You're throwing a lot of things out here, but they generally fall under being either (a) subjective, (b) deliberate policy choices by a democratically elected government, or (c) emergent properties of deliberate policy choices by a democratically elected government
Ultimately, if the people of this country don't want government spending on the sick and homeless, then it's not a decaying and illegitimate government, it is a well functioning and legitimate government as decided by a cruel populace.
Not to say the the government is perfectly legitimate, I could write an essay on issues with the way our government is structured and how certain design choices diminish citizen's representation in the government (for example: gerrymandering, first past the post electoral college allocation, and the near-permanence of effectively arbitrary state lines). But even the sum of these do not make our government illegitimate.
> it is a cultural crisis which is very hard to fix
I can agree on that much atleast.