[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 : 711 points
Date : 2021-10-19 17:58 UTC (1 days 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.
| known wrote:
| "If it moves tax it. If it keeps moving regulate it. And if it
| stops moving subsidize it" --Ronald Reagan (b. 1911)
| worik wrote:
| I tread that article, hoping it would explain why, in the giddy
| universe, would it ever have been a good idea to require
| prescriptions for hearing aids?
|
| Perhaps I missed it....
| sonicggg wrote:
| Health insurance coverage is a good one. Don't know any
| insurance that covers OTC equipment.
| 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...
| .
| silexia wrote:
| Monopolies granted by the government lead to disasters for
| consumers. Even when such monopolies were originally granted with
| good intentions.
| m0zg wrote:
| I heard Apple is working on hearing aid software for AirPods.
| This is excellent news all around. My hearing is pretty decent
| (save for very mild tinnitus caused by being an "invincible"
| idiot when I was younger and listening to music at max volume),
| but I'd love to be able to use vaguely AirPod shaped, reasonably
| priced hearing aids which would, for example, boost speech and
| attenuate noise in noisy environments, especially if they are
| able to do so directionally, for the source in front of me.
| jerkstate wrote:
| Please, do glasses next
| 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.
| OOvsuOO wrote:
| Audiology industry is filled with profit seeking corporations and
| they a have a HUGE political hand. They lobby. I would not be
| surprised to see the Audiology industry fight back this. They
| make huge profits and Audiologists are licensed workers.. Like
| doctors they're required to go though hoops and loops to get a
| license. The cochlear implant industry is the same it's all about
| profit and pushing the CI into babies and taking advantage of the
| early technology by using them on deaf people where in the future
| it will be more like cyborg tech way more advanced and they're
| just testing and pushing this huge industry. It's full of people
| that think a hearing aid or CI is a solution to the problem where
| it's really not. I would put neuro link tech into the same pool
| as CI tech. They're testing it on disabled people and touting the
| benefits while hiding the negatives.
| luckydata wrote:
| Do glasses first.
| kumarvvr wrote:
| I don't get what prescription is required for a hearing aid?
|
| Are there different types? Like with equalizers or volume
| controls?
|
| Why can't a person, who is hard of hearing, go to a store, pick
| one and start using it? Granted, let FDA approve them and mandate
| using only FDA approved ones.
| 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.)
| ineedasername wrote:
| This is part of an interesting trend in technological & human
| development. Massively expensive & highly specialized tech is
| being made common place & cheap more & more often, and perhaps
| more quickly.
|
| So, yesterday's "treatments" for people with problems are
| becoming today's augmentations for otherwise healthy people.
|
| --In years past, you might have a cardiologist prescribe the use
| of a constant heart monitor for a few days to track & diagnose
| issues. Now, you can get a cheap device that does that-- among
| other things-- for yourself. (Yes, the expensive specialized
| versions are still better)
|
| --Glasses were for people with vision problems (or simple
| fashion) but now are in the early stages of AR, and (relatively)
| mainstream use for simple augmentations like music listening and
| personal assistants.
|
| I'm sure I'm missing lots of other examples.
| 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.
| bookofjoe wrote:
| Not a good time to be in audiology school accruing massive
| student loan debt...
| 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?
| falcolas wrote:
| > If the earbuds you use to perform the hearing test are
| the same ones you use with the resulting EQ profile
|
| You also have to account for the microphone, which can
| (and will) have its own bias. Measuring from a flat
| response source, and producing for a flat response
| mic/speaker combination will produce the most accurate
| results.
|
| > active noise cancellation
|
| ANC creates sound artifacts at low volumes. It also
| provides, in ideal circumstances, around 25Db of noise
| reduction. You probably want between 40 and 80Db (or
| more) of noise reduction, depending on the ambient noise
| level around you. The threshold of hearing hovers around
| 10Db for healthy ears. Healthy ears can hearing your own
| heartbeat in an anechoic chamber (as close to 0Db as we
| can get).
|
| > wouldn't the same thing apply to EQ profiles that
| aren't intended to correct hearing
|
| If you're correcting for a 40Db loss at one frequency
| (taken randomly from the surrounding threads), applying
| it to a frequency where you have only 20Db loss can
| result in an extra 20Db of sound at that frequency. 20Db
| is 4x louder by perception, and over 6x higher pressure.
|
| For a point of reference, Apple music's EQ curves are
| 12Db, 24Db if you set the extremes. So yes, they could
| damage your hearing, but that will depend more on the
| volume than the EQ.
| 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.
| sgent wrote:
| The real issue is that an iphone cannot check for
| conductive or mixed hearing loss.
| falcolas wrote:
| > Let the market decide
|
| I really hate it when people say "let the market decide"
| when it comes to health care. It's how we get $10,000
| suppositories (a story earlier this week).
|
| It appears you really like Apple's audio hardware
| (whereas I think it's middling crap), know little about
| hearing loss, and I don't feel like arguing the points.
|
| Congratulations, you win.
| onphonenow wrote:
| That's not the market - if one person is paying and
| another consuming you get crazy distortions.
|
| As to whether AirPods etc are crap - I'll let you have
| you opinion- I like them and they seem to sell well
| 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.
| jrace wrote:
| A hearing test is done to compare your thresholds to what
| is considered "normal".
|
| Without controlled test environment you cannot compare as
| your test environment will change your thresholds, and
| therefore make the test invalid.
| falcolas wrote:
| An improper hearing test can result in an improper
| amplification curve, which can lead to further hearing
| loss.
