I am only speculating here, but it does seem to me that there must be some reason why business doesn’t seem particularly interested in getting medical insurance costs off their backs. They are competing with foreign industries that do not carry that weight, after all.
In my experience, most people who go into business for themselves are people in their late 30s and 40s who feel they have a good grip of their trade and have come as far as they can working for someone else. Outside of IT that is. IT is still the domain of the young who feel immortal.
People in their late 30s and 40s very frequently have families and are starting to feel the first frost in their bones. It is the age when you stop feeling imperishable, and start depending on having health care. Leaving your employment health care behind to start up for your self can’t be a comfortable feeling.
So while employment-sponsored health care is a competitive disadvantage versus foreign competition, there are ways and lobbies to impede foreign competition. What it also does is heavily disincline your best workers to shoot off, and start lean new businesses which compete with you right here.