For Kesey, his construction of "the combine" is the mental institution. It is a metaphor for the issue of social control. Kesey sees the mental institution not as a place for rehabilitation and therapy. Rather, he sees it as a dominating force that wishes to remove the humanity out of its patients, enabling them to become conformist tools of the establishment. With the emphasis on rebellion in his own life, Kesey sees "the combine" elements in the mental institution and other aspects of American society in which conformity is more valued over individual identity. The goal of "the Combine" is to ensure submissiveness of the individual by removing their humanity and will to voice dissent.
Chief sees this same element of control in his vision of "the Combine." Chief believes that the element of "the Combine" that is in the hospital is evident in its use of technology to control what people think, feel, and so. In describing how the hospital classifies its patients, Chief reveals his feelings and perceptions about "the combine's" presence in the hospital: "Not in the hospital, these, to get fixed, but just to keep them from walking about the street giving the product a bad name." "The product" is a clear reference to "The Combine's" desire for social control and submission of will.
The embodiment of "The Combine" for Chief is Nurse Ratched. She is the force that ensures control through the use of technology and pharmacology that Chief sees is "the combine" in action:
So after the nurse gets her staff, efficiency locks the ward like a watchman's clock. Everything the guys think and say and do is all worked out months in advance, based on the little notes the nurse makes during the day. This is typed and fed into the machine I hear humming behind the steel door in the rear of the Nurses' Station.
In this description, Chief employs the language of "efficiency" and "a watchman's clock." He also addresses "the humming behind the steel door." All of these help to bring out how Chief sees "The Combine" in the mental hospital. What Kesey and Chief see as "the combine" might have differences, but result in the basic premise of social control both within the hospital and throughout American society, in general.