[Does Fedex deliver goods to everybody in a region if only one customer in the region pays for their service?]
Yes. That is part of their business model. The sender pays Fedex to deliver the parcel and they offer their service in regions that are receiver-dense as well as regions that are sender-dense or balanced.
An alternative way to keep things local would be through enforced confederations or similar construct,
Indeed, pointing a gun in somebody's face is always an option. However, in the realm of politics which we are discussing, this is an option that should not be under consideration. RIR policy is only concerned with address allocation, not with network provider contracts or with peering policy or facilities construction or anything else. The only thing that RIRs can enforce is address allocation policy and practice.
There may however be places where such cooperation is appropriate, in which case RIR-policies should accomodate such a construct. ISP's who want such cooperation should probably establish an independent organisation that would act as the LIR for their region. There's nothing (exept possibly the 200 customer limit) in the current RIR-policy that prevents such a construct.
As has been repeatedly pointed out by others, the 200 customer limit is a REAL block to deployment of IPv6 by many companies. Until IPv6 allocation policies are made reasonable without silly artificial constraints with no reasoning behind them, then it is a little early to discuss regional cooperative LIRs. One data point that we already have is exchange points. How many exchange points in Europe have been successful in receiving a /20 allocation from RIPE? How many in other regions? I suspect that the answer is zero because RIR policies discourage the allocation of IP addresses to such confederations. --Michael Dillon