Good point. Although our county is mostly rural, they have a multimillion budget/24/7 paid fire department in multiple locations. Some residents are starting to ask if it's really worth it. Taxes are high here.
Heard part of an NPR story today about stand-alone emergency medical facilities taking a big bite out of fully staffed, traditional hospital emergency rooms. They said a trip to the conventional ED costs $400 or more BEFORE you even get any care, due to their huge overhead.
We have one of those here locally, which is owned by one of the 2 big local health care firms, they bought out the local commmunity hospital (after "partnering" with it to 'save it from its debt') and then closed it.
About 6 months later they reopened it, first as an Urgent Care, and then as the stand alone ER thing.
Those who were in the admin of the community hospital, got sweetheart deals for selling out the community (looking back, most of them had a previous hx with the bigger agency before they were hired at the CH).
Despite all that, my real problem with it is that it's not really an ER, because if you truly have any kind of emergency situation, be it heart attack, stroke, appendicitis, or whatever, you will need to transported to their city hospital to have it treated.
And then they do their level argue you into going to THEIR facility, as if you don't have any choice in the matter.
That said, it is available 24/7, so I guess it trumps my urgent care, which closes at 7PM.