The major telehealth bying google ads is Wal-Mart bying 10 large highway billboards. The indie therapist not being able to afford the auction is the mom-and-pop shop not being able to afford those buidboards.
now if the major telehealth would get a dedicated bandwidth and the indie therapist's video calls were getting throttled we would be talking roads etc.
For now it's the 'walmart moving into a small town' scenario but the bloomberg article blames the company that operates the billboards.
A billboard ad is not an explicit and direct "physical" connection to the product the way that a search result is.
Dedicated bandwidth and throttling, to extend my original analogy, would be like the roads going only to Wal-Mart or being difficult in some significant way to take anywhere other than Wal-Mart. It is the same problem only more pronounced.
The first search result you encounter when executing some search is much more similar to the first store you encounter when searching for some store (by taking the easiest or "most natural" path into the shopping district) than it is to viewing a billboard.
Edit -- To clarify what I mean about billboard ads:
A billboard ad is something you see that is unrelated to whatever else you are doing. Yes, a digital "billboard" ad is still a direct connection to the product being advertised but it is also distinctly separate from whatever content or activity it displays alongside.
A search result is the content/activity you have sought out by searching. There could definitely be a grey area if google's design made sponsored search results stand out more or be distinct in some way that causes them to read as some content other than a search result (either by position, border, size, color, etc) but that is very clearly not the case of their current design.
Sponsored search results look exactly the same as non-sponsored search results apart from the "Ad" text displayed with the URL. They are clearly intended to look and function the same as the "normal" content of the page and not intended to be an incidental "secondary" experience alongside your search.
The major telehealth bying google ads is Wal-Mart bying 10 large highway billboards. The indie therapist not being able to afford the auction is the mom-and-pop shop not being able to afford those buidboards.
now if the major telehealth would get a dedicated bandwidth and the indie therapist's video calls were getting throttled we would be talking roads etc.
For now it's the 'walmart moving into a small town' scenario but the bloomberg article blames the company that operates the billboards.