In health care, the problem of "the uninsured" has generated familiar cries for government intervention. San Francisco Supervisor Tom Ammiano recently proposed a "Health Care Security Ordinance," that would force employers with as few as 20 employees to buy health insurance for them. Employers would have to pay as much as $345 per month into a Health Savings Account (HSA) for each employee who works more than 80 hours per month. HSAs are special accounts designed to give individuals more control over their health-care spending.

Unfortunately, the notion that employers should be compelled to provide health insurance is sweeping the nation, thanks to the AFL-CIO's so-called "Fair Share Health Care Legislation" aimed at 33 states. "Fair Share" requires large businesses with more than 10,000 employees to spend at least 8 percent of their payroll on health care. It is widely recognized that this legislation is designed to punish Wal-Mart for hiring non-union labor.

Ammiano's urge to make universal health care a reality drove him to ride roughshod over small businesses that create jobs. Though he has backed away from the plan, the fine print nevertheless showed some potential.

Too many obstacles

Small businesses should fear government mandates, but not HSAs, which they are already free to open for their employees. Workers should gladly take a $345 per month pay cut in exchange for employers depositing the same amount in an HSA. When received as wages, it's fully taxable. If deposited into an HSA, it's tax-free as long as it's spent on health care.

Good as HSAs are, the federal government still puts too many obstacles in their way. For example, you also have to buy a high-deductible, highly regulated insurance plan in order to open the account, and small businesses may not be able to afford that.

The current employer-provided system is drowning in government mandates already. Employees cannot choose from a broad spectrum of health plans through their employers, (most employees may choose between two plans); the employer-provided system undermines the doctor/patient relationship because employees rarely deal directly with their physicians in determining costs and health benefits; and finally, employees choose extensive health plans through their work that cover much more than they need.

Consequently, health-care costs rise, and patients and small businesses that cannot afford employer-based health care suffer. California needs to allow health insurers to design HSA-compatible plans that small businesses can afford.

Employees with HSAs are responsible managers of their own health. HSA purchasers pay closer attention to the variety of health plans available, and choose only what they truly need.

Most important, HSAs help the poor and the uninsured: Around 29 percent of HSA purchasers earn less than $50,000 a year. Around 40 percent of HSA purchasers were previously uninsured.

Create more choices

Individuals need choices, responsibility, and money for health care.

Beyond de-regulating health insurance, California must exempt HSAs from state income taxes, as does the federal government and 41 other states.

Health care is not a right, it's a choice: So let's create as many choices as possible for individuals. Let's get government out of health care, and HSAs in.