|
| Perfect is perfectly acceptable to aim for, when it comes
| to your hearing for life.
| 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.
| dfinninger wrote:
| I'd take that tinnitus treatment in a heartbeat.
|
| The drumming-on-the-back-of-the-skull trick lasts just long
| enough for me to realize what the world _could_ sound like.
| (I tend to not do it anymore due to the mild depression I get
| realizing how fleeting the relief is)
| babarganesh wrote:
| i'd pay way more than 100k for a tinnitus cure. it would be
| worth significantly delaying retirement for. but there's
| nothing on the horizon. and yes, i have adapted to it well
| enough that it doesn't cause me anxiety and don't notice it
| 98% of the time. i just miss pure _hearing_.
| 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.
| kristofferR wrote:
| The things that makes it work good as a hearing aid are the
| microphones and other Pro-only features though, so the non-
| Pro can't be used.
| dominotw wrote:
| My dad has mild hearing loss and recent 'conversation boost' in
| airpods works like magic for him.
|
| Most ppl don't know that this even exists in their airpods
| because the settings are hidden deep inside hearing
| accessiblity .
| 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:
| Exactly, just useful for a screening, but not for
| determining actual settings.
|
| And there is more that is taken in to account when setting
| the hearing aids, such as: Age Speech comprehension issues
| Loudness thresholds cognitive issues
|
| As well there are a handfull of "red flags" that are looked
| for, some of which can only be done with a visual
| examination, and others by more involved audiometric
| testing.
| 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.
| crucialfelix wrote:
| I got high quality progressive eyeglasses some years ago.
| Hated it at first. It was like swimming in a fish bowl.
| If you don't position your head correctly things are
| blurry. Now it's completely natural and I love them. I
| had to learn.
|
| Hearing aids are the exact same. It's slightly unnatural
| but once you learn how to use the tool, it's a super
| power. I can hear conversations in crowded bars when
| normal people can't. Loud noises compress in a pleasant
| fashion. I just have to get used to some occasional
| spatial distortion and subtle flanging
| RHSeeger wrote:
| The thing is, though, that it appears to be very
| different depending on the person. And there seems to be
| a LOT of cases where the technology just isn't up to the
| task. Sure, we _can_ blame the user in every case, but if
| the cases are highly skewed to the users have a poor
| experience / not hearing well with them, then really it
| makes more sense to blame the technology until you have
| proof otherwise.
| jrace wrote:
| A better analogy is what if your vision loss was not only
| clarity, but also brightness?
|
| And once you put on your glasses everything is brighter.
|
| You need to adjust to the change, and then slowley adapt.
|
| Now what if putting on the glasses meant you saw far more
| on your peripheral vision?
|
| This too would be a big change and a barrier to getting
| better.
| BurningFrog wrote:
| > _it 's a vicious cycle of taking it home, realizing it's
| not really helping, and bringing it back to try a new one._
|
| Sounds like the calibration needs to happen in the home, not
| the doctor's office.
| jrace wrote:
| That sometimes was benificial, but mostly with just one n
| one and TV. Those you can control, but what about when a
| few more people come over? Or when the neighbor is mowing
| their lawn?
| crucialfelix wrote:
| Many companies have remote adjustment now. They connect
| online and the user and audiologist talk on video.
| 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?
| gramie wrote:
| One of the costs built into hearing aids is the lavish perks
| that the suppliers give to the audiologists. My partner got a
| trip for two to the Caribbean every year, to 5-star resorts,
| for selling a certain number of their hearing aids. There
| were about 60 people in our group, probably costing well over
| $5,000 each.
| lupire wrote:
| What's that divided by # of hearing aids sold?
| jleyank wrote:
| 2+ microphones, signal processing chip, audiophile+ miniature
| speaker, multi-octave equalizer, intercommunication between
| ears/dynamic adjustment, multiple profile, remote mic,
| bluetooth to phone. I think the top-end in-ear musician
| speakers are comparable, certainly in terms of sound quality.
| Maybe better as they have (far) more speakers/frequency
| response as their users are far more critical. They're not
| magical but they're good when there's not a lot of echo.
| TaylorAlexander wrote:
| How does the actual hardware compare to a $180 pair of
| AirPods? I wonder if basically Apple and Samsung should be
| making these instead of smaller medical device companies.
| jleyank wrote:
| I suspect there's nowhere enough money for apple or
| Samsung to enter the medical devices field for real. I
| would think the headphones have a Bluetooth receiver, a
| d/a converter and a speaker. They rely on the associated
| device to handle "adjustments". Might be noise reduceing,
| but that only adds a mic and a phase inverter. Much
| simpler device. Getting medical approval takes time and
| $$... Easier to put fine print that the things does not
| treat or cure anything.
| TaylorAlexander wrote:
| Looking over their marketing materials, the Airpods seem
| to have much more power than that onboard. They use their
| own custom silicon chip onboard and it seems to be pretty
| capable. I wonder if (doubt?) medical device
| manufacturers are designing custom processors for their
| hearing aids.
|
| "...the new AirPods feature Adaptive EQ that tunes sound
| in real time based on how AirPods fit in the user's ear.
| An inward-facing microphone monitors for sound, and then
| Adaptive EQ, powered by computational audio, tunes the
| low and mid frequencies to account for what may be lost
| due to variances in fit. "
|
| "To help with sound clarity, beamforming microphones
| block out ambient noise and focus on the user's voice,
| while users can also enjoy a hands-free experience by
| simply saying 'Hey Siri' for requests."
