The current fight to protect those profits is a microcosm of what you can expect to see if a larger effort to rein in health costs ever gets going. The defenders of the status quo won’t say that they are protecting themselves. Instead, they’ll use the same arguments that the medical equipment makers are using — that a change will destroy jobs, bankrupt small businesses and, above all, harm patients.

“This is small compared to what broad health care reform would look like,” Kerry Weems, the top official at the agency that runs Medicare, told me, “and you can see the reaction.”

The current system of overpaying the manufacturers dates back to 1989, when Congress adopted a “fee schedule” for durable medical equipment and allowed any company to sell the equipment at the official price. Soon after, the fee schedule became a target of would-be budget cutters, including officials in Bill Clinton’s administration and promarket Republicans like Representative Joe Barton of Texas.

This year, Medicare officials began accepting bids for 10 different products in 10 metropolitan areas. Starting with the low bidder and moving up the list — with a separate list for each product in each area — the officials selected enough companies to meet local demand and then some. The median bid among those winning companies became the final price. It was 26 percent lower on average than the current price, suggesting that competitive bidding could ultimately save Medicare $1 billion a year and patients $200 million or so in co-payments.

Unless the House bill becomes law — it would delay the start of any new bidding program for 18 months — the system will spread to 70 more areas next year.

So what about the equipment makers’ various complaints?

On close inspection, they’re pretty flimsy. My favorite is the notion that the new rule will force some companies to go out of business — which, indeed, it may. That’s sort of the point. After all, should taxpayers really be propping up any equipment makers whose survival depends on artificially inflated prices?

The most sensational charge is that a reduction in the number of suppliers will leave patients without access to oxygen machines, wheelchairs and other equipment. Certainly, Medicare will have to keep an eye on this. But remember that the government will still require that each metropolitan area have numerous suppliers for every product.