Of course they're not equipped for that. The military SAR guys are the ones that rappel into a crash site and see what they can do, stabilizing victims and lifting them out. What hospital in New York is equipped to go get crash victims out of upstate NY's remote areas?
That leaves nearly 40% survivable crashes. You want to just let them die? And in Canada, even 1/2 mile from the airport can take some time to find. I remember an R-22 crash a few years ago not far from a rural airport that took days to find. No one saw it take off, no one saw it go down. ELT didn't work. Heavy bush around that area.
Once again, I have to post this population density map to make the point that Canada is NOT the US:
View attachment 105049
Something like 80% of the population lives within 150 miles of the border with the US. That leaves a terrific amount of lonely space to crash in and it's usually fatal no matter what if you don't have an operable ELT. Even if you land the airplane with little or no damage. They just aren't likely to find you, especially if you're not exactly on a filed flight plan track. In BC alone there are something like 100 airplanes that have gone missing and never found. Once in a while someone stumbles on one of them.
I often told people to get on Google Earth and see what's out there in the way of roads or settlements, and see if you want to trust your ancient 121.5 ELT when flying across those areas. In fact, a Mooney, flying from the Okanagan in BC to Edmonton, didn't arrive. Searches turned up nothing at all. The pilot was following the highway, and presumably lost control in cloud in the Rogers Pass and spun in. The wreck was finally discovered ten months later by a medevac helicopter transiting the Pass, with the crew alerted to watch for that airplane. A sharp-eyed EMT spotted something and they went back and found it. It was about 160 yards off the highway. It's 121.5 ELT had broken loose and lost its battery. It worked when the battery was inserted. That's one of the sort of things the 406 was meant to fix.
https://copanational.org/tsb-cites-elt-issues-in-2017-mooney-crash/
And it's not just saving lives. It's providing closure for the families. It's minimizing the expense of the search, which can cost a million taxpayer dollars per day.