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You are here: Home / Anderson On Health Insurance / Can you hear me now

Can you hear me now

by David Anderson|  August 4, 20178:18 am| 78 Comments

This post is in: Anderson On Health Insurance

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One of the last things the Senate did before leaving town for August was pass the Food and Drug Administration (FDA) user fee reauthorization act by a lopsided vote total. This was mostly a house keeping bill. As part of the bill, there was a tweak to how the FDA regulates hearing aids.

The Boston Globe has the details:

As few as one in seven of the 30 million Americans suffering from hearing loss get hearing aids, and a major reason they don’t is the high cost of the devices, experts say. The average cost of a single hearing aid is $2,300. Most people need two….
Under current law, consumers in most states can buy hearing aids only from certified audiologists — professionals trained to test and treat hearing problems — or licensed hearing aid dispensers….
Food and Drug Administration bill that contained a measure written by the Massachusetts Democrat to allow consumers to purchase hearing aids without going through a licensed audiologist or other specialist.

This change was pushed by Senators Warren (D-MA) and Grassley (R-IA).

Is this a game changer?

No!

It is a marginal and incremental improvement to the US healthcare system and the quality of life for millions of people. The means of action is that it removes a barrier where economic rent is collected. There are numerous places in the US system where economic rent is collected which inflates prices and increases suffering. Knocking a few down every now and then is a solid start.

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Reader Interactions

78Comments

  1. 1.

    raven

    August 4, 2017 at 8:23 am

    Interesting, I bought some on Amazon that didn’t require a prescription and they weren’t effective so I sent them back. I now have really expensive Re-Sound aid that I got from the VA at no cost tome. They are better but they really don’t help all that much. Most people I know that have them don’t use them so I’m interested to see what difference this make.

    eta Hmm, so how will they know what range they need help in? Who will calibrate them?

  2. 2.

    Knight of Nothing

    August 4, 2017 at 8:26 am

    Hearing aids are truly one of the gigantic scams of our system. The technology used in a smartphone is far more expensive and complicated than a small speaker that fits inside one’s ear.

  3. 3.

    Chris

    August 4, 2017 at 8:36 am

    Can you hear me now

    Good!

  4. 4.

    ?BillinGlendaleCA

    August 4, 2017 at 8:42 am

    Huh? Speak up sonny.

  5. 5.

    raven

    August 4, 2017 at 8:44 am

    @Knight of Nothing: The “speaker” doesn’t “fit inside one’s ear”.

  6. 6.

    OzarkHillbilly

    August 4, 2017 at 8:45 am

    @Chris:

    Can you hear me now?

    WHAT???

  7. 7.

    raven

    August 4, 2017 at 8:48 am

    Shit fucking hilarious until YOU can’t hear.

  8. 8.

    Ohio Mom

    August 4, 2017 at 8:49 am

    I am always gobsmacked when I am reminded that Medicare doesn’t cover hearing aids. Being unable to hear makes you less safe all around, and really affects your quality of life. You’re out of it a lot.

    My MIL has hearing aids that she often misplaces, or doesn’t have fresh batteries for. Plus I don’t think they work all that well. We can’t tell if she is acting goofy because she can’t hear or because she’s lost a few more marbles.

    Is this one of those things where we are the only industrialized country that doesn’t do it?

  9. 9.

    raven

    August 4, 2017 at 8:57 am

    @Ohio Mom: I think a big problem is that folks often expect miracles from them. Mine are digital and I have an app on my phone that controls them. They do make hearing some things better like birds, rustling papers and car wheels on the road, but they don’t help that much in crowded settings. When expectations are not met folks have a tendency to just not use them.

  10. 10.

    OzarkHillbilly

    August 4, 2017 at 8:58 am

    @raven: I am half deaf. People laugh at me all the time. I laugh with them. Except in bars where there is so much noise I can’t hear them laugh.

  11. 11.

    raven

    August 4, 2017 at 9:00 am

    @OzarkHillbilly: I do worry about the isolation that comes with learning loss. You feel like a fucking moron always saying “huh” so often you just nod and drive on but it makes it less appealing to be in social situations. Add being sober for 26 years and it’s easy to be a hermit. . . or just fish. My issue here is that, if HA’s that have been with medical expertise are unsatisfying, what will buying them off the shelf result in?

  12. 12.

    Ohio Mom

    August 4, 2017 at 9:08 am

    @raven: An app on your phone to control your hearing aids? That is definitely beyond my 86 yo MIL. Plus, she’s always misplacing the phone.

    She does text though, when she has her phone in hand. That is a technology that has really helped her compensate.

  13. 13.

