I am not going to defend the US Healthcare industry, but EMS is often? usually? a service of your local government in the US.
Here in Maryland, our ambulance are stored in the firehouses next to the fire engines and staffed by the firemen... Paid for by the county.
When I went to Austin for a bachelorette party, one of the girls passed out and hit her head and the ambulance that came to check her out was also free of charge paid for by the city. Now, their dismissive paternalism was also free of charge because it was Texas, but my point is: emergency services are frequently not part of the predatory American healthcare industry.