|
| https://www.apple.com/newsroom/2021/10/introducing-the-
| next-...
| 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.
| lupire wrote:
| Replacement should be an insurance offer like the rest of
| electronics.
| bradknowles wrote:
| Maybe cheap to produce in larger sizes. As you have to make
| the components smaller and smaller to fit all the extra
| gubbins, each of those other components now become
| exponentially more expensive to design and produce.
|
| Yes, there's a lot of overcharging in this business,
| because the manufacturers charge what the market will bear,
| and because of insurance and lack of competition due to all
| the regulations they have to comply with, the market can
| bear a very high price.
|
| But it's still a very hard problem, and there's a very
| significant component of user training over the long term
| that is required. When you were a newborn, you didn't learn
| to hear and speak your native language in a single day, you
| didn't learn to see and recognize faces and read written
| words in a single day. You shouldn't expect a hearing aid
| to magically fix you in a single day -- your brain needs
| time to retrain.
| 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.
| jrace wrote:
| Tuning for them is more about slowly increasing the sound
| levels overtime than adjusting for understanding.
|
| As well you may want to work with a Speech Language
| Pathologist.
| jl2718 wrote:
| Why is a doctor needed to do any of that?
| tim333 wrote:
| I just looked at the NHS site and they suggest your doc check
| your ears are not just bunged up with wax.
|
| Beyond that I'm not sure why I'd need professionals rather
| than an app to do some hearing tests.
| 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.
| fnordfnordfnord wrote:
| My wife's grandfather should have all of that through his VA,
| Medicare, and supplimental insurance. His hearing aids are the
| most annoying low quality overpriced pieces of crap you can
| imagine. And that stupid headphone amplifier thing they've sold
| him, garbage, literal garbage. A hobbyist could do better.
|
| The new schema may not be a panacea but I don't expect it to be
| worse than the status quo.
| hansthehorse wrote:
| The VA will not co insure with Medicare but will with private
| insurance companies.
| 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.
| kwdc wrote:
| Their reasoning is that you should stop buying luxury
| superyachts each year and focus on your health. Its about
| priorities!
|
| On a related note, dentistry is another one that is usually
| not covered at all. Why even basic dental isn't covered by
| government healthcare as a prevention initiative still
| surprises me. Bad teeth can kill you / give you cancer /
| wreck chaos and damage organs in general etc and its all
| often detectable at early stages.
| 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?
| bookofjoe wrote:
| OT but knee-related: people need to understand that
| function after a total knee replacement will NEVER be
| better than that existing at the time of the replacement.
| The only benefit is reduction or elimination of pain. --
| retired M.D. (anesthesiologist)
| 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.
| keithnz wrote:
| my partners hearing aids has a smart phone app, but it
| seems to be built with the concept of someone else putting
| the calibration into it. They can then create profiles for
| the different situations, however it strikes me that the
| hearing test calibration could be done in the app as well.
| I would imagine for a lot of people, if you could just buy
| them online you wouldn't need the clinicians for many
| cases.
| dmi wrote:
| The app for my hearing aids allows my audiologist to make
| remote adjustments, so I don't even need to visit their
| office for straightforward changes. I really want to
| reverse-engineer it so that I can modify some of the
| details of the profiles myself.
| jessaustin wrote:
| _...especially with the use of a smart phone app..._
|
| Based on my observations of my father's struggles with
| various hearing aids, hearing aid smartphone apps are just
| as terrible as any other apps developed by hardware
| manufacturers. Don't expect the "clinicians" to help with
| this aspect either, because they were trained on a previous
| version of a different app and how could they be expected
| to figure out the apps that are used now?
| bane wrote:
| What's really needed is a decoupling of the hearing test
| from the calibration activity. A basic hearing test takes a
| few minutes in an isolated box with headphones (the 'ol
| click a button if you hear the tone test). From that
| profile it _should_ be trivial to build out the profile of
| what frequencies to boost and what not to and program the
| aids there.
| kradeelav wrote:
| I appreciate the optimism (and do think there's some room
| for efficiency improvements!), but each step is a little
| more complicated than that. a true audiometric room/booth
| to do the testing (eg fully soundproof) in is very rarely
| found outside of audiologist offices or specialized
| academic spaces, for starters, and I do believe those are
| required for paperwork (whether it be insurance related
| part of the process to getting the right device fitted).
|
| then there's also additional complications like types of
| hearing loss impacting calibration - some people react
| very negatively to higher (or lower) frequencies than
| others do, to the point facial stimulation can happen,
| and some people just have a frankly tricky profile that
| requires a trained audiologist on hand to work with them
| through several sessions, if not outright yearly on top
| of that, since the nerves and brain output can change by
| itself.
|
| (source: have a cochlear implant, been doing the
| described experience since I was ~ 3yrs old.)
| dmi wrote:
| To add to this -- I suffer from Meniere's disease, which
| manifests for me as variable hearing loss. Some days are
| bad, and I can hardly hear/understand speech even when
| someone is right in front of me and I can lip-read. Some
| days are good, and my hearing aids are uncomfortably loud
| or make things sound "weird". But most days, my hearing
| aids do exactly what I need them to :-)
|
| I've had audiograms taken on moderate and bad days, and
| the difference in frequency response was significant (up
| to 30dBA difference across only the lower frequency
| bands).
| dmurray wrote:
| I'd love to talk about this, could you email me at the
| address in my profile if you're interested?
