Abstract
Opponents of health care reform in the United States have often argued that such reform will be detrimental to small and medium-sized enterprises. The authors review the most recent data from a sample of 22 rich countries in the Organization for Economic Cooperation and Development (OECD), all of which, except the United States, have universal health care systems. By every measure of small-business employment, the United States has among the world's smallest small-business sectors (as a proportion of total national employment). These findings hold for self-employed workers and across all industry groups for which the Paris-based OECD publishes internationally comparable data, including manufacturing, computer-related services, and research and development.
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