CareTalk Podcast – Why Are Hearing Aids So Expensive?

Why are hearing aids so expensive? David and John investigate the rising prices of hearing aids, while making the case for over the counter options. 

David Williams:
Welcome to Cure Talk. America’s home for incisive debate about healthcare business and policy. I’m David Williams, president of health business group,

John Driscoll:
And I’m John Driscoll, the CEO of Care Centrics. David, what is trending?

David Williams:
Well, John, not surprisingly president Biden’s plan to fight COVID and in particularly, the mandates.

John Driscoll:
What’s new?

David Williams:
Well there’s mandates John, big mandates. So mandating federal employees to get the vaccine and contractors to get the vaccine and any company with a hundred employees or more, is now mandated to have the employees get the vaccine as well.

John Driscoll:
David, I think you’re looking at this, your language is all wrong. As Jimmy Buffet said recently, “Vaccines are the gateway drug to fun.” And there’s nothing more fun than going to work. And it’s going to be a lot less fun if people don’t actually get themselves vaccinated. I think this is a great idea, David. I mean, this isn’t so much a mandate as a path to actually guarantee a return to work and a return to a sane economy. If we’re going to leave an uncovered front by allowing unvaccinated people to run riot, so will the virus.

David Williams:
John, I think it’s a manly mandate. And I think actually what’s happening is that a lot of companies are actually happy to get a mandate from the top, the same way that the local school boards are happy.

John Driscoll:
Mandate me, baby.

David Williams:
Yeah. The same way that the local school boards are happy to hear the guidance from the state. So they don’t have to fight it out at their level, say, “Hey, Governor Baker told me to do it. Governor Lamont told me to do it.” Same thing. President Biden told the company to do it and listen, go complain to him. Anyway, I think it’s good, John. I mandate that you get the vaccine. I got mine. We’re good.

John Driscoll:
Yeah. I’m going to wait until you tell me what to do. So David what’s going on with hearing aids these days?

David Williams:
Well, John, not as much as going on with hearing aids, they should be going on as we thought might be going on.

John Driscoll:
Why are we even talking about this other than the fact that you’re hard of hearing? Why do hearing aids matter?

David Williams:
John, there’s something like 37 million adults in the US and over half of people, 60 and over who have hearing loss. So it’s a big deal.

John Driscoll:
David, it’s like 350 million people in the US.

David Williams:
There’s a ton of people, John, that need hearing aids and they don’t have them.

John Driscoll:
You may not hear them out there, but they’re there.

David Williams:
You can see them. Now, the reason you can see them as you can go to the drugstore and get a pair of cheap reading glasses, which is cheap, regular glasses, if you need them, but you can’t do that with hearing aids. Now, hearing aids, John, get this, they cost 2000 to $8,000.

John Driscoll:
Yikes.

David Williams:
A pair, that’s a lot. And so only-

John Driscoll:
It’s a lot of clams.

David Williams:
Only about one in four people who could benefit from hearing aids actually have one.

John Driscoll:
It actually is a serious problem. I’ve got some hearing loss from a military accident many years ago, but there are and the obvious point is that the over 65 population is the fastest growing population in the US, over 80 is growing even faster. We’re living longer. We’ve got 10,000 people qualifying for Medicare every day with the boomers finally booming into old age. And as you get over 70 or 80, modest to extreme hearing loss is common and not to make too sharp a point about it, because it’s sort of obvious, what you don’t hear, you can’t encourage. And the lack of good hearing or acceptable levels of hearing leads to a lack of socialization, which leads to loneliness, which is a chronic condition that can accentuate and accelerate other morbidity factors and can really accelerate physical and mental decline. It’s a real issue. Decent hearing is tied to socialization and it’s crazy that leaders in health care like yourself have prevented people from actually having more access to low cost hearing aids.

David Williams:
Well John, thank you for that compliment. What I’ll tell you is that this problem was supposed to have been solved because it was recognized and addressed more than four years ago. There was a law that was actually sponsored by Senator Elizabeth Warren and signed by the former president, Donald Trump back in 2017.

John Driscoll:
The natural collaborators, Elizabeth Warren and dear old departed President Trump.

David Williams:
So in 2017, this law came in and FDA was supposed to write rules by 2020 to enable over the counter sales of hearing aids. Now they haven’t done it yet.

John Driscoll:
How dumb is this David? We have the technology it’s relatively cheap. It’s available. We invented a lot of it. It’s crazy that we’re not lowering the regulatory barriers and accelerating people’s access to this. I mean, David, how do you defend yourself?

David Williams:
I’m not sure why you group me in with the former president and the current senator, but what’s happening is-

John Driscoll:
No, no, no. I’m saying you are a part of the regulatory healthcare establishment that wants to play by the rules that have always held us back in this particular area, from regulation and access to low cost hearing aids, which are an essential part of aging in society.

