Even in commercial organizations the QMS may not driven totally by profit, cost or efficiency.
Some examples:
In Europe there are strict laws regarding effluent which attempt to minimize environmental damage. Processes have to meet such requirements, e.g. by removing toxins from effluent prior to discharge. This is pure cost, no profit, and at best an attempt to reduce costs in terms of legal penalties should there be an accidental poisonous discharge.
There are also laws regarding the accuracy and confidentiality of personal information and companies must invest in appropriate technology and processes to comply, again pure cost, little or no benefit except in customer trust and loyalty.
Also, there are laws regarding electrical and fire safety in products, forcing companies to add cost in order to comply.
Sometimes a company gets into difficulties with customer satisfaction and its reputation suffers (e.g. it gets caught by the press abusing cheap labour in a foreign country, or maybe its product just sucks) and will buy its way back into public favour with special offers, low prices, an expensive PR campaign – all costs it hopes will pay back.
Finally, in markets where new products are the norm it's common that the first company to build significant market share remains at the top for years – once we all bought Sony Walkmans, now it's iPods. Another example is satellite TV, where one service provider, now a major player, had a policy for a while of “never mind the cost, never mind the quality, just build market share in each new country we enter.” Now, several years after, they're the dominant player in many countries and making fat profits.
How could the standard accommodate what amounts to betting behaviour at the CEO level on innovative new products? For example, Sony (I think I'm correct in saying) didn't do market research on the Walkman; their CEO simply decided it was a good idea and he'd do what it took to sell it. The only way for truly innovative products, I think, is to put your money where your mouth is, launch the product and hope people like it. Once the product is making money, then one tries to reduce costs. But CEOs have a habit of doing that and hardly need a standard to tell them.
I agree that quality teams often ignore cash and strive for unrealistic quality targets in terms of defect rates and customer satisfaction, and the worst of them lose their jobs because their quality activities run counter to business objectives (e.g. market share today, customer satisfaction tomorrow). But I think it should be a part of their education to put relevant cost metrics into the QMS when they align with the quality policy, as has been said.
Just my 2c,
Pat