A crude comparison of business formation between France (with socialized healthcare / retirement) and the US (without those), shows that the numbers are fairly close. Data is for 2020, which saw a 4% rise for France, whereas in the US numbers were stable. France also doesn't have as much of an "entrepreneurial" culture as the US, meaning people are much more likely to "look for a job" rather than found their own business.
France: Population: 67M, 850 000 new Business, 12 700 / 1M pop.
US: Population: 331M, 3 600 000 Businesses, 11 000 / 1M pop.
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Indeed. Many small businesses can't even afford sponsoring a sick leave directly AFAIK. At my location (in Europe) you pay a part of your monthly wage to the social security fund and once you get sick it covers your salary in the amount like if you kept working (and also pays you basic pension once you get too old).
In France, the "social security" (run by the state) doesn't cover the full salary, not even close. It only covers up to 50% [0], and only after three days (if you have 10 single sick days, you lose 10 days' pay).
You have to have your own insurance ("mutuelle", usually chosen by your employer — which you cannot refuse, but can augment) to have a better deal.
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[0] It covers 50% of the salary, but the maximum salary taken into account is 1.8 times the minimum wage, which is 2 798,24 € before tax.
https://www.ameli.fr/assure/remboursements/indemnites-journa...
Source: am on disability.
How do you pay for it?
Will it be run by the same entities that are having so much trouble balancing Social Security and preventing Medicare fraud?
https://www.propublica.org/article/we-asked-prosecutors-if-h...
The other part is that misery, fire bad customers and bad managers. It really isn't that difficult to be polite.