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Notes -
When Congress wants to cut discretionary spending, discretionary spending gets cut. (Obama-era sequestration was the most recent example). Even Moldbug agrees that the bureaucracy is effectively accountable to Congress*, should Congress care to exercise its power. And in the specific context of non-defense discretionary spending, Congress routinely do care to exercise that power. Discretionary spending isn't bankrupting America, entitlements are. See for example the charts in [this report] showing overall discretionary spending growing slower than the economy over decades, and barely keeping pace with inflation in the decade leading up the the pandemic.
The reason why cost-cutting politicians fail is that entitlements (and old-age entitlements in particular) grow faster than they can cut discretionary spending. You don't need shock-and-awe to cut discretionary spending, which is all Musk is doing so far. If Musk makes a serious dent in Medicare fraud (which he hasn't even started trying to yet, and won't be able to do by grepping lists of payees for woke keywords) he will save far more money than he could
Incidentally, in countries that haven't become pensioner-gerontocracies, you can really cut spending (including the equivalent of entitlement spending) the normal way. Canada and Sweden both cut spending by 7% of GDP in the 1990's, in both cases all that was needed was an electorate which cared about deficit reduction (which the US electorate claims to). The problem in the modern day (not just in the US) is that there are a lot of pensioners, and they vote. And the experience of the UK from 2010 through Brexit is that if you try to cut everything else faster than the welfare-state-for-the-old grows due to population aging, things start falling apart.
* In the sense that Congress can control budget, and has the ability to punish individual Deep Staters who defy it in a way the President does not because being criticised by name in a Congressional committee report is career-ending for a senior career civil servant.
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