There’s a bit of a dispute between Arnold Kling and Tyler Cowen as to the merits of a populist nationalist movement like the Tea Party as a practical tool for reducing the volume of federal spending. I think this bit of enterprise polling from Rasmussen counts as evidence in favor of Cowen’s anti-populist hypothesis:
Most voters nationwide (53%) believe any changes to Medicare or Social Security should be approved by a vote of the American people. The latest Rasmussen Reports national telephone survey shows 29% do not think such changes require a national vote, while another 17% are not sure. Women are more supportive than men of requiring a vote before making changes to these entitlement programs. Republicans believe far more strongly in the need for a vote than Democrats and voters not affiliated with either party. [...]
Budget documents provided by the Obama administration show that in Fiscal Year 2009 50% of all federal spending went to national defense, Social Security and Medicare. But only 35% of voters believe that the majority of federal spending goes to these areas.
Basically, the federal government spends money on programs that are popular, which makes reductions in spending politically difficult. In practice, populist mistrust of government seems to me to make it more difficult to grapple with the issue. If people were generally inclined to trust government officials, then people saying “reducing the rate of long-term growth in Medicare spending is necessary to prevent the country from going bankrupt” then the public might support reducing the rate of long-term growth in Medicare spending. But insofar as people are convinced that all the money is going to (presumably non-white) moochers while feckless politicians try to steal from deserving seniors, veterans, and soldiers then operationally it’s going to be very hard to persuade people to take specific steps that save non-trivial sums of money.
In principle, it should be possible to do a lot of the necessary cutting by essentially taking fat out of the health care system. But any such move is bound to be controversial and people tend to assume that anything which reduces Medicare cost growth must be bad for seniors. Good luck winning a plebiscite campaign on some kind of wonky efficiency-improving proposal dreamed up by OMB.