I still have yet to see a rational reason why billing insurance would be bad. Also, it seemed from the article that it’s already how every Hatzolah other than Queens works. EMT’s are not paid on commission (if they’re paid at all) so the assertion that they would prioritize based on economics is ridiculous.
I’m inclined to go with apushatayid, though. Going by the article alone, it seems like they did something their posek told them not to do. I thought the article did a poor job explaining why the Rav or anyone took that stance, which is why it’s up for debate now. There must be something we’re missing here.