@diberry - clearly the "pass" that Google is giving brands boosts their entire sites regardless of individual page quality. So it's not always a case of what the user wants, but a case of what the user gets. And that means it's relevance is brought into question at times - especially in large verticals.
Where critical information ( such as life related ) is required and relied on, MC/Google has previously stated their concerns about trying to manage it - but perhaps more from a SPAM standpoint rather than a brand related standpoint.
Although, this is important due to it's sensitivity, let's not forget the responsibility of how information is conveyed to influence thinking, and how it can have both good and bad consequences.
Concentration of power has it's benefits at times, but left for too long it is open to becoming stale or capable of administering an abuse of influence. For that reason alone, results and core market participants need some loosening up.
Small/medium business' need to be given the opportunity to participate and not be given up for dead as MC indicated, when he stated that those folks in large verticals may as well give up and go build in niche areas.
The niche medical example provided by @diberry is the sort of thing that needs to be encouraged to ensure that quality doesn't become polarized to a precious few brands that offer no depth in places.
If Google ticks a brand, users might automatically consider it good. Top ranking sites enjoy better engagement, simply because many users accept Google as making their choice for them. Because of that, user "trust" translating to brand doesn't mean the product/message is "trustworthy". In fact, as we all know, it can be the complete opposite. Left to dominate, it can actually kill off what is good, except for those that thrive on it commercially.