In Terre Haute, Ind., two rival hospitals want to merge, a move that supporters say will save patients money and help people live longer. But similar hospital consolidations in Tennessee, Virginia and North Carolina have resulted in government reports documenting diminished care. In more than a dozen states, certificates of public advantage (COPAs) permit deals like the one on the table in Indiana, even though the Federal Trade Commission otherwise considers them illegal because they reduce competition. As a result, the FTC has warned states to avoid COPAs and the mergers they create. In Terre Haute, state regulators will decide whether to allow Union Hospital to purchase
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