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The Oregonian Editorial Board

Earlier this year, Regence BlueCross BlueShield of Oregon found itself under a powerful spotlight. At a public hearing -- the first such hearing in more than two decades -- Regence had to justify its 22.1 percent rate increase request to state regulators, as well as to the more than 150 Oregonians in attendance.

Right now, public scrutiny of health insurance rate increases is rapidly evolving, and today marks another milestone. At 2 p.m. in Salem, another insurer, the ODS Health Plan, will make its case for a 9.94 percent rate increase.

ODS, to its credit, volunteered to be a guinea pig for what the state hopes will become a routine part of its due diligence. We'll reserve comment for now on whether the rate increase itself is justified. (It comes on top of an 8.9 percent rate increase in 2008, a 17.6 percent increase in 2009 and a 17.5 percent increase in 2010.) What is certainly clear, at this juncture, is that such public hearings are justified.

At the hearing today, ODS will have a chance to make its case. So will some of the 26,333 Oregonians covered by this plan, who would be affected by the rate increase. And so will consumer advocates from Health Insurance Rate Watch, a project of the OSPIRG Foundation. Through this initiative, funded by a federal grant awarded through the state, these advocates are drilling deeply into insurers' requests.

With highly technical issues, like utility and insurance rate increases, consumers need a foothold on a mountain of data. Consumer advocates who know their stuff are vital. It's also vital for the state's Insurance Division to mandate greater clarity. The division has been doing just that, and its website no longer seems as though it's written in a foreign tongue. It's become much more user-friendly.

Ultimately, of course, more than transparency is needed to ratchet down health care costs. To increase quality and bring down costs, Health Insurance Rate Watch asks whether insurers can show progress on several fronts: reforming payment methods to reward better outcomes; paying providers for coordinating care; designing benefits to prevent and manage chronic diseases; reducing unnecessary hospitalizations; and reducing medical errors.

ODS may be able to show progress on these fronts. Remember, in any case, that the state ultimately decided to approve a 12.8 percent increase for Regence BlueCross BlueShield, which is far less than Regence had sought but more than ODS is now seeking.

As impressive as it is that state regulators are now voluntarily doing the right thing and holding hearings, it would be even better -- more reliable and less dependent on individual goodwill -- if the Oregon Legislature required the state to hold such hearings. The Legislature should do that.

Meanwhile, today's hearing -- even if less well-attended than Regence's -- is bound to be illuminating. Mark this, Oregonians: An extraordinary spotlight has given way to a new normal of public scrutiny.

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