I think that how often the amateur service is used is a primary consideration. No problem with the local hams helping out a particular public service event once or twice a year. If they need communictions support every weekend then it becomes a different matter.
If local hams help out a hospital with communications during a storm, no problem. If the hospital runs classes to get all their employees licensed so they can purchase and operate less expensive 2M HTs in lieu of getting commercial radios then there is a problem.
Same sort of thing with the search and rescue. If local hams want to help with communications, no problem. If search and rescue runs classes to get all of their team members licensed so they can use 2M HTs in lieu of purchasing commercial equipment, there is a problem.
At least, that's my opinion.