The state of the current U.S. healthcare system remains a primary concern for small business owners, according to the latest Wells Fargo/Gallup Small Business Index. Almost nine out of 10 small business owners surveyed (86 percent) said the current healthcare system is in need of change, with six out of 10 saying a "a complete overhaul" (59 percent) is in order.

"As a small business owner, the success of my practice depends on the health and overall success of my employees," said Dr. Vacharee S. Peterson of Peterson & Peterson D.D.S. "It's important that I am able to take care of my employees and provide them with the essential resources and benefits that will keep them healthy and in the office, and ultimately, keep my practice thriving."

Small business owners were asked what effect adequate health insurance has on a company's employees. More than three-quarters (84 percent) agreed that adequate coverage attracts the best qualified employees, and nearly the same amount of respondents (81 percent) agreed that it improves employee loyalty. Eighty-three percent believe it reduces an employee's likelihood to leave a company. The Index found that over half of small business owners (55 percent) do not offer any health insurance to their employees, citing high cost as the number one reason (45 percent). Of these business owners, 55 percent said they would be "more likely" to offer such benefits if the federal government provided some financial incentives for this coverage.

"The majority of small business owners recognize the benefits of offering affordable healthcare coverage to their employees, but many feel they cannot afford to do so," said Rebecca Macieira-Kaufmann, executive vice president and head of Wells Fargo's small business segment. "A third of small business owners are cutting back on non-capital investments so they can provide healthcare for their employees. For several years health insurance has been a major concern for small business owners, and its impact is significant."