foolishness? It's been that way since you were in diapers!  

This 12 hr shift day is what you wanted.   So you can "maximize" your days off.   The schedule is actually the same scheduled hours either way. 

The Part 91 options are also for your benefit.   Flight schedules can terminate anywhere... ask an airline pilot or a GOM helicopter pilot about that.   The Part 91 actually gives YOU more flexibility.   The medcrews wanted to be considered paying passengers and lobbied Congress for that, so Congress gave them that.  Beyond medical crews now being considered 'paying passengers' requiring Part 135, nothing else changes.   They can be left behind so the pilot and company can continue to operate like any other Certificate Holder.   Even fixed-wing rules didn't change.  You think because you fly a helicopter, you are special in that category of duty/rest?   If it were really a big deal, the FAA would have required all Part 135 operators to consider their company crewmembes and employees "paying passengers" too, and demanded Part 135 rest requirements for them too.