    OzarkHillbilly

    August 4, 2017 at 9:11 am

    @raven:

    I do worry about the isolation that comes with learning loss. You feel like a fucking moron always saying “huh” so often you just nod and drive on but it makes it less appealing to be in social situations. Add being sober for 26 years and it’s easy to be a hermit. . . or just fish.

    I seriously find this part of my deafness appealing. It makes it easier to just tune every body out, avoid all the social interaction, etc etc “LEAVE ME THE FUCK ALONE!!!!”. That says something about me and I’m pretty sure it isn’t good.

  14. 14.

    raven

    August 4, 2017 at 9:12 am

    @Ohio Mom: Here’s a link. You don’t have to use it, I rarely do because it requires bluetooth to be on and then it routes phone calls through the HA’s which I don’t like. I’m sure the VA doesn’t pay near what they retail for but they are still expensive. I just have to go to my VA account and click a butting and batteries and filters show up in a few days.

    resound.com/en-US

  15. 15.

    pamelabrown53

    August 4, 2017 at 9:12 am

    @raven: @11.
    My spouse bought her hearing aids at Costco, A doctor at the Mayo clinic suggested Costco. 2 for about $1400. They’ve made a big difference in her life. She too, was feeling more and more withdrawn.

  16. 16.

    raven

    August 4, 2017 at 9:14 am

    @OzarkHillbilly: Probably why we get along so well, , , we’s bros. I always battle with what caused my loss, no ear protection when firing all those weapons or the Dead’s wall of sound!

  17. 17.

    raven

    August 4, 2017 at 9:15 am

    @pamelabrown53: Yep, she I researched them that’s what I was going to do if the VA didn’t pan out. It’s hard to find in writing anywhere but if you served in country you get free HS’s and glasses service related or not. I went for the freebies.

  18. 18.

    artem1s

    August 4, 2017 at 9:17 am

    @Knight of Nothing:

    Hearing aids are truly one of the gigantic scams of our system.

    sorry, tell that to my mother and millions who suffer in silence as they lose touch with the world around them. She was missing out on conversations, having to suffer verbal abuse from family members who couldn’t abide having the TV or stereo turn up to a volume where she could understand, and generally sunk into a pretty deep depression over the loss of control of her own environment. Luckily she could afford hearing aids despite the steep price and non-coverage. And all this was happening shortly after my father died. The difference in the quality of life for her was significant. Hearing loss is a very real problem that we have some, imperfect solutions for. Those are going to get significantly better as the Boomers with more discretionary income age and there is a larger market to sell to.

    Businesses who operate in a shady manner does not mean that the whole industry is a scam or that the users don’t have a real need. Is the eyeglass and contact lens market an insurance ‘scam’ because we’re not all wearing RPGs? I’ve never understood why glasses and decent eyecare is covered but hearing aids not.

  19. 19.

    FlipYrWhig

    August 4, 2017 at 9:22 am

    @artem1s: I thought the point of Knight’s “scam” language was to spotlight the price, not the device itself.

  20. 20.

    Davebo

    August 4, 2017 at 9:22 am

    @raven: I need to look into that!

    My Dad is 65% disabled and got some expensive hearing aids from VA but I have no service related disability but would love free glasses and yes, one day probably hearing aids. I’ve got to look into what VA benefits I may have more closely.

    True story, the one and only time I needed the VA (get a copy off DD214) it was shut down during the Clinton govt shutdown.

  21. 21.

    Florida Frog

    August 4, 2017 at 9:26 am

    Mr. Frog loves his hearing aids and so do I. He had significant hearing loss from years on construction sites. We were struggling to learn ballroom dance because he couldn’t hear the beat properly. His audiologist diagnosed the frequencies of his hearing loss and with his blue-tooth aids he can hear normally. His tango improved overnight. There are settings for crowded rooms and for music and they help quite a bit but are not perfect. All in all, they are quite expensive but have contributed immensely to our quality of life.

  22. 22.

    raven

    August 4, 2017 at 9:28 am

    @Davebo: I found out about it on Hearing Aid’s Forum. I was read for info and read some posts by this really grumpy asshole who was an audiologist. After telling him to go fuck himself he reveals that he was a VA audiologist and a Nam vet and gave me the scoop. I was really skeptical but I did what he told me, register with VA medical, go through the exam process and then wait a bit. I did an I got em.

    Were you in country?

  23. 23.

    pamelabrown53

    August 4, 2017 at 9:30 am

    @raven: @17.
    Not a freebie; you served your country :-) .

  24. 24.

    raven

    August 4, 2017 at 9:35 am

    @pamelabrown53: Ha!! That’s rich.

  25. 25.

    raven

    August 4, 2017 at 9:36 am

    @Davebo: Look for information from Doc Jake, he’s still there!

  26. 26.

