Many Americans commonly find themselves using “what” in conversation, or its popular variations, “pardon me,” or “excuse me.”  The cause of course is hearing loss, which afflicts about 30 million people over the age of 50.

Does it Matter?

The most common causes of hearing loss are age and exposure to loud noises over time.  It is more than a social inconvenience.  Even mild hearing loss triples the chances of falling.  People with moderate hearing impairment are 60 to 70 percent more likely to have been injured in an auto accident.  With severe loss, this figure jumps to 90 percent.  

And most devastatingly, inability to hear well leads to social isolation and eventually puts the victim at higher risk for neurological complications.  Dementia prevalence is 61 percent higher among people with moderate to severe hearing loss compared to those with normal hearing.  

Prevention

As with all medical conditions, prevention of disease is the best approach.  22 million American workers are exposed to potentially damaging noise at work each year.  Accordingly, The Occupational and Health Safety Administration requires employers to implement a hearing conservation program when noise exposure is at or above 85 decibels (the average school cafeteria weighs in at this level) averaged over 8 hours.

And personal responsibility is huge.  The hearing damage that listening to LOUD music causes is not an urban myth.  

Treatment 

And then there are hearing aids.  Remarkable advances in recent years in hearing aid technology have helped millions.  In one study, hearing aid use was linked to a 32 percent decrease in dementia prevalence.  But there is nothing like the original equipment, no matter how good or expensive the hearing aids are.  And cost is a significant factor.

Cost and Health Insurance

One could make the case that hearing deficiencies are a significant public health problem.  But the insurance industry doesn’t think so.  Most insurance plans either do not cover the expense of hearing aids, or have stultifying co-pays.  Medicaid covers the expense, though, and a few types of Medicare plans cover hearing aids.

Recently, regulatory agencies have now allowed the over-the-counter sale of hearing aids for people with mild to moderate hearing impairment, with savings that are usually less than a third of the cost of hearing aids obtained through the conventional healthcare channel.  The expense if born by the patient, with no help from the insurance plan. Preliminary research indicates that self fitted hearing aids are as effective as hearing aids fitted by an audiologist.

This holds great promise for the hearing impaired.  I remain puzzled, however, that hearing deficiencies have received such spotty coverage in our healthcare system.  If you need a new knee, insurance covers the expense.  If the arteries to your heart are clogged, you can get cardIac stents, no problem.  But in the pantheon of diseases that insurance usually covers, hearing loss is a second class citizen.