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Welcome to the City. The costs associated with 911 calls are covered in a variety of ways depending on the structure of the system in question. Some departments are tax base supported. These can be fire based or municipal third service. Any 911 call, transport or not, rich pillar of business or local homeless drunk, would be covered regardless of ability of the patient to pay. Some departments are volunteer supported by donations. Some departments are moving to a mixed system where taxpayer support is provided by local government and then patient is billed to help cover costs of services. In some cases people can, and do, pay. In some cases people can't, and don't, pay. Ability to pay does not in any way, shape or form affect the provision of services in a 911 environment. So what gives? Whoever told you that EMS in the US was only for people with insurance and crews were never called out to "BS such as homeless drunks..." was woefully misinformed. We answer and respond to a wide variety of calls from an exceedingly diverse patient population. Bums and wasters, eh? I'll admit your chosen adjectives are a little concerning. Perhaps it's time for you to take a holiday and get away from the ambulance for a bit. Don't assume anything. You thought wrong. Yes. Your impression of EMS in the US is very, very, very wrong. To be fair, I, and I imagine most of the others here, have encountered patients who didn't want to call 911 because they didn't want to pay the bill they thought (rightly or wrongly) they might receive. This is not the rule. Provision of EMS services dispatched by 911 in the US in given regardless of the individual's ability to pay. YouTube, like Wikipedia, is neither an accurate nor infallible resource for anything and everything you ever wanted to know. I imagine treatment of EMS providers by the public at large is similar the world over with some people exceedingly grateful for the services received and some people who will never be happy with anything. Paramedics don't have to work for a fire department to be able to accurately and reasonably answer your inquiries. I've worked for fire based, municipal third service based, hospital based/air medical based EMS in a number of areas in the US. There is a much wider base of experience with a much wider and more varied employment history when you look at the many people who post here. Fire based EMS is not the be all, end all of EMS especially here in the States. (In fact, many will argue that EMS should not be based in a fire department system anyway as the two are completely different jobs. That's another discussion altogether.)