Organizations that are poor and have no choice but to perform efficiently are the only ones that do. The catch is they get less done because they're poor. Buffalo doesn't have a subway but if they did you can bet your ass they'd get more for your dollar than than the MTA does. Likewise your local dirt and scrap haulers are making their trucks go further per dollar than the high dollar urban construction outfits could ever hope to. When you don't have a lot you care about how it gets used.
