regionalization" be applied to selecting one municipal service -- such as water or schools -- and having two small towns manage that service together. But in a land where 351 municipalities have town-level responsibility for each and every such service, such economies may be considered radical -- a threat to "local control."
But as a geographer who has lived elsewhere and then got involved in local affairs in Massachusetts, I eventually came to see important problems as expressions of the incredibly fine-grained structure of municipal services. Name any service provided at the local level, and Massachusetts is likely to have somewhere between 250 and 351 providers of that service, be it fire protection, libraries, water supply, or schools. Among other things, this contributes to the swelling of state agencies (education is the best example), because of the difficulty of maintaining contact with so many local officials.
It also means that purchasing is needlessly "lumpy" -- a county-sized area might really need five special pieces of fire, police, or water equipment, or perhaps one piece of library software. If all of those operations are separate, however, opportunities to economize are reduced. Similarly, a greater proportion of the budget can be spent on firefighters, police officers, librarians, and teachers, and somewhat less on the people who administer them. In Massachusetts, somewhere between 500 and 1,000 people hold a title of school superintendent or assistant superintendent (I would be willing to bet that nobody knows the actual number).
Because I see these factors contributing directly to the ongoing struggles over resources in my own town of Bridgewater, I have encouraged state government to step up its efforts to foster regional approaches. Ideally, most services could be offered at the county level, but Massachusetts is actually unwinding its counties and four centuries of tradition might make such a big step unfeasible. My Massachusetts Regionalization page describes my small role in a state-wide discussion of some more feasible steps, including my section of a report to the governor.