The British National Health Service buys in most “catalogue” hearing aids for costsunder $200 per unit by agreeing to purchase several million of the same thing. If the US could somehow organise its resources to allow large purchases from state sources then costs could be brought down, but at the price of choice. There are only 17 different actual hearing aids in the catalogue (it is quoted as having several hundred as they count each colour and each battery door configuration as a differet hearing aid) and most areas do not dispense all of them anyway! My area, for instance, dispenses one particular type of Siemens aids in Lite, Moderate, Power and Superpower versions, with special orders only being placed for very small children (Phonak Nios Micro) or profound losses that need an ultrapower aid which is a Phonak Naida UP. There is no choice, but there are hearing aids for low-income families. This is the first NHS hearing aid I have had that made my hearing better rather than worse, and I have worn aids for 20 years, so it’s not a panacea by any means, but for people who have a choice of put up with it or go without it’s fantastic. What you cannot do is say I’d like that one with the £50 upgrade option in it and I’ll give you £50, you either take the “free” one or you buy your own at full retail. Annoying if you then have to pay £2,500 for a T-coil! You also cannot just get these things fitted privately as the aid is not your property, it’s on loan.
So perhaps more of a two-tier system same as we have, people who cannot afford all the bells and whistles of choice can at least purchase a “state-ordered” hearing aid at costs of a few hundred bucks, and the fitting cost really should be an insurance reimbursement, it’s specialist medical treatment after all, if you got it on your teeth that would be a dental insurance claim, right? It’s pretty criminal that the FDA says you must see a hearing aid professional to get a hearing aid but it’s not a reimbursable medical device and the fitting is not reimbursable medical treatment! People who want wide choice could still go to the private market, but of course it would immediately shut down a good proportion of the current market as there would be far fewer people wanting a $3,000 hearing aid if there’s a $500 hearing aid, and margins for dispensers go out the window. Since you can’t just shut off a business’ revenue stream overnight you have problems. The states would find it tricky to purchase these aids only for the people who really really can’t afford any other sort because then the volume or orders is not there. It’s a catch-22, if Medicare/Medicaid (sorry, I don’t know what’s what in state insurance) cannot afford to pay for hearing aids then the price stays high. If Medicare/Medicaid started to pay for hearing aids then the price they paid for hearing aids would be much lower, but you have to order them first!
It’s like it’s a middle ground just now, either this is a medical device that needs specialist fitting and FDA controls or it’s not, and if it is medical then medical insurance should cover it, if you’re saying it’s not a medical device for insurance purposes then stop telling people they have to see a medical professional to get one! Reimbursement needs to be in some kind of sensible proportion also. I have a private medical policy here in the UK. The optical cover reimburses about 60% of what I pay for glasses, the dental covers almost all my dental work, the hearing aid cover is 75% of what you paid up to a maximum limit of £150. What?? What is £150 going to buy you in the way of hearing aids?