Large language models (LLMs) have become indispensable, but the most celebrated efficiency methods -- mixture-of-experts (MoE), speculative decoding, and complex retrieval-augmented generation (RAG) -- were built for hyperscale providers with vast infrastructure and elite teams. Outside that context, their benefits collapse into overhead, fragility, and wasted carbon. The result is that a handful of Big Tech companies benefit, while thousands of hospitals, schools, governments, and enterprises are left without viable options. We argue that the next frontier is not greater sophistication at scale, but robust simplicity: efficiency that thrives under modest resources and minimal expertise. We propose a new research agenda: retrofitting pretrained models with more efficient architectures without retraining, inventing lightweight fine-tuning that preserves alignment, making reasoning economical despite long chains of thought, enabling dynamic knowledge management without heavy RAG pipelines, and adopting Overhead-Aware Efficiency (OAE) as a standard benchmark. By redefining efficiency to include adoption cost, sustainability, and fairness, we can democratize LLM deployment -- ensuring that optimization reduces inequality and carbon waste rather than amplifying them.