In time of trouble, you can turn for help to family, friends, neighbors, private charity, or government. In roughly descending order of efficiency and humanity.
Including government at the end of that chain is a noble attempt to make sure no one falls through the cracks--like the federal reserve as a "lender of last resort". The problem is that, like the federal reserve, the guarantee at the end of the chain changes the dynamics at the front.
We respond to a government guarantee to care for the old and infirm by not doing it ourselves. Why plan to care for your mother when the government will do it? Why support private orphanages when you pay taxes to support institutionalizing them?
The result is emaciated expectations of family, friends and neighbors, and sickly private charity. Government may be inefficient and inhumane, but it's cheap--spending someone else's money--and it's guaranteed. So it dominates the space. And when the other options die away through disuse, it looks like there are no other options. And all that's left is dependence on the state.
The idea that it's government care or no care is an illusion created by a couple generations of government dependence. I am convinced that our way -- institutions, beaurocrats -- is really the inhumane way to care for the poor. I want to get rid of it, not because I don't care, but because I do.