SIOUX FALLS, S.D. -- From her seat behind the reception desk at Raven Industries, Becky Lyon picks up all the company gossip. The scuttlebutt about next year's health insurance premiums -- which are not due out for several weeks -- has been terrifying.

Twenty percent, she's heard. Twenty-five. Maybe even a 30 percent increase.

"With a 2 percent pay raise, that's a really big hit," said Lyon, a wiry 35-year-old with more debt than her age would suggest. "It really makes me nervous."

After surgery in January to remove a benign lump from her breast, Lyon was deluged with bills for her portion of the cost -- from the surgeon, the anesthesiologist, the hospital -- each more ominous than the last. "You owe this much now," the bold print screamed.

After paying $250 in cash, she put the remaining $750 on her credit card, where the interest keeps piling up. "And," she adds in a tone wavering between irony and fatalism, "my car is dying a slow death."

Raven chief executive Ronald M. Moquist parks his Mercedes in the company garage and has no big hospital debt to pay off, but he, too, is worried, over the rising medical bills his firm pays. The anxiety he and Lyon share is making the cost crunch in health care one of the most potent domestic issues of the election year.