Here in Australia most Ambulances run on a user pays scheme, a major difference is that as Australia is broken up into several states each state runs its own ambulance and hospital system with some funding from the federal govt. So for example you need to take a ride to hospital it will cost you. I feel this greatly reduces the amount of unneeded calls. Also if you want to not pay the $500 odd australian dollars for a trip to the hospital then you can become a member of the ambulance service. for around AUD$100 a year you get free ambulance services etc. Also if the fire brigade gets called out and it is not for an emergency you have to pay the call out fees.