| FPGAhacker wrote:
| There are actually a good reasons not to do this. A very
| large part of your hearing is brain training...your brain
| learning how to interpret the new stimulus it is getting. You
| need to give your brain time to adapt to new stimulus before
| evaluating whether you are hearing better or not. If you are
| constantly fiddling with your hearing aids, you never get the
| benefit of training.
|
| This may not apply if your hearing loss was sudden, but many
| people get hearing aids only after years of decline. Your
| brain adapts to what it has available and you learn to hear
| as best you can with the limited stimulus. When you finally
| get hearing aids, it feels like your ears have been
| unblocked.
|
| When it comes to interpreting speech though, especially in
| noisy circumstances, you have to give it time. Your brain
| isn't used to using the extra stimulus to interpret speech.
| In fact, it may have gotten used to hearing loss filtering
| out background noise and you may initially find all the
| stimulus makes it _harder_ to interpret speech because of all
| the background noise you now hear that you previously didn
| 't.
|
| If you don't have patience and start immediately futzing with
| volume all the time, you never give your brain a chance to
| adapt, and will be very dissatisfied.
| unkeptbarista wrote:
| I've been wearing hearing aids for almost 8 years. The
| brain training process is real and I'm glad the audiologist
| explained it.
| retrac wrote:
| Yes! Modern hearing aids do some fancy processing to shift
| frequencies into the more audible range of the patient.
| Many people do not have a simple "not enough volume"
| hearing loss. Personally, it's like someone went and messed
| with all the settings on the audio equalizer, and then
| added some muffling to make sharp sounds less distinct.
|
| When programmed properly, I find my hearing aids on their
| various speech modes to sound distinctly artificial and
| processed. I imagine it would be jarring to the
| uninitiated. Like a good speech codec or vocoder. It's
| unlike anything else.
|
| But having grown up with DSP hearing aids doing this all my
| life, I find speech coming through them very
| comprehensible, often shockingly so compared to my normal
| hearing -- even with other amplification like regular
| headphones. I do dislike my hearing aids for music, though,
| even on the normal or music settings.
| phreeza wrote:
| Couldn't this brain training effect be included in a
| progressive algorithm like the one suggested? Such that the
| brain is gradually "guided" to the best performance by
| ramping up the hearing aid?
| dmi wrote:
| My (Phonak) hearing aids had a multi-week ramp-up to full
| power, in order to give my brain time to slowly adjust.
| Dealing with things like the occlusion effect
| (https://en.wikipedia.org/wiki/Occlusion_effect) just
| takes time, and getting used to something being in your
| ear for a large number of hours per day.
| rkagerer wrote:
| All audio devices used to have an instant-feedback feature
| like this. You could dial it in with zero latency. Early
| technosapiens called it the Volume knob :-).
| 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.
| tenken wrote:
| I think this is more akin of the Android phone I have
| asking me if the call I just placed was: clear, had cutouts
| or dropouts, fuzzy background noise ... And they take that
| feedback and adjust my call quality in GoogleFi (in
| theory)... It's not just the concept of s volume button,
| but more the idea of reinforced (ai) learning over time, or
| algorithm adjustment with human feedback.
| soylentnewsorg wrote:
| ...which will simply make you more deaf. hearing aids do
| not simply amplify volume. you know, because they're not
| headphones and a microphone.
|
| but your idea is great too. if you can't hear one
| frequency, let's amplify all frequencies till the one you
| need gets loud enough, and go deaf to the other ones in a
| year. when you get old and need a hearing aid, you should
| stick with your method.
| mgerdts wrote:
| What you describe is almost as good as the deal anyone can get
| from Costco in the US.
|
| The return period is 6 months, I think. You also get one free
| replacement in the first 3 years if it is lost or chewed up by
| your dog.
| 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.
| wrycoder wrote:
| You're not wrong. Most people don't need all those overpriced
| ads-ons.
| oneplane wrote:
| Wouldn't it make more sense if the FDA just wanted everyone to be
| able to hear properly? I get that they are a policy institution
| and "hear better, implement it however you like" isn't much of a
| policy, but an almost-directive (buy whatever you want) seems to
| be rather decoupled from any health related issue which is what
| an hearing aid is for.
| 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!
| conductr wrote:
| Just ask for the PD on the prescription, they generally
| don't mind but also won't offer. It makes things awkward if
| they refuse. I ask in the exam room.
| 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.
| jollybean wrote:
| "it's also unclear why many routine checks couldn't just be
| done by a family doctor."
|
| Even though it's probably not that complicated, it's probably
| beyond the scope of a regular doctor to do proper checks - and
| - it's probably more expensive than getting your eyes checked
| by an optometrist, which is usually pretty cheap.
|
| In fact, the optometrist model i.e. regulated specialization
| for something that we don't need very expensive doctors for, is
| probably a good model for hearing. If there's something more
| complicated, then they refer you to the ophthalmologist etc..
|
| We should be trying to do this with everything i.e. get people
| into 3 year specialization programs which make basic health
| things affordable, and leave more complex cases to MDs.
| 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?"
| falcolas wrote:
| The impact of an improper prescription - headaches,
| eyestrain, creating lazy eyes - are far worse than buying
| pants which are too big.
| dsizzle wrote:
| You're just as likely to get the wrong prescription with
| an optometrist -- they're relying on your self-report
| after all -- except it's harder to correct, because you
| need to go and make another doctor appointment to have it
| corrected (vs using the machine again).
|
| Also, if someone feels they would get better vision
| correction working with a trained professional, I'm fine
| with that. I only object to _requiring_ a doctor's
| prescription to get glasses.
