We first encounter the "Combine" in chapter 1 of One Flew Over the Cuckoo's Nest when "Chief" Bromden argues that shaving before breakfast is the "worst time" to shave. He explains:
When you got something under your belt you're stronger and more wide awake, and the bastards who work for the Combine aren't so apt to slip one of their machines in on you in place of an electric shaver.
He then goes on to describe how he has no chance against the "machines" when forced to shave before breakfast, because all he will be faced with is screaming faces "trapped" behind mirrors.
This mysterious reference to the "Combine" is later explained as "a huge organization that aims to adjust the Outside as well as [the "Big Nurse"] has the Inside." From this perspective, we can understand that Bromden sees the "Combine" as a complex tool of oppression in which...
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patients at the mental health ward are manipulated, controlled, and managed. This authoritarian giant forces the mental patients into submission, but according to Bromden, it is also present int he outside world, such as the artificial damming of the waters in his ancestral hunting grounds.
In Chapter 1, Chief refers to the Combine as a kind of all-powerful conspiracy of people inside the ward who work to keep the patients docile. He says that he tries to shave after he's eaten some breakfast because, if he's eaten something, "the bastards who work for the Combine aren’t so apt to slip one of their machines in on you in place of an electric shaver." Chief feels that the people who work for the Combine are constantly trying to drug him and that they lurk everywhere, waiting to get him.
The Combine is like a large harvesting machine that mows down everything in its path. The Chief imagines that the Combine releases a kind of fog that temporarily renders him senseless. The Combine is an omnipotent, evil machine that controls everyone on the ward and that functions in the same powerful way that a thresher functions on a field.
The "Combine" is what Chief Bromden calls society, which he sees as a massive, oppressive entity that strings individuals together and shunts those members of society that are viewed as "mistakes" to the mental hospital to be locked away. Note how he talks about the Combine in the following quote:
The ward is a factory for the Combine. It's for fixing up mistakes made in the neighbourhoods and in the schools and in the churches, the hospital is. When a completed product goes back out into society, all fixed up good as new, better than new sometimes, it brings joy to the Big Nurse's heart; something that came in all twisted different is now a functioning component, a credit to the whole outfit and a marvel to behold.
Note the mechanistic metaphor that is used throughout this quote. Bromden talks of humans and society as if they are all a machine, with the Combine representing society at large. The hospital becomes a "factory" where humans who are "twisted different" are formed once again into "functioning components," cogs in a machine that will work. Such mechanistic imagery shows how Bromden and the other patients are profoundly dehumanised through their treatment. As parts of a machine, they are not allowed to have their own humanity.