1) Firefighters are NEEDED as rescuers for all kinds of emergencies. They need to be well trained as jacks-of-all trades and then have teams that master certain skills. They should be compensated well for their expertise. BUT $200,000 is ridiculous. There are physicians that don't make that kind of cash.
2) Paramedicine is NOT a skill to be practiced by firefighters only in true emergencies (i.e. attending in the private ambulance only when it's critical). Paramedics need focus, volume/experience to be great. They MUST be masters of their craft (and agencies should establish high performance standards)--and be compensated FAR more than current levels. There is a reason practicing physicians are not carpenters, plumbers and corporate CEOs all at the same time. It's virtually impossible to be experts at all of them. You'll be average at all of them. Firefighters should stick to rescue and be fantastic BLS providers. ALS providers should do it every time, all the time and get the bad-ass BLS providers back in their firetrucks for the next one. This increases resource availability and decreases response times.
3) Not everyone needs ALS within 6-8 minutes. Only a very small percentage need this and even then, it is a low percentage of those calls that result in clinically significant improvement in discharge outcome.
4) Yes, EMS is the catch-all. But it shouldn't be. Progression in establishing a mobile health care system should be pursued, but certainly NOT by the fire departments. This should be a branch of the public health system in cooperation with hospitals and private ambulances.