Not interested is arguing all this other stuff but I can answer this question.

#1 Veterans hospital and medical center at least for me was and still is
well oiled and efficient each time I go in for any medical care.

#2 I get my social security check on time every month.

#3 Medicare works with my regular insurance without issue
every time I seek medical care.

From where I sit I believe that could be considered efficient.......

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"What you hear in a great jazz band is the sound of democracy. “The jazz band works best when participation is shaped by intelligent communication.”
Harmony happens whenever different parts get to form a whole by means of congruity, concord, symetry, consistency, conformity, correspondence, agreement, accord, unity, consonance…….