While all the shiny new machines and longarms are wonderful, they are just out of reach for many of us. My machine quilting is not that great. I am the first to admit it. If something is special, I generally take the time to hand quilt. Sometimes I combine hand and machine quilting. I've never sent one out to be done.
I have done plenty of huge quilts, but space limits me to smaller ones nowadays. They are still fun to make, and a challenge to design.
There are plenty of threads here about quilting on a budget. The original quilters made do, and some of us still follow that tradition :)