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In Europe, they treat patients at the scene, whereas the US extracts the patient and transports to nearest hospital (and stabilize inside the ambulance). These approaches require very different types of equipment and manpower.
In Europe (the Netherlands at least) they don't treat patients at the scene, unless it's something very minor. They always stabilize the patient, them transport them to a hospital.
Either way, you don't need mega ambulances for either
No, there are major differences. The classic example was Princess Diana, who spent the last hour of her life mere yards outside a hospital with an emergency room that could have probably saved her life. French protocol, as you say, is the "stabilize" the patient before moving, whereas in the US the EMS would have done a scoop-and-run.
Yeeaahh, on the Diana thing.
Scoop and run is a great way to kill a patient on the way to a hospital
https://www.express.co.uk/news/uk/10321/Diana-s-life-could-have-been-saved-says-doctor https://print.ispub.com/api/0/ispub-article/12892
Scoop-n-run vs Stay-n-play has been a long-running debate, with conflicting data and studies.
European ambulances can do everything our ambulance can do, they are just more space efficient.