According to cbpp.org in 2015 the federal government spent $938 billion on "Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and Affordable Care Act (ACA) marketplace subsidies", in addition to spending another $362 billion on safety net programs, as well as massive outlays for Social Security, defense spending, and assorted subsides or tax credits for all sorts of institutions and corporations. It almost goes without saying, that in order to divvy out such funds, massive bureaucracies on top of other convoluted bureaucracies have been created in order to maintain and sustain such over the generations that the welfare state has been in existence. The elephant in the room, though, is if the whole purpose of helping out specifically the poor, the elderly, and the disadvantaged, is to get essentially money or its equivalency into their hands, why shouldn't the system be streamlined and simplified so as to achieve such, especially in consideration, that all citizens in America, are identified through their quasi-ID card, which is their social security number.
There isn't any good reason why current governmental policies are set up with all sorts of hurdles, endless forms, confusion, inconvenience, and social embarrassment in which often those applying for benefits, must kowtow to bureaucrats of all sorts, that honestly, are siphoning from those in need, the benefits that they need and are entitled to by law, by taking an unfair and undeserved piece of their pie, by their employment as well as because they are the "official" arbiters of who gets what and why. A far better policy is to cut out the bureaucracy or cut it down substantially, and give the benefits to the people as directly as possible, in a form that allows them to utilize their benefits efficiently.
This means, that when anybody comes of age, that they are entitled to by the welfare state that has already been instituted within this country, to health, food, and shelter benefits, of which those benefits should thereby be considered to be a form of income for those people receiving such, so that, for those that are gainfully employed at a good wage, they would not be entitled to any benefits, and if they still availed themselves of benefits because they are of age, they would be effectively taxed 100% of such on their tax returns, whereas those that earn little or nothing, or have crossed a certain senior age, would receive their full benefits directly into their debit card or its equivalency, in which, should they find employment, or make some additional income, would see their benefit percentage reduced on a sliding scale, until such time as their income reached the national and/or State published median in which case their entitlement to benefits would be vacated.
A welfare state set up in this format, would entitle all citizens to the basics of their citizenship, in a far more efficient style, which would effectively eviscerate the welfare bureaucracy as we know it, freeing up billions of dollars to go to the very people that have need of them. In addition, the true cost of this type of governmental assistance would be borne by the people, especially in the sense that the more inclusive society becomes in helping and aiding others to enjoy life, liberty, and the pursuit of happiness, then the less aid these people will need to avail themselves of, for this is in theory, the "united" states, consisting of a "united" people, which is one nation, indivisible, under the aegis of God.