The thunderous and rapid delivery of merger and acquisition headlines this past year—with Walmart and Humana most recently—leave big questions unanswered for health care marketers.

Are we headed to all national health brands? Are local or regional hospitals and health systems the next institutions to crumble under the innovative weight of Silicon Valley or convenience of on-the-right-corner national brands? Are health systems, feverishly resetting the most broken bones of any industry, going to magically grow another limb? How about a question from the Eeyore in our midst—are health systems heading toward the same fate as big box retailers—and health care marketers are just promoting a first-class ticket on the Titanic?

Rationally, we know that in the foreseeable future Amazon isn’t planning to take up neurosurgery and Walmart isn’t going to install a Level I Trauma Center. But their threat is real in today’s slim-margin and highly consumer-driven reality. And we would be exceedingly wise to not hide behind the shield of health care’s unmatched complexity and legislative dependence to protect us from the lessons of big fails in other industries.

So let’s take a moment to reflect on recent headlines, and allow our strategic mind to shift from the competition across the street to the emerging competitor in our pocket or on our countertop or credenza—where the answers to many of life’s questions and friction points seem to effortlessly disappear with a sound, touch or a swipe—and for an amount of money that the consumer forgets about more easily than their hospital bill.

Let’s start with observations, and conclude with three actions health care marketers can take right here and now.

Health care seems like the 21st Century’s Gold Rush, except California and venture capital prospectors are heading for the hills of health systems.

Recently, I was interviewing a health system finance VP in the southeast, for a client engaged in our firm’s Stand Up Branding process. I inquired about his voicemail message which clearly communicated he did not have any need for any more vendors.  He receives more calls, emails and mailings every day than ever before. And in his consulting work, venture capital groups have been a-knocking for advice before investing in health care solutions. With an incredulous tone he rhetorically asked: Why do they think the money is here? Where do they think all this money is coming from?

The 3.5 trillion reasons projected for 2018 and nearly 20% of our GDP have captured the collective entrepreneurial imagination—intrigued by a broken health care system that commands fixers. As tech start-ups in the garages of yesteryear were incubators for today’s billionaires, so are the waiting rooms of health care for today’s venture capitalists. In the first half of 2017 alone, 188 U.S. digital health start-ups attracted $3.5 billion in investments. But let’s talk about the trillion dollar number again.

Why $3.5 trillion should be threatened by 44 cents.

Let’s look at how consumers are changing their habits. While the majority of sales still occur in bricks-and-mortar stores, (wait for it…) we’re in the midst of a seismic shift to online retail and it’s not (yet) the Walmart greeter waving at more sales, it’s Amazon. A staggering 44 cents out of every dollar spent online is spent at Amazon—compared to Apple and Walmart each capturing less than 4 cents for every online dollar.

As these cash-flush competitors on which consumers already depend expand in the $3.5 trillion health care market and pursue partnerships, they are tipping the table to a nice slope for consumer choice to roll to their side for more health care services outside any critically-ill needs.

The movement of care away from the hospital or health system and the shift of consumer behavior to online transactions, is a parallel narrative recently lived by big box retailers. They were operating big-scale community mall anchors with small margins. Sales were shifting online and they were slow to adapt and busy operating their complex infrastructure—and as we all know, they fell, hard. Revenue losses for an already low margin business created screaming risk that their venture capital partners couldn’t take.