That would include paying teachers salaries and paying companies to pave roads and clean the city, pension, subsidies for various reasons including lots and lots of fraud lol
In Japan I think it's so high because of nationalized insurance, which in theory could be a great thing, but in reality means old people can pay $6 to get an ineffective lazy massage and go every day just to socialize. The government will pay another $25 to cover the rest of the fee.
Well, I don't see that as a negative thing. If the government can support the citizens by way of providing incentives , paying pensions and subsidies to make things cheaper, that a great development.
As for fraud, it's a global phenomenal affecting every government and officials.