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monroe county air ambulance is free to residents. I have no idea what "commercial revenues". It sounds like a way better system than what most of the rest of the country has. 

No Out-of-Pocket Costs for Monroe County Residents

There are no out-of-pocket costs for County residents who use the life-saving service. In the past, private air ambulances in the Keys have charged County residents tens of thousands of dollars in out-of-pocket costs for transport to mainland hospitals.