Comment by kelnos

This is a fine example of coming up with some "plausible" numbers to support a conclusion, but all of the "plausible" numbers are actually wildly incorrect.

A new ambulance will probably run 2-4x what you quoted. Gas/maintenance will not be comparable to a regular automobile; it will be significantly higher. Paramedic wage (though there will probably be more "cheaper" EMTs out there than paramedics) seems right, maybe a little high for some markets. $12k for liability seems shockingly low; I wouldn't be surprised if you're off by an order of magnitude.

Regarding salaries, you're not just paying for the people in the ambulance. You're paying for dispatch, operators, support staff, administration, etc. You're also paying them 24/7, not just for the times that the ambulances are actually making trips.

You also left out the cost of medical supplies and equipment, both of which need to be maintained and replaced.