[HN Gopher] The FDA wants you to be able to buy a hearing aid wi... ___________________________________________________________________ The FDA wants you to be able to buy a hearing aid without a prescription Author : cf100clunk Score : 407 points Date : 2021-10-19 17:58 UTC (5 hours ago) (HTM) web link (www.npr.org) (TXT) w3m dump (www.npr.org) | Spivak wrote: | As some with a mild APD this would be fantastic! It has never | been worth the cost and effort to get "real" hearing aids but I | would probably live in the oct version. | bserge wrote: | Jesus, why were they prescription only in the first place? | | Same shit as levothyroxine, a basic medication used by millions, | being prescription only. And many other drugs. | jrace wrote: | Asprin is not rx...and has killed millions. | | https://pubmed.ncbi.nlm.nih.gov/16086703/#:~:text=Death%20ra... | . | cf100clunk wrote: | What about building one's own hearing aid? This DIY project came | to mind: | | https://hackaday.com/2013/12/15/diy-hearing-aid/ | | No mention of DIY hearing aids from the FDA. | ghostly_s wrote: | Because there aren't any FDA regulations preventing you from | building a DIY hearing aid? | cf100clunk wrote: | But there are batteries (pun intended) of lawyers from the | hearing aid manufacturers who would act against DIY kit | vendors if asked. I wonder who/what is the best entity to | help shield DIYers from patents... | spicybright wrote: | Source? I've seen a myrid of kits that overlap heavily with | different products like a DIY hearing aid would. | fallingknife wrote: | Can't we just get rid of the prescription system in general, and | make doctors advisors like lawyers are? I don't need all these | gatekeepers "keeping me safe." In Mexico you can just walk into a | pharmacy and buy anything. Even pain killers. And it works fine. | The only drugs that seem to cause societal problems are the ones | that the government tries to keep you from getting. | luckydata wrote: | Do glasses first. | kiba wrote: | Some feature requests for hearing aid: | | Can we get hearing aids that are bigger? These small hearing aids | make it easier to lose, and I do not mind looking "disabled" to | people. | | Also would like to use bluetooth to both locate the hearing aids, | and to connect to devices as needed. | | Would be cool if the battery can be recharged as needed, maybe | through usb-c if possible, but magnetic charging would be | acceptable. | fullstop wrote: | I'm picturing D cell earrings over here. | | I'm not of the age or occupation where I need hearing aids, but | I think that I'd like overnight inductive charging, and I'd | take them out and charge them while sleeping. | noja wrote: | Two questions if you don't mind: | | Do you charge one ear at a time so you are never without some | level of hearing? | | Can you comment on the Live Listen feature of AirPods? | Jemaclus wrote: | I'm profoundly deaf, and I can answer these questions for | myself: | | > Do you charge on ear at a time so you are never without | some level of hearing? | | I'm completely deaf in one ear, so I only wear one hearing | aid. If I take it out, I have zero hearing, so... nope. | | Most hearing aids do not have rechargeable batteries, either, | so we have to change out the batteries on a regular basis. My | battery lasts about 7-10 days before I need to replace them. | | > Can you comment on the Live Listen feature of AirPods? | | It's not powerful enough to act as a hearing aid for my level | of hearing loss, nor is it calibrated correctly. | | To that last point, hearing loss is not simply a lowering of | volume. It impacts different frequencies at different levels, | so the normal amplification that comes from an AirPod or | similar headphone is not sufficient to compensate for | anything other than very very mild hearing loss. | barbazoo wrote: | You usually charge them at night. | Jemaclus wrote: | I have a BlueTooth-enabled hearing aid (ReSound Linq) that | connects directly to my iPhone. It's a life-changing feature. | It also has some capability to find hearing aids, but since I'm | profoundly deaf and not wearing my hearing aid means I'm | functionally completely deaf, then it's either in my ear or on | my nightstand, so I've never had the problem of "where did my | hearing aid go?" | 14 wrote: | Then you are in luck if looks don't matter just glue a couple | air tags to them and be done. | elliekelly wrote: | Do most elderly people even have the dexterity to use the teeny | hearing aids on the market today? | pugworthy wrote: | You may not have meant to, but your question just reinforces | the fallacy that hearing aids are for old people. Yes, | hearing loss does occur with age for many, but it's not as | uncommon as you might think for those not deemed "elderly". | | I've personally worn them since my mid 20's. I'm glad that I | ignored the perceived stigma of wearing hearing aids and got | them. They are like glasses for my ears. | cf100clunk wrote: | Not just elderly people. Rechargable devices would be a boon. | braum wrote: | I wear hearing aides every day. SMALLER would be better and | mine have BT5 and rechargeable. they are NOT cheap about | $6k pair with 3 year complete warranty included. Again | having options is the best thing, making them larger for me | would mean they are more easily dislodged when I bend over | to pick something up or are wearing them when working in | shop. Having some that have better weather or fully | waterproof would be great. I normal take them off when | working outside or in the shop. The sweat makes them mostly | useless because of the "noise" the sweat makes against the | mics. Then the sweat also makes them slick and they will | not stay in place. Having options is ideal and affordable | options would be great. I don't know why these things are | $6k pair when they share a lot of tech with modern in ear | options from bose/apple/ect. | criddell wrote: | > I don't know why these things are $6k pair when they | share a lot of tech with modern in ear options from | bose/apple/ect. | | It's because they can only be sold with a prescription | which means a lot of overhead and the expectation of | large margins for everybody. | | Get rid of that requirement and those will be be $600 | hearing aids. | cf100clunk wrote: | Agreed, it seems like $6k/pair is an astonishing cost for | what is not unreasonable tech in 2021 for an over-the- | counter product at much less. | funnyflamigo wrote: | Did insurance pay for them at all? Part of it is going to | be the whole "medical equipment" thing, the other is | where they play games with the price because they know | insurance will step in. | becurious wrote: | I stopped wearing my Oticon Opn S hearing aid when | running because they don't seem happy with sweat on a | long run. That and wind noise can still be an issue. Also | only having hearing loss in one ear means that they're | not really good for streaming audio but I do love being | able to take phone calls with my hearing aid. | | I'm ok with the cost since it's effectively half for me | and really $3K six or seven years would be fine | considering the quality of life improvement. Being in | large group meetings with multiple teams discussing | project planning could be painful for me. And it helps | with your relationship. When there's a background noise | source like road noise or AC or a running faucet your | brain will fill in based on the frequencies it can hear | and you will hear completely different words. | cf100clunk wrote: | I would add better integration with mobile devices beyond | bluetooth. I'm thinking a startup could create hearing aids | with self-tuning apps that employ spectral analysis and | echolocation capabilities for improving situational awareness | of the wearer. | nonameiguess wrote: | High-end hearing aids already do this on-device. I don't | think it would be a great development to require hearing aid | owners to own a smart phone and load an app onto it to be | able to get full functionality out of their hearing aids. If | the functionality needs to be externally configurable for | some reason, provide an external controller that comes with | the hearing aids. | cf100clunk wrote: | Yep, agreed on that - I was positing a better smartphone | suite of capabilities but not that hearing aids require | smartphones. | barbazoo wrote: | I've got an Oticon that has Bluetooth to connect to the phone | for the purpose of changing settings, streaming as well as | locating it. It charges using magnetic charging in a little | (proprietary) charging station. | jrace wrote: | All of that is currently available. (and has been for a decade) | inglor_cz wrote: | On a similar topic: I find it rather weird that contact lenses | need a prescription in the U.S. | | You will buy them over-the-counter here, and I have seen even a | vending machine full of them. (That was in Lithuania, IIRC.) | throwawaysea wrote: | Middlemen and gatekeepers are all over our medical industry. When | I travel I am always surprised at how much easier it is to get | drugs outside the US. Many prescription drugs here are over the | counter elsewhere and much cheaper. I hope we start removing | prescription gatekeeping more broadly, so I can stop paying | hundreds for performative office visits that offer no value. It's | also a big time sink just to get some mundane antibiotic or | skincare cream or whatever, when all that happens is that an FNP | runs through the most basic Q&A script that can be self | discovered online. | LocalH wrote: | Capitalism (as a _life goal_ , rather than one of many tools in | a toolkit) is what makes all that possible. If can insert | yourself in the middle of a transaction, and do that long | enough, then you can get pretty entrenched to the point where | people just expect it to be that way. | | I maintain that, if automobiles were invented _today_ , the | horse-and-buggy industry would be able to successfully fend | them off, based on the path regulatory capture has taken in the | last 150 years. | tpmx wrote: | There's plenty of capitalism happening in the countries where | these things are readily available. | | Cronyism is the word should have been looking for. | LocalH wrote: | Perhaps I should have said "societal goal". The stark | contrast between those countries, and the US, is that the | US collectively has this unwavering dedication to | capitalism _above all else_ , it seems in practice. | spicybright wrote: | Even if you disagree with this, the competition will bring prices | down to non inflated levels for everyone, and your insurance | premiums will likely reduce as an effect. | gumby wrote: | I just ordered some AirPods Pro to see if they will be adequate. | | I'm not sure hearing aids can really replace headphones for phone | calls etc until both HAs and phones support BT 5.2, and I don't | really want buy several $K of hearing aids that only work some of | the time. | slownews45 wrote: | Fantastic news. | | If you can afford the $5,000 - great! The current system works | for you. 80% of people cannot and so are stuck. | | For folks with mild/moderate loss (where a LOT of people don't | get help) something as simple as letting Apple tweak noise | cancellation to be voice enhancing and providing a tuning and | hearing test app in the iphone would be a godsend. | | The elderly miss out on a lot of family life because of hearing | issues - people stop talking to them even if they are fully sound | of mind because of this issue. I've seen this personally. | | And for all those who say apple is just a consumer products | company and there is no way their $180 - $250 airpods can provide | any benefit I think you might be surprised. | falcolas wrote: | FWIW, there is a nuanced difference between hearing aids and | iPods. Hearing aids basically apply a hearing-capability | matched EQ to the incoming sound. | | Why this matters: Hearing loss is not uniform across | frequencies, and we use huge portions of the spectrum for | different functions (truck backup beepers vs. car engine | noises, both used to identify what's coming your way). | eurleif wrote: | Samsung phones have a feature that tests your hearing at | different frequencies, creates a personalized EQ profile, and | applies it to your earbuds: | https://www.samsung.com/au/support/mobile- | devices/customise-... | falcolas wrote: | Cool. But without properly flat headphones and sufficient | sound isolation, I wouldn't put a ton of trust into it. | | It's probably good enough for an temporary situation, but I | wouldn't trust it long term. Improper amplification can | damage your hearing further. | eurleif wrote: | I don't know much about this topic, so interpret these as | questions, not as arguments that I have particular | confidence in: | | * If the earbuds you use to perform the