Trying to compare HEMS operations with Qantas is simply silly. Qantas carries hundreds of passengers per flight, HEMS almost always one. Qantas operates airliners to and from major airports, HEMS from unprepared scenes at night, and to and from hospital helipads which are some of the poorest in the country. They're almost always an afterthought, with obstacles all around. But disregard everything except the first point, and you still can't make a comparison, because of the sheer volume of passengers that Qantas and the other airlines move on each flight.
I've said it before, and I'll say it again. European and other pundits have no business pontificating on the state of the US industry, just as the US pundits should, and generally do, keep quiet about their industry. It's a different culture, under different rules, with different philosophies, expectations, and goals. Right or wrong, profit is the driving force for all business in the US, and that will not change no matter how much fun the rest of the world wants to make of it. Short-term profit is the end-all and be-all of the US economy, and short-term profit is not possible if multi-engine, multi-crew aircraft flown only under IFR are required. So get over it, those will never be required, and will seldom be used.