There's no reason to be defeatist; the US HEMS market is far from homogeneous. Even within the US there are many local and state governments that have taken a different approach to providing HEMS services to their constituents. The Austin, Texas STAR flight program, or Miami-Dade County Fire Rescue are just two examples that come to mind. They tend to be well-funded and highly regulated, just like many of the European HEMS programs. Anecdotal evidence suggests they maintain a similar level of safety.
Such programs provide a template for any other local or state government to follow, irrespective of FAA regulations; the state of the healthcare industry or the intrinsically capitalist nature of the country.