In every war there is collateral damage, and in the legislative battle to pass the long-delayed state budget, one of the casualties last week was a bill that would have provided paid sick leave to workers.

What that means is that for the next year, at least, millions of California workers will face two choices when they're sick: go to work and risk spreading their disease to their co-workers, or stay home and risk losing their pay or even their jobs.

It's not a pretty choice.

Nearly 40 percent of California's work force, totaling 5.4 million workers, do not have the right to take paid time off work when they are sick, according to data from the Institute for Women's Policy Research, or IWPR, in Washington, D.C.

“People are losing their pay, losing their jobs or being penalized in some other way because they had to stay home sick or to take care of a sick child,” said Vicky Lovell, acting director of research at the IWPR.

As with so many other things regarding worker health and safety, the United States stands virtually alone in not guaranteeing workers paid leave when they get sick.

In 145 other countries – including Japan and the top economies of Western Europe – employers are legally required to provide paid sick days or short-or long-term leave for illnesses. In 127 countries, employers must provide at least one week of paid sick leave per year. In contrast, outside of San Francisco – which recently passed its own law on paid sick leave – there is no such requirement in the United States.

True, many U.S. companies provide sick leave, including The San Diego Union-Tribune. If you're employed by a big business, chances are you're entitled to take paid sick days for yourself or, if you're a parent, to care for your sick children. The IWPR study, based on data from the U.S. Bureau of Labor Statistics, found that 99 percent of businesses with 5,000 or more employees provide such benefits.

But that's voluntary. With no legal requirement, many small and midsized businesses do not provide sick leave. As a result, 85 percent of food service workers in California lack paid sick days, as do 82 percent of construction workers, 78 percent of security guards and 63 percent of personal care workers, according to the IWPR study.

“I have spent many years earlier on where I went to work sick because I couldn't afford not to work,” one respondent said in a survey conducted for the San Francisco Department of Public Health. “It was really miserable for everyone involved: my co-workers, my customers and myself.”

Another respondent said, “I would like to get paid sick days so I can stay home without the fear of being fired.”

Assemblywoman Fiona Ma, D-San Francisco, introduced a bill requiring employers to give workers one hour of paid sick leave for every 30 hours of labor, though the workers could not use the leave until they worked 90 days. For full-timers, that would total more than eight days of sick leave per year.

The bill passed the Assembly and went to the Senate despite strong opposition from such organizations as the National Federation of Independent Businesses and the California Chamber of Commerce, which called it a “job killer.” Marti Fisher, a lobbyist for the chamber, said the bill “would cause employers to make tough decisions that would hurt California workers and cost jobs.”

A legislative alert put out by the chamber charged that “the ever-increasing burden of costly mandates on employers can cumulatively lower wages, reduce health insurance, limit training and produce job loss.”

That's an old argument and has been used against such reforms as the minimum wage, overtime requirements and the 40-hour workweek. But when you consider that 145 other nations have implemented paid sick leave without their businesses going belly up, you have to wonder what there is about American businesses that makes them so fragile that they can't provide sensible protections for their workers.

Nick Hardeman, Ma's legislative aide, argues that paying for sick workers to stay home is not some bleeding-heart humanitarian cause. It also makes business sense.

“For one thing, the public health benefits are tremendous, because co-workers of the sick employees are less likely to catch infectious diseases,” Hardeman said. “And studies also show that you also improve employee morale and reduce turnover by offering those kinds of benefits.”

The Schwarzenegger administration opposed the bill on the grounds that it would add costs to the state budget. The Department of Finance estimated that paying for the sick leave would add $600,000 to the budget, because the state would have to pay for sick leave for nurses who provide health care to elderly, blind and disabled patients in their homes.

If such nurses were state employees, they would be entitled to paid sick days. But because they are working for private agencies – which are in turn compensated by the state – their sick pay would be an added expense to the budget.

It was ultimately the nursing issue and not the business lobby that killed the bill, since the state Senate Appropriations Committee has put a moratorium on passing any bill requiring new spending. A number of other bills also have fallen by the wayside.

The Chamber of Commerce wasted little time in claiming credit, however. In a news release, it boasted that it had blocked the bill, working with “businesses up and down the state.”

Nevertheless, similar measures are being debated in 10 other states, from Rhode Island to Alaska. With 73 percent of the California public supporting paid sick leave – according to the latest Harris poll – it seems that a bill will pass sooner or later, provided we don't run into another budget mess.