I think you're talking about the CISC vs. RISC architecture debate. It's not quite as simple as saying that RISC is more efficient. By way of example... the Pentium 4 was more RISC like than the P3... which allowed it to hit some pretty crazy clock speeds. The problem is that RISC processors have their own issues (takes more instructions to get things done), and the Core Duo is far more like the P3 than the P4 architecture wise, moving a bit back toward the CISC end of the range.
This also doesn't really have much to do with NVidia's problem... which is that NVidia would have to design an "X86 compatible" processor (a catch-all phrase for a cpu that can run the various non-Itanium/non-embedded Versions of Windows without software emulation) from scratch... with no experience designing CPU's... to compete with a company many times their size and with much deeper pockets.
This also doesn't really have much to do with NVidia's problem... which is that NVidia would have to design an "X86 compatible" processor (a catch-all phrase for a cpu that can run the various non-Itanium/non-embedded Versions of Windows without software emulation) from scratch... with no experience designing CPU's... to compete with a company many times their size and with much deeper pockets.