At this point, over a year later, I can’t remember if I asked Senator Elizabeth Warren about the Spock ears, or what.
She had called me on the phone at my house in Maine. This was a couple of months after I had devoted one of my Times columns to hearing aids. I had lamented a number of things in that essay, especially the cultural stigma associated with the devices. Cool glasses? You’re Elton John. Hearing aids? You’re a little old lady.
It was my argument that hearing aids should be more stylish — provocative, even. If hearing aids came in the form of, say, pointy Spock ears, or lit up with crazy colours, wouldn’t you try them out? Maybe once?
But the senator didn’t want to talk about Spock ears. She wanted to talk about the Over-the-Counter Hearing Aid Act, which she had co-sponsored. After its passage in 2017, it headed over to the Food and Drug Administration for guidelines on how it should be carried out.
In general, over-the-counter devices will make good hearing available to millions of people.
The US Food and Drug Administration (FDA) is expected to issue those guidelines shortly, possibly as early as January. When it does, the world will change for millions with hearing loss.
The act reclassifies a whole category of hearing assistance devices so that people can buy them at a retail store, without have to go through an examination by an audiologist. Many of these devices, called Personal Sound Amplification Products, PSAP for short, are available already; they’re just not marketed as hearing aids. With the new law, such a device can be billed as a hearing aid, if it meets FDA standards.
Struggling to hear
The hope is that the act will make these devices more widely available — that people who have been reluctant to contact a doctor about their hearing may feel more comfortable simply picking up a device at a Walmart.
PSAPs are not for everyone. They are designed for individuals with mild to moderate hearing loss. Still, that’s a lot of people. Researchers at Johns Hopkins estimate that 25 million Americans have mild hearing loss, meaning they struggle to hear speech in many situations, not just noisy restaurants. Ten million more experience moderate loss — they are unable to follow a conversation without directly observing the speakers.
If your hearing loss is severe, or profound, these over-the-counter devices won’t do you much good. People who have lost, or never had, the ability to hear sounds quieter than conversational speech require devices more complex than these (as do many people with less severe loss). A good comparison is reading glasses: If your vision is impaired, you should see a doctor; if you just need a pair of readers, you can pick them up at the drugstore.
PSAPs, which join a broad category of devices that include so-called hearables, can also cancel out unwanted noise, stream music, even translate a foreign language into English. Through Bluetooth, I can use my hearing aids to talk on the phone. In addition to these, I own Hearphones, manufactured by Bose. When I ride the subway in New York, I use the noise-cancelling feature in the Hearphones to silence the world around me. At the same moment, I can stream music from my iPhone into my head.
There I am, sitting on the 1 train downtown, hearing no sound except the soft music of one of Chopin’s nocturnes for piano.
The Hearphones are also very helpful at a party or a restaurant, where an app on my phone enables me to silence the conversations of people behind me, and amplify just the voice of the person I’m with.
There are more than a few reservations about the new over-the-counter hearing aids, though. Some of these come from audiologists, whose business will surely be affected by the act. Taking audiologists out of the process raises the possibility that people won’t get the device appropriate to their needs. In the long run, a hearing aid that doesn’t work or fit can be worse than nothing. And medical conditions that require intervention might well be missed without a professional exam.
Cheaper hearing aids
But in general, over-the-counter devices will make good hearing available to millions of people. The average cost of hearing aids in this country is $4,600 (Dh16,893) a pair. The nonprescription devices won’t be free, but they’ll be cheaper — some for sale right now cost $300 to $350. My Hearphones cost $500.
The real problem is that in many cases, hearing devices are not covered by insurance. And even at $300, they will be expensive enough to keep many people from getting help. I’ll allow someone to my right to explain why the ability to hear shouldn’t be covered by all Americans’ insurance.
Why doesn’t Medicare cover hearing aids? Why do so many private insurers fail to do so? I understand the need to keep overall costs down, but something’s wrong when something as basic as hearing the world is considered one of those luxuries conservatives mock as “free stuff”.
The Over-the-Counter Hearing Aid Act isn’t the cure to the inequities of coverage, but it’s a start. Perhaps the next president will spend as much time trying to help all Americans hear better as the current one has spent trying to buy Greenland.
I don’t know if that US president will be Elizabeth Warren. But I do know that she sponsored a bill that will make the world better for people like me. It’s worth noting that her co-sponsor was Charles Grassley, Republican of Iowa. If Senator Warren wins, I’m sure she’ll face plenty of partisan resistance to her many plans. But the new act is proof that she can reach across the aisle in order to get things done.
A president who might make our lives better, instead of worse? A woman who has the ability to pass bipartisan legislation?
Say this in your Spock voice: “Fascinating.”
— Jennifer Finney Boylan, a contributing opinion writer, is a professor of English at Barnard College and the author of the novel Long Black Veil.