| eggsmediumrare wrote:
| That's like saying a family doctor will just ask you if
| you're feeling alright. I know optoms who have found
| parasites, diabetes, cancer... The complete disregard for an
| entire field of medicine in this thread is astounding...
|
| *Edit, saw your comment about not referring to the entire
| checkup.
| 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?
| balls187 wrote:
| It looks like it is becoming more common place.
|
| iCare Tonometer
| 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.
| conductr wrote:
| > 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
|
| This is not really the case. Online, warby Parker, etc. have
| built scale but the traditional retail still makes a
| significant portion of their profits here. And it's a healthy
| business by most standards. The staff and employed OD are
| typically compensated heavily through variable compensation.
| The primary industry metric is "capture rate", the percentage
| of people that buy eye wear after the exam. If I recall
| correctly it's about 65-70%. From an incentive perspective, the
| doctors and staff are salespeople through and through.
|
| Like all segments of healthcare, it has really started to
| consolidate. The independents/regional brands operating now
| will likely sell to PE roll up play when the foundering doctor
| retires. PE will exit to conglomerates. Most of these are
| boomer's and this form of consolidation is well under way. The
| already high margins can easily be improved by centralizing
| back office, etc.
|
| The vertical integration in the industry is insane. Luxottica
| for example leads retail, frame manufacturing, lens fabrication
| (laboratory), and owns the #2 insurance provider (of 2 main
| players). They have such power they can and do "force"
| independent retailers to use their POS software.
|
| Warby Parker has some hipness and definitely grew quickly. But,
| they hardly put a dent in the market. There may be some
| evidence that they expanded it, as happens with fashion. They
| would be more akin to Blue Nile in the jewelry space.
| Independent jewelers still dominate that market.
| 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.
| softveda wrote:
| In Australia you need to go to an Optometrist who is not a
| doctor, they can't prescribe medicines. There are few
| independent Optoms most are employed by spectacles chains
| nowadays. They also do retinal scan, check for glaucoma etc. No
| one pays for Optoms. The government pays for one free eye
| checkup every 2 years (used to be 1 year). The glasses and
| frames you have to pay. Ophthalmologists are specialists for
| eye diseases and needs to be referred by either GP or Optom and
| costs an arm and a leg. My last visit was $400+
| 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.
| bradknowles wrote:
| Not from my doctors. I asked.
|
| They said that an auto-PAP is not the first choice. A CPAP
| is a better choice, if it will work for you at the
| pressures you need. But they only work up to certain levels
| of pressure.
|
| An auto-PAP will work to higher levels of pressure, but
| then it has to continually adjust the levels of pressure
| that it applies based on the resistance it senses, and that
| is not as good for you as constant pressure.
|
| And there's no way a CPAP or auto-PAP is going to wake me
| up at night, short of causing me to go into an apnea
| condition and potentially die.
|
| Thank you, but no. I'll stick with my CPAP.
| 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.
| tim333 wrote:
| >You'd be an idiot to do so, however, as your vision can
| change with age.
|
| I just use reading glasses but the desired strength can
| vary day to day depending on what you are doing and my eyes
| vary too. This can be dealt with easier by having a number
| of pairs of reading glasses and seeing which works best
| rather than doing prescription stuff. You can buy reading
| glasses for PS1 here so I tend to get a few.
|
| I'd still recommend going to a good optometrist
| occasionally in case there is something more worrying up
| with your eyes.
| 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.
| neither_color wrote:
| Not if you order them from the UK ;-)
| 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.
| bradknowles wrote:
| My CPAP totally changed my life. I had no idea how
| horrible my sleep had been before.
|
| I refuse to sleep a single night without it.
| onemoresoop wrote:
| Did you experience Aerophagia and any weight gain when
| you got on the CPAP? I hear a lot of people have this
| issue..
| 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.
| degrews wrote:
| What? Doesn't 20/20, 20/15 etc. refer to visual acuity (how
| much detail you can see from a certain distance)? Are there
| people who prefer anything but the highest possible visual
| acuity?
| 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).
| heavyset_go wrote:
| This is important. Eye exams are not just the part where
| they have you look at letters on the wall in the dark.
| russdill wrote:
| Right, but then the way to do that should have nothing to
| do with corrective lenses and requiring them shouldn't be
| an artificial barrier to getting corrective lenses.
|
| If it's important, then it's important for everyone.
| 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
| BurningFrog wrote:
| Still unclear why Regulatory Capture only happens in the US?
| ddingus wrote:
| We allow bribes.
| lisper wrote:
| It happens outside the U.S. as well, but the U.S. has a
| particularly weak form of democracy which makes it more
| prone to regulatory capture. In particular, money is a more
| powerful _policial_ level in the U.S. than in most other
| democracies, and that creates a positive feedback loop that
| tends to encourage and reinforce regulatory capture (you
| use RC to make money, which you then turn around and use to
| pursue more RC in order to make more money...)
| 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.
| 0des wrote:
| I'm trying to visualize or recall any complications that
| could arise or have passed from shipping or receiving
| 'unsanctioned' glasses. I can't even imagine which
| regulating body would give orders to which enforcement
| organization that could make anything happen. To live by
| these rules is enabling my own abuse.
|
| Just curious, since you mention that you're soon to be in
| the business of eye exams, do you think at some point
| your business is going to have to maintain this status
| quo in order to 'play ball' legislatively during your
| growth phase? If yes, how do you feel about that? If no,
| can you explain why you'd be exempt? Are these laws
| something that articulates with your business model or is
| this only in adjacent businesses like providing lenses?
