1. The skyrocketing cost of college really does create enormous problems. I'm assuming the family profiled are either doctors or lawyers, because otherwise those $32K/yr payments would only last for a few years at most. (I paid $40K/yr in loans for both my wife and I when I got my first real job, but that happened exactly once... and we weren't buying BMWs or Land Rovers while we were doing it.)
2. Pensions, which have largely eroded away in the private sector, were enormously valuable. The switch from pensions to 401(K)s without a significant corresponding increase in pay is one of the most significant ways in which the real value of take-home pay has declined in the past 30 years.
But everything else could be cut in half, probably without even noticing:
1. $42K/yr on childcare is au pair/"elite" preschool money.
2. $5,000/mo mortgage is pretty high, even for a family of four in a high CoL area.
3. Three vacations a year @ $6,000 a pop. I take more than three vacations a year, but most of them are closer to $500 for a family of 4 (camping/backpacking). The expensive ones never get higher than $3,000. There's "getting away from work for a while" and then there's "flying a family of 4 to Paris a few times a year". The former is not a "luxury" especially for a high stress job, but the latter definitely is.
4. Luxury cars. For $10K they could buy a perfectly functional new car (which would last 10 years) every year. The only way that these are not "luxuries" is if they're required for work.
5. $3K on clothing per year, every year. That's high even for someone who has to dress nicely for work. Yes, nice suits are expensive, but they also last a long time. And your kids definitely don't need "meetings with high value clients" clothing.
6. $1K/mo on "children's lessons". I know how this happens, because I charged up to $100/hr for private tutoring while in grad school. But it's entirely unnecessary. It really is OK for your kid to get a B in an AP course. And if they need $100/hr quality tutoring for every course they're taking, the real world is going to be a rude experience. Also, $1K/mo on "children's lessons" while the kids are also young enough to need childcare is absolutely insane.