Apparently there are unincorporated areas that do not have fire service from the county but you can buy fire service from the nearest city's fire department. If you do not have fire service the firemen come and watch that the fire does not spread from your property to the neighbours who have service.

This ends up just as you would expect. The poorest and most indigent go without, and then there's death threats, newspaper coverage, the works. You wonder why people are permitted to make themselves wards of the state because if your house burns down your biggest savings vehicle is gone and you are homeless and a burden on the public pocket.

Similarities with medical coverage are incidental.