You don’t have to. You do what you want. I’d prefer to hire a company where the workers make more money. Right now they make a pittance.

Someone who's having a medical emergency is certainly in no position to go comparison shopping for ambulance services.

You would do it before hand of course

Let me just schedule in plans for my future heart attack and car accidents.

Yes because you don’t have health insurance until you have a heart attack right? You never pick that before hand do you?

When you get your bill, you could just double that as a tip.