If the money is owned by the same organisation that gets to spend it, the money is spent wisely. If it costs one fifth to arrange for a daily care at home versu

If the money is owned by the same organisation that gets to spend it, the money is spent wisely. If it costs one fifth to arrange for a daily care at home versus at a nursing home, then that's four fifths saved for something else in the total bill. However, if the one who gets to pay and the one who gets to spend are different parties then both try to optimise from their own perspective and generally end up with contradicting goals.