As a landscape and garden designer, I’m self-employed in a job that is tremendously satisfying. I get to oversee everything from the first sketch to the last wall curve, paving stone and climate-perfect shrub. But as with most small businesses in California, the sick economy of the last 5 years has affected my company, Derviss Design.

All of us are making do with a bit less, which is why I don’t understand how the health insurance industry gets away with doing the opposite.

The premium on my high-deductible policy from Anthem Blue Cross went from $189 a month in 2007 to $564 a month this year, a 200% increase. The most recent increase of 26% was the last straw. I was already in a policy with a $5,000 deductible and 25% doctor copays, but I had to downsize to an even skimpier policy. Now I have a $6,000 yearly deductible, $9,500 out of pocket limit and 30% copay on everything including hospitalization, with less coverage.

I can afford the new premium–but I expect to be paying out of pocket for all my care beyond a few preventive visits.

Certain preventive care, including a colonoscopy screening that my doctor said was due, is supposed to be 100% covered by the new policy. But I found to my shock that it’s only covered if everything is normal. If the screening finds so much as a polyp, then it’s “diagnostic,” not preventive, and I’m back on the hook. What is this, casino-style health coverage?

I wish I could shop for a better policy, but a pre-existing condition makes that impossible.

California insurance companies get to set their rates as they wish, and no one can stop them. As fewer and fewer people can afford private health insurance, the companies just charge their remaining customers more.

Other states successfully regulate health insurance rates, and the nation’s most populous state should be among them. Our elected officials have failed us by listening only to Blue Cross lobbyists, turning a deaf ear on the rest of us.