As a young, healthy person with a family that also lives in a major capital city, I also don't expect to need an ambulance for an illness related issue.

But DH and I drive a car almost every day, cross the road several times a day, have a toddler who loves to climb, who despite all my child proofing efforts could possibly get his hands on something poisonous (at home or at someone elses home), who falls over all the time, who doesn't look where he is going, who plays on playground equipment at the park, my house probably has spiders that I haven't seen... You get the idea.

Every day, just going about our daily lives we are at risk of seriously injuring ourselves. Yes the odds are low, but they're real. I've been in 6 car accidents in my life, none of them have been serious enough to require an ambulance, but gee everyday there are many, many others who aren't so lucky. What's to say, me or DH or DS won't be one of them one day. Whose to say that won't happen out in the country where an air ambulance is needed?

But like you said, you're willing to take the risk and could pay the bill if you needed to. I get it. We could also pay the bill if we had to, but I'd rather pay $100 a year and support the ambulance service (whether I need it or not) and know that if I think I might need it, I'll use it rather than take my chances and drive us to hospital.

Again JMO