    Davebo

    August 4, 2017 at 9:39 am

    @raven: But I don’t need a hearing aide (yet).

  27. 27.

    Nicole

    August 4, 2017 at 9:40 am

    I don’t think hearing aids are a scam; I just think the causes of hearing loss are many and varied and we think hearing aids can compensate for more than they can. I’m glad they’ll be a little more accessible to those who could benefit from them.

    (My aunt and my mom, her sister, both had hearing loss, but for different reasons. My aunt’s was likely since birth, but she went from hard-of-hearing to pretty much deaf in her 20s, and my mom’s was due to a medication she was given as a teenager for a sinus infection- the damage was progressive, and she didn’t realize anything was wrong for years. Had she lived, she’d have been deaf by age 40.)

  28. 28.

    Cheryl Rofer

    August 4, 2017 at 9:42 am

    Yikes! My doctor recommended Costco, where I got an excellent hearing aid for $850. It is programmed to my particular hearing deficit and can be controlled from my smartphone. It automatically adjusts to varying environments, though, and I haven’t needed to mess with it beyond that. The screen for controlling it is very simple. I can hear MUCH better in restaurants, which was the only place it bothered me.

    The hearing test was as good as any I’ve had in a doctor’s office. I am very pleased with the results, although now the deficit in the other ear is more obvious to me. It was a joy to hear all the stuff I’ve been missing, mostly in terms of frequencies. My GP pointed out that brain pathways decay the longer you go with a deficit, and they don’t necessarily come back. The first few days I heard too much of lots of stuff, but now my brain has adjusted. There is also research that shows that hearing loss is associated with a greater risk of dementia.

    It still seems to me that $850 is pretty high for a simple piece of electronics. You can get a good laptop for less than that. I’m glad to see the legislation. Every little bit helps.

  29. 29.

    sam

    August 4, 2017 at 9:45 am

    This could be really helpful for marginal cases in particular, like my dad, who ABSOLUTELY INSISTS that his hearing is fine, even though we all have to repeat things several times to get his attention, and the TV has to be on a ridiculous volume whenever he’s watching it (to the point where I worry about my own hearing loss when I’m at their house.

    In “normal” conversation, he *is* perfectly fine, but that’s when you’ve already got his attention and he’s engaged.

    He is also a guy who insisted he had perfect vision well into his sixties, then went to the eyedoctor who put some glasses on him (not reading glasses, but actual, nearsighted glasses), and he was like “OMG this is AMAZING, EVERYTHING IS SO CLEAR”. He had the same revelatory experience after cataract surgery.

    He’s a pretty youthful guy for a 73 year old, and I can only hope to be as generally awesome as he is at that age, but if I (or my stepmom) can go into a drugstore and buy a set of simple hearing aids for him without forcing him to a doctor that he refuses to go to because that’s an “old person thing”, it could get Mr. rode-motorcycles-and-muscle-cars-for-decades over the hurdle of realizing that he does have some hearing loss.

  30. 30.

    MattF

    August 4, 2017 at 9:45 am

    I lost most of the hearing in my left ear several years ago– the ENT said it was (mumble mumble unilateral neurogenic idiopathic mumble mumble) so there was nothing do do about it. I tell people to sit on my right if they want me to actually hear what they’re saying. Generally OK without a hearing aid except for the noisy restaurant problem. Although I’d try one if it wasn’t too expensive.

  31. 31.

    PhoenixRising

    August 4, 2017 at 9:46 am

    This is huge news for the 1/4 of Boomers who already know they are losing some hearing. It’s also big for Deaf/HOH people of all ages because…hold onto your hats…insurance for pediatrics covers $800 per ear every 3 years in my state and that is the ‘after’ picture. Many states are less ‘generous’ in regulating access to hearing technology for children.

    Getting my kid hearing aids was cheaper for us than planning for her to be warehoused for the rest of her life, and we had the money, but a lot of families rely on a hearing aid bank. Children with poorly fitted aids tend to refuse to wear them, and as a result cognitively normal children are tracked into illiteracy and dependence for life.

    This is huge for the affected families, and that group gets bigger with every baby born Deaf to a mom who used opiates during her pregnancy. Deafness is not going away now that we’ve whipped most childhood illnesses that caused it–drug use during pregnancy is taking up where that left off, leading to a spike in need for medical and educational services for Deaf/HOH children

    Big fucking deal–really.

  32. 32.

    PhoenixRising

    August 4, 2017 at 9:49 am

    PS Parents of Deaf children fought like our kids’ futures depended on it (because they do) to get this into the ACA, and we lost that battle. I am grateful that Liz Warren put her skills where her rhetoric is to get it across the line.

  33. 33.

    jeffreyw

    August 4, 2017 at 9:57 am

    Next they can look into the CPAP scam.

