It’s not a speculation that without the state/formalized help people will get left behind, it’s demonstrated in the US’s past and in countries that don’t have welfare systems in place today. When federal/state systems don’t provide enough help in the US, especially in times of natural disaster, we see neighbors come together time and time again via donations, food pantries etc., I don’t think that has disappeared at all.

The most attractive function of state led help is outsourcing specialty aid and organizing aid such that it’s not sporadic. With technology we should be able to better organize locally in the near future and move away from top down systems, at least as a precision supplement.