| 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.
| TedDoesntTalk wrote:
| What about the privacy issues of sending them my face for
| them to keep in a database forever?
| 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.
| TedDoesntTalk wrote:
| What about the privacy issues of sending them my face for
| them to keep in a database forever?
| 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.
| dqv wrote:
| It's only available in a few states :(
|
| I'm only commenting on what I've seen. I'm sure a lot of
| people get through the system just fine with no issues.
| But this list is a compilation of many people
| experiencing issues receiving healthcare.
| wbl wrote:
| It's definitely an issue. A shame the HMO model didn't
| catch on more.
| 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.
| TMWNN wrote:
| That's exactly how it works for me too, in the US. I
| haven't had to take a paper prescription to the pharmacy
| in many years.
| moistrobot wrote:
| Good, now let's do this for everything
| ameasure wrote:
| What is the rationale in making something like a hearing aid
| require a prescription? I can understand addictive drugs, you
| don't want them misused. What about the million other things that
| require a prescription?
| 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.
| falcolas wrote:
| How do you know when something is too loud without
| measuring it? If your answer is "ringing ears", you've
| already incurred at least some hearing damage.
|
| Do you have the tools to measure how loud your headphones
| are? I don't. And so I keep them as low as I can.
|
| Is there a limiter in amplifying headphones to keep them
| from going above a certain threshold (like 80Db)?
| jjk166 wrote:
| Why would you be trying to find the point at which it is
| too loud? The goal is to amplify things to the point that
| you can hear them clearly, not to go beyond that.
|
| Also hearing aids have manual volume control which a
| licensed professional has no influence over, so that
| doesn't really make sense as a justification for limiting
| availability.
|
| It's certainly possible to apply volume limiting to
| headphones, though again the people using amplifying
| headphones typically are dealing with the opposite
| problem.
| jrace wrote:
| When you have hearing loss you also have decreased
| loudness threshold levels, which will be freq specific.
| It is important that you do not exceed these levels, both
| for comfort and for speech understanding.
|
| hearing loss is far more than just "make it louder".
| 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.
| sprainedankles wrote:
| As someone with moderate hearing loss in both ears since ~1st
| grade, I'm all for expanding access to hearing aids. It took
| changing doctors in high school to finally get a prescription,
| and it was life-changing. Not cheap, but entirely worth it - I'm
| grateful to have had access at that point.
|
| Cost is still a challenge, of course. But I'd like to point out
| that my current set of aids ($2800 pair) just hit the 5-year mark
| of usage, and they are still working perfectly. For devices that
| I use ~16 hours a day, everyday, it's amazing. However, it took 3
| visits to the audiologist to get the tuning/fitting just right.
| For the first month of use, these hearing aids were "garbage" (I
| was really frustrated). But once we hit the mark, I have had zero
| complaints ever since.
|
| So, that all said, there is tremendous value to initiatives like
| the Bose SoundControl Hearing Aids (~$900 pair off-the-shelf
| hearing aids), but the biggest hurdle they face is the
| fitting/tuning portion. I've tried them, but they don't fit my
| ears well, so I can't use them effectively (yet - I want to try
| adjusting the receiver cables).
|
| I'm hopeful this is just the turbulent beginning of a new hearing
| aid market that expands access to as many people as possible,
| because it is far from a solved problem.
| 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.
| Rapzid wrote:
| Well, the USA is a land of laws too. Everyone is also crying
| that the USA wasn't giving enough vaccines to the rest of the
| world and is now moving on to boosters.
|
| Gotta put your mask on first.
| sharmin123 wrote:
| How to Protect Your Privacy And Personal Data from Hackers?:
| https://www.hackerslist.co/how-to-protect-your-privacy-and-p...
| 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.
| Underphil wrote:
| Interesting that you said client instead of patient. Is that
| just a thing that differs between countries?
| jrace wrote:
| In the industry (at least in Canada) outside of the medical
| system customers are "clients" and not "patients".
| Consultant32452 wrote:
| How did we ever get to a place where you needed a prescription to
| buy hearing aids in the first place? Was there a bunch of hearing
| aid junkies knocking over liquor stores to get another hearing
| aid fix?
|
| We need a ground-up reassessment of the whole concept of
| prescriptions. If it doesn't present a systemic risk it should be
| over the counter. If everyone over-uses antibiotics we might all
| die. Fine. But if some goober misuses blood pressure medicine,
| they can only hurt themself. Let people buy albuterol inhalers
| without permission. It's going to be fine.
| 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.
| jleyank wrote:
| It was a new iPhone SE and a new vendor (not Phonak which
| didn't BT). The sound was not as good as Phonak, and the
| BT worked much of the time but not reliably. This, of
| course, was not a problem for those wearing one aid - I
| have two. One pays a lot of money for promise which,
| honestly, isn't fully delivered.
| 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.
| throwawaymanbot wrote:
| Goodbye private coversations. Anecdotal evidence from people
| using hearing aid type devices to eavesdrop is
| ...well...disgusting.
|
| A medical need at least prevented those with no need from having.
| solatic wrote:
| Any real attempt at hearing aid reform cannot skip in-person
| hearing tests. You need somebody to look inside the ear to verify
| that the hearing loss is not due to earwax buildup or infection,
| and to run a tympanogram test to check for mid-to-inner-ear
| issues. Maybe the rest of a hearing test could be done with
| current headphone technology in a quiet environment, I don't
| know. But until somebody makes a take-home, ML-powered widget
| with both a camera and a tympanogram-capable widget, people will
| need to show up in person to get a dependable hearing test
| result.
