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As an example from Canada - it currently takes years for a person in Vancouver to get a place for their child in a government kindergarten. Likewise it can take years to find a family doctor as they're all heavily overloaded with patients. However someone living in a small town 50km from Vancouver generally has no such issues as government services are a lot more abundant there, when calculated per person.

I have seen similar patterns in other countries and it seems strange. Shouldn't the government try and spend a similar amount of resources per capita in every part of the country? Why is it that residents of capitals are frequently underserved compared to medium sized towns?

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    The premise doesn't ring true to me. Rural areas are in my experience chronically underserved by government services. – ohwilleke Apr 12 '18 at 6:04
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    @ohwilleke yes but medium sized cities are better served from what I see. People even move there just to have easier access to things like kindergartens and good schools. Same with any government branch - if you go to the downtown branch it will be full to the brim while the outer districts barely have any waiting times at all. – JonathanReez Apr 12 '18 at 6:05
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    @JonathanReez There are lots of medium sized cities that are not served by local, accessible government services - many of those Alabama counties without a DMV have medium sized cities. There is just no credible evidence whatsoever that your premise is generally true. I suspect that the real issue is that affluent places tend to have better government services than less affluent places for pretty obvious reasons, and you are being selective in what you think you are seeing. – ohwilleke Apr 12 '18 at 6:14
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    @JonathanReez: I don't know about DMV, as just about everything I need to do is on-line. But for the "middle of nowhere" rural offices, there's a certain minimum service if you're going to have an office at all. So you have an office that serves perhaps a few thousand people, or you have them driving a couple of hundred miles to visit the urban office. – jamesqf Apr 12 '18 at 6:20
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    And my anecdotal evidence as someone who lived in a small town that had a town hall which, at best, was staffed by 2-4 people and was open 3 hours a week Tuesday, Thursday, and Saturday only: rural towns have terrible government service. – Giter Apr 12 '18 at 12:35
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This is a good question and perception plays a strong part of it as well as the country and government.

In some cases, this is how we perceive it. Other cases, population density can be a drawback for some issues, like healthcare or school. Using your medical example, in a system where the government provides healthcare, a smaller city may seem to have more access to healthcare because of its population size to doctors, like a town of 1000 and 2 doctors (500 to 1) compared to a town of 100,000 and 120 doctors (833 to 1). Also, in these cases more people could spread a virus or disease faster, meaning that a higher density of population has more need. We can see this in some cases in smaller cities with transportation - it appears they have better transportation in some cases, but how many people are driving that often? Not much at any given time.

School can be very similar. Some small schools in rural areas can be really good with some skills at teaching because they have fewer students, so teachers can give more attention per student. Exceptions here exist as well, but if we're talking about government funded education this can be a pattern we see.

There are many exceptions to this. For instance, areas where people love to live (water), we may see higher ratios of doctors or educators, so these cities may tend to do better than other cities as far as access. Geography and weather will really depend - keep in mind, doctors have many options, and they can live where they want. As for capital cities, it depends. More internal or cold capital cities always seem like they need more help than capital cities on coasts and in warmer climates (or so it seems).

A good way of assessing this is just ask yourself where do most people ideally want to live? Then ask, with some skills (medicine) that have the flexibility to live where they want, where will they probably be? That will help you identify where bottlenecks in highly-skilled labor tend to appear.

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    Also, the two doctors in a small town will probably both be general practitioners, while perhaps 100 of the 120 doctors in the larger town will be specialists. – jamesqf Apr 12 '18 at 18:48
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How well a particular city serves its population's needs is determined by the extent of those needs, and the amount of resources (taxes) available to fill them.

For a small city/village, needs are usually met by a combination of self-sufficiency, and the community just generally helping one another. This makes the burden that government must fill far smaller, even if their tax base is too small to support some things.

Large cities have large burdens, just by the sheer size of the population they serve. This is made worse by criminal behavior that becomes much more obvious in a larger population, which drives productive citizens (the ones most able to afford to move) out into the suburbs, or new regions. The city no longer has access to the taxes from the people fleeing, which decreases their ability to deal with the ever increasing density of crime and poverty.

The long and short is that the people making up a city/region directly determine how prosperous it is, how prosperous generally determines how well needs are met, without going into the question of incompetent leadership(which were put into power by the people).

  • Note big towns also has a problem on prices. A new school or hospital must be placed somewhere and it's a lot cheaper to buy a small place in a small town than to buy a big place in a big town. Can there someting equivalent for wages – jean Apr 12 '18 at 17:32
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    "city no longer has access to the taxes from the people fleeing" - this trend has reversed in the past couple of decades. No one is fleeing Manhattan or downtown San Francisco anymore – JonathanReez Apr 12 '18 at 17:37
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    @JonathanReez: Don't know about Manhattan, but I live too darned close to a place that is filled to overflowing (and arguably well beyond) by people & businesses that have fled the SF Bay Area - and more are arriving all the time. – jamesqf Apr 13 '18 at 4:48
  • @jamesqf they're leaving the Bay Area because they can't afford it, not because they don't want to live there. It's gentrification rather than urban blight. – JonathanReez Apr 13 '18 at 18:09
  • @JonathanReez: Somehow I doubt that, as some of the businesses moving part of their operations here include names like Apple, Google, and Tesla. Nor, on an individual level, is it usually a matter of not being able to afford Bay Area prices. Of course you can get rather more hereabouts: what might buy you a mid-sized condo or "starter house" there gets you a mini-estate or horse property here. – jamesqf Apr 14 '18 at 4:52

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