If you're one of millions of Missourians living in a smaller community, hospital consolidations can be disastrous. Consolidation in such places almost invariably drives down the availability of basic healthcare to residents, compromising competition and inevitably driving up insurance costs. Even worse, these newly minted mega-hospitals deploy their increased market-share to drive down the salaries of the healthcare providers upon whom their communities depend. While one might assume that such a thing would at least lead to better patient outcomes, there is no evidence for that at all.