In contrast to Obamacare, the Bush health plan envisions a much smaller role for government and a much bigger role for individual choice and competition in the marketplace. Bush health care differs from Obama health care in five significant ways:

1. There are no individual or employer mandates.
2. People in the individual market would receive a uniform tax credit that is the same for every one of the same age, regardless of income.
3. Small businesses would be able to help employees obtain portable insurance that travels with them from job to job.
4. Health Savings Accounts would be larger and more flexible – including new options for the chronically ill.
5. State governments would have the ability to create rational risk adjustment for the insurers – ending the race to the bottom that we see in the Obamacare exchanges.

Without the employer mandate, all of the anti-job provisions in Obamacare would be gone. Right now employers have perverse incentives to keep the number of employees small, to reduce their hours of work and to use independent contractors and temp labor instead of full time employees. Under the Bush plan, no employer would be punished for creating jobs.

Without the individual mandate, families would be free to buy insurance that meets individual and family needs rather than the needs of politicians. What woman would willingly choose to buy health insurance that offers free mammograms while she is healthy but makes her pay full price if there is a symptom of something wrong? That’s only one of the many needlessly wasteful and expensive consequences of letting health insurance benefits be determined by the political system.