NEW YORK — A former Bush administration official says the current level of uninsurance among U.S. residents is unsustainable.

Some form of health reform is likely to occur soon because the system is so unstable, but the two most significant questions to ask about reform are “‘How much can we afford?’ and, ‘Are we willing to limit ourselves?’” Michael Leavitt, who was U.S. Health and Human Services secretary from 2005 to early 2009, said Tuesday at LIMRA International’s annual meeting.

The United States is already too heavily in debt, and lenders such as China already are questioning whether we can repay what we owe, Leavitt warned. That raises questions about what role the government can play in providing health care for most Americans, he argued.

“Because we can, does that mean can we afford to do it, and will we do it?,” he asked. “What is an American entitled to by virtue of citizenship?”

Leavitt predicted health care reform will place “a substantial number of additional people in Medicaid.” In addition, he said, “there will also be an end to medical underwriting. Medical conditions won’t select people out” of insurance.”

“Congress hasn’t a clue as to how to do that, but it will move forward,” Leavitt predicted.

Leavitt said, however, that liberal Democrats face serious obstacles to enacting the health care programs they seek.

“It’s required by their DNA to overreach,” Leavitt said. “Now the Democrats will seek everything on their agenda they have dreamed of in the past 12 years.”

Leavitt said the Republican Party is in too much disarray to put up an effective fight.

Instead, he said, “it’s the public that will be pushing back.”

Because 2010 is an election year, Democrats are under pressure to get something done soon, Leavitt said.

“We will see a bill before Thanksgiving,” Leavitt said. “In early December, that’s when the fun begins. That’s when congressional constituencies will start playing hard ball.”