OPINION:
For disabled veterans, courage in the line of duty ought to be rewarded with dignified, compassionate medical care post-discharge. Yet for too many injured soldiers, signing exit papers means entering a flawed health care system that systematically undermines patients’ health, independence and long-term stability.
Although the Trump administration has taken promising steps to improve medical facilities, strengthen hospital oversight and extend access to care at the Department of Veterans Affairs, a parallel policy change at the Centers for Medicare & Medicaid Services — the expansion of competitive bidding to include urological and related supplies — quietly threatens veterans’ access to high-quality medical equipment.
Of the 300,000 Americans living with spinal cord injuries, roughly one-fourth are veterans. I count myself among this group. On Nov. 2, 2003, the Chinook helicopter I crewed was shot down near Fallujah, Iraq, killing 16 of the 37 people on board, including three close friends.
I survived the crash, but I sustained a severe spinal injury that left me with cauda equina syndrome, loss of sensation, impaired bowel and bladder function, and weakness in my legs.
In the aftermath, I could not walk or stand, and the future was uncertain in ways no briefing ever prepares you for. Through rehabilitation, determination and family support, I slowly regained mobility, earned a college degree and eventually went on to work as a safety officer at Boeing. Like many other wounded veterans, I rebuilt a productive life, but that recovery did not erase the daily medical realities of a service-connected injury.
Early after my injury, I was instructed to reuse catheters, a decision that appeared driven by cost containment rather than clinical best practice. As a result, I developed frequent infections and came to accept them as an unavoidable part of life.
Even when supply quantities improved, the infections continued, and it became clear through painful trial and error that the assumption driving many procurement policies — that all products are effectively the same — is dangerously wrong.
Today, managing my condition means using sterile intermittent catheters at least six times a day along with daily bowel care products, and the specific catheter I use is not interchangeable with cheaper alternatives. Differences in design, such as tip configuration, flexibility and coatings, often determine whether I remain healthy and self-sufficient or end up back in an emergency room.
The wrong catheter can damage tissue, cause scarring and significantly increase infection risk, while the right one can prevent those outcomes entirely.
That lesson became brutally real in 2024 when a urinary tract infection combined with the flu pushed my body into septic shock. I spent 10 days in the hospital and paid more than $100,000 for emergency care alone, not including rehabilitation afterward.
Sepsis left me with memory loss, speech difficulties, reduced mobility and months of recovery, and by the end of that year, I retired — not because I lacked the will or ability to work but because preventable complications had permanently changed my capacity.
The expansion of competitive bidding directly threatens that fragile balance by narrowing options in the name of short-term savings. When government contracts prioritize lowest cost above clinical suitability, manufacturers reduce product lines or leave the market altogether. It’s a shift that distorts the health care supply chain well beyond Medicare, and it inevitably affects availability within the Department of Veterans Affairs too.
The result is one-size-fits-all medicine imposed on people whose injuries and medical needs are anything but standard.
Moreover, this approach is fiscally backward. Restricting access to appropriate supplies increases overall health care spending; it doesn’t decrease it. Preventing infections costs far less than treating them, while hospitalizations, IV antibiotics, home health services, lost productivity and caregiver strain quickly compound.
Disabled veterans have already accepted risk, sacrifice and long-term consequences in service to the nation, and we should not now be asked to surrender our health or independence to satisfy a spreadsheet or procurement metric.
Congress and the administration must ensure that strong safeguards are built into the competitive bidding program, including robust medical necessity exceptions, clinician-driven decision-making and explicit protections for specialized supplies.
Veterans and Americans with disabilities deserve health care policies that prioritize readiness, accountability and long-term outcomes, not systems that push vulnerable people toward preventable medical crises in the name of illusory savings.
• Gerald Santos is a retired U.S. Marine Corps and Army National Guard veteran who served 18 years. After being wounded in Iraq and sustaining a severe spinal injury, he earned a bachelor’s degree and worked as a safety and health manager before becoming an aviation safety officer at Boeing. Now retired, he is active with the Paralyzed Veterans of America and brings lived experience to veteran and disability advocacy.
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