Should Hearing Aids Be Sold Over-the-Counter?

I am a Vietnam veteran who suffered traumatic hearing loss while serving my country. I have been wearing hearing aids for nearly 50 years.

Because of my experience, I’ve become an outspoken advocate for the deaf and hearing impaired community. During the 1970s I joined the disability rights movement that resulted in the passage of the Americans with Disabilities Act of 1990. I developed the job placement model for persons with hearing loss that is being used today in state vocational rehabilitation, the Department of Veterans Affairs and school systems throughout the United States.

I am in favor of reasonably priced and accessible hearing aids for those who need them. At the same time, I strongly advise caution. This needs to be done in a way that avoids potentially serious unintended consequences, which could harm those persons with hearing loss, who are the people we most want to assist. Hearing loss is personal — therefore it should be personalized. That is why I have strong concerns about The Over-the-Counter Hearing Aid Act of 2017. It would make certain types of hearing aids available without the proper selection, customized fitting and diagnosis that only a trained healthcare professional can offer.

In 1969, while on a long range reconnaissance patrol team with the 101st Airborne Division, a rocket explosion significantly damaged my hearing and left me with traumatic brain injury. I returned home to Portland, Ore., where I went through vocational rehabilitation with the Department of Veterans Affairs. My request for education funding under the G.I. Bill was denied, based on my deafness.

When I returned from Vietnam in 1969, the VA fit me with my first pair of hearing aids. My hearing loss is a typical “explosion” combat type loss. I have very limited high register hearing and fair to good low register hearing. This means that understanding speech is difficult for me. I hear vowels better than I hear consonants. Listening to people speak sounds like an old record with a scratch in it.

Hearing aids in 1969 amplified sounds across the full spectrum of frequencies so by the time I could hear the higher frequencies the lower frequencies were so loud that they the hearing aids became intensely painful. Wearing the hearing aids was worse than being deaf. So, I removed them and put them in a drawer, as I did the next eight pair that the government gave me. To compensate, I learned to read lips. I found that my hearing aids had such limited uses in my life I was still better off without them.

As hearing aids improved over the years they were tailored more to my specific hearing loss. However, they were not tailored to my unique hearing needs. The noise from traffic was painful, as were public places such as crowded conferences and public places.

My story is not unusual. It is quite common among those who have hearing loss. Once I was diagnosed, I needed hearing aids that would work precisely for my specific hearing loss, as well as for my career, my lifestyle, and my environment. Imagine having eyeglasses that only worked when you wore them in your house but not when you left your yard.

The reason I needed an effective hearing solution was not just to hear sounds and speech. I knew that not being able to hear was negatively impacting nearly every other aspect of my life including my relationships, health and safety.

Hearing aids that are not appropriate for the user are potentially more dangerous than having no hearing aids at all. Improperly selected aids can cause people to give up on hearing aids completely and discourage people from trying to find correct ones, even if they are available, increasing the risk of the serious medical conditions associated with untreated hearing loss. For older Americans, hearing loss can have life-threatening consequences.

When you consider the negatives associated with having a major hearing loss that goes uncorrected there is a compelling argument to ensure that hearing assistance be made available for everyone.

However, when we also consider the negative consequences of inaccurate diagnosis, inappropriate or poorly selected hearing devices, and delaying appropriate treatment, there is an equally compelling argument to ensure that every hearing aid solution is correct and safe for each user.

 Making hearing aids available without ensuring they will be appropriate and effective for the user is the definition of unintended consequences. Unintended, yes but not unpredictable.

I have lived my life following one simple rule: Solutions should not cause greater problems than they solve.

My concern is that without a proper hearing diagnosis and being accurately advised about what level of hearing aid would be appropriate for the consumer and safeguards for quality and safety, the likelihood of someone walking into a drugstore and selecting a hearing aid that is right for them is not high enough for me to currently endorse the idea.

Put proper safeguards in place and it is a different story. Nearly everyone approves of the idea to going into a retail store and self-selecting a pair of reading glasses. What’s the worst that could happen?

How many of us would endorse going into a retail store and self-selecting glasses to correct astigmatism or treat a misalignment of a child’s eyes? Nobody. Yet hearing losses can be as complicated as any eye condition.

Before evaluating a solution to a problem, it is necessary to fully understand the problem as well as the unforeseen consequences that may be inherent in the solution.

I hope that a plan to give us all greater access for our hearing needs can be developed, however, I will not endorse a plan that only benefits retail stores and manufacturers. I will endorse a plan that benefits and protects persons with hearing losses and assists them to find the right hearing solution for their life, their goals and their family.


Richard Pimentel is a disability rights advocate, trainer and speaker. He is a senior partner in the firm of Milt Wright & Associates, Inc.

Morning Consult welcomes op-ed submissions on policy, politics and business strategy in our coverage areas. Updated submission guidelines can be found here.

Morning Consult