I had a discussion with a European friend about this a while back. In a "universal healthcare" setting, they don't have this type of problem with people using EMS for non-urgent calls. Why? Because people who call for a cab-ulance get charged with fraud, criminally and civilly.
I have no problem with requiring drug screens of welfare recipients, but I'd much rather see a law requiring medical necessity for Medicaid-paid ambulance rides. There is WAY more cost-benefit in addressing this type of "welfare fraud"... so why doesn't anyone sponsor this kind of law?
I understand that sometimes "momma's chest pain" is just indigestion instead of an infarction -- that's not fraudulent abuse of the system, those are the type of situations where any medical professional would agree that it's okay to err on the side of caution. And I think there needs to be some sort of protection for the EMS personnel, to protect them from claims of "they refused to give me a ride and I almost died" or "They didn't tell me this wasn't an emergency so I shouldn't be held responsible".
(How about a waiver in which the potential rider has to sign a waiver saying, "my symptoms are X,Y,Z, and even though EMS tells me that this is not a medically urgent situation, I still accept responsibility (legal and financial) for using this ambulance" or, on the flip side, a waiver saying, "I disclosed symptoms of X, Y, Z, only, and no other symptoms, and EMS advised me that, based on these symptoms, I do not have a bonafide need for an ambulance"... that way they couldn't tell EMS they had a hangnail and then claim later that they told EMS about their bulging and pulsating AAA but were refused a ride.)
Heck, how about just having the 911 dispatcher make a short disclaimer: "Use of an ambulance is specifically for situations involving the potential of disability or loss of life. If you request an ambulance to be dispatched to your location, you are accepting legal and financial responsibility for the fact that you do, indeed, have a serious emergency medical situation. Are you willing to accept that responsibility?"
Personal responsibility has gone out the window, and by allowing "cab-ulance" abuse, we are further perpetuating the problem. What is so wrong with making people take responsibility?