I am from a 3rd world country. I think I understand them quite well.
For the USA, it is different than for 3rd world countries. Our deficits kill us because our debts are nominated in foreign currency. So, when we make payments on our debt, the money leaves the country.
For the USA, the debt and deficit are local. They are denominated in the local currency. So, when you pay them, the money stays in the country.
It is the husband owes money to the wife. In our case, it is you owe money to your in-laws. Who hate you.