As a nation we motivate people to work hard and try their best. We establish a system in which the gov does all it can to ensure that justice is done by all. We provide the land of opportunity.
Then we recognize that even in a land of opportunity some will fail. We do not leave them to die in the street. Every person who makes that claim should be ashamed of themselves. It is not being advocated by anyone worth listening to.
Then as a nation we offer a network of methods of paying for, borrowing, and giving to those who are in need. A true lessaiz fair approach in which no action at all taken by anyone to shape the form that it takes would not be best. But nameless bureaucrats can't do it either. And just balancing the two is not right either. We don't need half of one and half of another. We need bureaucrats to do what they should do and we need the people of the nation to do what they should do - these are different roles not just a degree of how much of a role.
Our leaders cannot spend our money on objects of charity but there is no reason that they cannot inspire and lead. Citizens and leaders alike can shape a system in which charity (which is already exercised in the US more than in any other country on earth) becomes such an ingrained aspect of our national character that these issues become non-issues. State government can set in place the mechanism by which giving becomes so easy and painless and beneficial that just about everyone would participate and all with a need would be helped. The amount of people in need is not as great as some would have us believe. There is plenty of money to go around. Fifty dollars per person per month would pay for all medical public aid. that is a pittance. If Americans stopped giving on average 2% of what they earn and started giving 10% and if those who give nothing gave something then we would be awash in money. In fact, in some ways we already are. There are a zillion charities out there that collect millions of dollars for cats and the promotion of the arts. There are people who want to give but they don't know to whom to give. Can you name one charity that exists to pay for the medical needs of those without health care? It is hard*. Partly because the need is actually small and partly because that has not been a part of our national debate.
* I am thinking of the Ronald Mcdonald house but it does not pay for medical needs it pays for families to stay with sick children. Then there is Muscular Dystrophy foundation but they don't offer treatments they provide research and camps. Etc.