I agree, it is big, bloated, and inefficient. But probably the govt waste that bothers me is different from what bothers you. Massive government spending in the past has done amazing things: the interstate system is kind of mind blowing. NASA was cool. I want a new electric grid and nationwide high-speed rail, but that's never going to happen as a private venture.
I like the summary of the US as "an insurance company with an army":
http://voices.washingtonpost.com/ezr...insurance.html
But the root of that distribution isn't, to my eyes, the people we elect. It's the fact that we have given corporations an insane amount of power. There are countless instances of relatively reasonable people, when in a group, doing horrible things. A layer of abstraction between them and the results; shared responsibility; and it trickles down to "just following orders." I think corporations quickly get there. They tend to be evil simply because they lack basic moral sensibility.
So, yes, reign in the government; cut spending; get out of our homes and our personal lives. But the solution there is to stop pharmaceutical companies from defining how we view health, healing, and medicine; and to stop the defense industry from defining how we view the world.
I'm not saying that to suggest any grand conspiracy. To my eyes it's a natural product of a free market: there's no incentive to make healthcare efficient and affordable. There's no incentive to hold a reasoned view of the actual military threats that exist in the world, or how to fight them.
People with money will use that money to get more money. Pharm and defense are two massive industries, and it only makes sense that they will do what they can to continue to grow.