  34. 34.

    MomSense

    August 4, 2017 at 10:03 am

    @Ohio Mom:

    Can we also just add dental care to what is considered health care? I’ve never understood the arbitrary separation.

    While we’re at it, let’s make vision care part of essential benefits.

    One body, one plan.

  35. 35.

    Barbara

    August 4, 2017 at 10:04 am

    When I bought my daughter hearing aids (which she stopped using after one year) I spent more than $4000. What really underscored the extent of the scamminess for me was that the audiologist gave us an indefinite supply of free batteries. Now that I consider hearing aids for myself, I have noticed that there are a lot of new technologies that seem to be available. They are advertised at being a fraction of the cost of traditional hearing aids, although I don’t know how effective they are. It’s amazing that the hearing aid monopoly has lasted as long as it has, whereas, eyeglasses were unmoored from closed professional regulation a long time ago.

  36. 36.

    Barbara

    August 4, 2017 at 10:05 am

    @MomSense: I agree that basic dental care should be part of every health plan.

  37. 37.

    Ohio Mom

    August 4, 2017 at 10:24 am

    @MomSense: Yes to dental — especially because dental infections can kill you — and yes to eye care and glasses.

    Also, let’s add lymphedema compression garments and other supplies while we’re at it. The lymphedema community has been trying to get them covered by Medicare for ages, with private insurance hopefully to follow.

    As I have mentioned before, it is a federal law that breast reconstruction be covered for mastectomy patients —
    and one type of reconstruction, using tissue moved from other parts of the body (stomach, hips, etc.) can run a quarter of a million. But you are on your own if own of the side effects of your breast cancer surgery is lymphedema.

    We live in a very weird culture.

  38. 38.

    Ohio Mom

    August 4, 2017 at 10:31 am

    @PhoenixRising: I did not know opiate use by pregnant women could cause deafness in their children. Interesting to know.

  39. 39.

    Mel

    August 4, 2017 at 10:32 am

    @PhoenixRising: This is a big step. An unremediated hearing deficit truly does impact all areas of a child’s development: academic, physical, and social. Kids who have hearing challenges are often very hesitant to wear ill-fitting, noisy, or readily visible hearing aids because of the high incidence of bullying that occurs.

    I had a student who would wear her hearing aid in classes where she sat surrounded by friends, but would take it off and take her hair out of the ponytail to hide the device’s absence from teachers in classes where she sat with strangers or near kids who tended to tease / bully others. Not surprisingly, her grades were mostly A level in the classes where she felt comfortable and socially safe wearing the hearing aids, and low C level in those where she did not wear the devices.

    She had gotten her devices through a donation program (cost was way too high for her to obtain them otherwise) and they were large and quite visible and tended to make shrill squeaks unexpectedly, making her feel very self-conscious.

    Next, we need to get dental care covered, for kids and adults. It amazes me every day that so many basics (correcting correctable hearing deficits and vision deficits with devices or methods most appropriate for the patient; having care to maintain or replace teeth so that speaking and eating are able to be done effectively and painlessly and dangerous infections are averted, etc.) are considered “non-essential” in this country.

  40. 40.

    Yarrow

    August 4, 2017 at 10:32 am

    Glad to hear about this. I see the hearing aids counter when I go to Costco and had wondered about all that. My mom got hers at the ENT’s office after testing by the audiologist.

    Hearing loss isolates seniors and social isolation is a big problem for that age group anyway. Glad to hear of some barriers to getting hearing aids being lowered.

  41. 41.

    Yarrow

    August 4, 2017 at 10:38 am

    @Ohio Mom: Yes, dental health impacts all parts of health. It’s bizarre that it’s a separate issue.

  42. 42.

    chopper

    August 4, 2017 at 10:39 am

    @raven:

    for some it does. typically in the behind-the-ear unit tho.

  43. 43.

    Wapiti

    August 4, 2017 at 10:48 am

    @raven:

    I do worry about the isolation that comes with learning loss.

    My FIL has pretty bad hearing (WWII Navy engine rooms, plus whatever else), so my spouse and I were reading about how to deal with it. One book said that loss of hearing is possibly worse than loss of sight, for communicating and avoiding social isolation. (I wonder if that’s true in the internet age). My wife used to call her parents weekly; now we use Skype, which seems to work a lot better because they can see us, maybe pickup non-verbal cues.

  44. 44.

    MomSense

    August 4, 2017 at 10:49 am

    @Ohio Mom:

    You are so right about that. The mom of one of my former students suffered with lymphedema.

    BTW, hope you were able to find a good cardiologist.

  45. 45.

    gvg

    August 4, 2017 at 10:50 am

    My mom has very expensive hearing aids that she rarely wears. She says thye are loose and she is afraid of losing them, especially outside. She loves to garden. I think they don’t actually help her as much as needed.

