A Hearing Aid for Everyone

This article is part of the On Tech newsletter. Here is a collection of past columns.

My colleagues and I write a lot about failures of government and the horrors of technology. But this week we have good news.

On Tuesday, the Food and Drug Administration started the process — after a long wait — to create a new category of government-approved hearing aids that Americans will be able to buy without a prescription. Congress authorized over-the-counter hearing aids in 2017.

These over-the-counter hearing aids have the potential to prove that the best efforts of government and technology companies can improve Americans’ lives.

You can buy reading glasses at Walgreens without a prescription. Perhaps by this time next year, you’ll be able to do the same with an officially labeled hearing aid at a cost of a few hundred dollars.

Medical professionals, patient advocates and tech executives that I’ve spoken with are excited about the potential of over-the-counter hearing aids. They imagine the government’s blessing will spark new inventions from companies like Bose, Best Buy and Apple. And they believe that this could be the start of a golden age for hearing help.

“I’m crying reading this,” Nicholas Reed, the director of audiology at the Johns Hopkins Cochlear Center for Hearing and Public Health, said he wrote to his contacts on Tuesday after hearing the news.

When I wrote about this topic in April, I was surprised at the pernicious and widespread effects of hearing loss. Roughly 38 million American adults report some degree of hearing loss, and only a minority of people who could benefit from hearing aids use them.

Prescription hearing aids work well for many Americans, if they have access to medical care and can afford to pay an average of about $5,000. (Hearing aids are not typically covered by traditional Medicare. Coverage by private health insurance plans and Medicaid is spotty.) Some people also feel embarrassed about losing their hearing or are put off by tests and fittings for hearing aids.

Untreated hearing loss can be serious. Struggling to understand what we hear stresses the brain and is associated with cognitive decline, dementia and social isolation.

Research by Dr. Reed and other academics found that some nonprescription hearing devices on the market for $350 or less — they can’t legally be called hearing aids at the moment — were almost as good as prescription hearing aids for people with mild-to-moderate hearing loss. But hearing helpers in this category can be excellent or garbage, and it has been difficult to tell the difference.

The best listening devices might win approval as official over-the-counter hearing aids under the new F.D.A. rules. Experts say that more companies are waiting in the wings to offer new hearing products.

Bose announced in May a hearing device for $850, and the company told me that it wants to sell the product as an over-the-counter hearing aid when the F.D.A. finalizes its rules. The Wall Street Journal recently reported that Apple is studying ways to make its AirPods, which are wireless headphones, into a device to enhance hearing.

More gadgets don’t necessarily mean that more people will be helped by them. But the new market opportunity that the government created may open the door to ideas we can’t yet imagine, wholesale changes in public awareness of hearing loss and choices for treating it.

Dr. Reed tells me that he envisions that sleeker-looking and easier-to-use hearing aids can help erode the stigma of hearing loss and that new device manufacturers will offer more consumer education about the problem.

He and other experts also imagine more pathways for hearing assistance in addition to devices. Maybe there will be the equivalent of Best Buy’s Geek Squad to help people fit hearing aids that they buy without a prescription. If many more people seek hearing help, that could also mean more opportunities for health specialists who might offer hearing tests and treatments, separate from the devices.

People with more serious hearing loss may not be helped by an over-the-counter hearing aid. And even at a fraction of the cost of traditional hearing aids, many people still won’t be able to afford them. Some drafts of the domestic policy plan being batted around Congress propose an expansion of Medicare coverage to include hearing aids.

Health care in the United States costs more than it does in many rich countries and produces worse health outcomes. But at least in this one corner of health care, people may soon get more innovation and lower costs. Not bad.

  • Facebook is going to change its name. Okaaaay. The Verge reports that Facebook plans to reveal a new name for the company next week to incorporate its interest in the “metaverse,” a term for a broad vision that virtual human interactions will be as complex as the real thing.

  • Shifting from Hollywood tabloid to conspiracy theories: BuzzFeed News traced the evolution of Crazy Days and Nights from a celebrity gossip blog to a hub for QAnon conspiracy theories. “Gossip fans and QAnoners share a core belief: that behind closed doors, celebrities are doing unspeakable things,” BuzzFeed writes.

  • Talk to the world through your phone: My colleague J. D. Biersdorfer has advice on how to use your smartphone to converse in a language that you don’t know or to quickly translate a message or street sign.

I love Gritty, the oddball mascot for the Philadelphia Flyers hockey team. Here is Gritty playing with a VERY EXCITED dog friend.

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