Comment by astrange

Mainly the minimum size requirements are much larger (requirements related to stretchers).

Also, in some/all places the elevator union got basically all manufacturing processes banned so they have to be assembled on site by union workers.

https://www.nytimes.com/2024/07/08/opinion/elevator-construc...

And in the US, nobody in the relevant unions or regulators cares about cities - elevator workers and firefighters are all suburbanite pickup-truck-Americans. So they're rarely personally interested in anything that isn't about driving a big car around really fast. This has a big impact on road layouts and the outside of buildings, because of course everyone listens to firefighters, but all they want to do is drive a big red truck everywhere with nothing stopping them.

(Which sometimes leads to them eg shutting down pedestrian safety improvements, and always leads to big wide access roads.)