How can we structure society so as to take care of the basic needs of people?

This is a loaded question and an outgrowth of the communism question. And a result of my trying to think judiciously after some discussions with Republicans or libertarians. I’m not trying to promote the idea of equal access to wealth – although I might want to – but can we agree that an attempt should be made that no one starve, not receive medical care or be homeless in a rich country? Maybe that is too big a leap. If we are shooting for those goals, how can we achieve them? Or do we just not give a shit about fairness in society? Is it just dog eat dog, as it were?