it does exists in the US thats why you have private ambulance companies thats not in the 911 system !!!!
thats not fully true some areas yes private due transfers but there are some agencies that do them. mine doesnt go more than a prison medical transfer and one care facility which is in town literally across the street from the hospital but others may do just as many or some of the transfer calls but this ALS & BLS is something i think everyone wants to see including me but i also think that for ambulance services you should require training as it is a special task and with that training there would be EMT's and Medic's and Medic's would need to be a EMT before becoming a Medic