The Wesfarmers Ltd (ASX: WES) share price is treading water today on fresh acquisition rumours.

Shares in the diverse retailing conglomerate are down 0.4% to $65.33. Meanwhile, the S&P/ASX 200 Index (ASX: XJO) is up 0.4%.

After a quiet start to the year, word on the grapevine is Wesfarmers might be preparing for its next acquisition. If the gossip is true, it could be one of the company's largest deals in many years, trumping the $760 million takeover of Australian Pharmaceutical Industries (API) in 2022.

According to The Australian's Dataroom, Wesfarmers has been evaluating the worthiness of scooping up Ramsay Health Care Ltd (ASX: RHC) for months.

Ramsay Health was founded in 1964 by the late Paul Ramsay. What started as a converted house in Sydney is now a fully-fledged hospital and medical clinic operator spread across 11 countries.

Yet, despite the expansive operations, Ramsay's profits and share price remain unchanged from a decade ago.

Always searching for an opportune buy, Wesfarmers could be eyeing Ramsay as the next gem in its expanding healthcare collection. In 2022, the conglomerate acquired API — the company behind Priceline pharmacies. Last year, Silk Laser Clinics was rolled into the Wesfarmers health division.

Whether 'The Wolf of the West' hopes to eat Ramsay Health whole or pick it apart is unknown at this stage.

Ramsay contains a franchise pharmacy network and 40 in-hospital dispensaries throughout Australia. Furthermore, the company launched an online pharmacy in August last year, which might meld well with Wesfarmers' InstantScripts — a consultation and script-filling telehealth platform — acquisition.

Wesfarmers set an Australian corporate record in 2007 when it acquired Coles Group Ltd (ASX: COL) for $19.3 billion. Back then, Wesfarmers had a market capitalisation of about $40 billion.

Eleven years later, Coles had become a formidable competitor to Woolworths Group Ltd (ASX: WOW). But not without Wesfarmers pouring $8 billion into its turnaround. After all the effort (and money), the conglomerate spun Coles off at a valuation of… $20 billion.

Some argue the Coles escapade was a prime example of opportunity cost.

Ramsay Health is a similarly large candidate. At $16 billion, it's roughly 40% of Wesfarmers' size. More importantly, like Coles, Ramsay could risk dragging Wesfarmers' margins downward.

As shown below, the hospital operator achieved a 1.4% margin for the 12 months ended 31 December 2023. That's a far cry from the nearly 6% the Bunnings-owner is netting.

The Ramsay Health share price is basking in renewed attention today. At the time of writing, shares are fetching $53.00, up 3.8% from yesterday.