Let's say this has already happened and ossified across large, formerly-innovative companies that now have so much size and inertia behind them that it might take decades for one to "fail" in a traditional sense. What can be done to reverse the process?
It's almost as if we could solve the problem by having only one payer (a "single-payer", if you will) primarily motivated by patient interest instead of profit motive exerting downward pressure on costs.
Double meaning: "no one" can also refer to the Faceless Men, the magical face-changing assassins of Braavos, who kill on behalf of the common people with some frequency