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"It's the economy, stupid!"
Before it became a pop culture reference, that 1992 line by Democratic strategist James Carville was an important reminder to Bill Clinton's campaign staff: Keep it simple, keep to the facts and stay focused on what matters.
Thirty years later, hearing aids have become a political punching bag. As in 1992, no one is asking the right questions about hearing health care.
In 2017, Congress created a new class of hearing aids to be sold in drugstores for people with perceived mild to moderate hearing loss. Last fall, the Food and Drug Administration released proposed rules around these devices that addressed everything from sound limits to labeling. In the public comment period that followed, the FDA was flooded with concerns from health organizations, countless hearing professionals and nearly every state's attorney general. Nearly all said, as outlined, these devices could potentially do more harm than good. While we wait for the FDA to release final rules that will send over-the-counter devices to market, we must look at how we got here.
The root of the confusion around hearing aids, and the point that must be addressed to open access even more to care, is not cost; it's expertise and care. For three decades, consumer electronics companies have repeated one line: A hearing aid is a consumer electronics device, and manufacturers are overcharging people. These companies think the device is the "solution," disregarding the hearing professional's role. A hearing aid is one piece of the puzzle that must include expert care to ensure patient safety and satisfaction.
Since hearing aids have become part of a political debate, let's look at the hearing health care process as a presidential campaign. The party nomination is like the hearing evaluation, hearing loss like a candidate. No two are the same, and it takes time to sort out the differences. The evaluation determines the kind of loss a person has. Next, the presidential debates begin. While selecting a hearing aid is not as contentious as a debate, it is a process. Just like a debate gives voters clarity, the patient must understand how the device can help. A patient's unique hearing loss and lifestyle factor into device selection. It all comes together on voting day. The patient begins to experience results during the fitting, but it's not the last step. The purchase of this medical device includes professional care for the life of the hearing aid — the adjustments, follow-up appointments, cleanings and device warranties. The purchase is not the finish line but the starting point.
