Without employer subsidized health care it is a difficult thing. Even with that, for example, while my current employer does not require me to contribute out of my paycheck for healthcare premiums (a rarity nowadays, was much more common back in the 70s), my previous employer did and for a plan a non-Mustachian who does not understand how math works, they would pay about $3,000-$4,000 in their contribution for premiums (usually about $140/week for family coverage). Or you can move to a high deductible plan, which takes the employee portion down to about $40/week. Yes you have a higher deductible but if you add in the premium difference in a well structured program the high deductible plan could save the typical family about $1,000/year at any claims level, so I could be totally healthy or have a heart transplant and I'd still have money with a high deductible plan.
Long term care is one thing I struggle over, so I pray for something that just takes me when I get sick, like my grandfather who was fine and then just died in his sleep of a heart attack one night. I hate to think of the burden on my family otherwise, but I must admit I have not looked at the long term care policies to see if they make sense. My grandmother is currently in assisted living so I understand the cost through speaking with my parents. They are currently funding that for her through savings she had and she was the head of a corporate cafeteria as her job so no college education. They were also immigrants from Communist bloc so they knew how to save, probably better than a lot of Mustachians, so not sure how typical this would be, but it does show that they found a way even on a meager income to save enough. She is turning 95 this year and the facility she is at is about $8,000/month and quite run down but likely typical of most. For many others (my wife's father is the example I'll use), they do not have enough, they work through savings and then Medicare pays for the facility but you need to deplete everything you own to get there. And then it is a Medicare facility which is not always great and typically has a long waiting list. They were lucky in that a bed opened up in one very near his home, so his wife could easily visit (17 year age difference so she is still able to be on her own). He has since passed, but I think that situation is more typical, in that people do not have savings and it defaults to the social safety net.
Public school eliminates the under college costs for everyone who is not full of the belief that somehow a private education is always better. It is better at creating pretentious snobs, but I've seen a lot of private school kids that are dumb as rocks. The student is important. Inner city and rural school districts certainly present a problem, but many solid suburban school districts exist around every major city. It does usually place you in a housing situation as you describe, but this goes back to the LCOL space talked about a lot on these boards. I was born and raised in Chicago. Everywhere there is as you describe. Insane property taxes ($15,000 for a typical 2,500 sq foot 4 bedroom) and high costs (I sold a house like that for about $300K back in 2005, they are higher now). I know live in a city in Ohio and have a very similar home on a bigger piece of land that I bought for just over $200K and may less than $5,000 in property taxes, for what I would say is a better quality of life. Much better park districts, flourishing arts and culture and everything is less expensive from groceries to homes to sales tax. This is in one of those "good" school districts you talk about, one of the best in the state and also well rated nationwide.
For college you can impact that as well. Again, Ohio has the largest number of colleges of any state. In state tuition rates cut over $20K per year off of almost any tuition bill. Sure you might need to explain to your child the reality that virtually no employer not on Wall Street or Silicon Valley cares which school your degree is from and fight against the culture to attend some overpriced school with a lackluster placement rate and academic program and that just breed more of those pretentious snobs talked about earlier is not what they need. Northwestern is a good example of that.
Hope that helps understand how we survive here in the land of abundance.