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I’m not sure how true this is. Most times people complain about government spending it seems to relate to corruption, cost disease, and regulatory costs: Broadband programs that provide access to ~0 people for billions of dollars, bridges that cost 100X what they should, hospitals needing 10 administrators for every doctor etc. All of these are executive issues. The complaints about the actual literal entitlements ordered by Congress usually come up as complaints of vote buying, and regardless aren’t the core of the problem.
Those could literally all be true without caveat, and it wouldn't matter in the budgeting sense since those may seem like big numbers in absolute terms but are proportionally very small compared to entitlement spending. It doesn't matter of bridges 100x or even 1000x more than they 'should' if the budget is spending thousands times more on entitlement spending than on bridges.
To wit- according to the Biden administration earlier this year, the US has $40 billion allocated to spend over 5 years on bridges. By contrast, the combined Medicare, Medicaid, and Obamacare spending in 2024 is $1.67 trillion, and expected to rise to 3.1 trillion by 2033.
Put another way- 5 years of all bridge spending is less than 3% of one year's medical spending, and shrinking. You could make that $40 billion 10x, 100x, or even 1000x more efficient, but no matter how efficient you spend 40 billion it's a drop in the entitlement spending. Sure, you could argue that there are savings to be made there... but then you're not going into the discretionary budget administration, you're going to the automatic entitlement spending, which goes to the laws rather than the executive administration thereof.
Part of that's just baked into demographic politics.
When the Americans legislated Social Security in 1935, FDR signed a law that authorized payments for those 65 or older when the average American lifespan in 1935 was... 61 for men and 65 for women, according to a quick google search.
Today, social security can begin between ages 62 and 70 depending on your preference of payout amount... when the average American lifespan is about 75 for men, and 80 for women.
It fundamentally doesn't matter in a budgeting sense how efficient you are at executing the discretionary programs if the entitlements previous created on the assumption that less than half of people would live long enough to see them are instead expecting to pay for more than a decade. When you start adding in medical spending, which costs increasing with age, you're adding more. This is an issue of law and what the legislators deem is the appropriate entitlement, not administration of that amount. No matter how much you save on the executive side- and it can be very good to have more efficiency there!- it's not the central or determinative issue.
Is the average lifespan in 1935 one of those situations where its mostly just a higher rate of infant mortality?
No, this is life expectancy at age 20. People in the past didn’t die in their forties very often, but they did die younger than we do today.
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Two arguments here:
1.) Government spending: consider that the massive efficiency issue applies not just to bridges, but to nearly all government spending of any kind. While bridges alone are a small cut, it’s significantly more expensive to spend 10X or 100X for many different things.
2.) The issue goes beyond government spending to include government cost. Cost includes the expenses that are offloaded to the private sector, many of which are executive in nature. Rolling back a wide swath of administrative regulations could massively increase private wealth and save the public fisc indirectly. This also applies to the healthcare spending that makes Medicaid so expensive. That 10X multiplier is there as well (more than in most industries really.) Cut medical regs, increase doctor supply, etc etc.
The administration will have trouble with this politically though, since the second type of cost saving doesn’t show up in a straight “spending in 2022 vs spending in 2026” analysis
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