Belts and Metaphors

Krugman says "Lose the Belt".  Kinky, sorta?  So what's the difference between a government and a family tightening its belt?

When a family tightens its belt it doesn’t put itself out of a job. When a government tightens its belt in a depressed economy, it puts lots of people out of jobs; and this is a negative even from the government’s own, narrowly fiscal point of view, since a shrinking economy means less revenue.

I have beef with his metaphor comparison, especially in the Greece example.  A family not doing so well slashes spending on inessentials, but shouldn't postpone (serious) medical care and other (essential) big expenses, nor quit their jobs and reduce their incomes.  Austerity implies cutting everything, but I don't think that has to be the case.  The government need not put itself out of a job.  However, there are certainly many aspects of the government's spending habits that could be done more wisely.  As conservatives say (but rarely actually mean), cut the fat.