White not chosen for Chicago post, will remain in Louisville

Uhhh, actually, you have it backwards. That isn't the concept of Louisville's fly cars at all, and NEVER WAS. They idea was supposedly to be to dispatch a paramedic in a fly car (and I hate that term) - (higher trained, and someone that should NOT be sent to minor calls where no transport is likely) to the bad calls, since they can usually get there faster in the smaller, lighter vehicle, to be immediately followed by an ambulance that would generally take longer to get there - an ambulance that is NOT staffed by a paramedic, but by two experienced EMTs. Then, if transport is needed, one of the EMTs swaps out with the paramedic and follows the ambulance, with the paramedic in the back, to the hospital. Those same two EMTs could be sent to respond to minor calls where transport may or may not be needed, but where they won't nee paramedic skills.

There are a lot of problems with EMS, many not caused by EMS, however. There is a belief (although EMS will tell you differently) that you get service quicker if you arrive in an ambulance. EMS will insist that isn't true, but I've spent way too much time in ERs all over the city to believe otherwise. (I have never seen a patient brought in by EMS left in the waiting room, and many leave far too quickly for their problem to have been serious.) The EMS director (who despite being a doctor isn't their medical director) doesn't have the guts to develop a valid, defensible policy to support a "no transport" decision. (Many places have them, but it would be a change of culture in Louisville, I admit..)

Louisville Fire never wanted the responsibility of refusing transport, either.

Good Emergency Medical Dispatch (EMD) protocols, which a solid, and defensible, no response policy would go far to reducing the call volume - as would SUING people who don't pay their EMS ambulance bills. (Yes, I know that many would not pay, but haul their butts into small claims court anyway, who knows, they might win the lottery.)

I could go on, and on, and on ....