Third-party coverage
David H. Kirkwood · The Hearing Journal · 2002
“If it ain't broke, don't fix it” is a timeworn argument against change. Clichéed though it is, that sentiment sometimes seems to make sense. Change for its own sake or the wrong change can be damaging indeed.FigureHowever, clinging to the status quo makes no sense at all when it comes to the hearing aid distribution system in this country. Put simply, it's “broke.” When only about one in five hearing-impaired people wears hearing aids and the percentage is lower today than it was a decade ago, it's clear that our industry is largely failing to achieve its basic mission of helping Americans hear and communicate better. The reasons for that failure are complex and, no matter what our industry does, I doubt that hearing care will ever be as widely used by those who need it as are medical, dental, and vision care. However, all historical evidence to the contrary, I do not believe that the hearing-impaired person who wears hearing aids must always be the exception rather than the norm. THIRD-PARTY COVERAGE One development that promises to increase the use of amplification is the growth of third-party coverage of hearing aids, which is the subject of this month's cover story. The most obvious benefit of such coverage is that it would make hearing aids affordable to a larger segment of the population. According to a survey by a national benefits consulting firm, some 30% of hearing aid candidates who don't own them say they can't afford them. Granted, some people use cost to mask their real reasons for not buying hearing aids. Nevertheless, it stands to reason that if insurance paid, say, the first $1000 or $1500 per ear toward the purchase of hearing aids many current non-owners would get them. In my view, an even more significant advantage of routine insurance coverage is that it would bring hearing aids and hearing care into the mainstream. For various reasons, consumers do not generally view our industry's products and services as having the same degree of legitimacy as those of medicine, dentistry, and vision care. But, the more that insurance plans cover hearing care, the more it will be seen as a standard element of overall health care. Third-party coverage of hearing care is not without its perils. The greatest danger is that insurers will set unrealistic caps on the price of hearing aids and related services. If that occurs, everyone suffers. Manufacturers lose the incentive to conduct the R&D necessary to improve the technology. Dispensing professionals can't afford the time needed to provide insured patients with a level of care that will optimize the likelihood of a successful fitting. And, as a result, patients are denied the quality of devices and services that they deserve. However, well-crafted benefit plans can avoid these pitfalls. In many of the best plans, insured patients receive a specified (and substantial) amount toward the purchase of hearing aids. They can then elect to spend additional money to get the particular device(s) that they and their hearing professional select. Also, plans should not limit the patient's choice of licensed provider and they should cover professional services. A LONG WAY TO GO Currently, most hearing aid purchasers in this country pay their own way. However, increasingly help is available. For one thing, private insurance plans are more frequently including a hearing benefit. According to Hewitt Associates, about 16% of America's largest employers offered such a benefit in 2000 compared with only 9% in 1991. Secondly, four states have passed and six more are considering laws that cover hearing aids for children. Such legislation deserves support on its own merits. When a child has a hearing loss, his or her whole future is at stake. No child who needs hearing aids or a cochlear implant should be denied for financial reasons. A secondary benefit of laws providing coverage for children's hearing aids is that they may lay the groundwork for legislation that applies to adults. Finally, the Foley Bill, introduced last year in the House of Representatives, calls for Medicare coverage of hearing aids. While its chances of passage anytime soon are extremely slim, just the fact that it has been proposed should draw attention to the issue and add to the momentum toward third-party coverage.