Exactly right. You can't penalize people for *calling* an ambulance because the whole point is that they DON'T know what's going on. Could be a heart attack; could be pizza. But you could penalize them for insisting on hospital against the advice of trained responders. Especially when the diagnosis is confirmed by the hospital. I know this wouldn't help the problem of EMTs being run off their feet, but it might help some of the "big white taxi" and "beds in the hospital hallways" problems. ?