Question: If a natural monopoly exists, why would it be difficult for regulators to force the natural monopoly to produce the economically efficient level of output

If a natural monopoly exists, why would it be difficult for regulators to force the natural monopoly to produce the "economically efficient" level of output (where P = MC)? What is the typical alternative used to limit the natural monopoly's profits, while allowing it to earn enough profit to stay in business?

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