Don’t Make Us Beg

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Gael Hannan
June 14, 2016

It’s the kind of news that makes the hard of hearing heart beat faster.

No, there’s been no proclamation of National 50% Off Hearing Aids Day.

No announcement of a little pink pill that will make damaged cochlear hair cells spring back to life.

No scientific proof of a twice-daily mantra that will calm the neurons firing off tinnitus cannons in our heads.

It’s more like a climate change event, with the barometer rising in the world of hearing health care.

On June 2nd, the National Academy of Sciences, Engineering, and Medicine (NAS) issued what is considered a ground-breaking report: Hearing Health Care for Adults: Priorities for Improving Access and Affordability.  A powerhouse expert committee, comprised of members from all stakeholder groups, assessed the state of hearing health care, its affordability and accessibility for adults in the United States. The resulting study includes 12 recommendations that, if implemented, would bring hearing loss out of the shadows as a major and critical health and social issue. It would make it easier for a person with hearing loss to find and use high-quality, affordable services, technologies, and supports.

According to Brian Taylor’s recent article on HearingHealthMatters.org, responses from hearing health stakeholder groups have been varied, but they are united in saying that “the report makes hearing loss a national priority”.

The Hearing Loss Association of America (HLAA) strongly supported the recommendations in a statement: “They clearly emphasize that the individual with hearing loss – the consumer – should be the primary focus in the provision of hearing health care. The findings in the report touch on almost every aspect of hearing health care, underscoring the fact that managing hearing loss not only requires far more than the technology of hearing aids, but also involves family and society as a whole.”   

 

Bravo! Bravo!

 

The Recommendations:

  1. Improve population-based information on hearing loss and hearing health care

  2. Develop and promote measures to assess and improve quality of hearing health care services

  3. Remove the Food and Drug Administration’s Regulation for Medical Evaluation or Waiver

  4. Empower consumers and patients in their use of hearing health care

  5. Improve access to hearing health care for underserved and vulnerable populations

  6. Promote hearing health care in wellness and medical visits for those with concerns about their hearing

  7. Implement a new [FDA] device category for over-the-counter wearable hearing devices

  8. Improve the compatibility and interoperability of hearing technologies with communications systems and the transparency of hearing aid programming

  9. Improve affordability of hearing health care by actions across federal, state, and private sectors

  10. Evaluate and implement innovative models of hearing health care to improve access, quality, and affordability

  11. Improve publicly available information on hearing health

  12. Promote individual, employer, private sector, and community-based actions to support and manage hearing health and effective communication

As a consumer advocate with hearing loss, these statements thrill me with their possibilities. I am, however, just a bit concerned about #7.  I don’t believe that everybody requires the full-on hearing device with a hefty price tag. But while the OTC option is tantalizing, I also believe that anyone seeking hearing help should have some degree of professional evaluation. How do we balance this?

My other problem is that this is an American report and, although a member of HLAA, I’m Canadian.  This report doesn’t fully address the reality of hearing health care delivery in my province or country. So, after gleefully jumping up and down for a couple of minutes, I thought, “Who’s reading this in Canada? And how are we going to get the same sort of pot-stirring report here?  Who will step up?”

However, The Lancet, the renowned general medical journal, responded to the report, saying in part: Although initially developed to inform hearing health care in the context of the USA, the report has global implications in terms of prevention and treatment, particularly when addressing hearing loss as an important global health challenge.”

Yes, hearing loss affects millions of people worldwide. And the 12 recommendations are not really new news. Consumers and professionals have been saying the same thing for years.  Just not all of us. Together. At the same time.  Our words have not been followed up with action at higher levels, with policies that have legs, teeth, and high-octane support.

It’s time.  The market is shifting with the introduction of technology that makes almost anything possible. People with hearing loss want affordable options, and now that they can smell the change in the air, they will demand them.  And it’s clear that the hearing health industry is not only sniffing the same air, but is trying to decide what to do about it.

People with hearing loss are waitingsome patiently and some not– to see if this report will bring about change.  But we will work with you to make it happen. Justplease, don’t make us beg.

people support

Photo: Title from the NAS report.

