Maybe I'll read this Rousseau social contract thing, maybe I won't. But just because I need to eat doesn't mean my food is given to me. It costs money. Sure, if the people who sold McDonalds their buns, burgers, ketchup etc... gave them to them for free, and if the contractors who built their facilities did the work for free and if the utilities were granted to the building for free and all the employees worked for free then I could drive up to McDs and get me a free big mac "whenever" I wanted (giant line of people also wanting free big macs not included).
People do donate enormous amounts of their own time and money to all sorts of causes including healthcare. I donate money to some healthcare related organizations (komen, MS). Yes, I donate to both of those because my close friends and family have been affected by them. So, in that way I am a bit selfish. However, my statement that if you can't afford it you can't have it is meant to say that you can't magically create free supply to meet demand. It just doesn't work that way unless the ENTIRE supply chain is made free. That sort of utopian "social contract" is as close to impossible as I think anything could be. What is described as greed or selfishness is what motivates most of society to go do whatever job they do. That's how they earn the money to pay for the stuff they want out of society. Whether that's dollars or a barter system, if you didn't have people who were driven to excel by the desire to acquire money, society would not be able to function. Would you want a doctor who was being paid $7.25 an hour and had just a highschool education? No you'd want one who was smart enough to make it through med school, residency etc... which is years of really expensive training. Would you want him to be so accessible to people that you had to schedule your appointments a year in advance?
Fire departments and police departments are a service that I'm happy to contribute to as a local service. It is annoying that people who don't provide any part of the funds to run those departments can end up using them freely and therefore make it cost me more in taxes to support. But my local community being protected overall by fire and police services has a direct, positive impact on me and my family, so at least for my current location, I've deemed that acceptable. I don't know that I could see a privatization of those services being successful in my lifetime. Same goes for roads. I don't think your average DoT does a GREAT job of maintaining public roads, but we're reliant on them now and to change it would be devastating. But every public service comes at a cost just like every private service. You can hope to rely on some people having the means to pay for all people to use them, but when the all is greater than the some can even afford, then it doesn't matter how mean it sounds, it's just a fact that eventually someone's going to lose out. The longer that is artificially sustained, the more someones are going to lose out. If you can't afford it, you can't have it. Whether that's an individual or an entire nation. If you can't afford it, you can't have it.