The difference is the degree of correspondence of benefits to taxes. In socialized medicine, there is no correspondence at all. With fire protction, there is a degree of correspondence. If you are homeless, and have nothing to protect, you pay nothing in real estate taxes. If you own a large home, you have a great need for protection, you pay for it.
Certainly, there is an argument that can be made that the wealthy benefit from national defense and interstate commerce, and other government infrastructure, more than the poorest classes. But for healthcare, a millionaire would not benefit from a national health care system any more than the poorest citizens, who might not pay any tax. Indeed, the millionaire, is probably more likely to eschew the public health service and purchase private health care at an incremental cost.
But you are right, for many social programs, the principle is the same as communism, from each according to ability, to each according to need. Which is why we must always weight the structure and scope of such plans carefully.
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