What may appear to be a subtle change in government regulation will, I believe, have the largest impact on the nation's economy of any proposal in the past 50 years. It will unleash the most powerful economic force on the planet on the largest single industry and will profoundly impact entrepreneurs with new opportunities and increased costs.

The change is called the Health Savings Account (HSA), and if you haven't heard of it, you will. It unleashes the power of the market on health care.

Rather than having employers pay for health care directly under current benefit programs, individual accounts will be set up for each employee. The account will consist of two parts - a high-deductible health insurance policy and cash. The cash contribution is in before-tax money and can be no more than the deductible. Some employers will pay the entire cash contribution, but I suspect most will fully or partially match contributions made by employees.

For example, suppose the employee chooses a $5,000 deductible HSA insurance policy. Then let's assume that the employee makes an annual contribution of $2,500 to the cash account out of his salary with pre-tax dollars, while the employer fully matches the contribution with $2,500 to the employee's account. The employer's $2,500 contribution is tax-deductible to the employer but not taxable income to the employee.

The employee uses the cash account to pay health-care bills. If a catastrophic illness strikes, then the employee will use the entire cash amount to pay the first $5,000 of the cost, while the insurance policy pays the rest.

But here is the part with the profound impact: if the employee does not use the $5,000, the employee gets to "keep" the money saved by having it roll forward into future years to pay for retirement, similar to an IRA or 401(k) account. Any money saved builds up over time and can be invested in mutual funds or similar investments.

What this means is that employees will become more cost-conscious about health care. For example, a doctor may give a patient the choice of going to a low-cost outpatient facility for a procedure or an expensive hospital at five times the cost. If the employee has to pay the cost out of her HSA, she may choose the lower-cost alternative where today she will usually choose the most expensive alternative.

I believe the biggest impact will be in common doctor visits. If the visit will cost $100 out of their HSA, the employee may consider cheaper alternatives. For example, instead of an office visit the employee could make a $10 phone call or online visit in which she explains the symptoms and a nurse practitioner makes a recommendation.

Health care does not compete like other industries. When was the last time you saw an advertisement by a health-care provider that says, "Come to us for the highest quality kidney stone removal at the lowest price"? You see it all the time with cars or appliances. Health care "competes" by offering more expensive service because no one pays much attention to cost.

I believe HSAs will spawn massive entrepreneurial efforts by health-care providers to specialize and provide the highest quality treatments for the lowest-possible costs like we see in other industries. And wouldn't it be refreshing to see a little entrepreneurial competition in the health-care industry, leading to better service at lower cost?