More than 30 million Americans experience significant hearing loss, but only a third of them get hearing aids.
There are a lot of reasons why someone who needs a hearing aid won't get one: Some think their hearing loss is not that bad, others are too embarrassed to use them, and many people say they are just not worth the price.
Hearing aids cost an average of $1,500 per ear for a basic model, and unlike most technology, their price has not dropped over time.
What is worse: Most insurance companies do not pay for the devices. Even Medicare does not cover hearing aids — and the Affordable Care Act will not change that.
Some businesses see the hearing aid market as an opportunity. Costco has opened hearing aid centers in discount warehouses all over the country. Other companies have started selling their own brands of the devices directly online.
Ross Porter, the founder of online retailer Embrace Hearing, says hearing aids are only expensive because audiologists and distributors charge steep markups on them.
But Virginia Ramachandran, an audiologist with the Henry Ford Hospital in Detroit, says it is unwise to buy a hearing aid for the first time online. She says the device might be fine, but you will not know how to use it correctly.
"If someone gave you a laptop computer, and you have never used one before, you would not know how to turn it on, you would not know what programs or how to use them," she says.
Ramachandran says the only way to make hearing aids cheaper is to have more consumers enter the market. That way, she says, some of the research and development costs incurred by the industry leaders could be divided among a larger group. (According to the National Institutes of Health, "Only 1 out of 5 people who could benefit from a hearing aid actually wears one.")
Besides, Ramachandran says, what really keeps people from purchasing hearing aids isn't the cost — it's the stigma.
She led a study in 2011 where she divided patients into three groups. The first group could receive their hearing aids for free through their insurance, the second group was partially covered, and the third group had to pay for them out of pocket. Researchers then noted how long it took a patient to get a hearing aid.
They found little difference between the groups with partial or no coverage — but there was a "significant decrease in both the age and degree of hearing loss" for those whose hearing aids were fully covered by insurance.
Dropping the cost of hearing aids can nudge a senior in the right direction, but there are always going to be people who would rather go without.
Ramachandran says that in European countries where hearing aids are covered by insurance, rates of adoption are not significantly higher than in the U.S. She says cost might be a way to stall.
"People genuinely perceive hearing loss as being associated with older age, so any excuse not to get them is a good one if it is something that you do not really want," she says.
If seniors saw the devices as something as normal as eyeglasses, she says, they would be more likely to get them. This would expand the market and could eventually bring the price down.
The industry is already on it: Companies are in the market for aging celebrity spokesmodels to make the pitch.
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RENEE MONTAGNE, HOST:
Of the more than 30 million Americans who have significant hearing loss, only about a third actually get hearing aids. Some think their hearing loss isn't that bad, others are afraid of the stigma. But for many people, the strongest deterrent is financial. Hearing aids are expensive and typically not covered by insurance.
Brenda Salinas reports on why hearing aids have become a luxury good.
UNIDENTIFIED MAN: Hothouse. Baseball...
BRENDA SALINAS, BYLINE: If you ever get fitted for a hearing aid, you can expect to hear this sound. But one thing you might not be expecting, the sticker price.
ARTHUR CLARK: I was real surprised. I was really, really surprised.
SALINAS: That's Arthur Clark. He's an 82 year old retiree. He's getting his hearing aids repaired and he's looking to save some money, which is why he's here...
(SOUNDBITE OF ELECTRIC SCANNER)
SALINAS: ...at Costco. That's right. The place that sells 60 roll packs of toilet paper is in the hearing aid business. They have ties with big manufacturers and economies of scale. They can set up clinics like this one right in the store and give deep discounts on hearing aids.
(SOUNDBITE OF CROWD CHATTER)
SALINAS: Chris Asaro is a hearing aids technician at a Costco in Washington, D.C. He says that even with the discounts, many people can't afford hearing aids. He's seen seniors come in just for the free test. They want to see how bad their hearing has gotten, but many walk out empty-handed.
CHRIS ASARO: A lot of the times they are on a fixed income, they're on Social Security, they only get so much a month, so they can't afford to purchase a hearing aid.
SALINAS: Digital hearing aids have been around since the '70s. With most technology, price drops over time. Think of what a flat screen TV costs now compared to few years ago. But hearing aids are an exception. Their price has stayed about the same, about $1,500 per ear, the higher-end models can go up to a few thousand.
Ross Porter is the founder of Embrace Hearing, a startup that sells their own brand of hearing aids directly to consumers online.
ROSS PORTER: So the actual hearing aid itself is fairly simple. All it has is a few microphones, a speaker, a kind of internal chip to it and then the housing and the casing. But overall, the hardware involved in a hearing aid isn't more than a few hundred dollars per hearing aid.
SALINAS: Porter says hearing aids are expensive because audiologists and distributers charge a steep markup.
Don't blame us, says Virginia Ramachandran. She's an audiologist at the Henry Ford Hospital in Detroit and says many of her patients need to learning to use their hearing aids.
VIRGINIA RAMACHANDRAN: You can imagine if someone gave you a laptop computer and you've never used one before, you wouldn't know how to turn it on, you wouldn't know what programs to open up or how to use them. And so a huge component of a hearing aid is the professional services that go along with it.
SALINAS: She says if you want to make hearing aids cheaper, make it so more people enter the market. That way some of the research and development costs incurred by the industry leaders could be divided among a bigger group. But she says what's really keeping people from buying hearing aids isn't the cost.
RAMACHANDRAN: People genuinely perceive hearing loss as being associated with older age, and so any excuse to not get them is a good one if it's something that you don't really want.
SALINAS: Dropping the cost of hearing aids can nudge a hearing impaired senior in the right direction, but there are always going to be people who would rather go without. They're embarrassed.
Ramachandran says that in European countries where hearing aids are covered by insurance, rates of adoption aren't significantly higher than ours. She says if seniors saw the devices as something as normal as eyeglasses, they'd be more likely to get them. This would expand the market, and it could even bring the price down. The industry is already working on this strategy; they're looking for aging celebrity spokes models to make the pitch.
MONTAGNE: Brenda Salinas. NPR News.
(SOUNDBITE OF MUSIC)
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