>Healthcare makes up the lion's share of that spending;

I heard US healthcare, rather famously, spends more per capita than any country in the world, despite still being rather terrible. Maybe the solution is actually reforming it in an European way (including universal free healthcare)? Your other points are very interesting to me, especially negative feedback loops of austerity - I never thought about that before.

Yes the US could save a ton with a more efficient healthcare system. Additionally we have shockingly high costs for basic infrastructure as compared to other developed nations which could also provide savings if we could streamline that.

For the economic impact of austerity there has been a lot of good scholarship about this recently. Check out Austerity in Crisis?: A Narrative Review of Its Economic, Social, and Political Effects in Times of Crisis https://arxiv.org/abs/2510.10449

Yup. It’s full of waste, inefficiency, and pocket lining.

Fixing the healthcare system might be harder than fixing the budget at this point