ABOUT THE AUTHOR: James “Spider” Marks, a retired U.S. Army major general, was the senior intelligence officer for the 2003 liberation of Iraq and the former commanding general of the U.S. Army Intelligence Center. He currently serves as the director of geo-political intelligence for Academy Securities, a New York-based veteran-owned bank.

In the global competition for economic and strategic dominance, China has made one thing abundantly clear: it is not content to play fair, and it is not waiting for permission. The Chinese Communist Party has invested heavily in gaining control over critical supply chains, especially in the health care and pharmaceutical sectors. The United States cannot afford to help them do it.

Yet that is exactly what the Centers for Medicare & Medicaid Services (CMS) is poised to do with a new rule that would expand its competitive bidding program to include essential medical supplies like urological and ostomy products, as well as continuous glucose monitors (CGMs). On the surface, this may appear to be a routine effort to reduce Medicare spending. In reality, it threatens to accelerate China’s control over the U.S. medical device market, undercut American innovation, and compromise the health and dignity of millions of patients.

I spent my career understanding how nations compete — not just with weapons, but with economics, technology, disinformation and supply chains. And right now, CMS is on the verge of handing a strategic advantage to our greatest geopolitical rival.

When CMS selects suppliers through its bidding program, it awards contracts based almost entirely on price. That sounds good in theory, but in practice it creates a race to the bottom. The lowest bidder wins, and often that means turning to offshore manufacturers who can churn out product cheaply while sacrificing quality.

Nowhere is this truer than in China, where government-backed factories can produce enormous quantities of disposable medical supplies at costs no American company can match. If CMS adds these highly specialized internal-use products to its bidding system, we should expect Chinese manufacturers to flood the U.S. market with low-cost catheters and diabetes monitoring equipment, pushing out domestic suppliers who cannot survive on razor-thin margins.

That is not just a trade issue. It is a national security issue. We learned during the COVID-19 pandemic what happens when we depend on adversaries for masks, gloves and ventilators. Do we really want to extend that same dependence to critical urology products that cancer survivors and people with spinal cord injuries rely on every single day? And instituting competitive bidding for CGMs — cloud-connected, real-time medical devices — would give China access to sensitive health data of millions of Medicare beneficiaries.

This is not an abstract warning. I have seen firsthand how China operates. They do not play by our rules. They subsidize exports, manipulate standards, and corner markets with the goal of eliminating U.S. competitors. Once that happens, their whole of government control pricing, access and innovation.

Which brings me to another point: innovation. The United States has long led the world in developing safer, smarter, more effective medical devices. That leadership depends on private companies being able to invest in research and development. If CMS forces these categories of products into a price war, the incentive to innovate disappears. Why spend millions designing the next-generation catheter or glucose monitor when the government will only reimburse the cheapest product on the list?

This is not just a policy miscalculation. It is a strategic mistake with long-term consequences. American patients will lose access to technologies that could improve their comfort, independence and quality of life — not because those technologies don’t exist, but because the system stopped supporting them.

What makes this even more troubling is that the broader policy direction of the administration is moving the other way. Through the use of Section 232 tariffs and other tools, President Donald Trump’s administration has launched a serious effort to onshore medical manufacturing and reduce U.S. dependence on foreign suppliers. That effort should be applauded. But CMS’s proposal undercuts it. You cannot claim to support medical independence while simultaneously creating government policies that push more production overseas.

CMS should reconsider this rule. Protecting taxpayer dollars is important, but not at the expense of national security, economic competitiveness, and patients’ well-being. We should be supporting American manufacturers who play by the rules and invest in innovation, not undercutting them in favor of foreign companies that view our health care system as just another market to dominate.

This is a time for alignment between our health policies and our national priorities. It is not too late to get this right.