|
| The biggest thing the FDA could do would be to standardize a
| digital format for hearing tests and require new hearing aids to
| be programmed on the basis of the standard format. This would
| allow people to go in-person to get their hearing checked by a
| technician, get a test result, and then program that test result
| into any hearing aid of their choice bought on the open market.
| 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."_
| joshsyn wrote:
| Anything regulated just becomes pricey.
| 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.
| arch_btw wrote:
| Yeah but have you ever worn a hearing aid? My wife has a very
| expensive and up to date one and there is so much white noise.
| She can play music on it but can't hear well enough in that ear
| to get any use out of that. I just don't feel like they will
| ever overlap that much since they have to cater to people who
| are quite deaf.
| jrace wrote:
| Noise reduction only works so good...but when the "noise" you
| do not want to hear is speech, they have a much harder time.
| 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.
| munk-a wrote:
| Technical improvement has been pretty stunted since the 90s
| anyways. The hearing aide market is insanely marked up and
| ends up costing an extremely significant chunk of change
| whenever you need a replacement. I also would mention that
| custom in-ear monitors for musicians apply to a really niche
| market as well - so we don't really have a broad market to
| compare either of these to.
| rjzzleep wrote:
| Actually CIEM balanced armature drivers were originally made
| for hearing aids. They're conceptually very similar, but most
| of the market is consolidated to 2 main manufacturers Knowles
| and Sonion(+ some niche manufacturers).
|
| If anything the Chinese are disrupting this market, in price,
| volume and choice. Just like they're doing with cheap lenses
| such as omnivision.
| 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.
| jrace wrote:
| Starkey used to be an industry leader. Sadly, not for a few
| decades.
|
| Watch Oticon, and Sonova (Phonak/Unitron).
| encryptluks2 wrote:
| Kids of fraud are no joke. I'm pretty sure I'm a kid of
| fraud.
| scoopertrooper wrote:
| I'm not familiar with those allegations, but none of that
| precludes them from innovating in the hearing aid space.
| afarrell wrote:
| It is hard to do good work when you don't have a team you
| trust.
| some_random wrote:
| >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.
|
| Amusingly this already exists, there are a bunch of ear muffs
| (and some in ear equivalents I think) that relay sounds from
| outside in that cut off when a threshold is reached. They're
| pretty much exclusively sold for use with firearms, I'd love to
| see them developed more to work better in a setting other than
| the woods and shooting range.
| zucked wrote:
| Having just experienced a pair of these, it was incredible. I
| don't have extensive hearing loss beyond what being a
| teenager listening to music too loud will do for you, but the
| way these headphones relayed "normal" sounds while rejecting
| "loud" sounds was one of those - "why aren't these more
| popular?" moments. It felt truly superhero-esque.
| 3pt14159 wrote:
| I echo these sentiments. It's a truly surreal experience if
| you're comfortable with firearms.
| wrycoder wrote:
| And yet Bose discontinued their very helpful Hearphone product
| and has introduced a much more expensive and less capable
| conventional aid, which they are marketing to older people.
| Very disappointing!
| skellera wrote:
| I was just thinking about this with the announcement of the new
| AirPods. Apple could really take the concert earplug market
| while getting great natural marketing (people wearing AirPods
| at concerts). Just balance and lower the volume for concerts.
| MisterTea wrote:
| > Just balance and lower the volume for concerts.
|
| Or just buy a decent set of earplugs that dont require
| charging, bluetooth or $200.
| wrycoder wrote:
| My AirPod Pros with transparency mode enabled and set to max
| volume and treble don't provide as much gain as my
| MDHearingAid pair ($400), and the external sound quality
| isn't as good.
|
| Apple has a real opportunity here, and they are slow in
| seizing it. I suspect some kind of an arrangement with the
| hearing aid manufacturers regarding iPhone-ready hearing
| aids.
|
| The name of the game here is to allow people to dial in their
| own preferred level of compression (amplifying soft sounds
| more than looks sounds) and equalization using their iPhones.
| 8ytecoder wrote:
| Have you tried the new accessibility options in the latest
| firmware? You can now feed in an audiogram as well as
| enable conversation boost via that
| wrycoder wrote:
| Yes, I've done that. I'm hoping that 15.1 next week will
| make some improvements.
|
| Apple could have such a great product here, if they would
| just add gain comparable to the currently available
| hearing assist devices, and then add compression,
| equalization, and clipping of loud noises.
|
| Simple amplification isn't enough.
| t_serpico wrote:
| Great point. They're primed for this.
| babyshake wrote:
| I'd think that even if turned off, Airpods and similar
| devices act as decent earplugs in a pinch.
| bookofjoe wrote:
| When I'm outside running on sidewalks along city streets,
| music via AirPods Pro with Noise Cancellation turned on
| sounds a bit better BUT I prefer to keep this feature
| turned off in favor of being able to hear ambient cars
| etc.
| etherealG wrote:
| I've spent hours trying to find a review of transparent
| mode on AirPods or any other similar transparency modes
| with regards to reducing wind noise amplification while
| still allowing sounds of cars etc. through. I'm looking
| for a good solution to listening to music while riding a
| bike that's safe but better sound quality than bone
| conduction. Sadly I can't find any objective measurement
| of these combinations of noise cancellation and pass
| through. I can't even find a review that mentions if this
| is how pass through is meant to work vs just passing
| along all sounds. If the latter then wind noise pass
| through sounds like a good way to completely ruin your
| hearing. I guess these days all we can find is marketing
| and reviews that amount to puff pieces with rare
| exceptions.
