A survey of Utah small-business owners should erase any doubt that the country needs to reform health care, and reform it now.

Businesses here with two to 100 employees not only rank the cost of medical care — insurance rates in particular — as the single biggest financial impediment in their companies, more than two-thirds of arguably the most free-market-oriented economic sector in the country are demanding comprehensive change, even if it means partnering with state and federal government.

"That's because this very pragmatic, bottom-line oriented core of the economy recognizes that it's going to require partnership of individuals, employers, insurers, health-care providers and yes, government, to fix the system," said John Arensmeyer, founder and chief executive officer of Small Business Majority. The national small-business advocacy group has been targeting health-care reform for four years. The group announced the results of its latest random poll of Utah small businesses at a Wednesday news conference.

"Here and nationwide, the soaring cost of care is dictating whether a business expands, limiting new hires and even if someone starts a new business," Arensmeyer told the Deseret News in an interview. "The vast majority of small-business owners here and across the country believe they have not only the financial but the moral imperative to offer medical insurance."

The survey shows unequivocally that small businesses want the state and federal government to be partners in reform, with the federal government establishing standards but building in flexibility that individual businesses and state governments can live with, the survey shows.

Of the 300 business owners polled in June, 49 percent labeled themselves Republican, 14 percent Democrat and 24 percent said they are independent.

The system has become a "behemoth problem" for the economy, even in a state where health-care costs are lower and quality of care is higher than anywhere in the country, said Natalie Gochnour, the Salt Lake Chamber's CEO.

"Reform is no less critical to the long-term strength of business in Utah," she said, adding that businesses that stop offering coverage and employees who lose or don't enroll in a medical-insurance plan save money in the short run but add to the cost of the system over time, creating the "economic behemoth" that health care has become.

Only 40 percent of Utah businesses provide coverage to employees. That's nearly 30 percent fewer than 15 years ago. The decline has pitched sharply downward in the past few years, and chambers of commerce statewide expect the trend to continue as the economy contracts.