Epiphany, I think you have to accept the fact that the US is not Australia, which is not England, which is not anywhere else. Practices in one country have no bearing at all on practices in another country. Culture, tradition, even language is different in different countries, and criticising another country's laws and ways of doing things is not a productive exercise. There have been EMS accidents in Australia, and the rate per hundred thousand hours is likely not significantly higher than the rate in the US. You hear of lots of US HEMS accidents because there are close to a thousand EMS helicopters flying every day here.
I personally think HEMS should be run by the government, at whatever level, but here in the land of the free capitalism rules, so that ain't gonna happen, and making a profit will continue to drive the industry. There are very few HEMS ships flying with two pilots, regardless of the number of engines, because the second salary cuts into profits, and every program would do without pilots at all if they could figure out a way to do it. EMS directors hate pilots, always will, and we get what we get. Take it or leave it.