hearing test are | the same ones you use with the resulting EQ profile, why | does it matter whether the earbuds are flat or not? If | you're taking measurements in a transformed coordinate | space, and applying those measurements in the same | transformed coordinate space, shouldn't that be | equivalent to taking measurements in the original | coordinate space and applying them in the original | coordinate space? | | * Why isn't active noise cancellation a good enough form | of noise isolation? | | * If using an EQ profile that only matches your hearing | loss imperfectly can damage your hearing, wouldn't the | same thing apply to EQ profiles that aren't intended to | correct hearing, like the media player presets "classical | music", "rock music", etc.? For that matter, wouldn't it | apply to a flat EQ profile? Is there something special | about an imperfect hearing correction EQ profile, | compared to other EQ profiles? | slownews45 wrote: | And you are CERTAIN that the iphone could not | | a) conduct a hearing test | | b) do a hearing based EQ on incoming sound? | | c) do sound profiles (ie, optimize for speech?) | | Realize that calling already may use some of this - using | microphones to pick out speech from background noise etc. | | For folks who have hearing issues you could have one device | that would cover your movie watching, your phone calls, and | hearing enhancement. For $180. | falcolas wrote: | > conduct a hearing test | | It could not. A hearing test requires an environment with | exceptional isolation and flat-response drivers (iPods are | not remotely flat) to be done properly. | | > do a hearing based EQ on incoming sound | | It could, given a proper prescription for the EQ, and an | understanding of the response curve of the iPods' mic and | drivers. | | > do sound profiles | | Not required, the EQ is tied to your hearing damage, not | your environment. | slownews45 wrote: | I've got a higher end audio setup, I can put the sound | calibration mic in the listening position etc (think YPAO | / Audyssey etc). But you get little weird sync issues at | times between sources / displays etc. | | On a whim I tried Apple's wireless sync. It's end to end, | and works as well as I could with manual tuning (which I | would do by filming at high speed a time audio sync | track) | | https://www.reddit.com/r/appletv/comments/itm711/psa_wire | les... | | So they demonstrated a consumer device could, in a few | seconds, generate a fantastic sync solution across my | entire input -> output -> room stack. Or I could spend an | hour fiddling around in settings. | | Airpod pro's provide a some level of isolation already | especially if you run the fit check. airpods are also not | that bad. | | You could do a calibration curve at factory if needed for | drivers. You could run a very user friendly process to | fine tune, in the comfort of your own home, a profile of | your hearing loss. You could update this anytime. | | You could then also obviously offer some presets to | amplify things in a targeted way. At the dinner table? | Focus on voices. At a concert, do a music preset. | | We've heard all this before with camera's by the way. The | iphone doesn't have a "real camera". Yes, I used to shoot | full frame. Yes, the iphone's cameras are "crap". But for | many people they are "good enough", and they have other | benefits, ease of use, easy to learn, not a big extra | expense etc. | | Let the market decide, apple can provide a warning -> if | you want to wait for insurance to approve a hearing test, | then schedule one, then wait for a device to be ordered | and ship, then go back, then be dependent on an | audiologist to tune things for you etc you should do so, | but if you want, try out little app here to see if it | helps. | jrace wrote: | They would need a properly calibrated set of | headphones/microphones and environment to conduct a proper | hearing test. | mnemotronic wrote: | <i>It could not. A hearing test requires an environment | with exceptional isolation</i> Don't be so picky. Or | don't let the perfect be the enemy of the good enough. | RHSeeger wrote: | I had some trauma induced hearing loss recently and cannot | hear certain frequencies at all with my left ear. When I | stand outside next to the (small) waterfall with it on my | left size, I can hear "part" of it from my left ear... and | the other part as if it was coming from the woods on the | right side. It passes right by my left ear w/o me hearing it, | bounces off the woods, and comes back to me. It sounds like | there's 2 different waterfalls, one on each side of me. | falcolas wrote: | Trippy, isn't it? A similar phenomenon can occur without | hearing damage, where the reflection to the right ear is at | the right phase to cause wave-interference with the source | waveform that reaches the right ear. | mnemotronic wrote: | I'll bet most earbuds with active noise reduction and | equalization could be tweaked to provide augmentation similar | to a hearing aid. The current algorithms for active noise | reduction are designed to suppress external sounds -- all | they have to do is invert the logic and amplify external | sounds. Just add EQ to make my wife's voice come in better. | ddlutz wrote: | This is me. 28, had mild hearing loss for about 3 years now in | one ear due to a bad ear infection. I can get by fine, however | I'm definitely missing out on a lot of "richness" of sound. I | can't hear high pitched noises, or subtle differences between | noises in my left ear at all. And everything in general is a | little muted. Since I can hear perfectly find out of my right | ear I'm not convinced spending thousands of dollars is worth | it. | | I would spend $10,000+ if my tinnitus could be cured | permanently though. | kristofferR wrote: | Yeah, the AirPods Pro's are amazing as hearing aids. | | The only issue is that they are very visible and only last 4 | hours each charge (I suppose you could get two pairs and switch | between them every four hours). | slownews45 wrote: | Airpods 3's should be 6 hours without spatial audio. And yes, | I do use one at a time! The charge time is pretty quick. | aurizon wrote: | A hearing test measures how sensitive your hearing is in each ear | at a range of frequencies - they send a beep at a certain | frequency and ask you if you can hear it, and lower the volume | until you can not hear it, raise it to confirm you can hear it. | This is repeated in each ear over the normal range of hearing, | nominally 20- Hz to 20,000 Hz, most older people have lost at the | low and high end. The detailed frequency/volume curve allows the | hearing aid to be programmed to bring hearing to the 'normal' | curve. Some people may have lost hearing at certain frequencies, | it may be an irrevocable loss? That said, an iphone with | headphones can easily create and administer a tone to each ear | that can be varies in frequency and intensity - with the customer | pushing a button when he loses the tone, repeat to confirm, then | on to the next frequency until the audio range is covered. They | the customer is given test results and he sets an on the phone | equalizer at the values needed for each frequency and he is good | to go. It needs to be made to limit the intensity to a maximum, | and some gaps might remain where he has lost hair cells and will | have a permanent frequency gap that can not be cured unless we | learn how to grow new hair cells in the right place of the right | length. A huge market will open up, there will be a wailing and | gnashing of teeth in the old FDA shielded crooks, who must adapt | or fold. If they adapt, they will do well. | jrace wrote: | And the test is done in a controlled environment with | calibrated equipment. | | A "iphone hearing test' is a useful screening tool, and no more | sadly. | aurizon wrote: | Well, a subjective test, in a quiet room, with test tones for | references is satisfactory for most purposes - if the system | determines that it is unable to assess the situation, it can | be escalated to an MD. | jrace wrote: | How much would you pay for: | | *Hearing test | | * Hearing aid fitting | | * Usage counselling | | * Follow up adjustments | | * Annual retest of your hearing | | * Replacement of lost hearing aids | | * Unlimited repair for 3 years ?? | | ====== I got out of the Audiology field in 2015. At that time all | the above was included for every hearing aid we sold (Prices | varied from $750 / ear - $3600 / ear. | | When I was in that field many companies tried "pay as you go" | models, instead of bundles. | | You know what happened? People paid the minimum (test, and fit) | the never returned for repairs or re-tunings. | | And then complained to everyone that "hearing aids don't work". | | Buy a hearing aid today from any major provider in Canada and you | get: | | Initial test | | Initial fitting | | Follow up tests | | Follow up re tunes | | Counselling | | repairs - including full replacement in case of loss | | Batteries | | In-clinic repairs and cleanings. | | 100% return, and in some cases $0.00 3 month trial period. | | There is far more to fixing your hearing issues that just | amplifying sound. Sadly, most people wait too long before trying | a hearing aid, and give up because they hear too much noise. | | Imagine returning your eye glasses because you still see ugly | people. | | I truly wish hearing aids were far cheaper, and that was a very | hard part of my job and one of the reasons why I changed careers. | RHSeeger wrote: | > There is far more to fixing your hearing issues that just | amplifying sound. Sadly, most people wait too long before | trying a hearing aid, and give up because they hear too much | noise. | | Of the people I know who have gotten hearing aids, every single | one of them was disappointed. Every single one of them still | had trouble hearing. As far as I can tell, the only thing the | audiologists appear to be able to be able to correct for (with | current hearing aids) is "make it louder". If more than that is | needed, it's a vicious cycle of taking it home, realizing it's | not really helping, and bringing it back to try a new one. | | The above seems to be particularly true when the hearing | problem is heavily weighed towards not being able to hear | certain/higher frequencies, so can "hear" people talking, but | can't understand it; especially if there's any background noise | at all. | | I sympathize that your job was hard and that the clients made | it harder. But the clients following directions and trying | multiple different hearing aids ... doesn't really solve the | problem in a lot of cases. Hearing aids are very expensive, far | too expensive for a result of "I still can't understand people | talking to me". | jrace wrote: | Perhaps it is because most of those people expected the | hearing aid to work for them, and did not want to do any of | the work they needed to do themselves. | | Imagine not reading for 10 years because of bad eyesight, eye | glasses do not make it so your brain can read, but instead | makes it easier for your brain to see the symbols. your brain | still needs to decode and comprehend them. | | Our hearing system is far more complicated. You can look in | the direction you want to see....but you hear all around you, | even through walls. | | You cannot stop hearing, even in your sleep. It is far more | crucial to our environmental awareness than more people | realize. | RHSeeger wrote: | > Perhaps it is because most of those people expected the | hearing aid to work for them, and did not want to do any of | the work they needed to do themselves. | | Or, alternatively, it's exactly what I said and the device | + audiologist combination just isn't up to correcting a lot | of common hearing issues. That seems far more likely than | the vast majority of people doing everything wrong. | tdeck wrote: | This honestly doesn't sound very empathetic toward | patients. Many of these people had fine hearing and then | lost it. They've already "learned" how to hear and they | reasonably expect the hearing aid to help restore it. | | In your analogy, it would be like if my vision got worse | and I got eyeglasses which partially restored it, but | mirrored everything upside down with tons of static. Now | I've got to learn to read upside down and tune out the | static, but don't worry because I get 10 free lessons with | a reading instructor. Oh and none of this was clearly | explained to me or part of my expectation when buying | glasses. | TaylorAlexander wrote: | I guess one question is: do those things have to cost thousands | of dollars? What are the primary cost components? Are the | people doing these jobs highly paid? Are they highly paid | because of high costs of college tuition? Would free college | help lower their costs? | jrace wrote: | My opinion: do those things have to cost thousands of | dollars? --yes and no, costs could come down, but in the | lifetime of a hearing aid it could be replaced 3 times or | more at no charge to the user. | | What are the primary cost components? The primary components | are: Microphone {cheap to produce} Receiver (speaker) {cheap | to produce} Processing Chip {expensive to R&D, cheap to | produce} | | Are the people doing these jobs highly paid? Salary in Canada | was between $60,000 (diploma) - $100,000 (Doctorate) when I | left the industry. | | Are they highly paid because of high costs of college | tuition? Depends, but after leaving for IT and making more | than that with less education - I am unsure if they are | "highly paid" | | Would free college help lower their costs? I would hope so, | but doubt the savings would pass on to the consumer. | bluGill wrote: | > I guess one question is: do those things have to cost | thousands of dollars? | | No. Hunters (and shooters) have been buying electronic ear | protection for years at much lower prices. There is no FDA | approval, and they are not needed so the manufactures have to | compete. The result is hearing aids in everything but the FDA | approval. Some people find they work better than hearing aids | because the manufactures have to tune them to work well for | their customers which means background noise reduction (not | just gun noise reduction) | | Don't get me wrong, those who are borderline find the hunters | hearing protection better. If your hearing is very bad you | need expert tuning for just year ears, and that can't be | offered without FDA approval. | | The high end ones are $200, and internally pretty much the | same thing other than the programming. The cheap ones are $30 | (but not programmable) | TaylorAlexander wrote: | These are good points. I was wondering about the costs of | the doctor's visits, but you're right we should perhaps | make those optional. | | I realized one thing that would help is "open hardware". If | you're supposed to see a doctor to measure and tune some | value maybe a device with an open interface and an app | would suffice (which I think others here mentioned today). | | The reason I asked about the cost of the doctor is I am | interested in doing things like giving them free school in | order to lower their need to charge high prices. Generally | I would rather every person has a good local doctor they | can see for free, but we could also deregulate these | devices and let people sort out amongst themselves how to | get the right fit. I would just want to take care that | people aren't damaging their hearing further with improper | use. | brutus1213 wrote: | Any insights on tuning process for little kids? (2-3 year | olds?) These guys don't really have the ability to provide | feedback for retuning. | jl2718 wrote: | Why is a doctor needed to do any of that? | bluGill wrote: | Maybe not a doctor, but you need someone to test your hearing | and write a custom frequency map for how your ear works. Good | hearing aids are not simple amplifiers, they have complex | signal processing to make it easier to hear what you want to | hear (if you like music they make music worse, but you can | understand the lyrics - this is a simplification, but good | enough) | scottlamb wrote: | > Buy a hearing aid today from any major provider in Canada and | you get: [...] | | Do you know what the status quo in the US is? (I don't, other | than the prescription requirement from the article.) What you | describe for Canada sounds pretty good to me, but I wouldn't | assume any part of US healthcare is as inexpensive as Canadian | healthcare or that the regulations are as well thought out. | jrace wrote: | No idea, but an initial search at "Connect Hearing US" (which | also has a large Canadian arm states; | | "2-week FREE hearing aid trial* Try before you buy, | absolutely free! Take a new pair of hearing aids home for two | weeks to see how they work in everyday situations -- no money | down and no obligation. | | 3 years FREE Batteries Get three years of batteries included | with your purchase no matter what hearing aids you buy. Each | year you will receive a box of 60 batteries for each hearing | aid. | | 3-year Warranty and 3-year Loss & Damage Enjoy a three-year | manufacturer repair warranty and three years' loss and damage | coverage for all hearing aids" | https://www.connecthearing.com/cost-of-hearing-aids/the- | conn... | brutus1213 wrote: | It is not perfect in Canada. Getting aids for our child and | was shocked that this is a few grand out of pocket (after | gold standard work insurance, provincial aid, etc). The | province pays 500 bucks per hearing aid, which seems | ridiculous given the costs. We are well to do so it doesn't | matter but I am shocked that this isn't fully covered given | the taxes I pay (in tech .. so you can guess). For kids, | this should be fully paid by the government - no questions | asked. As a few others (who seem to be knowledgeable) have | posted .. if u miss out on hearing, you start to be less | productive member of society. Being in a western, rich | society where we pay for stupid shit all the time out of | taxes, the govt not fully paying for some basic model of | hearing aids seems like a crime (basically, not enough | people are impacted, so politicians don't care). I'm glad | the US is improving the situation here for its populace. | thegrimmest wrote: | So your argument in favour of socializing this is that people | tend not behave optimally, in your view? This seems like a poor | reason. Let the people who fall victim to their biases suffer | the consequences, don't impose the cost of holding their hands | on those who are capable of managing themselves. | jrace wrote: | It was not an argument, but a statement. | | If one model (pay as you go) causes harm to the whole | industry (people know believe hearing aids do not work) then | why would the industry continue? | thegrimmest wrote: | I'm suggesting the model to use should be decided | individually by members of the industry, not imposed on the | industry as a whole. If some orgs want to use pay-as-you-go | that's fine. If others want to offer more comprehensive | service, that's fine too. I'm arguing for allowing the | interactions to take place, even if some choices made are | suboptimal. | jrace wrote: | They can. | | As far as I know (at least for Canada, circa 2015) there | were no laws or regs stating how, what or when to charge | for services. --other than some kind of return period. | aidenn0 wrote: | Because it's easier to get someone to pay $100 for | something they aren't sure will work (and then have their | beliefs confirmed) than to get someone to pay $1000 for | something they aren't sure will work (and then have their | beliefs refuted)? | thegrimmest wrote: | I think it depends on the someone in question | jrace wrote: | Would you rather pay $100 for something you are not sure | will work...or would you rather ay $0.00 to try it first? | | And then still be able to return it at least within the | first 30 days of paying for it? | retrac wrote: | Canadian here as well. I have a 35 dB / 70 dB loss in each ear | respectively. | | It is a pretty sweet deal if you can afford it. They do just | ship you already-programmed replacements if you've lost one. No | questions asked. Free adjustments. Very comprehensive. It's | pleasant and stress-free while you're covered by one of those | packages. | | But it's if you can afford it. When you can't afford the all- | exclusive package there's really not much else. I spent about | half of my childhood, teens and 20s without hearing aids due to | cost. Held back my education at all levels. Even when I went to | university, while I was eligible for provincial funding for | hearing aids at a student, I was still expected to pay the cost | up-front first. Independent adult students don't usually have | $5000 cash lying around. I missed most of my first year. | mherdeg wrote: | Hmm, why charge $750 instead of billing $20/month forever and | giving new hardware every 3 years? | asciimov wrote: | Easier pill to swallow. People on a fixed income don't want | to have their benefits reduced by $20 every single month. | | Public healthcare should just cover it. | germinalphrase wrote: | " Sadly, most people wait too long before trying a hearing aid, | and give up because they hear too much noise." | | Are you suggesting that getting hearing aids preserves your | hearing or simply that people with advanced hearing loss | benefit less from them? | jrace wrote: | Hearing aids allow you - rather enable you - to listen again. | Without them your understanding and comprehension gets lazy. | | Imagine if you stopped playing basketball because of a bad | knee. | | Then years later you get a knee brace and are able to play | again. | | How long, and how much practice would you need before you | could play at the level you were at before the knee problem? | | And without properly fixing the problem (just using a | mobility aid) could you ever return to pre-knee problem | levels? | dmurray wrote: | I've long thought the problem with hearing aids is the | calibration process. People (often old, confused, and less | tech-familiar) try them on and spend half an hour answering | questions about "does that sound better?" | | What if, instead, the calibration process worked constantly? | Give the user a button to press when they don't hear something | well, and another when they do. Let them have this for a month, | let them try it in their kitchen, their bedroom, the local shop | or bar, outdoors. Run some reinforcement learning algorithm to | optimize for getting more "good" presses and fewer "bad" ones. | Optionally, adapt separately to each environment. | | Is there a "smart" hearing aid calibrator that works like this? | If not, but you think it's plausible, I'm interested in working | on it. | jrace wrote: | THere may be now, but not 5 years ago. | | I have many ideas about how the industry can be improved, | especially with the use of a smart phone app and user | interactions. | | Not only is it plausible, but would make the clinicians | (fitter) job easier and lead to far more hearing aid sales. | EastOfTruth wrote: | > What if, instead, the calibration process worked | constantly? Give the user a button to press when they don't | hear something well, and another when they do. | | On TVs, they call those buttons volume buttons, it is | revolutionary. | RHSeeger wrote: | A lot of the time it's not absolute volume. If you can't | hear certain frequency ranges well, boosting the volume of | all ranges is just going to drown out the ones you can't | hear well. | EastOfTruth wrote: | so a smart volume button | phkahler wrote: | That pays attention to the environment and changes the | volume (part of the spectrum perhaps?) that is what | you're likely to be listening to. | | This is of course a huge oversimplification, and aiming | for it is probably what the industry is doing. | jrace wrote: | That is exactly what the tech does, automatically adjusts | based on the amount of noise and speech in the | environment. And going a step further, applying | directional microphone control to better pick up sounds | where the speech is. | neffy wrote: | Exactly - hearing is much more complicated than just | noise sensitivity. For example, a somewhat underdiagnosed | problems is issue with the frequency bins that the brain | segments sound into for recognition deteriorating. | Symptoms are - can hear just fine in a nice, uncluttered | audio environment, say a test centre, but has issues if | there is any significant background noise. | Swizec wrote: | > Symptoms are - can hear just fine in a nice, | uncluttered audio environment, say a test centre, but has | issues if there is any significant background noise. | | Also a problem if you're not a native speaker. I am | fluent in English and have been able to watch movies | without subtitles for 20 years at least, probably more. | | But put me in a noisy bar and my error correction suffers | a lot. Suddenly it's hard to follow a conversation that | in my native language would be effortless. | | The worst situation is listening to a loud video on bad | speakers. Doesn't matter how much you crank the volume, | people are hard to understand because the brain's error | correction isn't good enough. Use a good speaker and turn | down the volume, suddenly it's perfect. | robocat wrote: | Do any hearing aids frequency shift, or compress the | frequency scale (e.g. just higher frequencies compressed | down to lower frequencies so that voice tone stays | constant and sibilants get shifted down into hearing | range). | jrace wrote: | yes, I know Phonak hearing aids were doing that since | about 2012. For some