As health care costs have steadily increased year by year, businesses have turned to high-deductible, low premium plans tied to health savings accounts to reduce their -- and their employees' -- up front costs, a trend reported by The New York Times. Deciding whether to aid or inhibit this trend will be one of the key implementation decisions under health reform.

The benefits of these types of plans are obvious for the relatively healthy, who rarely have to get the kind of medical services that trigger the high deductible payment. The ability to pay for out-of-pocket costs with pre-tax dollar stored in a health savings account can also soften the blow. These plans seek to address one of the market failures in the current system that help drive up the costs of health care: the fact that consumers who only pay a small co-payment for most medical tests and treatments have little incentive to shop around for the best deal.

However, those who are older and sicker may find that the high-deductible plans cost them more in the long run, as they have to fork over large sums of money for every treatment. This could provide a disincentive to get routine care or treatment that may stave off more expensive problems down the road, which is part of the rationale behind providing insurance coverage to everyone.

Those implementing health reform will have to decide whether there should be a cap on deductibles. Health reform stipulates that insurance providers must fully cover some basic services, an effort to make sure that people don't forgo routine medical care because of the cost. The question is, how much -- if at all -- should health reform aid and abet the trend toward more high-deductible plans? Should it encourage such plans for the young and healthy, while discouraging them for older workers? Should it allow high-deductible plans as long as certain services are covered? If so, who will foot the bill for the routine services?

High-deductible plans can only achieve their goal of making consumers more selective about their choices if enough information is available to allow consumers to compare prices. As the Times story points out, this information can still be hard to find without significant personal initiative to call around to different providers. The exchanges taking effect in 2014 will make price-shopping easier for those who are, for example, getting coverage in the individual market. What can be done to make price shopping easier for those who remain in employer plans?

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