https://youtu.be/YBC9-MF2D-U?si=KItftXIWu4LflNRG
*If you "band together," you are now a governing force. (even if it is "private.")
it is not a monopoly, it is a managed oligopoly (few number of firms)
Also, if a universal single payer would happen in the United States, pent up demand would flood the Health care provider system; so expect an explosive number of bills. for how long is up for debate, maybe just for 10 years, one generation, or longer (3-4 generations) depending on how much pollution has built up in the system to treat. Single payer universal healthcare would decrease advertisement costs, so if there was any kind of political rhetoric that would work....maybe aim at how many health inclined companies have significant chunks of expenditures on on their marketing. for example: Many pharmaceutical companies have 50% of their expenditures on marketing, where it could be going to research and manufacturing, etc....
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