With only 2 percent of the country’s population, Massachusetts accounts for 12 percent of the nation’s public health offices. Nearly every small town has its own office, an  expensive requirement at a time municipalities are struggling to fund necessary services.

Public health offices are only one example of the duplicative spending on local services in Massachusetts. Unlike many other states that regionalize services such as police, schools, and fire departments, a vast majority of the state’s cities and towns each have their own departments.

Mike Widmer, the president of the Mass Taxpayers Foundation said the regionalization of those services should be considered more seriously by the commonwealth.

“Having two or three fire stations in a small community manned 24 hours a day is the product of an older era,” said Widmer. “There are fewer fires nowadays and more need for emergency medical services.”

But despite the potential savings, the tradition of local rule is still cherished by Bay Staters.

“This is very difficult to pull off because there is resistance,” said Widmer. “Communities have an identity. I think there is no magic cure to the lack of local aid, but sharing regular services is one option.”

Massachusetts has slowly eliminated nearly all functions of county government, putting it in contrast with states such as New York and Florida, where county governments provide fire services, county road departments and sheriff’s patrols for small towns.

But many local officials are set against any such regionalization in Massachusetts, including North Adams Mayor John Barrett III.

“Anytime I hear the word regionalization it ends up costing towns more money,” said Barrett. “I see that with regional school districts. The salaries of administrators are much higher and benefits are higher.”

Barrett said that sharing services among communities instead of regionalizing would be a more palatable way to save small towns money.

“There are mutual aid agreements between towns for fire and police in the Berkshires,” said Barrett. “We provide 911 services for neighboring communities for a small fee. Those are the kinds of things that help in sharing costs.”

Some regional organizations have attempted to reconcile the tight command structure of local departments with the resources of a larger police agency.

Law enforcement councils are regional cooperatives of small police departments funded by state grants and local taxes. The councils provide extra assistance for all member agencies.

“The bottom line with the councils is that it’s about local control,” said Woburn Police Chief Philip Mahoney, president of the Northeastern Massachusetts Law Enforcement Council.  “We respond to individual communities, and the local police chiefs are in charge. We work with them as their guests.”

Mahoney said the councils provide special services like SWAT, K-9, and computer crime units to its members. Volunteers from the member departments staff the special units, which are funded by the dues of the member agencies.

Schools are another service built on town taxes; a burden that are shared by multiple towns.

Jonathan Considine, a spokesman for the Department of Elementary and Secondary Education, said the department encourages towns to look at regionalism as a more efficient option. But he also said combining school districts is a complex and difficult process that has stopped many towns from considering the cost-saving option.

Only 16. 2 percent of the state's 500 public schools operate in regional compacts.

“Regionalization has not happened much in recent years,” said Considine in an email. “Manchester-Essex was the last region to form around 2001. Regionalization involves quite a bit of study and negotiating between the towns involved.”