Relief from the High Cost of Hearing Aids?

Last month the prestigious National Academies of Sciences, Engineering and Medicine issued a report with a series of recommendations that, if adopted, could revolutionize the way consumers receive and pay for hearing health care in the United States.images

Unfortunately, this report was not widely covered in the mainstream press, and although I wrote about this at the time, I’m also addressing it here, for those who may have missed this important development.

About 30 million Americans have hearing loss, but 67 to 86 percent of those who could benefit from hearing aids do not use them. The report called hearing loss “a significant public-health concern.” It is of course also of significant personal concern for those with hearing loss.

The June 2 report by the Committee on Accessible and Affordable Hearing Health Care for Adults represented input from experts in hearing research, public health, geriatrics and audiology, as well as from industry and consumer groups.

Consumers hope the recommendations will ultimately result in relief from the high cost of hearing aids, little insurance coverage and the limited availability of hearing professionals.

The committee listed 12 recommendations, but here are the four I consider most important.

  • Make buying a hearing aid easier by removing the Food and Drug Administration’s regulation requiring a medical evaluation or a waiver before a hearing aid can be purchased.

    It’s not difficult for consumers to waive the medical evaluation, but many people feel they are required to see a doctor before buying a hearing aid. This is a stumbling block for many. As the report pointed out, the only time a medical visit is essential is if you display “red flag” conditions, including sudden or rapidly progressing hearing loss within the previous 90 days, acute or chronic dizziness, pain or discomfort in the ear, or a visible ear deformity.

  • Promote hearing screening in wellness and medical visits.

    Most primary care doctors do not conduct even a cursory screening for hearing loss, even among the elderly. Failure to recognize hearing loss can be a threat to quality health care. A patient may not hear the doctor clearly, for instance.

  • Make lower-cost, over-the-counter hearing devices more widely available by implementing a new FDA category for them.

    This refers to personal sound amplification products, or PSAPs, and other less costly over-the-counter hearing devices.

  • Improve the compatibility of hearing technologies with other communications systems.

    This refers not only to compatibility of hearing aids with other hearing assistive devices and technologies, but also to developing “open platform” hearing aid programming. This would allow health care professionals — or, eventually, the device owner — to be able to program the settings on any device from any manufacturer, which is currently not the case.

In many ways, the report echoes the highly critical findings of a White House advisory group’s report last October. The group, as reported in the New York Times , said that industry concentration and overregulation meant that hearing aids had “not experienced the dramatic reductions in price and increases in features that have been routinely seen across consumer electronics.”

“When compared in complexity to today’s smartphones costing a few hundred dollars each,” the report said, “even premium-model hearing aids are simple devices but can cost several thousand dollars.”

The response to the White House report, as well as to these new recommendations, has varied widely among industry, consumer and health care groups — “hailed by some groups and denounced by others,” noted audiologist Barbara Weinstein, writing on the website Hearing Health & Technology Matters.

But she urged all parties to work toward common goals. “It is a win-win for all stakeholders to close the gap between the proportion of persons with untreated age-related hearing loss and the proportion of those who enjoy a measurably high quality of life as the result of hearing health care interventions purchased through audiologists.

“We are part of the problem and part of the solution. Let’s change that balance and remain essential,” she said.

One group supporting the recommendations was the Hearing Loss Association of America HLAA, the largest consumer group in the United States representing people with hearing loss. You can read HLAA’s statement here.  Many of the recommendations in the report echo earlier HLAA policy recommendations.

You can read a summary of the report here. The full report — “Hearing Health Care for Adults: Priorities for Improving Access and Affordability” — is available from the National Academies Press online or by calling 202-334-3313 or 800-624-6242.

Click on the link to read.  New Report Pushes for Cheaper, Easier Hearing Aids.


This post first appeared on AARP Health, June 10, 2016

Katherine Bouton is the author of “Living Better With Hearing Loss: A Guide to Health, Happiness, Love, Sex, Work, Friends … and Hearing Aids,” and a memoir, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You”. Both available on




5 thoughts on “Relief from the High Cost of Hearing Aids?

  1. Hearing aids are NOT consumer electronics like smartphones, but medical devices like a pacemaker or dentures. The economies of scale that apply to computers and smartphones which sell millions of the exact same device each year do NOT apply to hearing aids which is a much smaller market that is very research intensive and MUST be customized to each individual ear and each individual hearing loss for optimal results. One-size-fits-all over-the-counter hearing aids are just not possible. There are literally hundreds of these types of cheap devices being sold right now, and you know what? Most of them end up in the drawer and further the incorrect notion that “hearing aids don’t work” because they are NOT a properly fit properly tuned hearing device. If a one-size-fits-all inexpensive hearing device was possible, it would already be out there and flying off the shelves. It is not for manufacturer’s lack of trying or because of “odious regulations” that these are not available. It is because each ear is as unique as a fingerprint, even on both sides of the same head. One-size-fits-all is just not possible in the hearing healthcare field. That’s like trying to make dentures one-size-fits-all over-the-counter devices. It’s just not going to work.