of our more severe hearing impaired | patients it was a noticeable improvement in speech | comprehension. | spicybright wrote: | Definitely not the same, hearing aids do a lot more signal | processing than just amplifying sound. | mgkimsal wrote: | go further, and having 'hearing aids' that would let you | rewind the last 5-10 seconds of a conversation to hear | something again without asking people to repeat | themselves... | jrace wrote: | Hearing aids have volume controls, which some clinicians | disable for new users - as it causes more problems than it | fixes. | | And just like the TV remote they increase all sounds - good | (speech) and bad (music and explosions). | | The issue is not just "is it loud enough" but rather, "can | you understand what you want to hear when you want to hear | it?" | | imagine yourself at a busy restaurant. you want to hear | your spouses speach better, and the wait staff- but turning | their speech up also turns up the people you do not want to | hear. | | how do you fix that? | | noise reduction, speech enhancement, directional | microphones are just some of the tools a hearing aid uses. | | But ultimately what needs to happen is your brain works | harder at comprehending what you want to hear(yes, it is | work, and like all work people do not want to do it). | | So they think...hmmm, I will just pay $xxxx.xx and I wont | have to work anymore. | chrisfinazzo wrote: | Reminds me of the race to the bottom we're also seeing in | orthodontics. | | Whether like me, you never got the hang of a retainer | after braces - or went off braces too soon, in my case - | there has been a number of companies trying to get costs | down and make the process less expensive and onerous. | | Yet, talking to my regular dentist, who has used | Invisalign with patients before, it's not the fact that | there are more competitors in the field, essentially | putting pressure on the DMD's and others to up their | game, it's that after the initial consult, the entire | process is (largely) unsupervised. | | If you don't fit (or tune) something like this properly, | it doesn't work. | criddell wrote: | For the first four items on your list, I would pay for the | hardware cost of the hearing aids plus $200-$300. The last | three things should be optional like Apple Care or other | service contracts. | | Is tuning (and retuning) something that could be automated? | Because of tinnitus, my hearing is not the same every day and | so static settings feel like the wrong solution. | oneplane wrote: | Same in The Netherlands, and you don't pay out of pocket for | those either in most cases. It also makes a lot of sense for an | insurer if you think about it: people that are able to sense | their surroundings reasonably well might be less likely to get | into accidents causing that to then cost a lot of money. From | an ethics standpoint it also makes sense to be in a society | that aims to give people a good standard of living. Someone | slowly loses the ability to listen to music for example might | have a harder time enjoying life if music was an important part | for them, that might cause various forms of distress which can | turn into 'expensive' treatment for that. | | Some people argue that ethics have nothing to do with it, but | if that were the case, highly expensive insurances would be | mandatory, and payouts would be zero since business-wise that | makes a lot of money without being ethically encumbered. | chairmanwow1 wrote: | Correct me if I'm wrong, but isn't this something people could | do on their own at home if the hardware had a decent setup UX / | tuning instructions? This doesn't necessarily seem like | something that couldn't be done pretty automatically. | cf100clunk wrote: | See the Hackaday link I posted earlier for one such example. | AlbertCory wrote: | Almost half the comments relate to eye exams & glasses, not | hearing aids. There's almost no one defending the present system, | and I suspect if you took a poll of the US population, at least | 90% would favor deregulating hearing aids. Probably glasses, too. | | So why hasn't it happened? Those people who said "regulatory | capture" get a gold star. A small group who will suffer _a lot_ | manage to defeat a much bigger group who will benefit by a much | smaller amount. | Damogran6 wrote: | So do I...oddly, I went and got my hearing tested and my issues | are with processing, not hearing. The guy said "I actually can't | prescribe you a hearing aid, even if I wanted to." | | So, there should be some barrier to entry. Just not at $3500 an | ear. | jrace wrote: | That is a very realy situation for most people. | | A hearing aid - AIDS you in hearing, but your brain does the | processing and speech comprehension. | | if you start wearing a hearing aid now you will just get lazier | with your "hearing". Just like if your knees are sore, and you | get a knee brace - when you should have done exercises to | improve your muscles supporting your knee - the brace will do | more harm than good. | bserge wrote: | I am in pain every fucking second of walking. | jrace wrote: | So you should be treated differently than someone who | "doesn't walk much because my knees are sore. | JCM9 wrote: | There are a number of healthcare areas in the US that have been | protected by regulation, but it's increasingly unclear if this is | good for patients, consumers, or public health at large. The | increasing sentiment seems to be probably not. | | Vision care is another area I'd expect to see more changes and | disruption coming down the pipeline. Vision care is very | important and advanced cases require special skills, but it's | also unclear why many routine checks couldn't just be done by a | family doctor. | | The US requires one to see a "doctor of optometry" to get a basic | single vision prescription. That industry used to make its money | turning around and selling you glasses from the same office but | that whole industry has been turned upside down by online | retailers like Warby Parker and such. Why the US can't follow the | models followed most elsewhere in the world is unclear, but it | would remove a lot of extra steps and costs in getting a basic | care of glasses. Ophthalmology (medical doctors) are still very | much a thing but most countries don't have this model of needed a | "prescription" from an optometrist for a basic pair of single | vision specs. | WillPostForFood wrote: | _There are a number of healthcare areas in the US that have | been protected by regulation_ | | Really, isn't it all areas? | xmprt wrote: | One pretty big (and relatively unknown) law is that your doctor | needs to give you your vision prescription so you can buy | glasses elsewhere (usually for much cheaper). I think a lot of | them get around this by letting you look for glasses while | waiting and not telling you that this law exists. | kwiens wrote: | You're absolutely correct that this has had a huge impact. | This is actually the FTC's eyeglass rule and not a separate | law, something that I didn't know until they started getting | involved with Right to Repair. | | https://www.ftc.gov/enforcement/rules/rulemaking- | regulatory-... | [deleted] | gumby wrote: | They often leave off the IPD (distance between your pupils) | to make the prescription useless (you can measure the | distance yourself). | tyingq wrote: | They also get around it by first handing you a prescription | that doesn't have your pupillary distance noted. It's such a | passive-aggressive bullshit move. | tristor wrote: | The bigger issue is that a prescription alone is not enough | to order new glasses, you also need pupillary distance | measurements in order to ensure the lenses are ground | correctly. Many many optometrists will not provide these, | only the legally obligated prescription. While for most | people who have minimum prescriptions you can use a phone app | or similar to get a rough PD, for anyone with serious | prescriptions even minute variations in PD can prevent proper | vision correction. | otabdeveloper4 wrote: | I'm not in the US; when I got my latest pair of glasses | they just used a ruler. It works fine. | | (Yes, I'm exactly one of those people sensitive to "minute | variations".) | handrous wrote: | I used the "ruler on a mirror, open one eye, center it on | the end of the ruler, close it and open the other eye, | mark where the center is on the ruler, then read the | measurement (in mm)" method. Did it a few times to be | sure, exact same results every time, just have to keep | your head still and geometry does the work for you. | Glasses made using that measurement have been entirely | fine, no problems. | adolph wrote: | Worked for me too. Had my PD measured afterwards and | device value was same as mirror method. | donatj wrote: | I needed my PD to get prescription lenses for my Oculus | headset and it wasn't on my prescription. | | On a whim I asked at a glasses store in the mall if they | could measure mine. They happily did it for free. Your | milage may vary on that of course, depending on the person | you interact with. | dsr_ wrote: | On the other hand, your PD should not change once you are | an adult, outside of major traumatic events. | vburg wrote: | They made me sign a waiver then gave me the wrong | measurements. | JCM9 wrote: | If an industry's strategy to keep itself alive is keeping | the distance between your eyes a closely protected | secret... the end appears near. | FemmeAndroid wrote: | This happened to my wife just last month. I was very | frustrated when I saw that she hadn't received a PD, but I | didn't realize that this is a frequent and intentional | decision at this point. Extremely frustrating. | mikeInAlaska wrote: | My local optometrist uses a $99 Enshey (check amazon) IPD | measurement device. I guess if I was ordering glasses for | my entire family (we do), it would probably be worth it. | nicoburns wrote: | Really? Mine just eyeballed it with a ruler! | etaioinshrdlu wrote: | I've probably been to 5 optometrists over the years and | they all provided PD. | radicaldreamer wrote: | I asked about 3 times for a PD measurement at my last exam | and they distracted me and failed to put it on the | prescription or measure it... didn't realize this was | probably intentional | bluGill wrote: | Last time I got glasses I bought from them, and asked | about swim goggles - which they don't carry. They then | happily wrote my PD on a paper for me to use when buying | swim goggles - or anything else. (too bad I lost the | paper since...) | elliekelly wrote: | The law specifies they have to give you the paper | prescription (for no extra charge beyond the cost of the | exam) _even if you don't ask for it_. There's no getting | around it. Either they give you the prescription after your | exam or they're not compliant with the law. Consumer | ignorance or apathy isn't a valid defense. | nomel wrote: | You would think that someone would have a smartphone app for | this. | dzhiurgis wrote: | Life pro hack - look out for "free eye tests" - get the | prescription and walk out without a purchase. Something like | 90% of market is captured by Luxotica hence 4x price when | compared with online. | dboreham wrote: | I find Costco to be a reasonable workaround. | skybrian wrote: | Getting new glasses is different from screening for eye | diseases, though it's typically done at the same time. I doubt | a GP would have the special equipment they use for screening? | It's pretty specialized. | | Apparently the need for this gets more important as you get | older: | | https://healthy.kaiserpermanente.org/health-wellness/health-... | JCM9 wrote: | Many optometrists don't do much more than use a hand held | scope to look into your eyes. I'd imagine most GPs either | have that on hand already or could get it easily. It's not | like you need an MRI machine in the office to do an eye exam. | | Yes some office have fancier equipment, but here it's unclear | if that's actually better for patients and public health or | just a way to bill more. Doing a basic exam and then | referring those to true specialists is generally the model | followed by nearly everything else in healthcare. | jjeaff wrote: | I have been to maybe a half dozen different optometrists | over the last 25 years and they have always used several | expensive looking machines to screen for eye disease. Most | frequently a machine that uses a puff of air to measure the | pressure in your eye and more recently, a machine with a | bright light that gets detailed imagery of the vascular | structure on the back of your eye. | JCM9 wrote: | Yes, although that test is automated and typically done | by a technician not an optometrist. You can train someone | to use one of these machines in a few hours. If this was | a key test no reason we