NPSHI - Eastern Canada
I used to fly into Kingston Ontario regularly and there was often a Medivac on the ramp. Usually a B 1900, twin pilot.
The conditions those companies operate under is completely different than the US. They are a cost plus service contractor to the Health Service who are pretty stingy.
Even then there was waste but no price gouging.
The pilots told me they were never put under pressure. The biggest issue was often inbound to native reserves with gravel strips , no ATC or local weather.
They seemed to like the flying. As they were all young it was a stepping stone job.