If my family's small local business was a health insurance company, we could double prices during a deep recession while amassing a fortune in invested savings. Woohoo!

As the customer base fell, we'd just jack up prices again. It's a laughably impossible model for almost any business. But not for Blue Cross, Blue Shield and their ilk. They don't have to care that the rising cost of health insurance premiums can tip a family from solvency into ruin.

The facts speak for themselves. Health insurance premiums for California families have risen 153 percent since 2002, more than five times the rate of inflation. Families such as mine struggle to pay insurers while giving up everyday necessities.

While we have worked hard just to keep our income from dropping, our monthly health premium doubled in the past three years. Our plan, with a $10,000 family deductible, offers limited benefits, yet we continue to be strong-armed into ever-higher premiums and other fees.

We're purchasers of individual insurance, like the growing ranks of consultants, independent contractors, entrepreneurs and the long-term unemployed. However, employers and workers are not exempt from the pain either, as small businesses in particular pass along more of the cost of insurance, or drop coverage altogether.

How can this occur? The truth is, only four insurance companies control 71 percent of the California market, and they set their premiums behind closed doors. Average California residents are being priced out of the health insurance market. By the end of last year, 6.9 million individuals in California were uninsured — more than any other state in the nation.

This crisis has difficult implications for our communities. Uninsured individuals are less likely to seek health care, leading to a long-term legacy of illness and suffering. Our hospitals are already overburdened by uninsured patients who seek emergency treatment as a last resort, incurring bills they cannot pay. Families who struggle to make the "responsible choice" and pay for private coverage often find themselves in the same boat when savings and options run out.

Health insurers argue that premium rate increases merely reflect the escalating costs of procedures, equipment, pharmaceuticals and an aging population. However, such assertions can't be verified without greater accountability at the outset, when the exorbitant increases are proposed.

Health insurance is rapidly becoming a privilege only the elite can afford. As consumers, our tolerance has worn thin, especially while insurance companies hoard surpluses in the billions of dollars, many times over what the state requires for financial stability.

Given the lobbying power of the insurance industry, the Legislature is too paralyzed to fix this. Now it's up to voters. Your signature can put health insurance reform onto the California ballot. Go to www.justifyrates.org to download and sign the petition to get the Insurance Rate Public Justification and Accountability Act onto the November ballot.

Californians long ago approved insurance regulation, and the result — despite dire predictions by insurers — was a stable, competitive market and reduction in auto rates compared to the rest of the nation.

So let's finish the job and require health insurers to get approval of their increases before they go into effect.

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Kerry Abukhalaf lives and works in Alameda. She is a volunteer patient advocate for JustifyRates.org.