couldn't just put one in every GP | office and have eye pressure checked during an annual | checkup. | RHSeeger wrote: | Those machines cost money and require some amount of | training to use. Having them in an office that | specializes in using them makes sense. Having your GP | have every type of machine for every types of checkup | (eyes, ears, CAT, MRI, etc... all things that _could_ be | at the GP, but aren't) would not be cost efficient. | InvertedRhodium wrote: | > annual checkup | | We're supposed to go EVERY YEAR? | throwawayboise wrote: | LOL I know. I haven't been for a "checkup" in close to 30 | years. | dsizzle wrote: | Not sure why vision checks require a doctor at all. In the end, | they're just relying on your responses anyway: "What's better: | A or B"? In fact, I'd go further and say it doesn't even | require another person. | | I, for one, am glad to see this bill. | falcolas wrote: | FWIW, a checkup for me is 1 part refraction, one part retinal | inspection, one part corneal inspection, and one part | automated refraction/pressure checks. | | Only one of those parts can be done without a doctor or | highly specialized equipment. | dsizzle wrote: | Right, I was only talking about that 1 part. (Wasn't | suggesting there's no use for optometrists!) | falcolas wrote: | I guess I'm a bit confused then - if it's part and parcel | of a regular checkup, what's the value of breaking the | refraction out into a wholly separate activity? | dsizzle wrote: | Your vision could change faster than however often you | need your cornea examined or whatever. Or someone may not | be able to afford a doctor's visit but know they need | glasses (ignoring the question of whether it's right for | people to not be able to afford an eye doctor's visit). | | Extending your logic to other areas would end up with | absurdities like needing a doctor to measure your waist | size before you can buy clothes. "You should visit your | doctor regularly anyway, what's the value of allowing | people to buy pants without a prescription?" | mbg721 wrote: | Vision checks have also changed a _lot_ in the last five | years or so. I have a pretty strong prescription and always | used to do rounds of reading charts and "A or B", and now | there's a machine that scans my eyes and gets it _very_ close | to right, with an adjustment or two at the end. | dr_dshiv wrote: | 12 years ago, I walked into a second hand eye glasses shop | in India and they had one of these machines. It was | amazingly effective. I felt duped by all the optometrist | appointments asking me about A or B. | mixmastamyk wrote: | Duped, because they are doing it the old-fashioned way? | dr_dshiv wrote: | Because they are making theater to justify their cost. | comeonseriously wrote: | Did the machine tell you if anything else was wrong with | your eyes? Could it? | dr_dshiv wrote: | It could determine my index accurately. It couldn't tell | if I had symptomless eye cancer, however. | fn-mote wrote: | To me, the tradeoff of an expensive modern machine vs an | cheaper iterative process seems logical. I think it's | funny that a second hand shop has the fancy equipment... | but they must know it sells glasses more effectively. | | Here, the machine results are used as a starting point, | validated by A/B but I don't know if the human part is | effective or just theater. | dr_dshiv wrote: | Well, assuming the optometrist charges around $50 per | hour, after 10 patients it would pay for itself. I assume | the machine is simply cheaper, which is why it was used. | forbiddenvoid wrote: | This machine is not new. I remember it being used to | approximate my prescription when I joined the US Army | almost 20 years ago. | balls187 wrote: | They can now check ocular pressure without the puff! | ro_bit wrote: | That's amazing! The puff is soooo uncomfortable! Is the | technology to do this widespread? | jtwaleson wrote: | Eye exams are not easy or one size fits all. The machine | does objective refraction, which is a different and more | error prone method than subjective refraction. Also for | multifocals you'll need a more tailored prescription. | There's definitely progress in autorefractors though! | tryptophan wrote: | >require a doctor | | Just a note, but optometrists are "doctors" (because | optometry is a doctoral degree), but not doctors in the | colloquial sense, ie people with MDs who work in hospitals. | | Ophthalmologists are the MDs that specialize in eye disease, | and are the ones that treat infection and do surgery. | leguminous wrote: | Optometrists treat infection and disease, and can work in | hospitals as well. My fiancee is an optometrist who did her | residency in a hospital and has worked in hospital systems. | JCM9 wrote: | Vaccine administration is another area that has seen / is | seeing broad deregulation. In many states one needed a medical | doctor to "prescribe" a flu shot or other vaccine. Now many | states have moved to allow such "prescriptions" to be written | by pharmacists and issued right there on the spot in a | pharmacy. | | Some physician groups fought that tooth and nail... not because | there was any real evidence of people dropping dead from mis- | prescribed vaccines but because it was a good stream of easy | revenue for their office billing insurers for giving the shot. | This change was much better for consumers and for public health | overall by making vaccines more readily accessible. | m463 wrote: | I missed a very critical vision deficiency with my child | because I only did cursory vision checks when growing up. | | I think this influenced the ability to see characters which | greatly impacted reading ability. | colordrops wrote: | In china you can get prescription lenses at a local market | without any involvement of a medical professional, at extremely | cheap cost. There isn't much evidence that this is causing | negative medical outcomes. | | On the flip side it used to be very easy to get antibiotics | without a prescription there. I'd be surprised if this is still | the case. | balls187 wrote: | > The US requires one to see a "doctor of optometry" to get a | basic single vision prescription. | | You can take virtual eye exams, which are reviewed by doctors | to issue a prescription. | | The real issue isn't the basic care of glasses, instead it's | the screening of your eye health. | | When you go to Urgent Care, say for a laceration, they do a | quick work up, including taking your temp, blood pressure, | blood o2, weight and height. | | Having your eyes checked out in person with a comprehensive eye | exam annually is a good habit. And tying it renewing an Rx for | Contacts / Glasses just makes it easier to do. | diob wrote: | There are so many cost barriers to treatments. It's definitely | not for patients at this point. | | For instance, I am supposed to redo my sleep apnea test every | so often. But it's out of pocket? Why bother, I know mine is | due to my genetics (I'm not overweight). So why am I subjected | to reproving my need for a prescription? | | For eyeglasses, if someone wants to continue the same | prescription they can't. | | It's like healthcare in the USA is a damn subscription model | with yearly fees to keep getting things just prescribed (let | alone treatment on top). | dsr_ wrote: | That's particularly odd because the normal prescription for | sleep apnea right now is for a self-adjusting PAP machine -- | an APAP -- which has quite a range of pressures that it will | automatically apply to minimize apneation events. And if you | exceed the range, it will wake you up and alert you to that | fact, too. | KennyBlanken wrote: | > For eyeglasses, if someone wants to continue the same | prescription they can't. | | What? You don't need a medical prescription to order glasses | online. You can put in whatever numbers you want and they'll | happily make them. | | You'd be an idiot to do so, however, as your vision can | change with age. | ViViDboarder wrote: | I had to submit my (very mild) prescription for glasses to | Warby Parker. | gregw134 wrote: | You certainly do for contacts. I have to order mine from | the UK because all the US websites require prescriptions. | ericmcer wrote: | You 100% need a prescription to order prescription glasses | or contact lenses online. Expired prescriptions will be | rejected as well. | comeonseriously wrote: | Contacts are regulated like drugs, so, yeah. But there is | no such restriction on eyeglasses (in the U.S.). | Depending on the state, they do "expire" (in FL it's 5 | years), but you can still use it[0]. I have bought some | beaters from Zenni and made the Rx up myself (I used to | work in a lab a hundred years ago, so I can figure out | how much more plus my readers need). | | [0] Some places will reject it just because they don't | want to deal with your complaints about a new pair not | working. Other places will read what's on your current | pair and match that. It really depends on who is making | the glasses. | comeonseriously wrote: | > You'd be an idiot to do so, however, as your vision can | change with age. | | Not to mention, getting an eye exam is more than just | clearing up your vision. It can reveal other issues (and | not just eye related! They can often see other problems, | like say, cholesterol issues, for example.) | coupdejarnac wrote: | I'm going through this right now. I know I probably need a | cpap machine, so paying $300 out of pocket to rent a stupid | device to record my sleep seems like a waste. | tpmx wrote: | Well, at least you're doing it. | | Crude but realistic: There is a pretty high number of | (often but not always overweight) undiagnosed/untreated | people suffering from obstructive sleep apnea on the roads | every day. They are causing a number of avoidable accidents | every day. | | I think it's criminal to make CPAP as unaccessible as it is | in the US. | coupdejarnac wrote: | Not to mention lost productivity. I wonder what the | dollar amount for my lost productivity over my lifetime | due to poor sleep would be. Probably very high. | tpmx wrote: | Yeah, I probably lost a few years of productivity myself, | before I got it diagnosed. | IgorPartola wrote: | I am constantly reminded that the word "to disrupt" should be | in all instances replaced with "to fuck up". | KennyBlanken wrote: | Evaluating someone's eye for glasses can be done entirely by | machine as can manufacturing the glasses themselves. I do not | understand why we still force people to spend 5-10 minutes | sitting in a chair in a dark room going | "better....no...worse...better..." | asciimov wrote: | The machines can't gauge for personal preference. Many people | don't like their vision right at 20/20. I personally like | mine closer to 20/15. | joe5150 wrote: | This I think has a lot to do with individual experiences | with optometrists. I went to probably half a dozen | optometrists since adolescence before I happened to end up | with one who actually made it clear there's a degree of | subjectivity with an eyeglass prescription. | comeonseriously wrote: | Because an eye exam isn't just about the final prescription. | It's about whole eye health (retina health, cancer, | cholesterol, diabetes, etc). | lisper wrote: | > Why the US can't follow the models followed most elsewhere in | the world is unclear | | To the contrary, it is very clear: regulatory capture. | | https://en.wikipedia.org/wiki/Regulatory_capture | JCM9 wrote: | Yes... didn't know what the technical term was but that's it | mschuster91 wrote: | > but it's also unclear why many routine checks couldn't just | be done by a family doctor | | Ordinary GPs aren't experts and the equipment for doing vision | checks is expensive and consumes space. | | IMO, medical care should be completely re-organized. Get rid of | GPs as a profession (outside of cruise ships and the military) | and GP practices entirely. Instead, have community clinics for | everyday medical needs spread out over the country that have a | team of skilled nurses for triage with a number of subject- | expert doctors at the second level, and large/university | clinics for everything the community clinics can't deal with | (urgent/trauma care, oncology). | | That would also shorten training times and effort for new | doctors by a _significant_ degree - e.g. in Germany, an | ophtalmologist requires a full medical degree (over six years, | not counting waiting times because medical study places are | short in supply) followed by five years of specialized | training. Realistically, training any expert doctor now takes | at least twelve to fifteen years... and that 's frankly absurd, | and part of why medical costs are so sky-rocketing. Not many | students make the ridiculously high entry requirements, many | don't survive that time (and sometimes literally - suicide | rates