One of the great ironies of the past 40 years is how socialist nations adopted aspects of capitalism and capitalist nations adopted elements of socialism.

The definitions that caused so much global tension in the ’60s and ’70s have softened as both sides took up elements of each other’s economic philosophies.

China, for instance, is rapidly learning how to do capitalism. And there is even less doubt that the United States has gradually added more and more social benefit programs over the years.

The transition results in awkward dilemmas, particularly in our delivery of expensive health care services.

One of those came up last week when the Sun Journal reported that federal officials plan to go nationwide with a competitive bidding system for home medical equipment purchased through Medicare.

That’s a big market and it includes everything from respiratory equipment and supplies to wheelchairs and scooters.

After running a pilot program in several metropolitan areas, Medicare officials want to bid all that equipment and then limit the number of suppliers to the lowest bidders.

Doing so could save the government $25.7 billion and Medicare beneficiaries $17.1 billion between 2013 and 2022.

That would be a big win for federal taxpayers as well as senior citizens who must share in the cost of purchasing such equipment.

Runaway Medicare costs, which reflect ever-more-expensive medical care, may be the biggest single threat to our nation’s fiscal stability.

Billions of dollars worth of benefits have been promised to recipients, while we have not cut expenses or raised taxes to pay for them.

The system is unsustainable. So, what’s not to like about cutting costs?

Plenty for those invested in the current system of selling this equipment, local and regional device dealers.

Two industry groups — the American Association for Homecare and the New England Medical Dealers — oppose the idea, calling it flawed, inefficient and dangerous.

The capitalist in us all says open bidding by large companies that can bring economies of scale to bear on prices is a good thing.

Witness the tremendous impact Walmart and Amazon.com have had on prices. 

On the other hand . . . Yes, there is always another hand.

This could just as easily be seen as a government contrived end-run around an existing market system that will harm established businesses.

Two trade groups favor legislation that calls for adopting a “Market Based Pricing” system that would divide the country into many small areas for bidding and “ensure that bidders with no local presence cannot overwhelm local bidders with a vested interest in the market.”

Which plan is capitalism? Which is socialism? One, proposed by the feds, calls for wide-open bidding. The other, proposed by business, seeks bidding restricted to existing “vested interests.”

The same dilemma arose when Congress, under a Republican president, adopted the last large expansion of Medicare: The drug program.

Congress ultimately sided with the vested interests, in this case drug companies, and specifically ruled out a unified bidding system that would have saved billions for seniors and taxpayers.

It will be interesting to see how Congress squares capitalism and socialism — and the critical need to cut federal spending — this time around.

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The opinions expressed in this column reflect the views of the ownership and the editorial board.