This has been misquoted by the media. if you look at the paper itself it says you have to save 1.6 extra lives per 100 patients. Not per 100 deaths. This means that you have to reduce the overall death rate by 33% if the cost of a year's life saved is $50000
In the UK the value is put a lot lower. That means you have to reduce mortality even further - the cost of the helicopter is the same as in the US or as we all know greater but the saving is less per life saved.
The only objective UK study suggested a saving of as little as five lives per annum per aircraft. On this basis there appears to be a mountain to climb. Indeed unless you move 33% of all likely to die patients by helicopter and save their life in every case
you can never meet this target. Fortunately this slightly daft academic exercise is simply that. The real financial reason for HEMS is the massive reduction in other ground resources needed to meet government deadlines in rural areas. The humanitarian reason is the reduction of pain and suffering, equality of care plus the ethos that the public deserve the best possible care regardless of the individual cost:benefit ratio if it has been decided that the care in general should be available.