Bitcoin Payments - Can We Do This Better?

The biggest layer to protocol for bit coin to day are exchanges. And if you're exchanging crypto for fiot, both sides of that transaction have to be trustless in order for the exchange mechanism to be trusted. The payment system is still regulated and still shitty, it's still slow. So how do we solve this wit this problem? Well, how are we solving this problem to day? And can that be abstracted into something that's at least more open and more centralized?