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Google and Facebook. Coca-Cola and Pepsi. Those tech and pop conglomerates are considered to be duopolists in their fields. But even they can’t hold a candle to hospitals’ market power.

A recent financial filing from a large, tax-exempt hospital system in Orlando provides a glimpse, and serves as a reminder, of just how concentrated America’s hospital markets are.

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Orlando Health is borrowing $300 million to build new facilities and make upgrades, and the system filed paperwork last month for this debt offering. In filings like this, hospitals usually describe the characteristics of their markets, like the percentage of inpatient admissions they control, to attract interest from municipal investors.

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