Although the benefits world has been focused on consolidationamong carriers, providers and pharmacy groups, other areas ofhealth care are also seeing market domination by a handful ofplayers. The consolidation of market share in industries such asmedical device manufacturers, medical supplies and health careservices are surely significant factors in rising health care costsfor employer-sponsored health plans, yet much of it has happenedunder the radar.

In a recent report, "America's Concentration Crisis," the OpenMarkets Institute outlines many areas of health care that are nowdominated by just a few companies. "Growing monopoly power in thehealth care sector contributes significantly to the high prices,poor quality, and lack of access that millions of Americansexperience when interacting with the health care system," thereport says. The report adds that for both consumers and employers,some large companies may produce numerous brands and productslines, but control of the markets remain in the hands of just a fewplayers.