Building up my city as much as i can without buying more tiles cause they are expensive to upkeep.

I have a general medical facility set to the east side of the map and a smaller med up in the rural town for the west side. only TWO ambulances are currently being used. idk how to get them to actually pick people up.

I have three landfills with two add ons just to try and keep up with garbage production.. i still can't. and i'm drowning in fees.

there seems to be a huge demand for low density housing and as you can see i've about hit the extent of how much this can hold. do i have too many medium density buildings?

I can't seem to make enough money to buy things like the incinerator or other 500K+ buildings.

my strategy has been to build a geothermal asap to boost my income then add a landfill, school, police, taxi station, fire station then bus station.