one major inefficiency hinted at but not directly named is the coordination problem (a la mythical man month). the tech startup ecosystem addresses that by having each startup "do one thing well" and having a simple way to coordinate efficiently (monetary payments in exchange for products/services).
This doesn't solve the problem, it just makes it invisible.
When you buy something complex from other company, time spend communicating is not seen as bureaucracy, but productive work - on your company's end, communication may well be as efficient as possible.
The same can be true at other company.
When you sum the time/money spent on both sides, it's often worse than 'inefficient bureaucracy' at large company (which does both things internally). It may seem more inefficient just because people are able to see the entire process.
If small companies really were more efficient, they wouldn't be able to grow too much, as they would be outcompeted by already existing small companies. The reverse actually happens.
not sure i get your point. i'm talking about the services ecosystem around tech. when i need servers, i just sign up at heroku. when i need source control, i get github. when i need agile tools, jira. need an html framework? bootstrap. analytics? email marketing? sales automation? bookkeeping? transportation? lodging? etc. etc.
it's super efficient--just go to a website and pay. i spend no time coordinating my efforts with those companies, and the price i pay tends to compare very favorably to building it ourselves.
the coordination problem is wrung out of the equation because teams are small and must compete. haier replicated this within the company with their STS model: each group in the supply chain effectively "paid" the upstream group and that became a simple metric for efficiency of coordination.
there are a number of business school case studies that talk about addressing coordination inefficiencies in large firms -- toyota (TPS/kanban) and haier (OEC/SST - http://zaipul.wikispaces.com/file/view/The+Haier%27s+Tao+of+...) come to mind.