I cannot speak for Milwaukee, but many places in the US do not have taxpayer funded EMS (hence why ambulance bills are so damned high). Taxpayers fund police and fire and EMS is either solely or partially volunteer services and/or private companies. Most private companies are trash, some try to be good but are constrained by the fact that they still need to pay their employees and buy equipment. They may get some compensation from the cities and towns that they serve, but it is tiny. When I worked EMS we had towns giving us $2,000 for an entire year’s coverage. The small city that we covered gave us $100k a year to run, but we wrote off hundreds of thousands of dollars every year running calls for them because it was so low-income no one could pay their bills, so that money had to be made up elsewhere. And people wonder why the emergency health system is collapsing and why bills are obscenely high. We could have a very low per-person or per-household tax and have the best system ever with the best trained, well paid providers using the best of equipment, but instead, no one wins and you get a high bill, ambulance shortages, and tired, underpaid, burnt out crews. Forgive my rant. EMS was the only job I ever loved but it sucked me dry at the same time.