Resisting thread jack...fighting urge...can't maintain..aaahhhh!
By back door I didn't imply nefarious. I meant creative/imanagive. Obviously, co-opting an existing helo operation was the easiest least expensive way to stand up what was at the time essentially an experiment.
How can it be better? The obvious is cost. That is why bid it out and see how the state stands up. But it may be made better in other areas as well. Competition fosters innovation. For every government contracting horror story you can bring up there is a government failure in execution cost or fraud. Full accountability in government? Really?
Don't look now but many traditional government services thought the eternal purview of government has been privatized. We have a private fire department in my state. Several cities with traditional fire departments still contract for medical or ambulance service. Even in the UK all their rescue and some LE helo operations are contract. I think Canada may be going that way too.
Clearly the MD system is top rate and it appears the peeps like it. So I can't imagine anyone being afraid of open competition. It should stand on its own.