I think you've got you head in the clouds, which is better than up your backside, but not by much.
Quite simply, insurance reimbursements are not going up, they're going down. Adding a statistically relevant number of mid level providers in field roles would be financially ruinous to any EMS organization. This isnt going ot change, at least not for the better and still remains the most significant reason why we aren't advancing as fast as we'd like. There simply isnt enough money coming out of the faucet to sustain a significant increase in the cost of doing business. Perhaps, maybe, possibly, some day, in a galaxy far far away, we'll see a jump in reimbursement when we finally bend the industry over and make an EMS degree a requirement for licensure; but to speculate that 10 or 20 or 50 years in the future you'll see a predominantly mid level/paramedic staffing configuration is preposterous.
If nothing else, its complete overkill. You dont need to be an NP to do my job. If we were to get into a serious full scale treat and release type of system, they would have value; but hauling nana from the manor to the ED as an NP? Who would take that job? Who's going to go through all that schooling to still have to get up at three am and stair chair a 300lb person down three flights because their cellulitis isnt getting better?
No sir, I think you're dead wrong.