Most hospitals are unionized; at least on the West Coast. Volunteer firefighters: some areas are full of people who don't want their taxes to go up to pay for

Most hospitals are unionized; at least on the West Coast. Volunteer firefighters: some areas are full of people who don't want their taxes to go up to pay for a career department. Many areas are so sparsely populated they can't afford one even if willing. The amount of training and education required keeps going up, and not everyone has a job they can just walk off from to respond to calls on no notice. It's harder to effectively volunteer as a FF than it was even a few decades ago. Sometimes it's addressed by having formerly all volunteer or smaller combination career/volley departments be absorbed into a neighboring career department that can spread the cost out to a larger area. Sometimes egos win out and the ability to do the job suffers.