‘‘Our health care financing system does not work, and it’s understandable that state legislators see a need to step in,’’ said Gordon, a senior research consultant for the Iowa Policy Project and co-author of the report — Prescriptions and Placebos: Fixing Health Care in Iowa — for the non-partisan Iowa Fiscal Partnership. ‘‘They must be careful, however, to take a long-term view and not miss the underlying problem of spiraling health care costs.’’

    Previous efforts have encouraged employer-based coverage through tax credits, small-employer purchasing pools, mandates for large employers and other ideas, said Gordon, a historian who wrote ‘‘Dead on Arrival: The Politics of Health Care in Twentieth-Century America.’’

    On their own, these proposals represent a fragmented approach to the problem that would do little to expand coverage or increase affordability, and could actually make things worse, he said.

    ‘‘I really think that trying to patch up employer-based insurance is like moving furniture into a burning house. It guarantees double-digit inflation and rising uninsurance into the future,’’ Gordon said.