among medical students are way above average!), and those | who have their MD are left with fifteen years worth of student | debt which means they have to charge extraordinary hourly rates | simply to be able to pay back the loans. | busymom0 wrote: | I understand why things like drugs we inject in our body need to | be regulated. But I don't understand why hearing aids need to be | regulated this way and even need a prescription. It's either "hey | I can hear well and it fits my ears well" or it's "it doesn't | help me hear well". | jrace wrote: | Because improper use can cause significant hearing loss. | tpmx wrote: | Next do CPAP, please! | kristofferR wrote: | Contact lenses next? | | It's amazingly stupid that I, as a tourist, who knows exactly | what types of contacts I need, may need to get a US prescription | for contacts. | weaksauce wrote: | if you have an address for any length of time you could use a | service like coastal.com as when I bought mine I am pretty sure | they didn't ask for a formal prescription. I only have | experience with them but maybe others like warby parker or the | like are similar? | bastardoperator wrote: | How are optometrists supposed to make money if they don't sell | you services and glasses from their showroom? | DaveExeter wrote: | They charge for the eye exam. | bastardoperator wrote: | That's the break even, those optometrist tools aren't cheap | and that's to get you in the door. The real money comes | from frames and contact sales. | RHSeeger wrote: | Then their business model is broken and they need to | charge more for exam. | adam_arthur wrote: | How are people supposed to make money when we have machines | producing all these goods! | | Maybe your post was sarcasm though :) | | That's the economic progress of humanity. We automate, and | jobs that were once valued are no longer needed. | | Easy to look at a specific instance and fight against the | change, but in the long run it's better for everybody. | | Glasses/Vision in particular costs hundreds more than it | needs to. Glasses could be produced and sold at $10-20 bucks | if regulations were eased. What is the material cost to | produce these? You can get reading glasses in grocery stores | for a few dollars. | | I'm fairly well off and even I feel bad paying over a hundred | dollars for some of this stuff. Imagine all the lower | earners/poor that pay hundreds of dollars for glasses for no | reason other than protectionism. | | The entire eye exam can be automated very easily (and I | believe already has). Would be easy to have machine learning | algorithms that can diagnose problems from the image of your | retina scan. I really don't think it'd be that difficult, if | it doesn't exist already. | [deleted] | bckygldstn wrote: | For the commenters asking: this applies to contact lenses, not | eye glasses. | | From the Contact Lens Rule [1]: "a contact lens seller cannot | provide contact lenses to its customer unless the seller either | obtains a copy of the prescription or verifies the prescription | information with the prescriber" | | The Eyeglass Rule [2] doesn't contain this stipulation. | | https://www.ftc.gov/enforcement/rules/rulemaking-regulatory-... | | https://www.ftc.gov/enforcement/rules/rulemaking-regulatory-... | DeusExMachina wrote: | It is amazing how things that we take for granted somewhere | do not work in other countries. | | Here in The Netherlands, I can walk in a shop and get contact | lenses off a shelf. It does not even need to be a dedicated | shop. These are available in generic care shops where you can | also buy shampoo, vitamins, and even some medicines that | don't require prescriptions. | nostromo wrote: | Many states have that rule though. | | In California, for example, you can't buy prescription | glasses without an active prescription. | | I found this out when my glasses broke on the weekend and | couldn't get replacements before talking to a doctor -- none | of which had availability for several days. So I suffered | from headaches and poor vision for several days thanks to | this ridiculous regulation. | jsmith45 wrote: | Sure states may have that rule, but it is totally legal to | go to a state that does not have the rule, buy some glasses | and bring them back. (Or to buy online from a state that | does not have the rule). | | Neither the FDA nor FTC at the federal level technically | require prescriptions for glasses. Indeed, most online | glasses shops will simply take you at your word that you | have a prescription, presumably because they are located in | a state that nominally requires a prescription, but places | no requirement on the shops to verify that the customer | really does have one. | | This is totally different from contacts, where at the | federal level, sellers must verify the prescription with | the prescriber, except that if 8 business hours have passed | since they started trying to contact the prescriber, | without hearing back, the prescription is considered | verified. (That last is to prevent the prescriber from | trying to prevent customer from getting lenses elsewhere by | refusing to verify). | bckygldstn wrote: | Interesting, I thought I had bought glasses in a CA Warby | Parker store without a prescription. | | Maybe it's a Tesla-style showroom thing where you look at | the frames in store but technically buy the glasses online. | jtwaleson wrote: | Do you mean contacts or glasses? | 0des wrote: | Surely it's not glasses, I just go to the website and punch | in my measurements, pick frames and they arrive shortly | after. | jtwaleson wrote: | Afaik you need a valid prescription by law in the US. This | might not be strictly enforced or verified by the | retailers. | 0des wrote: | I'm curious which law that might be. Is this something | you've run into legal issues with in the past? | jtwaleson wrote: | I'm CTO of easee, an online eye exam and have been | involved in some US market research. It's a rapidly | developing field and a lot of regulations are a gray area | or different per state. E.g. it might be mandatory to | have a valid prescription, but it might not be mandatory | for the seller to verify this before selling glasses | online. | | I've just learned some new things about the eyeglass rule | from a sibling in this thread. | tshaddox wrote: | Is this really a problem in practice? I've always had a valid | prescription when I buy glasses, but at the glasses store I | just flash them the prescription on my phone for a few seconds. | It's a PDF on official looking letterhead, but I don't think | there's any verification. I suppose it's probably not the best | idea to fake an eyeglass prescription, but it certainly seems | like it would be very easy to do. | hellbannedguy wrote: | Thanks! I have been thinking about this route. | gmadsen wrote: | yes, considering many people can't afford to see a doctor | luckydata wrote: | In California I couldn't buy anything without a US | prescription when I immigrated, everyone refused it. | kempbellt wrote: | For contacts, it's incredibly frustrating when your eyes | barely change over many years, but prescriptions only last | two years (or one, depending on state). You may need to | resupply on contacts, but are not able to purchase them | without a new prescription. | | You can be 1 year and 11 months into your prescription and | buy 4 years worth of lenses, but at the two year mark, you | can't purchase them at all without another visit to the | doctor and explicit approval for a specific prescription. | | My particular annoyance is that I usually buy a year or two | worth of lenses at a time - one set usually lasts a month, | but I don't wear them every day. So I can stretch out the | time a bit further. By the time I'm down to my last set and | want to resupply, I'm required to visit an optometrist. | Spending money on another eye exam that tells me nothing new. | It's even more frustrating if I completely run out and have | to use a set longer than is ideal while waiting for an | opportunity to visit a doctor. | | I get that wearing the wrong prescription lenses isn't ideal, | but I don't understand why prescription lenses are gatekept | like narcotics. If you can't see well or have the wrong | prescription, there's a natural incentive to visit an | optometrist and figure out exactly what you need. | bckygldstn wrote: | > I don't understand why prescription lenses are gatekept | like narcotics | | Unfortunately, the answer is regulatory capture. | Optometrists in the US make the majority of their income | [1] from selling glasses and contact lenses, which of | course they also prescribe. There's been a lot of lobbying, | collusion, and non-compliance in the industry which the | (admittedly biased) link below outlines well. | | [1] https://keepcontactlenschoice.com/the-issue/faq/ | jjeaff wrote: | There isn't any verification. They certainly don't call the | optometrist to verify. Not saying I've done this, but one | could submit an old Rx and change the date in Photoshop as | well as the name and number of the doctor and buy contact | lenses or glasses online just about anywhere. Theoretically, | of course. | dymk wrote: | Of course, it's also both theoretically and practically | fraud, and most people would rather spend the $100 on an | eye exam every 2 years than expose themselves to rx fraud | (2 years jail / $2k fine) | bckygldstn wrote: | * I had an optometrist only give me a prescription for | glasses, even though I indicated I wear contact lenses on my | intake form and was wearing them at the appointment! When I | realised a few days later after being denied trying to buy | contacts with a glasses prescription, the optometrist said I | would have to come in again and pay for a full consultation | (out of pocket as my insurance only covers one per year). | | * I've tried to buy contacts online in the US with an expired | prescription, the retailers say their hands are tied, they | need a current dated one. | | I now just buy contacts online from Europe or New Zealand. No | BS, same price, the EU company I buy from includes a mini bag | of haribo gummies :) | weaksauce wrote: | i'm pretty sure us based online don't require a formal | verification... i only have experience with coastal though | and only for glasses. | bckygldstn wrote: | The law only applies to contact lenses, not glasses. | handrous wrote: | I've used Vision Direct (someone linked them, above) for | contacts, with an "expired" subscription. Entered | whatever numbers I liked (so, the ones from my existing | contacts boxes), paid, and received contacts. Only | slightly cheaper than buying at my optometrist's office, | but saved me pointless visits resulting in "yep, looks | like your eyes haven't changed... yet again". Reckon I'll | stretch those to every 3-4 years rather than annually, | assuming I don't notice problems sooner. | | I've used Coastal and Zenni for glasses. No problems. | fshbbdssbbgdd wrote: | I've successfully bought contacts online from multiple | vendors by putting down a disconnected number as my | optometrist. | res0nat0r wrote: | My contact prescription hasn't changed in 10+ years and | I've been tired of having to go across town somewhere to | get an eye exam, 1-800-contacts has an online exam you can | take and don't need to drive anywhere and it's all digital. | I've used this the last 2 times I've renewed and gotten new | contacts and what I'll keep doing from here on out. | xnyan wrote: | >I now just buy contacts online from Europe or New Zealand. | | I would love to do that, could you share which vendors you | use? | bckygldstn wrote: | I usually just search for "contact lenses EU", check they | ship to US (most will list this in their FAQ) and pick | the cheapest. | | Looking through my email receipts, I've used: | | lenstore.co.uk | | visiondirect.co.uk | | contactsexpress.ca | | specsavers.co.nz | throaway46546 wrote: | I found it amusing that none of those are in the EU. | bckygldstn wrote: | Yeah, I mean EU as in EUrope, not EU as in The European | Union. | buildsjets wrote: | Neither Canada nor New Zealand are in EUrope. | iudqnolq wrote: | I've had a good experience from vision direct. A student | I know says it's the recommended option for foreign | students at the university in the UK they go to. | max-ibel wrote: | You need to know your prescription, but not present it if you | order on Zenni for instance. Parker Warby is probably the same. | treeman79 wrote: | I ordered an optometry kit from Amazon as my prescription | changes by the hour most days. | | Was very interesting to play around and helped me isolate the 2 | prescriptions that my eyes drift back and forth from. | | Something that eye doctors had given up on trying to help me. | buildsjets wrote: | I need a different prescription depending on how wide