Fighting the high cost of hearing aids

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PITTSFIELD — Frederick Drobiak gets reminders about his hearing loss when he least expects it. Including from friends.

"People come to my house and say, `How can you have your television that loud?'" said Drobiak, 75.

The TV is that loud, he explains, so he can catch everything on "Judge Judy" or "Morning Joe," two of his favorite shows.

Drobiak knows he needs help with his hearing. He attended a presentation by an audiology company at his Berkshire Town housing complex, but feels priced out.

"It's very expensive and a lot of people can't afford them," he said of hearing aids. "I really do need it, I think. Sometimes I don't hear the whole conversation."

Cost is said to be one reason why most of the 48 million Americans who experience hearing loss in at least one ear do not use hearing aids.

In a move to cut prices, Sens. Elizabeth Warren, D-Mass., and Chuck Grassley, R-Iowa, are co-sponsoring a bill that would enable people with mild to moderate hearing loss to buy hearing aids over the counter, without a prescription. A hearing was held this week on Capitol Hill on a similar bill in the House, co-sponsored by U.S. Rep. Joseph P. Kennedy III, D-Mass.

Lawmakers argue that costs would come down if device manufacturers could market directly to the public. They want to open the process of treating hearing loss and encourage innovation.

Sen. Warren said "outdated regulations and high costs" strand six out of seven people with hearing loss.

"Here's a place where we need a little less regulation, so that more people can get access to hearing aids at prices they can afford," Warren told The Eagle. "Allowing some hearing aids to be sold over the counter would increase competition and innovation, bringing down prices and expanding access."

Unless the law is changed, she said, hearing aids will remain unaffordable for millions — or force them to dig deep to pay high costs.

Those prices scare Drobiak, who works part time at the Pittsfield Senior Center.

"My brother has hearing aids and he paid about $4,000," he said.

The average cost of a hearing aid in the U.S. is $2,000, according to AARP Inc., formerly the American Association of Retired Persons.


While the AARP, the Gerontological Society of America and the Hearing Loss Association of America all back the measures, others warn that people with moderate hearing loss need to be properly evaluated.

Neil DiSarno of the American Speech-Language-Hearing Association dismissed a comparison some have made between hearing aids and cheap eyeglasses.

"Hearing loss is extremely complex and it's not like putting on a pair of readers," said DiSarno, the association's chief staff officer for audiology and a 40-year audiologist.

Though at first opposed to the Senate and House bills, his group is now working to make sure the legislation addresses safety concerns it is flagging, including the risk that parents might buy aids for children and accidentally damage their hearing.

"No two hearing losses are the same," DiSarno said. "It looks like the Senate wants to do something good. It's one of those feel-good bills."

He said his group is not seeking to protect the status of audiologists.

Critics of the bill say it must specify "output limits" for hearing aids, require labels that invite customers to report problems and spell out inappropriate use of the devices.

The law would apply to over-the-counter sales only to people 18 and over. After being filed March 21, the measure, S.670, was referred to the Committee on Health, Education, Labor and Pensions.

Both the Senate and House bills draw on recent recommendations from the President's Council of Advisors on Science and Technology and the National Academies of Science, Engineering, and Medicine. Versions of the Senate measure had been filed in two earlier sessions.

Warren and Grassley cite a 2012 finding that only 14 percent of those with hearing loss use aids. DiSarno says other studies suggest nearly a third of those who need the devices do have them.

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Vanity, not cost, is a leading reason people put off getting hearing aids, he said. But he acknowledged that high prices are a factor.

"There's no doubt it is costly, like all health care is costly," DiSarno said of buying hearing aids. Medicare and most private health insurance plans do not cover the full cost. "The burden is totally on the consumer, which makes it appear more expensive. It hits the consumer hard."

The AARP, the nonprofit that advocates for 38 million members over the age of 50, says the ability to hear is central to preserving social interaction while aging.

David Certner, the group's legislative policy director, has been pressing the government, particularly the FDA, to give customers more choice on hearing-aid options. He cites a 2016 study in the Journal of the American Medical Association that only about 20 percent of people with hearing loss now use a device.

"Cost and other factors, such as access and social stigma, prevent people from using these life-altering technologies," Certner said.


Rosamond Rice, who is 70 and works as a volunteer at the Pittsfield Senior Center, saved up and bought hearing aids after noticing she was missing things.

She'd also become aware of how people with unaddressed hearing loss, including the center's Drobiak, risked social isolation.

"I've seen what it's like when you don't hear well," she said from her post in the welcome area at the North Street center.

Rice, a retired librarian who lives in Pittsfield, said she paid about $2,000 after being told, following an evaluation, that she had mild hearing loss. It had been getting hard to hear the TV, she said. More importantly, as an occasional judge at poetry slams, she needed to savor every word.

"The bill is a great idea if [the process] can be divorced from the pushy hearing-aid people," she said.

Vincent Marinaro, executive director of the senior center, said he has had an audiologist visit to help elders understand hearing loss.

He believes high costs bar people from a technology able to keep them engaged with life.

"I think it's huge," he said of the price barrier. "I don't want to spend $6,000. I'll get along without it. There's a lot more important things that people have to pay for. It can be frustrating."

Marinaro and his wife, Sheila, like many older couples, find that hearing issues can complicate communication.

"It's like glasses. When you need glasses, everything gets a little foggy. It's not crisp," he said. "The same with hearing. You listen and you miss that word because it's not crisp. You wouldn't bat an eye to get the brakes fixed on your car, but when it comes to your body, we're not wanting to spend the money."


The House version, H.R.1652, went before a hearing last week in the Rayburn House Office Building.

One of the bill's co-sponsors, U.S. Rep. Marsha Blackburn, R-Tenn., noted that the measure has the backing of the Academy of Doctors of Audiology.

"It is a win-win situation for consumers, for patients and for innovation," she told the hearing. Allowing hearing aids to be sold over the counter, she said, will boost competition, lower prices and foster innovation in hearing technologies "without increasing risk to the public," she said.

Her House co-sponsor, Kennedy, was one of several to note the bill's bipartisan support.

"I think the idea of a Blackburn-Kennedy-Warren-Grassley combination is a winning one going forward on a whole bunch of stuff," he said with a wide grin.

But lobbyists with the American Speech-Language-Hearing Association attended the hearing — and will continue to push for changes.

This week, in advance of the House hearing, the group's president, Gail Richard, called for the version to drop proposed over-the-counter sales for people with moderate hearing loss.

"To do otherwise would put the public at risk," she said. "Greater degrees of hearing loss are serious medical conditions with broader health implications."

And those issues, she said, "demand individualized treatment and counseling by an audiologist."

Reach staff writer Larry Parnass at 413-496-6214 or @larryparnass.


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