Hard to reduce deficits substantially without much bigger policy changes: https://en.wikipedia.org/wiki/Triffin_dilemma
That said, Medicare and other entitlements is where my mind went too as I was reading. Negotiating drug prices is a good step in this direction by the current administration.
https://www.usatoday.com/story/news/local/2024/08/16/10-pres...