my | pupils are. I have separate glasses for night driving. | Discovered this after a consultation with a real | ophthalmologist, not an optometrist. They can dilate your | pupils with eyedrops to take what's called a wet refraction. | MandieD wrote: | OMG. You may end up having changed my life - it had never | occurred to me that a) this was a thing I could just up and | buy, and b) it really isn't that expensive. | | No more worrying that I'm about to stick myself with the | wrong prescription because the optician (yes, that's who | measures you for glasses in Germany) or I lost patience | trying to find the boundary between spherical and cylindrical | correction, or doing this at the wrong time of day, all for | less than a pair of glasses costs. | | Any brand recommendations? | treeman79 wrote: | I got a 200 dollar set that I'm happy with. It comes with | "glasses" to attach the lenses to. But suggest ordering one | that is more adjustable. The one it came with doesn't | adjust for distance between eyes. | jtwaleson wrote: | Cool, that's a great hacker approach! Fine-tuning like this | isn't economical for eye doctors, and 99.5% of the population | isn't interested but it will give you the best results. | | Just checking because it looks like you're from '79 and talk | about drifting vision: you know about presbyopia and | accommodation? You might need multi-focals. | treeman79 wrote: | It's cranial pressure and sixth nerve palsy. As my cranial | pressure goes up my horizontal eye nerves weaken causes | vision to go double. | | Prism glasses fixes this. But it's a completely different | power. +3 goes to -1 or anything in between. | | As pressure goes down it reverts. Medication or activity | can drop or raise it in an hour or less. | jtwaleson wrote: | Wow, that's more serious than what I was expecting and | beyond my limited ophthalmology knowledge. Glad that you | managed to find a solution. | jedimastert wrote: | Is that true? I've ordered all of my glasses online for the | past few years, and they've never asked for anything other than | a form to fill out. | TedDoesntTalk wrote: | I don't buy online because I want to see how they look on my | face first. | | Many shops won't sell you glasses unless your prescription is | under 1 year old. This allows them to charge you for an exam | when you don't necessarily need it. | handrous wrote: | Lots of Zenni frames are so cheap that it's non-crazy to | just order like 3 pair you think might work, and keep the | two you like the least as backups, wearing the one that | looked best. They also have "see it on your face" tech | that's... OK, for narrowing it down. Better than nothing, | and better than looking at them on a model. | bckygldstn wrote: | Sites like Warby Parker will send you a bunch of frames to | try on for free so you can see how they look. | | And I find sites like Zenni are so cheap that it's worth | taking the risk: an ugly pair can go in the car /gym bag / | work desk for if I lose a contact lens. | distances wrote: | Every time I change glasses I try at least 20 frames, | more likely 40 frames, before finding anything close to | acceptable. Something that looks fine on a shelf most | often looks ridiculous on my face. Can't imagine ordering | online. | Turing_Machine wrote: | Some of the online shops now actually allow you to upload a | selfie, and they'll composite your chosen frames onto your | face. | | Probably not quite as good as a live view, but not bad. | comrh wrote: | Blood work too, let me just test my own cholesterol please. | skizm wrote: | Visiondirect.co.uk sells contacts to US customers without a | prescription FYI | kevin_thibedeau wrote: | Then the doctor leaves their signature off the prescription so | that it is effectively useless. | Turing_Machine wrote: | I've had no trouble ordering from online retailers such as | Zenni Optical just by typing in the numbers from the | prescription. No signature needed. They do ask for a | prescription date, and require that to have been within the | last two (I think it is) years, but as far as I can remember | it's all on the honor system. They don't even ask for the | doctor's name. | | Edit: it occurs to me that this may very well be one of those | things that's dependent on state laws, so your mileage may | vary. Worth a try, in any event. | | Edit 2: and yeah, this is for old-school glasses. The | requirements for contacts may be more stringent. | kevin_thibedeau wrote: | 1800contacts definitely rejects unsigned prescriptions. You | have to upload a scan and they have manual review. | dqv wrote: | This is just a general thing I've learned from working | adjacent to US healthcare... It's annoying to work with and | there are all kinds of little rules because of how | inefficient the system is. | | First, always have a list of all relevant phone numbers (at a | minimum, but other information is helpful too) to any | healthcare entity you need to work with. Your primary care | doctor, your pharmacy, your hospital, your preferred lab, any | specialists. Also have all your insurance information on that | same list - especially the different numbers for different | departments (e.g. provider lines, authorization lines, etc). | Just assume they don't have any of your information on file | or their information is inaccurate and needs to be updated. | | Always get a paper copy if possible (I think some things have | to be electronic in certain states, but just strongly | emphasize getting a paper copy for anything else). | Pharmacies, labs, other offices always say whatever you need | wasn't sent (even if you watch them send the request and it | says it successfully went through). And yes make sure it has | the doctor's signature on it! I'm not sure if it's specific | to insurance companies or just certain medications, but they | sometimes require diagnosis codes in some states. Find out | prescribing rules in your state... I think it has to do with | narcotics, so make sure you know the rules in your state for | narcotic prescription. | | Always know, ahead of time, the exact lab you're going to and | hound the doctor's office about using the right paper work | and ensuring diagnosis codes are present (there is apparently | no universal lab paper work, so knowing ahead of time is | important). Get a paper version of the _signed_ referral. It | needs to have the diagnosis codes and whatever other codes | are required for billing (honestly not sure why medical | offices aren 't doing this by default, but whatever). Make | sure one of "with contrast" or "without contrast" is selected | if you see those options on the request sheet for radiology. | Assume you won't be able to contact the doctor after this | visit to have the lab order sent again. Also assume that even | if you can reach the doctor, that the lab won't accept the | order without a written copy. | | Always get confirmation from the doctor if the prescription | is covered by insurance. There are apps like Coverage | Search[0] that can give you some information about whether it | will be covered or not. | | And of course there are a bunch of other annoying little | rules that I just haven't encountered yet. | | On top of the ridiculous costs, it's your responsibility to | make sure things go smoothly ;) gotta love US healthcare | | [0]: https://apps.apple.com/us/app/coverage- | search/id834992816 | quickthrower2 wrote: | Exactly what you need when you are sick. That's horrendous. | Here you just get a script and walk up and pay for it. | Probably more complicated if you need insurance to cover it | but I guess that is rarer here in Australia. Some medicines | come out pricey though I admit, for example melatonin is | about $30usd a month equivalent, so there might be extra | loops if you need assistance with that cost. | wbl wrote: | Or use kaiser. | verve_rat wrote: | Wow, I'm so sorry you have to put up with that. My non-US | experience: I logged in to a website, clicked a couple of | buttons, and the doctor sent a repeat prescription to the | pharmacy yesterday. I expect it to be ready to pick up | later today. Done. | moistrobot wrote: | Good, now let's do this for everything | annoyingnoob wrote: | Can we free vision correction next? The US is behind the times. | jjk166 wrote: | > Prescription device means a device that, because of its | potential for harm, the method of its use or the collateral | measures necessary to its use, is not safe except under the | supervision of a practitioner licensed in this state to direct | the use of such device and for which "adequate directions for | use" cannot be prepared | | How were these ever prescription devices to begin with? | falcolas wrote: | Improperly tuned, they will damage your hearing - a permanent | effect. | jjk166 wrote: | That doesn't make them unsafe. Plenty of devices can damage | your hearing but are still perfectly safe to operate. | | I fail to see how adequate directions for use could not be | prepared. | GaylordTuring wrote: | How? Because you simply amplify the sound too much? | jrace wrote: | yes. | | Hearing aids can exceed 120dB. | | As well improper mid-long term use can cause comprehension | and "hearing in difficult situations" issues. | frabcus wrote: | Does this relate in any way to us getting cheaper hearing aids? | | A pair of bluetooth streaming rechargable ones is about $3000. | With Transparency mode and the latest software for AirPod pros, | you can adjust the frequency distribution, and get what seem to | be servicable hearing aids for $250. | | What I'd like is proper (medical) assessment and fitting, but of | cheaper commodity aids that are much much better made with better | apps than most of those on the market now. | jrace wrote: | The tech in the hearing aids is cheap. | | it is the fitting and follow up where the money you spend | should be going. -- that and repairs and regular maintenance. | ricardobeat wrote: | In my experience with a family member, the fitting and tuning | done by the audiologist is as good as a random guess. | Constant noise and screeching even after multiple, expensive | tuning sessions. As a result the hearing aids get tossed away | unused most of the time. | | The adjustment offered by something like the AirPods Pro seem | much more effective. | jrace wrote: | Then you need to go to a different audiologist. | | Most of my rejected fittings were from people who had far | too high expectations. that did not stop me from trying, | and when unable to get success provide a 100% refund, and | refer to a different AUD. | Ansil849 wrote: | > For decades, the FDA has regulated hearing aids as a | prescription medical device -- an arrangement that adds to the | cost and effort people must expend to get them. | | What is the rationale for this? | akira2501 wrote: | It's a treatment for a specific medical condition. Those | devices and claims about them are universally regulated. | | I also don't believe deregulating the market is going to work. | The reason prices are so high is because there is a small | monopoly of manufacturers that control global supply and a | small cadre of middle-men that are allowed to create whatever | markup they like. | | Deregulating the middle men doesn't really solve the | fundamental problem. I would expect a lot of patent lawsuits to | be filed against small manufacturers and distributors if the | government gets it's way here. | | It's an attempt to solve an endemic lack of regulation with | even less regulation. | jrace wrote: | Same rational for an eye exam and Rx. it is more complicated | than just "do you see or not?" And medical issues can, and are, | discovered with a comprehensive hearing evaluation. | | As well improper use can cause permanent damage. | spaetzleesser wrote: | It's always funny to see how the land of the "free" and free | market" is not very "free market" when it comes to protecting the | profits of favored industries like medical even from its own | citizens. | | Things like being required to go to a doctor and pay big $$$ to | get a hearing aid or not being allowed to import drugs from | countries where they are cheaper are absolutely not "free | market". | | Even during COVID the country could not deploy cheap rapid tests | but only super expensive PCR tests. | lifeisstillgood wrote: | Cautionary tale: Opticians | | I went for an eyetest. A woman with 3 years post-grad training | sat down for 45 minutes, ran a battery of tests, detected a | bacterial infection in my eye, sent me for a hospital appointment | the next day, and gave me a prescription that I filled out | online. My payment to her - 25 quid. | | I did get her some chocolates to say thank you. | | Now name another (para-)medical area where the medical part is a | loss leader for the rest? (I am worried i will hear a lot of | Americans ...) | jrace