The US EMS pilots are severly underpaid (in most cases) eg. Start pay $44,500 (work that out in pounds)!! for EMS up in the north east, Philadelphi way, where house prices are not that much different to the UK, then take out your medical each month...get the point! Also in the US there is a severe lack of respect for these "drivers," a lot of the shifts are 7 on 7 off, 12 hour days, and often you will exceed this and the extra hours you are not paid for!!!!!!!!!!!!! This isn't EVERY EMS program that does this but the majority... The US also flies Night vfr, (we know that this an unsafe practice as they fly to unknown landing sites) also they do single pilot IFR as well.....All for that huge paycheck!
hope this helps.