Hearing Aids: The Latest Political Hot Potato

I know, I know. You read Sound & Vision to learn about audio and video topics. It’s a welcome refuge from the political furor that has engulfed every other facet of our lives. But, of course, ultimately, nothing is immune from politics. So, let me ruin your day by telling you about the latest political hot potato: hearing aids. You heard me right. Hearing aids.

Hearing aids are big business. As Baby Boomers (finally) start to age, their ears need a little help. Specifically, 40 percent of those age 60 and older have significant hearing loss, and that doubles to 80 percent for those 80 and over. The average price for a hearing aid is $4,700, with some costing $8,000 or more. And those are real out-of-pocket dollars because Medicare won’t pay for it, and most private insurance companies won’t, either.

Hearing aids are regulated by the Food and Drug Administration, and a prescription is required to get one. Although it varies from state to state, generally consumers must consult with a licensed hearing-aid dealer. An audiologist or otolaryngologist takes the patient’s history, does a physical examination, and produces a comprehensive audiogram. When a hearing aid is prescribed, its audiometrics can be customized to optimally treat the patient’s hearing loss.

Personal sound amplification products (PSAPs) are an alternative to hearing aids; they are sold without a prescription and can be used to treat mild hearing loss. They range from junky $20 devices to $500 models that are essentially bare-bones hearing aids but cannot be called such. PSAPs are not medical devices and are not regulated. PSAP manufacturers such as Samsung, Panasonic, and Bose are eager to get into the more lucrative hearing-aid market.

The Over-the-Counter Hearing Aid Act of 2017 would allow a new class of “hearing aids” to be sold over the counter.

Elizabeth Warren (D-Massachusetts) and Charles Grassley (R-Iowa) have introduced a bill in the Senate that calls for a new class of hearing aids sold without a prescription; the same bill has been introduced in the House of Representatives. As its name implies, the Over-the-Counter Hearing Aid Act of 2017 would allow a new class of “hearing aids” to be sold over the counter. These devices would be considered medical devices and must meet FDA guidelines for safety and effectiveness, but you wouldn’t need a doctor to get one. A consumer would test her hearing using an online program or phone app, then pick a hearing aid that best fits the criteria.

Proponents of the bill, including PSAP makers, argue that current laws prevent consumers from getting the help they need. OTC hearing aids would help those with hearing loss and save them money. Much like using an optical chart on a kiosk at Walgreens to buy reading glasses, consumers could quickly and inexpensively remedy moderate hearing loss. For many people, a physical examination is not necessary, and nothing would preclude a consumer with more severe hearing loss from further seeking the assistance of an audiologist. The option of obtaining hearing aids without a prescription would benefit consumers.

Critics of the bill, including traditional hearing-aid manufacturers and audiologists, protest that hearing loss should not be self-treated, but rather requires a skilled professional. Proper diagnosis, fitting, and adjustment can be complex, and self-treatment would frustrate consumers and would waste more money than it saves. In some cases, for example, when it is caused by wax buildup, hearing loss can be reversed; in other cases, hearing loss is a symptom of a serious underlying illness. In either case, hearing loss should be treated by a professional, not remedied by a trip to a big-box store.

So, you decide: Over-the-counter hearing aids — potentially useful products for Americans that could save them lots of money, or medically ill-advised products designed to boost corporate profits? We now return you to your regularly scheduled, non-political Sound & Vision.

333hill's picture

great article. I have starky aids that cost me 6500 a few years ago and all kinds of hearing problems. Do you think I can use over the ears headphones with hearing aids/ My interest is at home listening to lps and cds, sacds, etc.


Billy's picture

I'm an RN and deal with a lot of elderly people. I have seen a lot of HAs in actual use, and it a'int pretty. These things are cheap thin plastic that break all the time needing expensive repair. Many elderly don't have the dexterity in their fingers to replace an over priced battery or even put the tiny things in their ears. Why they are so small is beyond me. At the age these things are needed, does vanity really come into play that much? And, don't even get me talking about the cost. Thousands per ear? I think we all here know that a decent set of ear buds or a small headphone is probably all that would ever be required. In the old days of the Soviet Union, elderly people were given essentially a pair of Radio Shack quality headphones with a cigarette package sized amplifier in their breast pockets, cost like 20 bucks, and worked quite well from what I have read. We could do something similar, especially with 30 years of electronic advancements.Plus, an elderly person can put on something larger much easier, a lot less likely to lose them too.(and even if ya did, the economic loss would be minimal. Back to batteries. Why no rechargeables? Every piece of electronics I own in that size range is USB rechargeable, so why do HAs have expensive and difficult to replace little round batteries? I am under sixty, yet my arthritic fingers really struggle to replace those things when people ask for help, most 80 year olds can't at all, yet they are the target audience for these. I will agree with one thing the Beltone people say, ear wax might just be the problem. I have removed a ton of it over the years out of many ears, but it is a taxing and long process. Inconvenient for people to have done, and expensive. Most MD offices hate to do it as it takes a lot of office time with varied results. An ENT specialist will usually have a machine that will do both ears in less than a minute or two, but that is really expensive. I have toyed with the idea of starting an ear wax cleaning store front in some strip mall, but soon realized that the red tape would be enormous.There is no reason why the government and special interests should have some simple types of health care so complicated and expensive, except that it is that way for their own good, not the general public. Health care could be a lot less expensive in this country if we were allowed to try a few new ideas like this. I think people would flock to my little strip mall store front to have those pesky ears cleaned out for say 20 bucks or something like that. Of course, that might cut into the over priced HA cartels bottom line and they would soon buy off enough politicians to make it go away. Our country needs a lot of reforming. So much over pricing, especially aimed at the elderly..like morticians for instance. Another subject, better not get started on that one. Okay, rant over.

jarango's picture

Any reader of Sound and Vision with hearing loss should check out the Bose "Hearphone". I've used hearing aids for 10 years, partly because I play in an orchestra (100 db+ in my seat in front of the trombones) and partly because of too much time in DC-3's in the 1960's. The Hearphones are by far the best hearing device for music (flat to 10K Hz and higher) and for meetings (extremely directional, if desired). Very adjustable with phone. Ugly (looks like a wireless earphone rig, with yoke around your neck) but better than any hearing aid I have tried, and I've tried many in search of one that accurately boosts music and can handle loud sounds. The Hearphones are not perfect (mics can overload at 95+ dbs) and takes time to adjust them, but otherwise a bargain at about $450.

Tommy Lee's picture

My Mother went to a very reputable Doctor of Audiology, had her hearing tested, and was sold a very expensive, tiny in-ear device. I was not present, just my sister, who just wanted to make Mom happy. Mom was in a nice nursing home and already had a progressive nerve condition that made her hands shake and prevented her from doing any delicate work. She used the aid successfully ONCE. She couldn't insert the device correctly, and neither could the nurses or aides. It was non-returnable.
I don't have a dog in this hunt politically, but anything that would save people money that would otherwise go to such a sophisticated ripoff artist is fine with me.