  1. I agree with this even though we have been trying to do this for many, many years here. My parents worked side by side with Dr. Laszlo to find ways to educate the public and the government about hearing loss and they worked extremely hard to implement hearing test in babies all across Canada. This was only one, small stage of getting the message out there in terms of how much of an impact hearing loss has on a person’s life. We still have a long ways to go in Canada in providing better quality care for those of us that are hard of hearing.

  2. My big concern is that this report seems to be focusing on keeping the cost entirely on consumers instead of extending insurance coverage to hearing aids and the necessary care to get them programmed and maintained, and that the report seems to be cutting the professional care out of the picture. The best results in hearing health care are achieved by working with a qualified professional that ensures the aids are fit to each individual ear, and then properly maintained over the life of the aid with updated hearing tests, adjustments and regular professional deep cleaning. They want hearing aids to be like glasses and they are fundamentally not. It is a much more complex problem, and the solutions are also much more complex, not to mention much tinier and more difficult to work with.

    Seriously, there are hundreds of inexpensive one-size-fits-all amplifiers on the market already. If one-size-fits-all over-the-counter hearing healthcare was possible and worked well for the end consumer, these products would be flying off the shelves, everyone would be happy and we wouldn’t even be having this conversation. The problem is there’s no one-size-fits-all hearing, not even on two sides of the same head, so hearing help must be customized to each individual. It’s not like a laptop or even the “cheaters” glasses, where they can manufacture thousands of the exact same thing and throw them on the market and make 99% of everyone happy. It just doesn’t work that way.

    Instead of trying to cut the hearing care professionals out of the picture, we need to get insurance companies to treat hearing care as the serious issue that it is and cover hearing aids and necessary aftercare just as they cover other medical issues. The only reason they are focusing on cost with the hearing health care market is because consumers are expected to shoulder the entire burden themselves. However, the reality is that hearing aids are one of the absolute best deals in health care. They are the only health care with a trial period and money back guarantee. They are the only health care where the majority of the aftercare services and repairs are included in the original purchase price, sometimes for a period of a few years, sometimes even for life. You actually get a physical device that you use on a daily basis for years on end for the investment. The cost of hearing aids has not really increased very much over time, but has stayed stable adjusted for inflation despite huge advances in the technological capabilities of these devices. So instead of just attempting to make them “cheap,” which is doing the patient a disservice by cutting out professional care, how about we actually cover them as the necessary health intervention that they are including all the necessary services a consumer needs to get the best possible results.

    Since I’m on my soap box anyway, while we’re at it, dental and vision should also be covered. Why society treats hearing, seeing and eating as afterthoughts when these things definitely impact our everyday functioning and quality of life is beyond me.

  3. Yes. Number 12 regarding communication is my great concern. Why do so many organisations require me to provide a TELEPHONE number? I am deaf for goodness sake. To make things worse I cannot even get websites to accept my name and address and email because the “computer says no” as my telephone number is missing!

  4. What a terrific post from Alina. The “flying off the shelf” comment is particularly noteworthy. I have to add that there are both good and bad aspects to insurance coverage. Insurance should cover these health devices, but then if over-the-cuunter devices work, won’t the insurers elect to only cover these lower priced devices? This places the professionals further out of the picture. Additionally and historically, many professionals refuse to accept what insurers pay. This is true of all healthcare services and devices. I believe that insurance coverage is necessary, but it will be difficult for professionals to remain at the point of healthcare delivery. Just ask physicians how successful they have been.

  5. “Improve affordability of hearing health care by actions across federal, state, and private sectors”
    What good are evaluation, education, and “getting the message out there” when a pair of hearing aids can cost more than a used car?? The profit margin is more than that of drug companies, who take much more risks and have much more research costs!
    A prior article stated that companies add improved technology about every 6 months. Why? Cell phones would cost many thousands if their companies did that!

  6. We liked your idea about a Half Price Hearing Aids Day but don’t think we can make it selling at half price just one day a year, so instead we do it every day. Seriously! It bothered me that more than half of the people I tested couldn’t afford what we were selling, so I created a business plan that lets us make money selling hearing aids for half, and often less than half, the price charged by my competition. Today we have four stores in Michigan and Indiana, and have plans to expand nationwide. It’s really easy to sell hearing aids at half price. No buyers remorse and very few returns. Best of all we make a lot of families very happy. Not being critical of anyone else, but for us, it’s the right thing to do.

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