Medicare's plans to bring competitive bidding to durable medical equipment procurement actually will reduce competition and limit access to needed wheelchairs, oxygen tanks and other vital equipment, a group of suppliers say.

They also believe that the program, set to begin locally in less than two weeks, will end up costing more after big suppliers grab a larger and larger market share, freeing them to then raise their prices.

"You wind up with a government-created oligarchy," said John Shirvinsky, executive director for the Pennsylvania Association of Medical Suppliers, yesterday in Green Tree.

Currently, patients are able to choose among suppliers who meet Medicare's fee schedule.

For most suppliers, Medicare represents 40 percent to 50 percent of their business, Mr. Shirvinsky said. If the competitive bidding program goes into effect, "nine out of 10 people in this business are going to be forced out of business," he said, because they won't be one of Medicare's approved vendors.

The competitive bidding program, part of the Medicare Improvements for Patient and Providers Act, was to go into effect a year ago, before Congress stepped in. Medical suppliers are hoping they can persuade Congress to delay it again.

Proponents say competitive bidding will bring down costs, both for the program and for beneficiaries who pay a portion of the costs.

But suppliers argue that durable medical equipment represents only 1.6 percent of the Medicare budget, so savings would be minimal.

Lucy Spruill, director of public policy and community relations for United Cerebral Palsy of Pittsburgh, said the competitive bidding program would, for example, greatly reduce the number of suppliers for power wheelchairs.

"Right now, the waiting list for a wheelchair is three to six months," she said. "Reducing the number of suppliers will make that wait even longer. If you don't have a backup chair -- and insurance won't pay for that -- you can be bedridden for that period of time."