Besides being illogical (i.e. it's bad to eliminate waste), this exemplifies the problem with change. Any time there is a ANY constituency that is rendered worse off, no matter how justified it is, it is nearly impossible to effectuate change because the affected group screams bloody murder.

But, wouldn't you? More importantly, shouldn't you? If the people in your government are doing something that is not in your best interest then you SHOULD speak up against it. After all, the word "representative" is based on the word "represent". If they are not representing my interests to the government then I should make that known.

If I have ailment X and a bill is being pushed that pulls funding/ assistance away from ailment X, then I should make it known that I am unhappy about it. What if it is now guaranteed that I will die from ailment X? You're saying that I shouldn't kick and yell about it? I'm about to die!

However, if it is also helps people with ailment Y, Z, I, J, K, and L, then it is the government's job to recognize that maybe I am less important to the bigger picture. If enough people will be negatively impacted to the point that I will not be reelected, then maybe it doesn't truly benefit my constituency as much as I think it will.

Of course all of this is in an ideal world without accounting for the power of advertisement funding and the fact that most of the voting population isn't well educated about the issues.

A great deal of jobs in US defense are completely bureaucracy and make-work programs in disguise while the political discourse makes it sound like our soldiers are so underfunded they're marching into battle with muskets and bayonets.

A ton of people in government related jobs only have equivalent roles in jobs at equally large and capital inefficient bureaucracies.

> A great deal of jobs in US defense are completely bureaucracy and make-work programs

Obamacare was actually a make-work program for taxi drivers, who were needed to take all those poor people to and from their medical appointments.

Unless there was a single-payer system that didn't tie healthcare to employment and provided basic cover for everyone.

That doesn't solve the problem of the growing politicization of healthcare, especially given new life extending tech and augmentation, and it may make it worse in some ways: Year 2090 and an elderly bureaucrat can afford to be more productive than a sick impoverished child, who gets the funding?

Basic cover is provided for everyone.

Individuals can then purchase separate private insurance for optional health procedures and for faster elective care.

Australia's healthcare system works on a similar model. Everyone gets basic free cover, but waiting lists for elective surgery can range from weeks to months.

If you optionally pay for private health insurance then you can get better, faster treatment, including for elective surgeries.

In your hypothetical 2090, the sick impoverished child gets their basic needs taken care of by the basic cover, and the elderly bureaucrat gets his life extending tech and augmentation paid for by the private insurance he's been paying in to his entire working life.

Once the sick, impoverished child recovers, they can return to school, graduate, get a good job and pay in to private insurance so that by the time they are elderly they can also afford life extending tech and augmentation.

Broken window fallacy.

https://en.wikipedia.org/wiki/Parable_of_the_broken_window

Edit: Which is not to say those impacted won't need assistance moving on to other things. But, cutting the fat should be a net benefit to society.