    I had an acquaintance right after high school who was nearly deaf and rather than asking every thing to be repeated louder in school, chose to fake her way through. she did get labeled as dumb too. she wouldn’t wear hearing aids. When I knew her her new boyfriend later husband was working on that issue, getting her to change her mind. I think she had picked up some lip reading to help fake her way through life. I hope school sustain the current anti bulling philosophy though I doubt they have it all solved yet. It’s amazing how many things are affected by bulling that isn’t even recognized.

  46. 46.

    Ohio Mom

    August 4, 2017 at 10:54 am

    @Yarrow: Ohio Dad is probably looking at heart valve replacement surgery before the end of the year. One pre-surgery essential we just learned about is a trip to the dentist to make sure there are no infections brewing.

    Eye care can be a Catch-22. Our insurance only pays for “medical” eye issues, not exams to determine if/what eyeglass prescription you need. But how would you know if you had say, glaucoma, if you never went for an eye exam, which wouldn’t be covered if the opthamologist didn’t find anything wrong?

    Other industrialized countries can’t be as nuts as us.

  47. 47.

    Ohio Mom

    August 4, 2017 at 10:59 am

    @MomSense: Thanks! Ohio Dad asked around and found a cardiologist he is super-impressed with. The doc spent a lot of time explaining everything and was very hopeful and reassuring.

    Now Ohio Dad is in the take-lots-of-tests stage. We are racing past the top end of the deductible.

  48. 48.

    Yarrow

    August 4, 2017 at 11:05 am

    @Ohio Mom: That’s a good tip. Oral health can affect so many things. I have a friend whose niece was financially not very well off and had a lot of unexplained health problems–fatigue, aches and pains, generally not feeling well. She also had a lot of dental problems. She finally got a job that had dental benefits, went to the dentist and they pulled several teeth. Amazingly all her unexplained fatigue and aches and pains went away. I doubt she’s the only one who has had that happen.

  49. 49.

    raven

    August 4, 2017 at 11:06 am

    @chopper: No, the tube from the amplifier and buds fit in the ear.

  50. 50.

    brendancalling

    August 4, 2017 at 11:25 am

    I need two hearing aids very very badly, so this is good news indeed.

  51. 51.

    MomSense

    August 4, 2017 at 11:28 am

    @Ohio Mom:

    Oh I’m so glad to hear that.

  52. 52.

    Uncle Cosmo

    August 4, 2017 at 11:34 am

    Thanks to various & sundry for the reminder to schedule an appointment with an audiologist. It’s long past time. (Intermittent tinnitis, plus I miss consonants & often cannot focus on whoever’s talking if there’s a lot of cross-noise.) Also for the hint about Costco & less-criminally-costly devices.

  53. 53.

    the Conster, la Citoyenne

    August 4, 2017 at 11:37 am

    Bernie Sanders was the only no vote? LOL.

  54. 54.

    Sloegin

    August 4, 2017 at 11:38 am

    Hearing aids are not a scam, the pricing of them most definitely is. I’ve got a Widex that I’ve had for about 8 years, gotten rebuilt, think I paid $1500 for it; My audiologist is pushing me to get a new one and I want the one I have. Widex doesn’t make the model in the US any more and I really don’t have $2k to drop. Looking online I found my Widex still being sold in India. 50 bucks.
    The current industry is designed around extraction of wealth from olds. for those of us who lost hearing when we were young, we’ve always understood that the medical device market is designed around creating economic suffering to people who need help the most.

  55. 55.

    grandpa john

    August 4, 2017 at 11:45 am

    @artem1s: The problem is that not all hearing problems are helped with hearing aids, but the companies will still sell them to you without mentioning this. My problem is fluid collection in the middle ear I was sold a 3600 dollar pair that helped very little, you had to open the battery compartment to turn them off no off/on switch, and a set of high priced batteries lasted less than a week even with them turned off. So this turned out to be a high priced lesson for me, and I still don’t wear them

  56. 56.

    germy

    August 4, 2017 at 11:49 am

    Anecdote from Martin Mull about his hearing aide. He had a small part on “Two And A Half Men”

    Okay, here’s what age will do to you. There was this scene where, in very short order, I’m supposed to be Charlie’s mother’s date. They want to fix me up with Charlie’s mother, and instead I show up at the house with my own date, this 22-year-old beautiful, beautiful young fashion model. A Miss Sweden kind of gal. And when the door opens, we’re supposed to be in this deep kiss and embrace, and she said, “Go for it,” and I said, “Okay!” And I’m feeling really good about myself, feeling, “Hey, I’m still young enough to do this, I can still be the leading man.” I wear hearing aids, and these hearing aids have little pre-recorded messages every now and then for you. Just as our lips meet, I hear in one ear—in a female voice, no less—the words, “Battery low!” [Laughs.] And no one else heard it, but to hear that message just as your lips are about to meet those of a beautiful young girl? It lets you know that, you know, you may have been too long at the fair.

