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Publisher's Note: This thought-provoking discourse on the unquestioned pursuit of “efficiency” reveals how the discussion of efficiency in the delivery of public goods, such as education and health care, has risen to prominence in postindustrial society. Stein's provocative argument, reminiscent of the thinking of Lewis Mumford, demonstrates that efficiency can too often be a cloak for political agendas, and that pressure for efficiency can actually be a detrimental rather than a positive force. Citizens in public schools, community clinics, and hospitals are shown engaging directly with such agendas, redrawing the face of the state as they impose new ways of delivering public goods. Stein demonstrates how they are calling not only for efficiency but for accountability and choice as they confront the dilemmas of democratic processes in a global age.