The province of Quebec, roughly the equivalent of the state of New York in size, and Virginia in population does NOT have a helicopter emergency response.
Utah, population 3 million, has multiple life flight systems. The one in my insurance network has 4 helicopters and 3 fixed wing aircraft. About 8 other life flight helicopters operate in the state.
Is this expensive and inefficient? Yes. But we are worth it.
Canada, with ‘free’ healthcare views people as expenses to be optimized.