The state of health-care competition in Nevada isn’t good, and it figures to decrease if UnitedHealth Group completes its $4.9 billion deal to acquire DaVita Medical Group.

Many will write it off as another example of the brave new world of American health care, one in which insurers evolve into medical and pharmaceutical delivery services as the traditional lines are erased. With the country’s health care and insurance monoliths reconfiguring business paradigms, our profit-driven system continues to struggle to balance a solid bottom line with available and affordable care.

For those who study health care for a living, the problem of consolidation and cross-pollinating services is simple: As a general rule, decreased competition leads to higher prices and poorer performance.

With Nevada health insurance options dwindling, the proposed melding of DaVita into UnitedHealth’s OptumCare division would be like the Yankees adding pinstripes. UnitedHealth is already a heavy hitter in the Silver State. DaVita physicians joining the team is part of the company’s attempt to deliver medical care.

With the merger moving forward far too swiftly for some, the Federal Trade Commission stepped in this past week with a request for more information about the UnitedHealth Group purchase plan.

The American health-care matrix is complex and morphing all the time. Insurance companies, care providers, pharmaceutical giants and physicians groups continue to attempt to add strength and profitability while reducing costs and liability. It’s easy to see how a generation of insured patients isn’t just confused, but scared at the possibility of too few choices and rising costs.

With its duty to enforce antitrust laws in health-care markets to prevent anticompetitive conduct, the FTC’s message is clear and consistent. From the website: “When health-care markets are competitive, consumers benefit from lower costs, better care and more innovation.”

That’s exactly what’s not happening in Nevada and many other states. The greater danger is the gratuitous gutting of the Affordable Care Act by the Obama-obsessed President Donald Trump, which appears to be just one sign of the trouble ahead. In the time of Trump, when “regulation” is the filthiest word in the President’s salty vocabulary, agencies such as the FTC are under increasing pressure to allow big mergers to go forward.

It’s also true that doctors and insurance providers were exiting the state before the UnitedHealth acquisition was announced. DaVita is known for its approximately 300 kidney dialysis clinics in six states, and the deal is a sign UnitedHealth plans not only to insure patients, but deliver medical care as well. In a statement, Optum’s CEO Larry C. Renfro enthused, “Combining DaVita Medical Group and Optum advances our shared goal of supporting physicians in delivering exceptional patient care in innovative and efficient ways.”

It’s not alone. CVS Pharmacy has moved to purchase insurance giant Aetna for $69 billion. Proponents say the merged services will improve patient access to medical care, at least at the corner doc-in-the-box.

The harm caused by big mergers isn’t always obvious at first. But not only do consumers lose the leverage choice provides, some hospitals are bound to be left out of the giant’s favor.

Then there’s the non-price competition, the quality-of-service issues that generally provide hospitals with bragging rights and easy advertising campaigns. Without competition, critics ask, where’s the incentive to improve service?

The FTC slowing the process or even rejecting it would be no scandal. In fact, it happens on a regular basis in health-care markets across the country that continue to consolidate and challenge the antitrust laws against unfair competition. The federal agency is in place for a reason.

At this point, UnitedHealth is in position to control well more than half of the primary physician services in Clark and Nye counties. The FTC is right to be concerned at the potential ramifications of the UnitedHealth acquisition of DaVita in a Nevada market that already scores low in myriad medical categories.

A massive network of doctors riding for the UnitedHealth brand could be the future of medical care for many Nevadans. It begs the question of whether the future of most patients’ medical care will look a lot like an urgent-care clinic.

That may end up a good thing, but you’d have to take their word for it.

Contact John L. Smith at [email protected]. On Twitter: @jlnevadasmith.