I don't care that we spend money to bring clean water and sewer to our neighbors. There are multiple studies about what the larger community gains by doing so - ALL over America.
 Rural Alaskans do pay for their water and sewer service- at a higher rate than we urban Alaskans. There was a great deal of concern in the early 2000s about folks dropping below 6 g/day per capita to lower costs for themselves. ANC residents average 100g/day per capita. 
Below 8g/day puts folks' health at marked risk.
I think the concerns  here are 
http://www.iser.uaa.alaska.edu/Publications/sustainA.pdf
are most important in evaluating and choosing projects where money is well spent.
Aging water and sewer infrastructure all over America ( Detroit-lead?) is a serious concern. Poor decisions about what can be afforded or what is a viable result in real damage to real people. 
I cannot resent folks getting the basics- I just cannot.