Secretary of Health and Human Services Katherine Sebelius today sent a scathing letter to Anthem Blue Cross of California demanding to know why the Wellpoint Inc. subsidiary is raising that state's individual insurance premiums 39 percent.

"These extraordinary increases are up to 15 times faster than inflation and threaten to make health care unaffordable for hundreds of thousands of Californians, many of whom are already struggling to make ends meet in a difficult economy," she writes. "Your company's strong financial position makes these rate increases even more difficult to understand. As you know, your parent company, WellPoint Incorporated, has seen its profits soar, earning $2.7 billion in the last quarter of 2009 alone."

She could have also pointed out, as Matthew Holt did on the Health Care blog yesterday, that Wellpoint ceo Angela Braly earned nearly $10 million in salary, stock and stock options last year. That ought to get people fired up and ready to go.

What's going on here? Have the Democrats finally found their inner populists now that health care reform is threatened with going down in flames? Last week. House Speaker Nancy Pelosi, a Californian, promised to make her first order of business after returning to Washington (once the runways are cleared of snow) repeal of the 1945 McCarran-Ferguson act, which grants the insurance industry antitrust immunity.

"Anthem Blue Cross has a responsibility to provide a detailed justification for these rate increases to the public," Sebelius wrote. "Additionally, you should make public information on the percent of your individual market premiums that is used for medical care versus the percent that is used for administrative costs. Policy holders in the individual market deserve to know if their premium increases would be invested in better medical care or insurance company overhead costs like salaries, profits, and advertising."

California is already investigating those issues. Is there some reason to think a Federal Trade Commission or Justice Department antitrust investigation would do better?

What situations like this call for isn't tougher antitrust enforcement. It requires systematic regulation and oversight of insurance industry. Rate increases should be reviewed before they are imposed. That is what state regulators do now with electricity and natural gas rates.

However, that can only be done by a powerful state or federal regulator -- sort of like the ones established by the House and Senate health care reform bills.

Californians don't need two, three, many Wellpoints, or jawboning by HHS. What they need is strong regulation of the insurance industry, which can only be delivered through comprehensive health care reform.