Former Iowa Congressman Jim Nussle says the government won’t be able to handle expanded health care coverage for Americans without reducing expenses in the whole health care system. Nussle was a guest host this morning on the "Squawk Box" on CNBC.

"The choices are so tough," Nussle said.

Nussle suggested the hardest decisions may come in Medicare, the government’s health care system for the elderly. According to Nussle, the nation’s 50 million seniors and the rest of the adult population are going to have to become more conscious of what they’re spending.

"I think you probably will see people continue to be concerned about this whole issue of cost control of health care. It’s out of control," Nussle said. "Unless you can bend that growth curve somehow, there’s almost no way the government can have a bigger footprint in this and actually make it work in the long term."

However, Nussle sees Americans in a sort of "what have you done for me lately" mindset and that makes cost-cutting in any level of government difficult.

"They’re not saying, ‘Reduce the costs in my backyard,’" Nussle said. "They’re saying, "Reduce it over across the street in somebody else’s backyard.’ That’s what’s going on."

Nussle has formed a D.C.-based consulting firm called "The Nussle Group." Nussle was the 2006 Republican nominee for governor, then he served as President Bush’s budget director. Nussle served eastern Iowa for 16 years in congress and rose to become chairman of the House Budget Committee.

During this morning’s turn as a guest host on "Squawk Box" on CNBC, Nussle got to ask questions of guests, including financial guru Warren Buffett who was the last guest on this morning’s show.

Radio Iowa