On July 9, 2021, President Joe Biden signed executive order on promoting competition in the American economy. This directive has many parts to it and will affect some long-standing issues that have been considered anti-competitive. Among these issues is the ability to purchase hearing aids over the counter. According to the presidential order, “Only 14% of the 48 million Americans with hearing loss are able to use hearing aids.” This is due to the high cost of hearing aids being more than $5,000 per pair. Click here to see the President’s order https://www.whitehouse.gov/briefing-room/statements-releases/2021/07/09/fact-sheet-executive-order-on-promoting-competition-in-the-american-economy/ The presidential order also stipulates that a “major driver” of the high cost of hearing aids is that a consumer can only get hearing aids from a doctor or specialist after having a medical evaluation. The order goes on to state that “experts agree that medical evaluation is not necessary”.

Let us look at this issue.

Purchasing hearing aids is a big step for anyone. Since hearing loss usually happens gradually, it takes quite a while for a person to know or acknowledge that there is a problem. Quality hearing aids not only help a person hear better, but they also more Importantly help to preserve hearing. Consider the scenario of going to a drug store like Walgreens or CVS to purchase hearing aids without a medical evaluation.  A person walks in and browses the shelves until they find a pair of inexpensive hearing aids that look nice and appear to do the job sufficiently. This hearing loss sufferer picks them up, takes them to the counter, plops down a large amount of money and walks out with a pair of new hearing aids. This sounds like it would work in theory, and surely everyone would be happy if this actually fixed the problem.

A few questions come to mind when we look closely at this purchase. First, what type of hearing loss does this person have? Is it a conductive hearing loss that is a result of some type of middle ear issue? Or is it a sensorineural hearing loss that has to do with the inner ear and/or the auditory nerve that sends the hearing information to the brain for processing? Without a qualified hearing exam there is absolutely no way to know. Follow this link for symptoms of hearing loss http://ihsinfo.org/IhsV2/Hearing_Health_Info/010_Hearing_Loss_Symptoms.cfm

A thorough hearing exam is the only way to ensure that hearing loss is being treated properly. A specialist or an audiologist is trained to test for serious issues that can only be revealed by a hearing exam. Let us consider the case of a person that has a cholesteatoma. This rare, but very treatable condition is an abnormal growth of skin cells deep within the ear. If this condition is left untreated it can cause damage to the tiny bones of the middle ear called ossicles. Another major concern is that of balance. Since the middle ear is home to the semicircular canals that control balance and eye movement, any middle ear problem can progress into a serious condition if not identified early. A thorough hearing exam includes measurements of air tone and bone conduction. The specialist or doctor that is administering the exam is trained to spot issues that arise from these measurements being out of tolerance. If a bone conduction score shows signs of possible nerve damage or cholesteatoma then a further medical evaluation is needed.  When a person picks a pair of hearing aids off the shelf at Rite Aid, they are not getting a thorough hearing evaluation. Although the customer is trying to hear better and save money, they may not be getting the proper treatment. This could lead to many long-term issues down the road.

Another issue to point out is that not all hearing loss is the same. Typically, hearing loss will start in the higher pitches or frequencies. This is where we get the clarity in speech and how we distinguish between words. In treating a hearing loss such as this, it is important to have a complete hearing profile. With this profile the professional that administers the hearing exam can tell where the hearing loss is greatest. Quality hearing aids can be programmed to amplify the pitches or frequencies that need to be amplified and not the frequencies that test normal. Purchasing hearing aids over the counter without a hearing exam does not address this issue at all. Follow this link for more informationhttps://www.medicare.gov/coverage/hearing-balance-exams

Over the counter hearing aids cannot be programmed to an individual hearing loss. These types of hearing aids are simply amplifiers that boost all the pitches or frequencies at the same time. Many users of these amplifiers will complain that they do not help them hear better but simply makes everything louder. Quality hearing aids will address and treat the hearing loss effectively thereby helping to preserve hearing.

Over the counter hearing aids may be of use to someone with a very slight or mild hearing loss, but there no way to know the level of hearing loss without a thorough hearing exam. The question that comes up is would you like to save money by purchasing hearing aids over the counter? Or would you like to know what type of hearing loss you have and treat it effectively?

Everyone would like to save money and get hearing aids easier. Maybe a good place to start would be with Medicare. Currently, Medicare does not cover hearing aids. If the President would like to help hearing loss sufferers get the treatment that they need, maybe they should be covered by Medicare.  A $5,000-$7,500 pair of hearing aids can help an older American on Medicaid if the out-of-pocket cost would be $1,500 to $2.000.