In our little town, decades before the current emergency rooms on wheels with trained EMTs or paramedics, ambulance service was free. The ambulance was very similar to a Cadillac hearse, except for the red light on top and siren. It was owned and operated by the local funeral home, and if you needed emergency transport to the hospital, it would be the undertaker himself who strapped you to a gurney and loaded you into the ambulance. I guess if the patient expired in transit, he'd just make a U-turn back to the mortuary. Anyway, it was an appreciated service, and I suspect something similar was very widespread throughout the country.