David Williams:
John, if I had a hearing loss, which I either do or don’t, I would prefer to personally go to a hearing professional and I would actually like that approach. But I do think that especially for mild hearing loss that these other OTC devices should be available. Now, who else thinks that? Apple and Bose, because they both released devices. Apple is part of the AirPod Pro and Bose has a device that actually can be used this way, but they can’t really exactly wait for the FDA. The FDA was supposed to be done now. So some of these companies are starting to put things on the market, but there’s a lot of confusion.

John Driscoll:
Which they should.

David Williams:
Yeah. Okay. But the problem is, John, some of the things that are not very good, some of them are just these sound amplification devices.

John Driscoll:
Yeah it’s like those big horns that you used to see in movies, would stick them out. And the problem with that is that there’s an element of distortion. So gross sounds are not precise and understandable, but I think it’s great that Apple and Bose are trying to bulldoze their way into this regulated high margin, this ring fenced oligopoly of the regulatory oligarchs of hearing aids. I mean, David, again, I’m just appalled that you are supporting this.

David Williams:
I don’t know what corner you’re trying to paint me in John. I’ll just be clear, I think OTC hearing aids should be available. I personally would not-

John Driscoll:
Oh, you mean over the counter? Or is there another acronym you want to throw in there to confuse?

David Williams:
Yeah. Over the counter, John, they should be available without a prescription or without having to see an audiologist. I personally would see an audiologist for myself, but putting it back on you, John, one of the problems here has been that insurance traditionally has not covered hearing aids, probably one of your decisions back in your youth.

John Driscoll:
No, I completely agree with you. I think that that insurance should be covering particularly the lower cost alternatives. It would be very easy to create a market, a mass market, if you will. The best devices are super expensive and super high technology, but the lower cost mass versions could be created. And I’ve always supported, not unlike you covering it, by insurance companies. And the fact is that there is a lot of supplementary dollars available for managed care plans to actually use as differentiating tools for their sales to actually cover typically uncovered benefits, whether it’s dental or OTC vitamins, or things like hearing aids and food. And I think that opens the way to validate it. And you create a market where there’s a lot of demand so that you could actually produce these things at low cost and mass volume.

John Driscoll:
And now’s the time to do it because I do think that the dam is breaking. And there’s a lot of areas in the medical industrial complex, which has served you well, David, where regulation supports margin and revenues that prevent access to people of what they need at a low and reasonable price. And I think now’s a great time to focus on this because in addition to access at the high-end, Apple and Bose expensive big brands, you could easily see if insurers were to actually get together and do the right thing here. How they could collaborate with incentives and create a market for low cost mass distribution of devices that could really help people stay connected to their social groups in society.

David Williams:
John you’re mentioning that you actually, despite the fact that I said that a lot of insurance doesn’t cover hearing aids, a lot does, and especially Medicare advantage and about half of Medicaid plans, we haven’t spoken so far though about the stigma about wearing hearing aids. And I think that’s traditionally been a barrier. People don’t want to look like they’re feeble or disabled by wearing hearing aids. What’s your take on that? And is that changing?

John Driscoll:
I think in a world where everybody’s got ear pods or big Beats bunny ears, at the high end, they’re getting hyper precise and small and you can barely tell that they’re there. And in fact, there’s a Star Trek element to it. I mean, maybe not with you and I, but with people who look cooler than us, those people in the Apple commercials who are skateboarding and skiing and walking up buildings and they all look so damn happy, with stuff in their ears. I think in a funny way, Bose and Apple are going to make hearing aids cool. Not for you and me, that that would be too high a bar, but for others.

David Williams:
Yeah. I actually think that’s right. And one of the reasons to get the consumer players in there is not just to keep the price down or to bring it down, but actually to improve the usability and to reduce the stigma and make them cooler and more fun. And frankly incorporate them just into routine consumer devices. It doesn’t have to be a separate-

John Driscoll:
Got to actually get the word out there that 75% of people who should have hearing aids don’t and, I almost said to make sure they hear us, but to make sure that they and their families understand that this is a solvable problem and could directly tie to less loneliness and lower comorbid conditions and and help age gracefully. I mean, not like you and I, David, we’re not aging gracefully.

David Williams:
Forget that.

John Driscoll:
But for those 75% who need it, that’s the message that needs to get out there. And then let’s get some incentives out there that create a market at a lower cost point.

David Williams:
Well, John, I agree. Let’s get the FDA to do its job. No reason why they shouldn’t get these standards out there. Let’s do things like we’re doing here with our podcast, which by the way, there’s captions available for it on YouTube and people can listen or watch, and I’m going to get my hearing aid, John, and you may well be wearing one right now without me even knowing it.

John Driscoll:
What?

David Williams:
Yeah. All right, John, that’s not funny, but in any case, that’s it for yet another edition of Care Talk. I’m David Williams, president of Health Business Group.

John Driscoll:
And I’m John Driscoll, CEO of Care Centrics, be sure to subscribe on your favorite service.