What!?

I recently found myself living in a strange and different world. People were speaking to me; I knew because their lips were moving, but I couldn't hear them. I suddenly had become "profoundly" deaf, which is the step beyond "severe" deafness.

As you might imagine, necessity being what it is, I have gotten smart about hearing aids. For instance, while Moore's Law has held sway in the computer industry since 1980, the same cannot be said for hearing aids. They are unreasonably expensive. $1,000 - $3,500 per ear, depending upon which device you buy. This is the same technology you'll find in an iPod or a smartphone, more or less. Music players and cell phones cost hundreds, not thousands of dollars.

Why do hearing aids cost so much!? Why isn't Apple making an iHear? Don't tell me it's a small, dying market. It could be twice the size of Viagra and those other ED meds. And Viagra used to sponsor a NASCAR race car! Phonak, the Swiss hearing aid manufacturer, sponsors a bicycle racing team.

The hearing aids business is a regulated and collusive affair. Everybody involved is making good money, and nobody wants to rock the boat. Potential newcomers face a daunting gauntlet of regulatory and institutional resistance designed to spoil change and protect the status quo. So patients/consumers pay through the ear for hearing aids.

I recently spent $2,600 for a pair of hearing aids. Before I have to replace these (average life of a hearing aid is 5 years), I want to foment change that will give people like me more options when it comes to hearing aids and LOWER COST. This isn't just about me saving some (serious) money, it is also about making these devices available cost-wise to a much larger segment of the population that needs them but cannot now afford them.

I don't want to fight the entrenched forces-that-be, because that would be too expensive and time consuming. And it probably wouldn't work.

Instead, I want to promote the development of assistive listening in mass-market mobile entertainment and communication devices. The makers of cell phones and MP3 players should want consumers to stick a set of earpieces in their ears and leave them on and in all day. That way, consumers will make more calls and buy more music.

The problem with this scenario is that people have to be able to have a face-to-face conversation with the people around them, without removing their all-day earpieces. They need to hear horns honking, sirens wailing, dogs barking, and children crying.

The solution will be to put capabilities in the devices to allow people to hear the world around them when they want or need to, through the earpieces, without removing them.

So, for the always-on-and-in mobile entertainment/ communication device scenario to happen, the makers are going to have to put "hearing aids" in these devices. And, once that happens, it should be a small matter to make these devices compliant with the Americans with Disabilities Act (ADA) by letting the hard-of-hearing (HOH) adjust the volume and the sound profile of the device to suit their needs.

In order to invest the HOH with the power of the pen on this issue, here is a list of some of the specifications that these devices will need to meet to satisfy the particular needs of the hearing impaired. Please feel free to comment if you have additions/corrections/etc. to this list:

• Two problems, frequency-specific sensorineural hearing loss (loss of sensitivity) and frequency-specific loudness recruitment (reduction in dynamic range), are generally experienced by the HOH. Only a digital, programmable hearing aid that can dynamically shape individual frequencies will be able to deal effectively with both problems.
• Users should be able to dock the devices to a PC to download updates and content and to program various functions, including hearing aid settings. Users should be able to input their audiogram data into the PC as a basis for programming device settings.
  
• Users should be able to program multiple hearing aid profiles into a device to deal with different use cases (eating with friends in a noisy, crowded restaurant, driving in a car, talking with someone in a quiet room, speaking to someone on a cell phone, or watching a movie or a play).
• In compliance with the ADA, assistive listening technologies have been installed in many public and private locations. These technologies include inductive loops, infrared, and radio frequency (FM) systems. One or more of these technologies should be accessible with the communications and entertainment devices of the future. (That way no one will miss their flight because they cannot hear the PA announcement when they are listening to the Queen's greatest hits.)

What's the next step? I want to get some feedback from the HOH community and from you. What do you think? Post a comment and let me know.

Down the road, if it looks feasible, I'd like to get the backing of an appropriate organization, or organizations, to publish requirements and standards and test always-on-and-in products put forward by manufacturers.