Even before the COVID-19pandemic, health care was at the forefront of Americans' minds. AGallup poll released January 13, 2020, placed health care at the top of issues importantto voters in the upcoming election. Moreover, a recent surveyconducted by Public Agenda in partnership with USA Today and Ipsosfound that Republicans andDemocrats agree about the need to fix the nation's health caresystem.

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But is a single-payer system the way to go? A recent study showsthat American small business owners, at least, have strong—butdecidedly mixed—opinions.

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Employment web site SimplyHired conducted a survey of 543 Americans whowere running their own business, self-employed in theirown incorporated or unincorporated business, or currentlyengaged in entrepreneurship. The survey defined single-payer healthcare as "a type of universal health care financed by taxes thatcovers the costs of essential health care for all U.S.citizens."

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Related: Even amid COVID-19 pandemic, Americans not sold onsingle-payer health care

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The study revealed 70% of business owners either supported orstrongly supported a single-payer system. That support was nearlyunanimous among Democrats, at 96%, compared to 37% ofRepublicans.

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Employer-sponsored health care was hardly left in the dust: 67%of respondents either supported or strongly supported that system,with 74% of Republicans and 62% of Democrats throwing in with thefamiliar plan.

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Single-payer came in for slightly more opposition thanemployer-sponsored plans, with 27% either opposing or stronglyopposing. Employer-sponsored plans were opposed or strongly opposedby 18% of respondents.

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The most common perceived benefit of single-payer was lowerexpenses, while the most common concern was increased businesstaxes in order to fund the program. One respondent, a 62-year-oldwoman with six years' experience as a business owner, said, "I amnot equipped to handle higher taxes. I would have to let employeesgo. I pay a very good wage. That is important to me, and if I weretaxed much more, I would have to make cuts."

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Similarly, a 38-year-old woman with 12 years' experience as abusiness owner opined, "Single-payer is bad for everyone, bothprivate citizens and businesses alike. We pay more taxes, get lessdone, have longer waits for doctors and procedures, and much lesspersonalized care."

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Overall, nearly three-quarters of business owners felt theadvantages of a single-payer system would outweigh thedisadvantages.

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"Honestly, as the owner of a very small business, it probablywould increase the business taxes a bit," said a 46-year-old womanwith six years' experience as a business owner. "I believe thatdisadvantage to me is far outweighed by my employees (and myself!)being able to get affordable health insurance."

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If expenses for business owners were to fall significantly undera single-payer program, 57% of those surveyed said they would usethe extra money to increase their employees' wages. Respondentsalso considered transferring money into savings or putting ittoward employee benefits, at 36% and 35% respectively.

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According to the study, 43% of business owners and entrepreneurssaid health care would play an extremely important role inhow they would vote in the 2020 election.

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Richard Binder

Richard Binder, based in New York, is part of the social media team at ALM. He is also a 2014 recipient of the ASPBE Award for Excellence in the Humorous/Fun Department.