She applied to a Georgia hearing aid charity and was told she made too much money in her job as an employment specialist for an organization that serves the hard of hearing. Insurance didn’t cover the devices; it rarely does.
Now, she said, “I pay a monthly payment plan. But again, it’s worth it to me.”
With hearing aids she knows birds are singing and music’s playing. She can hear planes overhead and be more alert when walking alone in a park.
Haque knows the eventual federal legislation may not apply to her level of hearing loss, and she doesn’t have a position on the bill. But she does think more people should have access to hearing aids.
Groups such as the AARP and the Academy of Doctors of Audiology think the federal bill would be a step in that direction.
The bill would create a new “over-the-counter” class of hearing aids. They would still require Food and Drug Administration approval for quality, but they would no longer require dispensing by a licensed professional. In effect, they could be bought over the internet.
Not all patients could buy them, probably only those with low or moderate hearing loss.
Free-market or free-for-all?
Right now, there are two classes of aids. “Hearing aids” must be approved for quality by the FDA and dispensed by a hearing professional such as a doctor or audiologist. “Personal sound amplification products,” or PSAPs, are over-the-counter. Not only are hearing aids regulated by the FDA, but equally importantly, each state has requirements about selling them.
Industry representatives say there’s an important reason for such requirements: insuring that the sophisticated devices are calibrated by professionals to the user’s individual hearing.
But that requirement has also galvanized activists who say that the regulation often has an unfriendly side effect.
“You find the doctors that have exclusive rights (to dispense hearing aids) will have contracts with a manufacturer to sell their particular model,” said Sam Hammond, an analyst at the free-market Niskanen Center. “That’s why they’re so expensive.”
That alone might drive up prices and deflate competition to improve hearing technology. But in addition, he added, it discourages entering the market “because when you go to market you find there’s 50 different states and 50 different regimes.”
Industry representatives replied that the majority of the cost of a hearing aid goes to the professional who fits it to the patient — which ought to be done anyway to protect the patient, whether there’s a contract or not.
“As a business leader, I believe competition is the cornerstone of capitalism and propels each hearing aid manufacturer to produce the best product possible,” Brandon Sawalich, the chairman of the Hearing Industries Association, said in an email. Sawalich is president of Starkey Hearing Technologies, one of the few hearing aid manufacturers.
Sawalich said legislation to sell hearing aids over the counter may help some customers, but only those with mild hearing loss.
If it’s also opened up to those with moderate hearing loss as the legislation proposes, he said, people may get inadequate hearing aids. In that case, he added, “consumers may abandon their effort to address hearing loss altogether, putting them at increased risk of long-term complications of untreated hearing loss.”
It's not an unfounded concern. But it's outweighed by the potential to get those people help, said Andrew Scholnick, a lobbyist for the AARP. Researchers estimate that 80 percent of people ages 55 to 74 who would benefit from hearing aids don't wear them.
“There’s certainly the potential of somebody buying the wrong hearing aid,” Scholnick said. “But we think if they do, they could say this is the wrong hearing aid, and it might set them up to see a hearing health professional.”
Free-market groups who oppose the legislation as written do so from a very different standpoint than Sawalich’s. They are concerned it will expand regulation: that some PSAPs could be moved into a new category sought by the bill and suddenly be subject to regulation.
There is a deep split among the free-market groups, and some have taken brutal aim at Carter.
Although the U.S. House Energy and Commerce Committee voted for the legislation unanimously, Carter was targeted as a hypocrite. A commercial funded by a group that lobbies for limited government called Frontiers of Freedom blasts Carter because the legislation is also backed by liberal Massachusetts U.S. Sen. Elizabeth Warren. “We expect these bait-and-switch tactics from Elizabeth Warren,” the ad says. “Not Buddy Carter.”
Carter said it’s “ludicrous” to suggest he would work in conjunction with Warren.
“I’m happy to hear that she supports free-market principles,” he said. “I think there’s hope for her. She should support more of them.”
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