  57. 57.

    germy

    August 4, 2017 at 11:53 am

    I love the idea of over-the-counter hearing aides, but I worry about harmful technology; the “As Seen On TV” crap that shows up at my local pharmacy. I read that if you’re wearing a cheap “amplification” device and something loud happens around you (like a passing ambulance or police siren) you could get your hearing further damaged.

  58. 58.

    glaukopis

    August 4, 2017 at 11:53 am

    I only need a hearing aid in one ear – a result of Meniere’s Disease – but the aid doesn’t help that much because the hearing loss from that is in the low frequencies and aids can’t really do much about it. I do notice an improvement with the high frequency loss which is common as we get older though. I had extensive testing while it was still covered by my employer’s good insurance, so don’t know what it would cost now, but 5 years ago I paid around $500 for the one. I have not noticed a real improvement in crowd situations (or meetings, which was one of my original motivations for getting one).

  59. 59.

    germy

    August 4, 2017 at 11:56 am

    Funny… the ad I’m seeing at the top of the page is “The Invisible Hearing Aid That Everyone Is Talking About!”

    People may be talking, but I can’t hear them in a crowded restaurant.

  60. 60.

    StringOnAStick

    August 4, 2017 at 12:00 pm

    I ended up with hearing g aides at age 50 and got used to wearing them. Too used to it, since I stepped into the shower twice with them and each event was a $400 repair. You can’t get them wet, including sweat. Now I tend to just use them for work and I should know better than that. Having one ear be deafer than the other means you can find quiet for sleep though.

    I’m an RDH and I need the HA’s because dentists tend to mumble into their masks and the general background noise is similar to restaurants, the least hearable places of all if you have hearing loss. And I agree that dental care is important for health; some of the oral disaster areas I’ve seen have definite health implications and untreated gum disease increases the risk of heart attack and stroke, among other bad things.

  61. 61.

    Milo

    August 4, 2017 at 12:01 pm

    I’m confused. So now people can buy hearing aids from people who aren’t trained to customize or fit them?

    Isn’t that like getting prescription eyeglasses from Some Guy?

  62. 62.

    Knight of Nothing

    August 4, 2017 at 12:03 pm

    @artem1s: my point is not that they aren’t needed — they *are* needed and are essential for many people (I myself have hearing damage and will likely need them sooner rather than later). My point is that the tech they use is cheap and readily available, and should not cost $2300 per ear or anything like that.

  63. 63.

    Knight of Nothing

    August 4, 2017 at 12:04 pm

    @Sloegin: exactly. Apologies if my earlier comment wasn’t clear – the scam is the price, not the device.

  64. 64.

    germy

    August 4, 2017 at 12:05 pm

    I don’t get the industry obsession with “invisible” hearing aids. I really don’t like sticking something tiny into my ear. I can’t even stand foam earplugs. I feel like I’m pushing earwax further into my ear canal.

    Anyway, don’t all the ear doctors repeat that joke “don’t put anything into your ear except your elbow!”

    I wouldn’t mind wearing some big thing that fits over my ear. Who cares?

    The younger generation enjoys all sorts of wearable devices. Maybe in ten or twenty years hearing aids will be big, brightly-colored things that cover the whole outer ear. There’ll be no stigma, because body augmentation will be a point of pride, rather than shame.

  65. 65.

    germy

    August 4, 2017 at 12:07 pm

    @Milo: I wear reading glasses that I bought off a rack at a dollar store. I probably wouldn’t be able to do the same thing for distance glasses, though.

  66. 66.

    Milo

    August 4, 2017 at 12:27 pm

    @germy: Well, yeah, reading glasses are like the OTC hearing aids already available, which help some people with extremely mild hearing loss. But the vast majority need earmolds made, and the device customized to their precise loss. Just like eyeglasses. This seems, though I haven’t read more, to basically allow your local Check Cashing shop to sell the equivalent of not just reading glasses, but prescription eyeglasses.

    The vast majority of hearing losses aren’t fixed by ‘Make everything louder in my ear.’

  67. 67.

    germy

    August 4, 2017 at 12:32 pm

    @Milo:

    The vast majority of hearing losses aren’t fixed by ‘Make everything louder in my ear.’

    I agree. And see my comment #57 about my concerns.

  68. 68.