|
| Would you be willing to give a personal experience? Have
| you tried transparent mode in windy conditions?
| abakker wrote:
| with a lot of woodworking tools the AirPods pros
| definitely offer more protection than nothing. Not sure
| what attenuation they offer, but for the truly damaging
| higher frequency noise they _seem_ to do a pretty decent
| job.
|
| I still wear real ear protection, but for the odd cut, or
| for any other day to day situation with loud noises the
| AirPods do a good job.
| jermaustin1 wrote:
| Same thing for me. Ear protection + AirPods = Silence.
| What I like about the AirPods Pro is they actually fit
| INSIDE my over ear protectors.
| t-writescode wrote:
| Are we confident that Airpods Pros (or similar) would be
| effective noise isolation to reduce tinnitus?
|
| This is especially in question, to me, with the numerous
| reports of people _getting_ tinnitus while wearing the
| airpods with noise cancellation on.
| tim333 wrote:
| Getting tinnitus that was is just a function of how much
| sound there is in your ears. So headphones with loud rock
| music can cause issues, headphones on quiet less so and can
| block external noise, as can a blob of wax or whatever.
|
| You don't really need fancy noise cancelling for tinnitus
| prevention, just some form of bung in your ear.
| dominotw wrote:
| > silencing a loud restaurant so you can have a quiet
| conversation or improving the audio of a soft speaker could be
| useful for everyone.
|
| Yes i use noice cancellation and voice isolation on my iphone
| here in india where noise is out of control. I can even take
| calls now outside in traffic and it sounds like i am in a quite
| room to the other person. This one of the greatest
| technological improvements in the recent past for me
| personally.
| 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/
| owenversteeg wrote:
| Huh, looks like they also have these for music:
| https://www.etymotic.com/product/music-pro/
|
| Has anyone here tried them? I'm very curious how well
| they'd work to use at concerts.
| jrace wrote:
| They are excellent compared to standard ear-plugs.
|
| Not as much reduction in harmful sounds (do not use with
| heavy equipment for example) but do a great job of
| equally attenuating a wide freq band.
| jdfellow wrote:
| I use their passive ER20SX ear plugs for concerts and
| love them. The active hearing protection they make look
| great but rather expensive.
| 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.
| tornato7 wrote:
| Some years ago there was a set of headphones sold for
| hunting (amplifying sounds of animals and reducing
| gunshot noise) that were very popular among the hearing-
| impaired community as a cheaper alternative to hearing
| aids.
| jrace wrote:
| If all you need is to amplify everything, they work fine.
| bradknowles wrote:
| I want something a bit more selective. Like, capable of
| completely blocking out the sound of my wife snoring.
|
| I'm sure that I'm not the only one in this boat, but I may
| be one of the rare males complaining about their wife
| snoring.
| stefs wrote:
| one upside of being hearing impaired: the wifes snoring
| doesn't bother me much.
| jrace wrote:
| Part of snoring is low frequency sounds, which even with
| fully plugged ears, transmits through bone conduction.
|
| also long term use of ear plugs with sleeping can cause
| unwanted side-effects.
|
| When we sleep our hearing system does not turn off
| (safety), and when you wear ear plugs while sleeping you
| run the risk of making your hearing work harder - and
| then if you have no plugs in your hearing system is now
| (hopefully temporarily) more sensitive than before.
| grp000 wrote:
| That sounds like a really interesting problem. You'd need
| microphones good enough, small enough, and cheap enough
| to hear the signal, Signals processing/machine learning
| software robust enough to pick up a user-selected pattern
| and in a reasonable latency, and then a processor small
| enough and power efficient enough to process it all while
| again also being economical enough, and then have it last
| 8 hours.
| kragen wrote:
| "Completely blocking out" is out of reach,
| technologically; you'd need 80+ dB of attenuation, and
| the best anyone can do with things that fit around your
| head (earplugs, noise-canceling, etc.) is about 40,
| before you even start to touch the questions of
| selectivity and power usage. If you need 80 dB of
| attenuation your best bet is to contract an acoustics
| engineer to build a wall out of several layers of
| different materials.
| [deleted]
| throw10920 wrote:
| Would "bring[ing] the tech industry innovation to hearing aids
| through natural progression of headphones technology" mean that
| hearing aids would now need to be coupled to a smart device?
|
| If so, then hard-of-hearing people who work in secure areas
| where they can't bring their phones will be very unhappy...
| jollybean wrote:
| I think a better option might be to ensure that easy and
| affordable access to all the 'other things' that go along with
| hearing aids is available. I'm not sure if it's just as simple as
| 'throw in a device'. I'm wary that inappropriate use and
| maintenance could have negative health effects.
|
| Sometimes even the most very basic counselling has quite an
| effect.
|
| Perhaps we should create a nursing/paramedic level specialization
| for this and allow those people to offer such services.
| 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.
| Ginden wrote:
| Can you estimate that harm in term of DALYs?
| 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.
| jleyank wrote:
| Buy lightweight frames and lenses, have progressives and get
| anti-glare coating and "we'd be back to paying $700/pair" is
| like, last year if I miss a sale. Lenscrafters, not a small
| shop. They're all owned by the same site, and I work on the
| 50% off of lenses sale. Frames are 150-300 as I avoid big-
| name style. These are way more than +2.5 diopter reading
| glasses, and you might imagine that astigmatism and
| progressives does wonders for straight lines...
| 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.
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