wrote: | In Canada I did the very same, but for free. | | Free hearing evaluation, discovered ear infections, referred | back to GP. At no time was I compensated by the client or the | government. | gigatexal wrote: | This is going to murder companies like audibene.com / hear.com | nickthemagicman wrote: | how about the FDA lets us buy whatever we want without a | prescription because we're adults? | jrm4 wrote: | NOW DO CPAP MACHINES | jleyank wrote: | Having worn hearing aids a long time (don't turn sh*t up to 11), | I should point out that they require setting per-ear and one can | have multiple programs (voice, music, ...). My fear of | rechargeable aids is that with serious+ loss they'd burn through | batteries in a (very) short time and if they're not replaceable | it makes the aids disposable. Fitting is helpful as it's also | done for mid-high earphones. | | This will have to be paid for somehow, and somebody has to do the | tests to know what to set. Same as glasses. So we should be able | to get the raw aids at a lower cost and then deal with the | extras. Costco sells reduced priced aids, so there's a little | flexibility in the industry. | | For my last set pre-covid, there were behind-ear (big), in ear | (small) and in ear canal (very small). If you saw True Lies, | their "radios" were probably dummy in-ear-canal aids. As I'm not | blessed with a 15+ dex and like other posters I don't mind being | see so the behind ears are ok. They can be hidden as dangly | earrings with a sheath to make it interesting if you'd like. | Otherwise, it's a bloody conservative industry re: colors. I | wanted blue and red so it matched stereo wires :-). | | And my attempt at bluetooth connectivity for phone calls failed | as the things could not stay sync'd during conversations. Better | to just use a headset. | jrace wrote: | "And my attempt at bluetooth connectivity for phone calls | failed as the things could not stay sync'd during | conversations. Better to just use a headset. " | | And that is what you should use the money you paid | for....getting proper follow up and adjustments, including | making your BT work. | | BT and hearing aids have been used for over 10 years. | ricardobeat wrote: | What exactly is the audiologist going to adjust to improve BT | reliability? | jrace wrote: | Apply new firmware to the hearing aids. help you set your | phone to work properly. Return them and use a different | make/model that works with your phone. | tpmx wrote: | I guess noone is opposed to them offering their services | doing just that, as long as they don't actually _have_ to | use them. | ChuckMcM wrote: | It has always seemed broken to me that hearing aids were not | covered by healthcare, nor was there some sort of VSP like plan | for hearing aids. I've worked with folks who had hearing aids | from childhood and it is a big expense to bear while their | glasses are subsidized. | | Of course, the vision folks turned it into a racket for | extracting cash. So ideally we'd want to avoid that and perhaps | fix the vision racket while we are at it. | the__alchemist wrote: | Great news. I've been learning about and implementing real-time | DSP algorithms for audio enhancement. (Cortex-M7) I started this | hoping to make scifi headphone that enhance hearing for normal | people with different presets, but realized what I'm essentially | building is more like a hearing aid. Didn't even realize the | regularly issue. (Although using the article's terminology, could | probably already market this as a PSAP and be fine. (?)). | ygjb wrote: | Check out nuraphones; I don't know enough about hearing and | audio to know what voodoo they are doing, but as a person with | significant hearing loss, the hearing customization they | perform during set up allows the device to emit the right | frequencies at the right volume that I can hear a significant | portion of the left audio channel (which is impressive, given | that I am "profoundly deaf" in that ear). | the__alchemist wrote: | Awesome. Looks outstanding from their site. Seems to be | marketed at music listening, especially in noisy | environments, although I can't tell for sure. | Vecr wrote: | I'm pretty sure That's what 3M Peltor Comtac headsets do, they | have microphones on the outside and speakers on the inside, | without passing through gunshots or explosions, so you can | maintain situational awareness in a combat situation. | the__alchemist wrote: | Sounds badass! | paxys wrote: | Similar frustration - I need a prescription to buy contact lenses | every year. So I have to go get an annual eye checkup, which is | still fine because it is preventive care and (mostly) covered by | insurance. However, optometrists around me refuse to give a | prescription for contact lenses without an additional $70 | "contact lens fitting" fee which is not covered by insurance. The | whole thing is a scam. | pessimizer wrote: | The headline is deceptive. It's more like _" Congress ordered the | FDA to let you buy a hearing aid without a prescription, and the | FDA refused for half a decade afterwards."_ | gpt5 wrote: | We are seeing a long term consolidation between hearing devices | and headphones. | | On the headphones side, we are getting smaller, truly-wireless | headphones with some ambient sound features (such as noise | cancellation, and iOS hearing features). New trends like AR would | just accelerate the change due to the need to solve all day worn | audio devices. | | On the hearing aids side, almost every hearing aid today acts as | an always connected set of headphones for your mobile phone (and | has been like that for years on iOS). | | Deregulating this could bring the tech industry innovation to | hearing aids through natural progression of headphones | technology. | | This trend would make hearing aids not just target hearing | impaired people, but also individual with normal hearing. For | example, features such as protecting your ears against a sudden | loud noise, silencing a loud restaurant so you can have a quiet | conversation or improving the audio of a soft speaker could be | useful for everyone. | bsder wrote: | I know people complain about price, but custom in-ear monitors | for musicians are on the same scale of price as hearing aids. | Good in-ear monitors like good earphones are expensive. | | I suspect, like the earphone market, this is going to become a | marketing-driven race to the bottom that swamps any genuine | technical improvement. | themodelplumber wrote: | Long live the consolidation. May it work out better than the | consolidation between tuna cans and more expensive hearing | aids. | | (I have a friend who's an audiologist...watch Starkey, they are | very proactive about industry changes and headwinds.) | justinph wrote: | Starkey is not exactly a quality company and I would be more | than happy to see them put out of business. They tried to | shaft their employees out of retirement money, they inflated | their donation numbers, and a former executive was sent to | prison for all kids of fraud. | mschuster91 wrote: | > features such as protecting your ears against a sudden loud | noise | | Reminds me of the Artemis Fowl series or the first Iron Man, | awesome to see former science fiction coming closer to reality. | Adaptive ear protection in real life would be really | interesting on construction sites or for musicians... | ansgri wrote: | These seem to exist for quite some time, like | https://www.etymotic.com/product/gun-sport-pro/ | johncessna wrote: | I've got a product similar to these and they're great. You | can have a normal conversation and it didn't take me long | to realize their eavesdropping potential. My Surface | headphones also have a feature that more or less acts as a | hearing aid. | Ginden wrote: | BUT WHAT IF PEOPLE ABUSE HEARING AID?????? | | To be serious: amount of things that are "prescription only", | even if they can cause only minimal harm, is astounding. | jrace wrote: | You can cause more than "minimal" harm. Both hearing loss and | comprehension can be changed by an improper hearing aid. | onemoresoop wrote: | What if they do end up with a better hearing though? Think | about the consequences.. | | Or what if the ENTs haven't lobbied lately but instead the | device makers did this time? | jrace wrote: | Perhaps you do not realize, or are just trying to be funny, | but most audiology professionals do this to help people hear | better. | [deleted] | cf100clunk wrote: | "People with mild or moderate hearing loss" should be free to | purchase these sort of generic hearing aids in much the same way | that buying non-prescription reading glasses is common. If | problems persist, it is time to consult a professional. | causi wrote: | Heck, imagine if prescription glasses were only available from | government-certified vendors. We'd be back to paying $700 a | pair like the bad old days. | kfprt wrote: | Glasses are a huge ripoff due to the industry being a | monopoly with no help from the government. | Turing_Machine wrote: | There are some online retailers that have pretty good | prices. | kfprt wrote: | Spare a link or two? | wmeredith wrote: | I like these: https://eyeglassfactoryoutlet.com | mixmastamyk wrote: | https://www.zennioptical.com/ | yboris wrote: | https://www.eyebuydirect.com/ | TylerE wrote: | An improperly tuned hearing aid can make your hearing worse | though...actively causing further damage. | mwint wrote: | Right, but I can also buy an improperly tuned chainsaw and | cut my arm off. | | I'd argue that there should be a giant warning on the box | about proper tuning, and leave it at that. | cf100clunk wrote: | Reading glasses can be exchanged or refunded at most stores | if they are not suitable. I would hope the FDA specifies | the same for OTC hearing aids. | dfadsadsf wrote: | Setting FDA requriemetns on return is example of | overregulation that is frankly not needed - I struggle to | come up with online/DTC brand that does not have free 30 | days return policy. Virtually all electronics on Amazon | has free return. This is pretty much industry standard. | jrace wrote: | But who does the "proper" tuning? | kevin_thibedeau wrote: | We really need prescriptions for headphones to save people | from themselves. | falcolas wrote: | Pointed out in a grandchild comment, but it's basically | happening now. Phones will limit noise exposure from | headphones, based on NOIA and similar standards. | 14 wrote: | I don't know about that but if there was a quality | headphone that limited how loud my kid can play things and | stopped spikes of loud audio during the loud parts of | movies I would buy it today. | mixmastamyk wrote: | iOS has volume limits in the control panel, partially | helps. | takk309 wrote: | https://isotunes.com/products/isotunes-lite | | These are limited to 85db output. I have a pair that I | use in my woodshop as hearing protection, which they are | rated for, and really like that my music or podcast stays | at a consistent volume. I also have volume normalizing | turned on in Spotify. | hellbannedguy wrote: | Someone threw out a pair of hearing aids on my street. | | I was interested in the technology so I experimented with | them. They were a Costco brand, and retailed for 550.00 | | These were not loud enough to hurt a mouses ear at full | volume. They were so low power I didn't even think they would | work at first. | | America has a lot of people who need hearing aids, and can't | afford them currently with all the bs. | | And I don't know what we will do with all the overeducated | Audiogists, and Opticians. They can jump on the wagon of out | sourced American workers? | Spivak wrote: | The wrong glasses prescription can make your sight worse as | well but you can still buy reading glasses and buy | "prescription" glasses of any strength. | cronix wrote: | I'm sure that's true. I'm also pretty sure that number is a | lot smaller than the number of people in the general | population who permanently damage their hearing using non- | prescription headphones that they can purchase anywhere to | listen to music every year. | jedimastert wrote: | So can wearing reading glasses you don't need. | wmeredith wrote: | This is the same reason prescription glasses are | prescription. They change your vision over time. | aaron695 wrote: | I don't think this is true, but the hearing aids this might | be possible on will not be over the counter anyway - | | > The agency proposed a rule to establish a new category of | over-the-counter (OTC) hearing aids. When finalized, the rule | would allow hearing aids within this category to be sold | directly to consumers in stores or online without a medical | exam or a fitting by an audiologist. ___________________________________________________________________ (page generated 2021-10-19 23:00 UTC)