    How about instead of removing the professional servicing of consumers and hearing aids from the equation, we instead force insurance companies to treat hearing loss like the serious medical condition that it is and actually make them cover hearing aids? This way, the consumer can actually get a properly fit properly programmed hearing device that doesn’t break the bank and doesn’t compromise their hearing health or hearing ability. Why isn’t that a part of the discussion? Why isn’t this the focus of the discussion?

    Especially when compared to the costs of other medical care, hearing aids are an absolute bargain, giving you something physical that you get to use and benefit from every single day that includes the professional fitting and maintenance and even comes with a trial period and money back guarantee in most cases – most of which is not offered in ANY other health care at all. For instance, I have to have a medical test a three times per year that costs $4000 EACH TIME I have to have it, no money back guarantee, no guarantee the results are going to actually help me, nothing I get to take home and use, just expense after expense after expense, which *does* happen to be covered by my insurance company meaning that I can get the treatment my doctor recommends. That’s a decent pair of hearing aids with lifetime service right there – every time I have to get that test. The ONLY reason that the cost of hearing aids is such a concern is because consumers are expected to bear that burden 100% themselves because hearing loss is NOT treated as the serious medical health concern that it actually is.

    So instead of turning the argument into “Let’s have consumers unrealistically self diagnose and self treat a serious medical condition with one-size-fits-all sub-standard over-the-counter cheap hearing devices”, let’s focus the argument on getting health insurance to cover hearing aids and hearing loss as the serious medical conditions they are and pay for the necessary treatment needed to get each individual the best results possible that they both want and deserve.

    Thank you.


    • Thanks for your comment. These recommendations apply to people with everyday mild to moderate noise or age related hearing loss. They do not apply to people with severe hearing loss or to any other kinds of hearing problems, especially including those “red flag” conditions: pain in the ear, single sided hearing loss, sudden hearing loss and drainage, among others.
      I’m not going to address your issues one by one because I’ve done it elsewhere .


      • Professor Jerry,
        July 7, 2016

        Hearing is entirely about cognition and nothing else. Even properly fitted current super expensive hearing aids don’t address this fundamental issue. I am a 77 year old member of the National Academy of Engineering with only mild hearing loss who easily enjoys classical music played at normal hi fi volume. But even though I can hear all conversational sounds, either in a group or one-on-one, I only understand less that 70% of the words and sentences that enter my ears. However, when I watch TV and use closed caption, being able to see the words greatly improves my cognitive hearing abilities.

        My expensive fitted and tuned Phonak hearing aids do not cure the cognition problem! So, I will not buy what’s out there again. And I am sick and tired reading reports from prestigious organizations that promise that economically viable relief can be right around the corner. What I want is somebody to invent a system that hears all English speakers, with and without foreign accents, and within a few milliseconds send it wirelessly to my ear plugs and plays it back slowly with perfect enunciation with a synthesized voice with a pitch of about 200 hertz. Such a device will solve all cognitive hearing problems.

        I am willing to pay thousands of dollars for such a device.


      • I think many people share your experience, and I agree that the problem is not in cognition but in hearing. I hear everything. I understand far less. But this is where hearing rehabilitation can really help. It’s hard to find one-on-one hearing rehabilitation, although Geoff Plant at the Hearing Rehabilitation Foundation in Somerville, Mass., is trying to teach others his method. But absent one-on-one training there are some good internet programs that can really help with speech recognition — it cognition. One is LACE program, which I have used. It’s a program that records your progress and increases the difficulty as you go along. The goal is to do at least one half hour session per day. Doesn’t sound like much but often that time is hard to find. But even done not according to the rules, I’ve found it useful. The other is Read My Quips, which is clever and enjoyable. Listening to recorded books, with a print copy of the book nearby to help with things you may not catch on the recording, is also helpful. You are very lucky to be able to continue to enjoy recorded classical music. That’s one thing I can’t do and I miss it terribly.
        When you watch TV and understand he words, it’s because you are hearing bimodally — it’s like reading lips and hearing better. Since you are a scienctist, yo might enjoy reading abot it. It’s call The McGrk/Macdonald effect. You can google it, I think.
        Thanks for your thoughts.


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