One goal of CivilizedSociety could be to provide a defined minimum quality of life for all citizens, regardless of that citizen's merit.  This could include for example, housing appropriate to climate, access to clean water, adequate food, clothing, primary and emergency medical care, means of communication and basic education.
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The MinimumStandardOfLiving is not the same as a LevelPlayingField, rather it serves as a "floor" to a playing field of arbitrary equality.  TheAmericanWay concentrates mainly on the LPF aspect.  Since no minimum standard of living is defined or enforced, citizens can "fall through the cracks".  

''They do even in societies that (loudly) claim to provide MSL.''

Can't win, don't try?  Some countries have certainly established societies with narrower and shallower cracks than others, and I would be surprised if making an effort to do so had nothing to do with it.

There are also those that choose to not live to the standards of the majority. Not all of those that choose thusly are sane, though some/many are.  ''It doesn't matter.  The issue is, if a person chooses to live at the MSL, are they able to?  --AndyPierce''