Yes, the question is absent a government, or at least given some theoretically perfectly business neutral government what are the barriers to entry for (in tfa)

Yes, the question is absent a government, or at least given some theoretically perfectly business neutral government what are the barriers to entry for (in tfa) an infrastructure company or (in this thread) a modern hospital. I suspect that while compliance with various regulations do add barriers the "natural" barriers are already high enough to keep out sufficient competition to exert real downward pressure.