally restructure a crucial part of the state's economy without much study, reflection or examination of the potential unintended consequences.

The Legislature did this drill with workers' compensation and then the electricity industry in the 1990s, and both turned out to be disasters. Now lawmakers are turning to health care. Will this be the next state-induced meltdown?

Senate Bill 2 would require companies with 50 or more workers to provide health insurance to their employees, and those employing 200 or more to also cover the families of their workers.
At first blush this might sound like a sensible deal. Most employers of that size already provide insurance. Requiring them all to do so would "level the playing field." But this landmark proposal is fraught with problems.

The largest is the widely accepted but questionable assumption that underlies the legislation, the idea that health care is the responsibility of employers. This is a concept that people have grown used to since American companies, faced with wage controls, began offering health care as a benefit after World War II and slowly, over time, increased their involvement in that deeply personal issue.

We would never require companies to provide a "food plan" for their workers, though surely daily nourishment is even more important than health care. Or provide for our housing, even though shelter is next on the list of human needs after food. In each case we as individuals demand that our employers, in exchange for our labor, pay us enough so that we can buy our own food and shelter, as we see fit.

But we have accepted employer-provided health care as if it were inevitable. And as a frog in a pot of water brought slowly to boil does not notice his fate until it's too late, the concept of employer-provided health care might be doing us harm that most people have yet to see.

Mandating employers to provide health insurance amounts to a tax on hiring. Those who do not or cannot provide the benefit would have to pay a real tax to the state to cover the cost of the insurance. The amount of that tax would be determined, and adjusted, by an unelected board, which would also establish the package of benefits. This can't possibly help encourage the creation of more jobs in California.

But even people unconcerned about the state's economic climate should worry about the potential effect on health care. By relying on employers for this benefit, we forfeit control over something crucial to our lives. We are forced to live with the limited choice of plans our employers provide, and the terms of those plans are negotiated between our bosses and the health care industry, with little regard for what we need or want. This convoluted relationship also contributes to the increase in health care costs, as the people who ultimately use the service have little or no connection to the payment of the bills.

Now, in the name of fixing those problems, the Legislature wants to do more of what got us here in the first place.

Requiring employers to provide insurance would create a guaranteed market for the health insurance industry, which in turn would be able to jack up its premiums without having to worry about losing customers. It's no surprise that the authors of this bill briefly considered adding cost controls to the package. They will surely be needed down the road if this measure passes.

But controls on what doctors, hospitals and drug companies charge will not change the factors that are really driving up costs: our aging population and the fantastic developments in medical technology that we all want for ourselves, as long as we think that someone else is paying the bill.

What might happen when employers can no longer afford to offer this benefit, and the state is forced to move in and limit the expense? One scenario is that patients will continue to use the services without regard to the cost, since they are not paying for it directly. But those who provide the service will be less willing to do so since they will be receiving less compensation in return for their labors. That disconnect between demand and supply can only make matters worse. Long waits for service and, ultimately, rationing are the possible long-term results.

Some will say that this is a doomsday scenario, a worst-case outlook that will never come to pass.

But the well-meaning reformers who tinkered 10 years ago with our system for compensating injured workers did not foresee the near collapse of the program facing us today. And the authors of the bill that restructured the electricity industry never asked what would happen if wholesale prices went up instead of down. The answer: blackouts and a financial debacle for the state's utilities.

Let's hope the Legislature asks some tough questions about health care before reaching for another solution that turns out to be worse than the problem it was supposed to solve.