I live in Australia, and we do have a few public toilets, but honestly 90% of the time if I need one when I'm out I'll use one in a food court or a department store or some other private enterprise which seems to have a financial incentive to provide good quality amenities.*

Does this not happen in the US? And if not, can anyone muse as to why? I would figure that the incentives would be the same.

* I expect that there's a legal requirement for many of these businesses to provide toilets, but the level to which they maintain them is without doubt over and above any requirement of law, certainly better than any public facilities.