Grumpytroll
You make a good point. If the doctor says take your loved one by helicopter you sure will not argue. However the reason the doctor says use a helicopter is often due to defensive medicine. If there is a helicopter and he doesn't use it and the patient 'goes off' he might be sued. If the helicopter has an accident that isn't his problem.
In practice it is a little more complicated. Receiving hospitals may want to get e patient as early as possible for financial reasons. Using a helicopter may also increase the patient severity on which reimbursement is based. Some major centres are desperate for volume.
Whether or not the US use helicopters when they are not needed is not the issue - it is after all their money and they have to pay 18% of GDP on it. The issue is whether this indulgence results in a lower amount of ground transport and creates a vicious circle making helicopters more necessary, and second whether this dependence means that helicopters are used in marginal weather at night over poorly lit territory single pilot.
The US are now over funding community hospitals whereas systems such as Medicare often underfund urban hospitals - for example Medicare may only pay them cost less 30%. Together with telemedicine and mandatory continuing medical education, the desire to ship out everyone ASAP may abate. I for one will be happy.