A bad week for Oracle - their health business and underlying cloud platform has suffered multiple massive breeches with damming evidence, and overt denial, minimisation of the matter.
All over the world? If not, then there's the replacements, although I'm sure they're not FOSS.
I don't think this class of customers care much about OSS. Vendor costs are an accepted business expense, passed onto customers, funded by tax dollars. Why would these big players dance around trying to get what they need from OSS when there's this "tried and true" vendor already proven.
Sure they're greasy, unhelpful, extorters... but hey... "this is big business baby! You gotta tango with the big boys if you wanna play ball in this field, bucko" :_)