    ? Martin

    August 4, 2017 at 1:20 pm

    Don’t overlook the role of OTC here. While germy’s point at #57 is very well taken, Apple and Cochlear just announced a new product partnership the other day:

    The system he was using came from a collaboration between Apple and Cochlear, a company that has been involved with implant technology since the treatment’s early days. The firms announced last week that the first product based on this approach, Cochlear’s Nucleus 7 sound processor, won FDA approval in June—the first time that the agency has approved such a link between cochlear implants and phones or tablets. Those using the system can not only get phone calls directly routed inside their skulls, but also stream music, podcasts, audio books, movie soundtracks, and even Siri—all straight to the implant.
    “While our devices have been built to support hearing aids for years, we found that the experience of people trying to make a phone call was not always a good one,” says Sarah Herrlinger, Apple’s director of global accessibility policy. “So we brought together a lot of people in different areas around the company to start investigating ways to make the process easier.” As she indicates, Apple’s accessibility team has been working for several years to support conventional hearing aids—an initiative whose results are made apparent by not only the dozens of hearing-related products in the App Store, but also a Hearing Aid Mode built into the iOS settings. It connects with hearing aids whose manufacturers have adopted the free Apple protocols, earning them a “Made for iPhone” approval. Apple also has developed a feature called Live Listen that lets hearing aid users employ the iPhone as a microphone—which comes in handy at meetings and restaurants.

    And further to germy’s point:

    Merging medical technology like Apple’s is a clear benefit to those needing hearing help. But I’m intrigued by some observations that Dr. Biever, the audiologist who’s worked with hearing loss patients for two decades, shared with me. She says that with this system, patients have the ability to control their sound environment in a way that those with good hearing do not—so much so that she is sometimes envious. How cool would it be to listen to a song without anyone in the room hearing it? “When I’m in the noisiest of rooms and take a call on my iPhone, I can’t hold my phone to ear and do a call,” she says. “But my recipient can do this.”

    Now, there’s two angles here. One, do you trust Apple as an OTC device provider to address germy’s concerns? While not all will, most will. Apple is very well regarded as a trusted player in the disability community. And many other companies will sit in a similar space – J&J or Bose or whoever. It doesn’t all have to be Ronco.

    The other angle is the kneejerk “Oh, sure, but Apple will cost you a fortune, because Apple”. But Apple isn’t actually selling anything here. If you already have an iPhone, you already have half of the system. The other half is Cochlear’s device which Apple helped design, however:

    Though Cochlear—which, according to its senior VP for research and development Jan Janssen, has about half of the implant market—is the first to use the system, Apple will offer the technology free to qualified manufacturers.

    Apple’s angle here is pretty straightforward. They want you to buy iPhones, and so giving away the technology to do this helps them even if they don’t charge for it. They’re adding value to an existing product to make it more desirable, without adding cost. This is one of the big problems with the rift between consumer and FDA approved products – it’s really difficult to get the benefit of sunk costs. A glucose monitor will need a battery and processor and screen and industrial design, distribution, and so on – all things that an iPhone already has and is probably better at in every capacity because these are the things Apple is expert at. So if you can turn that glucose monitoring into an app, you can add that functionality pretty much for free without having to duplicate all of the hardware. That’s going to be key going forward. Another example:

    These sensors are getting small and efficient enough to deploy for day to day use, and pair them up with your smartphone which can use GPS to get a large-scale sense of the environment along with increasingly impressive computational power (if you have a new iPhone there’s about a 50/50 chance it’s more powerful than your laptop), suddenly new categories of medically assistive devices can be brought to market for pretty low cost.

    Yeah, you still need the regulation there, but Apple’s convinced the FDA a few years ago to allow a different approach. Apple’s argument to the FDA was that they could do the testing more thoroughly and much faster than the FDA can, and that the FDA should allow companies with strong track records that are willing to partner with the FDA more broadly to release non-invasive medical products without pre-approval, but that the FDA will be able to demand that products from these partners be pulled off the market. Essentially Apple argued that their brand value was so great that putting out a harmful product would cause so much more damage than the FDA could cause to them. And the FDA agreed. There’s a lot of startups trying to get into this space (which people should rightfully be wary of) but it’s just a matter of time before there are other trusted names doing this.

  69. 69.

    ? Martin

    August 4, 2017 at 1:35 pm

    @germy:

    I don’t get the industry obsession with “invisible” hearing aids.

    The hearing aid industry is the largest application of 3D printing out there. It’s a HUGE competitive advantage for them, and that’s why they’re obsessed with it as it promises to both lower costs and make their product more appealing. Additionally, they know that non-consumption is their biggest competitor – people that don’t want to reveal their hearing issue and forgo hearing assistance. If they can make a product that allows image-conscious people to wear them, that’s a huge market benefit, and benefit for people as well.

