In other news, a new study from the American Medical Association argues consolidation among health insurance companies has created virtual monopolies in cities across the US. In 56 percent of nearly 300 metropolitan areas, one single provider controls at least half of the local health insurance market. The study says 43 states have levels of market concentration that would normally be expected to lead to antitrust investigations. According to the AMA, more than 400 mergers have taken place in the health insurance industry over the last decade. Meanwhile, premium costs paid by average consumers have seen double digit increases far above inflation and wage hikes.