All this election year talk about health care seems to be about extending it to people who don't have it: children and the working poor.
But I wish a candidate would talk about people who have health care, but feel it slipping away like a greased watermelon.
Like me.
When my husband and I started in this working game, our companies each covered both of us. What the primary coverage didn't pay for, the secondary coverage did. I think I may have turned a profit on the birth of my first child.
Time passed, and his company offered a handsome bonus if he did not sign up for its coverage. Didn't matter. I signed him up for my company's coverage. And the bonus money was sweet.
Over the years, that bonus dwindled to nothing. And now I have to pay a penalty if I want him covered by my company.
Sorry, pal, I said. You are on your own.
Now he is covered by his company as a single person. Weird.
And expensive. The amount we now pay for medical insurance is almost double what it was.
The military has been paying the medical bills for my son since he enrolled at the Naval Academy, but I didn't think I had to worry about coverage for my daughter while she was in college.
Until this year.
I had to prove - with a tax return and an official college class schedule - that she was, indeed, still a dependent.
("Have they met Jessie?" one of my friends asked. "Have they seen your credit card statements?" asked another.)
And this year, my company's health coverage includes a financial penalty for smokers.
I don't smoke, but I have this little problem with pasta, and I am wondering if there will soon be a penalty if my BMI exceeds 24, or if my fasting glucose tolerance test hits some kind of red zone.
I am wondering when the premiums we pay will be tied to our driving record or the number of hours a week we log at the gym. Whether we wear our seatbelts 100 percent of the time, have more than two drinks a day or eat red meat more than once a week.
You are not paranoid if you can prove they are after you. So I asked a couple of experts in the field if companies will soon try to control rampaging health care costs by tying premiums to the good, or bad, health habits of employees like me.
Turns out, I am right.
They are just trying to figure out how to do it.
"We are inching closer and closer along this road," said Peter Cole at Crawford Advisors in Hunt Valley. His firm helps employers design and administer health care coverage.
"Will you actually get screened before you get coverage some day? I don't know," he said. "Personally I hope it never comes to that."
"This idea of charging differently based on behavior has gotten the attention of employers," said Paul Fronstin, chief health economist at the Employee Benefit Research Institute in Washington. "The question is how to implement it."
This should come as no surprise. Auto insurance rates are tied to behavior - tickets and accidents and DUIs.
Companies, who have done everything they can to negotiate prices down with the hospitals and the providers, are looking for new ways to economize, Cole said. Facing an obesity epidemic that will only make matters worse, companies are now looking toward aggressive wellness programs as a way to keep health care costs down.
But will companies choose to encourage good health care habits by rewarding people for lowered cholesterol readings or will they penalize employees for ignoring their doctors' orders to lose weight?
"When I work with employers, I encourage them to use the carrot instead of the stick," Cole said.
Fronstin sees the day when an employer says if you have diabetes and you don't follow your doctor's suggested regimen, your premiums are going to be 10 percent higher, or if you suffer a complication related to your neglect, your deductible will be $500 instead of $200. But if you follow your doctor's instructions, you will not have to pay a co-pay for your medicine.
"We are talking about getting people to be responsible," he said.
But I am worried about where this is going.
If I don't get a mammogram every year and I am diagnosed with Stage 3 breast cancer, do I have to pick up the tab? If I don't get my teeth cleaned every six months and I get gingivitis, is the gum surgery on me?
And what kind of credit - lower premiums, a rebate to my Health Spending Account - do I get for the fact that I am pretty sure my yoga classes made spinal surgery unnecessary?
And what happens if my employers find out about my little pasta problem?
susan.reimer@baltsun.com