The best thing that could happen for US small business is universal health-care. I know, because I have owned small businesses since I was fourteen—47 years ago, and am a scientist entrepreneur.

Everybody knows that small businesses are the engine of employment and global competitiveness for America. It’s small businesses that invent the next big thing.

Facts are pesky things. And, anybody who has access to the Internet can get access to all the best scientifically valid research on medical issues for free. OMG, it’s called www.pubmed.gov—the index of all the worlds’ best health research. At pubmed, search “small business” AND “health-care”. Seventy-seven scientific articles show up pronto. The first “hit” is about “small-business employment in 22 rich economies,” just published in 2010.1

What most American’s don’t know is that most small businesses in every one of our 21 major economic small business competitors for innovation—in Europe, in Canada, in Australia, in New Zealand, in Singapore, etc. NEVER worry about health insurance. That’s because all 21 have universal health-care systems, except the United States. “So what?” you say.

In other countries, small businesses have a competitive advantage. And, the United States—land of free enterprise—has among the world’s smallest percentage small-businesses as a proportion of total national employment compared to those other 21 countries. Betcha the tea party isn’t saying that. Catch the meaning? All these other countries that are supposed to be so terrible are actually better for small business to start up and operate. In America, you can start a small business and work in an entrepreneurial business or have health insurance. In 21 other countries competing against the US, people can start a business, work in an entrepreneurial setting AND have affordable, good health insurance.

As a small business owner in the US, I cannot touch what 21 other countries can offer.

But, maybe this doesn’t touch you, because you are on Medicare or work for a big employer or some government entity. Just consider these data about small businesses in America from our own Small Business Administration. Small firms (less than 500 employees):

• Represent 99.7 percent of all employer firms.
• Employ just over half of all private sector employees.
• Pay 44 percent of total U.S. private payroll.
• Have generated 64 percent of net new jobs over the past 15 years.
• Create more than half of the nonfarm private gross domestic product (GDP).
• Hire 40 percent of high tech workers (such as scientists, engineers, and computer programmers).
• Make up 97.3 percent of all identified exporters.
• Produce 13 times more patents per employee than large firms.

A deeper look into the data from the study by Schmitt and Lane paint a scary future picture about America’s future compared to the other 21 rich companies with public health care. Here are just a few findings:

• America has the second lowest share of self-employed workers (7.2 percent).
• Among US businesses with fewer than 20 employees, just 11.1 percent of those are manufacturing firms—but 18 other rich countries have a higher share of small manufacturing businesses.
• United States has the third lowest share (25.3%) of research and development related employment in firms with less than 100 employees.

So what happens to America’s economy as our proportion of small businesses declines further in comparison to 21 powerhouse economies of the world—all of which have that terrible, awful thing called a national, universal health care? Just start to watch our economy tank or lag further, our debt rise, and more people die or get sick. Remember, some who die or get sick will be your children and grandchildren, because for the first time in the history of the United States, our children are already having a shorter lifespan,2 more disabilities, and more health and mental health problems.3 Funny, you don’t hear this touted on TV or in the robo calls.

Why is universal health care important to small business? Please put on your thinking cap. I cannot hire the best and the brightest, because I cannot assure that they or their families will be covered. If you are the best or brightest, you are not going to risk jumping to the next big thing, if you, your spouse or kids might die. Hello?

And what about the entrepreneur like me? The leading cause of bankruptcy for small businesses in America is not so much bad business, it is getting really, really sick. I know that whole deal, because I have had cancer.

And for the record, we have four employees (plus dependents) on our health-care plan. In November, our cost went up 26%. The health-insurance company has done everything it can to get rid of us, just possibly because I’ve had a rare cancer that nobody knows why it happens. Hope we can sign up right away for health-care plan, like every industrialized competitor has but we don’t. Universal health-care and a public option is good for business and America’s future. The only other option is to file suit in the World Trade Organization for unfair competitive practices of the other 21 countries for providing health-care to their citizens.

References Cited

1. Schmitt J, Lane N. Small-business employment in 22 rich economies. Int J Health Serv 2010;40(1):151-63.
2. Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, et al. A potential decline in life expectancy in the United States in the 21st century.[see comment]. New England Journal of Medicine 2005;352(11):1138-45.
3. O’Connell ME, Boat T, Warner KE, editors. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities. . Washington, DC: Institute of Medicine; National Research Council, 2009.