Every day across America, children with spina bifida, adults with spinal cord injuries, and seniors with debilitating illnesses rely on catheters to perform one of the body’s most basic functions safely.
For years, my Louisiana-based company has helped many of these medically vulnerable people stay healthy at home.
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Most people never think about urological supplies like catheters. But for people who cannot urinate on their own, they’re as medically necessary as insulin or a wheelchair. Getting the right product — and getting it on time — can be the difference between stability and a trip to the emergency room.
That’s why a little-known Medicare policy moving forward in Washington is deeply concerning.
The Centers for Medicare and Medicaid Services is preparing to expand a “competitive bidding” program to include urological supplies like catheters. The idea is simple — award contracts to a small number of companies offering the lowest price.
But what looks efficient on paper could create serious problems in the real world.
These products are not interchangeable commodities. There are more than 1,300 catheter variations on the market, with differences in size, flexibility, coating, and design. For many people, it can take a lot of trial and error with doctors and medical equipment companies to find the specific product that fits their anatomy, mobility, and medical condition.
When catheter users are forced to switch products or companies, complications can follow quickly.
Complex catheter-associated urinary tract infections are among the most common reasons catheter users end up hospitalized, which is costly and difficult to treat. A poorly matched product — or even a disruption in supply — can increase the risk of infection, pain, and loss of independence.
The people most affected are likely to be those least equipped to navigate these disruptions: seniors, people with disabilities, and families caring for medically complex children.
What’s most worrying is that this policy doesn’t just threaten products. It threatens the local care networks wrapped around them.
Community-based medical equipment companies do far more than provide products. In many cases, we function as extensions of overburdened urology clinics. We help our customers avoid crises before they happen. We teach them how to use products safely, troubleshoot problems, coordinate with doctors and caregivers, and check in when something seems wrong.
That kind of support keeps our customers healthy and out of hospitals.
During hurricanes and power outages, we have sometimes been the only catheter company still operating in parts of southeast Louisiana — personally delivering supplies to shelters and evacuation sites because catheter users cannot safely go without them.
Consider the experience of one of our customers, a mother raising twins with spina bifida. The children suffered through repeated infectious and medical setbacks because they didn’t have catheter systems that met their needs. Their mother constantly worried about whether they’d end up in the hospital. But after they received safer catheter systems, the twins got sick less often, made fewer trips to the doctor, and got the chance to simply be kids again.
In addition to safety, one of this family’s biggest challenges was functionality and independence. Because the boys use wheelchairs, they need a closed system catheter appropriate for their mobility needs but were initially given a straight-tip catheter instead — forcing their mother to carry urinals and even improvised containers while away from home.
Or consider the experience of a school-aged girl whose recurring infections and catheter complications made everyday life humiliating. She dreaded going to school. She became increasingly isolated from other children her age. Only after finding the right products and consistent support was she able to regain confidence, stability, and a sense of normalcy at school.
That kind of local support cannot easily be replicated by a distant national contractor managing patients from a call center hundreds of miles away.
Yet the structure of this new bidding program effectively favors large, national companies with existing infrastructure and multistate licensure, creating barriers for many community-based companies. Under the current design, 92% of medical equipment providers will be excluded from the program.
As these companies disappear, end users won’t just lose businesses — they’ll lose the freedom to choose the products that fit their needs, comfort, and dignity.
This also means fewer choices in companies and the loss of trusted relationships and personalized support.
People could lose businesses, jobs, and community-based healthcare infrastructure built up over decades.
Ironically, a policy intended to save Medicare money could ultimately cost more. When individuals lose access to the right products and support, they don’t simply adapt. They get sick. They visit emergency rooms. They are hospitalized with preventable infections and complications — all of which are far more expensive than the supplies themselves.
FLYING ICUS ARE ON LIFE SUPPORT — THIS MEDICARE REFORM IS THE CURE
There is still time for Congress and Medicare officials to reconsider this competitive bidding program before real harm is done.
For the people who rely on these supplies every day, this isn’t about government contracting. It’s about whether they can stay healthy, remain independent, and live with dignity in their own homes.
Micheline Stephens is the owner of PCG Medical in Metairie, Louisiana.
