Speaking as someone who has attended many a Town Meeting, I like them. They let people express their opinions and can be fairly effective at dealing with specific items like whether to get a new fire engine or whether to approve new zoning for some part of town, and they give more of a sense of connectedness to the town government. But they take up a lot of time--think how many people don't take the time to vote--town meeting takes a long time, even if everything is routing. And they aren't good at allowing people to have input into the actual rules--you can't practically modify a zoning regulation at town meeting, or make significant changes to budgets. It is too hard and takes too long to go over all the details and make sure that they are correct. So you can complain, but you either end up having to pretty much adopt the budget that was submitted, or else reject it entirely. I'm sure that happens sometimes, but not at any town meeting I've been at--it would be a big pain, as they'd have to redo the budget really fast, or else schedule another Town Meeting to approve the revised budget.

Some towns have informal consultations with concerned citizens to try to iron out issues that might be contentious, but that requires even more time and effort on the part of the citizenry.

I don't really see how any of this could work in a large city or a state. I think the mentality goes with the scale of the meeting--you know the other people because they are your neighbors, so you don't just view them as people with horribly wrong ideas.