Al wants more hair, less fat, and a better sex life ... and he wants his health plan to pay for it.

Al wants a trimmer waistline. Hanna wants the surgery that will give her ears, which she was born without. Both think their HMOs should pay. Hanna and Al are at the limits of the emerging gray zone between medical need and medical want. It's a zone sure to become grayer, as medicine strays even further into the murkey region of lifestyle enhancement.