You misunderstood my question. Many ALS systems operates with 1 EMT and 1 paramedic on the truck. If the patient requires no ALS interventions, the paramedic drives, and the EMT is in the back with the patient. If they require ALS, the EMT drives. if it's borderline, usually the EMT drives and the paramedic does the stare of life.
Fire/EMS here, that's how we do it in our system. However our department is pushing to get a lot of the EMT-B's to AEMT for the reasons mentioned above about assisting in ALS procedures, drugs, etcs.
I'd also say a majority of the calls that end up "ALS" are more so for pain management and comfort measures that aren't necessary to save life or limb.