This week’s news that the Jameson Health System in New Castle intends to merge with the Pittsburgh-based health care giant, UPMC, came on the same day as a story in the New York Times reporting that the Federal Trade Commission is challenging some hospital mergers on the grounds that consumers will be hurt by increased industry consolidation.

Merging hospitals claim that consolidations lower costs and benefit patients through better and more-coordinated care. In the past few years, executives at merging hospitals have also said that the Affordable Care Act, the heatlh care reform law also known as Obamacare, is adding pressure for mergers.

But the other side of the story focuses on the basic economic theory that less competition leads to higher prices. This is the view of F.T.C., where research has found that hospitals facing less competition generally charge higher prices.

The F.T.C. has blocked three hospital mergers in the past two years, but the agency has challenged only about 1 percent of proposed consolidations.

A judge in one case noted that a proposed hospital merger would give one company a large majority of physician services and could charge higher prices to health insurance companies, which would then pass on the higher costs to consumers — and their employers — in the form of higher premiums.

It’s an understatement to say the health care industry is in transition.

For several decades, health care costs have increased faster than inflation. President Barack Obama and supporters of ACA argued that it would bring down health care costs. But so far, the ACA has mostly expanded health care coverage using subsidized health insurance policies offered through state or federal exhanges. Supporters argue that the ACA will eventually help bring down costs, but there is little evidence of that yet.

There is broad agreement, though, that the ACA is motivating health care mergers — and with the F.T.C. saying mergers generally harm consumers by reducing competition and raising prices, it appears the government’s position on health care costs is one of the right hand not knowing what the left hand is doing. Didn’t Obama and lawmakers crafting Obamacare consider its impact on mergers and how mergers might harm consumers?

Nationally, the ACA has created plenty of uncertainty with consumers, doctors, health insurers, hospitals and employers who provide health insurance to their employees.

If the national landscape is characterized by uncertainty, then the Western Pennsylvania market can be described as nearly chaotic. The main reason for additonal uncertainty and anxiety here is the ugley divorce between Highmark and UPMC.

For decades, Highmark/Blue Cross-Blue Shield dominated the regional health insurance market. And UPMC, which has grown through decades of hospital mergers and physician practice buyouts to include 20 hospitals, 3,200 doctors and 400 doctors offices, was the dominant health care provider. UPMC and Highmark worked as partners, with hundreds of thousands of people having Highmark insurance and seeing UPMC doctors.

That relationship ended when Highmark bought the struggling West Penn Allegheny Health System and the two gaint nonprofits suddendly saw each other not as partners, but as competitors. In many cases people are now being forced to choose between leaving their UPMC doctors if they have Highmark insurance, or paying substantially higher premiums to continue seeing their regular doctors, who are now considered “out of network.”

Longer term, with UPMC and Highmark/West Penn Allegheny operating as vigorous competitors, there could be lower health care costs. But lower costs are no guarantee in the still-evolving new world of health care in America. In the meantime, Western Pennsylvania is in for a rough ride.

At Jameson Hospital, financial troubles pushed the board of directors to sell out to UPMC. While there will be new investment in Jameson by UPMC, there also will be a loss of local control and the likelihood of more patients being sent to UPMC facilities in Pittsburgh, raising costs and making visits by friends and family less convenient.

At Butler Health Sytem, CEO Ken DeFurio expects to see some impact from the Jameson deal. DeFurio agreed that the ACA is placing additional burdens and costs on smaller hospitals, but aded that he and the BHS board remain committed to staying independent.

Commenting on the Jameson merger, DeFurio said mergers are not inevitable. He says BHS talks with UPMC routinely and collaborates as well as competes.

Time will tell how BHS navigates the changing health care landscape, but remaining in dependent seems to have strong local support — and federal support, at least from the F.T.C.