    That’s mostly a solved problem now. It could benefit from some more refinement, but there’s no major invention really needed at this point – that effort is on the cochlear side. The real work is on the processing side of things, as noted in my previous comment, but even in that case, it can likely move to OTC as well. It’s just a matter of time before ML can walk a user through the process on their iPhone, doing more or less the equivalent of A/B testing through a wide range of hearing issues and solutions and then building the exact profile the user needs.

  70. 70.

    germy

    August 4, 2017 at 1:40 pm

    @? Martin: Interesting. I remember when I first read about Cochlear implants. The “science” writers made claims like “a deaf person got her hearing back!”

    But when I read further about Cochlears, the hearing restoration isn’t the same as normal hearing. It’s more like buzzing. Maybe the technology has improved? I didn’t know you could enjoy music that way. It’s more like everything sounds like a kazoo, from what I understand.

  71. 71.

    ? Martin

    August 4, 2017 at 1:54 pm

    @germy: It has improved, but there’s a lot of work to go. Here’s a pretty good description of the problem.

    It should be possible to make cochlear implants more music-friendly, says Les Atlas, a professor of electrical engineering at the University of Washington. But there’s a reason current models are so limited, he says.

    “There is no easy way to encode pitch as an electrical stimulation pattern,” Atlas says. Also, it takes a lot of computing power to encode something like pitch information in real time.

    As a result, even the newest cochlear implants provide very little information about pitch, Atlas says. To make his point, he plays a recording of a few piano notes, followed by a simulation of how those notes might sound through a cochlear implant. The simulated version sounds like the same note being played again and again.

    I am certain that Apple is working on this problem. They do have the computational power to do pitch encoding in real time in an iPhone and they’re now on the inside of this problem working on it. I’d be curious how the device I mentioned above handles music, because taking it straight from the music playing device without having to go through yet another DAC should help quite a bit. So while it may not be there yet, it might come pretty quickly.

  72. 72.

    chopper

    August 4, 2017 at 2:50 pm

    @raven:

    that’s typical these days, but i’ve worked in hearing aids, and receiver-in-canal tech has been around for a while.

  73. 73.

    mskitty

    August 4, 2017 at 3:41 pm

    Okay, now I am near enraged … I went to the audiologist attached to my ENT and the hearing aids were approx $6500 before insurance, about $3000 to me.
    They do help a lot, though – I can watch TV sitting with other people, understand people in restaurants – I discovered how much I depended on lip-reading!
    But I do HATE being taken advantage of!

  74. 74.

    PhoenixRising

    August 4, 2017 at 4:13 pm

    @? Martin:

    It’s just a matter of time before ML can walk a user through the process on their iPhone, doing more or less the equivalent of A/B testing through a wide range of hearing issues and solutions and then building the exact profile the user needs.

    My kid’s most recent pair of Starkeys were shipped from the audiologist we met through Gallaudet and set up in that way.

    What is interesting to me is that they really are quite highly customized. She recently asked whether her next pair could be Phonaks like the previous ones. This turned out to be a programming discrepancy, not a hardware one: because the new ones are set to help her decode speech better, they don’t mute background as well at 21mph. So she’s frustrated by not knowing how fast her horse is cantering. The hoofbeats are not a ‘speech’ sound! This was quite problematic last week as she had to ride in mud for the first time and the particulars of how the device is programmed became more clear to her.

  75. 75.

    Tom DeVries

    August 4, 2017 at 4:51 pm

    Oh, sure, you can treat all kinds of ailments yourself, just with Google and common sense. Who needs a doctor?
    A hearing aid is an expensive complicated tool. I have one. Paid a genuine expert audiologist to diagnose my problem and suggest the right solutions. His service includes coming back for a free checkup every six months. Ask my wife: money well spent.

  76. 76.

    BruceJ

    August 4, 2017 at 6:09 pm

    @PhoenixRising: They can have multiple programs for different settings, She should talk to her audiologist about that. Mine currently have 4: regular (which we’ve tuned for speech) ‘Party’ (which mainly focuses on voices right in front of me), ‘Music’ (which is pure amplification, no mucking about) and ‘Telecoil’.

  77. 77.

    BruceJ

    August 4, 2017 at 6:11 pm

    @germy: ROFL. My wife’s previous aids had a choice of voices, hers was a male with British accent that she nicknamed ‘Battery, James Battery’

  78. 78.

    BruceJ

    August 4, 2017 at 6:15 pm

    @StringOnAStick: Modern aids can be waterproof. Siemens makes a model that is waterproof to (iirc) 3M depth. The factory rep that helped my audiologist tune mine loved to show off their wireless data connector and water proofness by dropping them into a cup of water, then programming them. Check the IP code of the aids.

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