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Amazon building With its technological prowess, long investment horizon, bottomless appetite for new business and tolerance for thin margins, any mention of Amazon’s interest in health care rattles investors. (Photo: Shutterstock)

Without having done much yet, Amazon.com Inc. is already transforming U.S. health care — and not necessarily for the better.

The mere threat of the online giant getting into the health business prompted the country’s two largest pharmacy benefit managers -- CVS Health Corp. and Express Scripts Holding Co. — to join forces with two of its largest insurers, Aetna Inc. and Cigna Corp. These deals will put more U.S. health care under the control of fewer companies. The merging companies say this will lower costs for consumers and the country. But the reality will likely be less rosy and more complicated.

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