How long to hear?

October 16, 2006 4:39 PM

Hearing Aid waiting list The BBC reports that in some British NHS hospitals the waiting list time for a digital hearing aid is 200 weeks (in others it is 2 weeks...) and perhaps 4m people could benefit from an aid, but don't have one. Not an NHS bashing - but what would the situation be elsewhere? Presumably in some countries - the US? - the waiting list for a digital hearing aid would be infinite, eg if you don't have the money you'll not get one? Does Medicare/Aid cover this over 65? What about Canada?
posted by A189Nut (48 comments total)

I think there's a place for questions to the internet. Somewhere near...
posted by wilful at 4:43 PM on October 16, 2006

I don't think there's any kind of a waiting list with Medicare. It's insurance, so you buy whatever, and then the people send the bill to Medicare. That's how it works.

The reason NHS sucks so much is because the brits underfund it terribly. They spend much less per-capita then Canada then medical care and far less then the U.S.
posted by delmoi at 4:45 PM on October 16, 2006

Hmm, according to this Medicare does not cover hearing aides.
posted by delmoi at 4:46 PM on October 16, 2006

New Zealand here: been waiting about 2 years, maybe a little more. My need is not urgent, and I'd be getting it for free, so I shouldn't complain too much....
posted by Infinite Jest at 4:47 PM on October 16, 2006

What?
posted by QuietDesperation at 4:49 PM on October 16, 2006 [2 favorites]

It is true -- Medicare does not cover hearing aids, which means men and women who have learned frugality from living through the Depression would rather force their grandchildren to scream at them three or four times "I LOVE YOU GRANDMA! GET A HEARING AID!" than spend the approximately $1K US it costs to hear their loved ones again.
posted by ltracey at 5:05 PM on October 16, 2006

Amount spent per captia is not a reliable metric of healthcare quality. The USA spends more per capita than most other countries, but is not necessarily the best [pdf].
posted by blue_beetle at 5:05 PM on October 16, 2006

The reason NHS sucks so much

What gives you the impression that it sucks? It isn't without it's problems, but there's overwhelming popular support for the NHS here in the UK.

So much so that the Conservative Party have made *their* support for the principle of free healthcare for everybody at the point of delivery as a central principle of their new platform.

People complain about non-urgent waiting times in parts of the system, but the US system would be completely unacceptable to most British people -- thank God.
posted by PeterMcDermott at 5:14 PM on October 16, 2006

Not covered by Medicare in Australia either.
posted by tellurian at 5:17 PM on October 16, 2006

Hearing Aid aren't covered in Ontario (but the hearing assessment is).
posted by bonehead at 5:26 PM on October 16, 2006

In Canada (summary in order from of best deals to worst):

Quebec: Free hearing aids for loss of 35db in your best ear as an adult, or 25db as a child, or going to school (e.g. university) and the gov't will cover the purchase and replacement cost of a hearing aid and an assistive listening device.

Alberta: For adults, the maximum subsidy is CD765 for one hearing aid. Seniors above certain income levels are required to make a co-payment of 25% of the purchase price.

Similar rules apply to the families of children up to the age of 18. In this group the maximum benefit is approximately CD1,000 for one hearing aid and CD1,850 for two.

Ontario: Adults and children are eligible to receive 75% coverage of the cost of one or two hearing aids up to a maximum grant of CD500 per hearing aid. The subsidy is available once every three years. The patient must cover the extra cost for expensive models.

Manitoba: Subsidizes hearing aids for Manitoba residents under the age of 18 who require a hearing aid, as prescribed by an otolaryngologist or audiologist. Coverage includes 80% of a fixed amount for analog devices, up to a maximum of CD500 per ear or up to CD1800 for a digital or analog programmable device. In addition, coverage includes 80% of fixed amount for additional services such as dispensing fee, ear molds and ear impressions. There is a deductible of CD75 on all claims.

BC: Assistance for hearing aids in BC is available to patients who are eligible for Enhanced Ministry of Human Resources sponsored Medical Coverage, who lack the financial resources to meet the need, or who need hearing aids to obtain employment.

Atlantic Canada: Children and students up to 21 years of age are eligible to purchase a variety of types of hearing aids and accessories at wholesale cost.

Saskatchewan: Hearing loss prevention programs, counseling and public education for free. Hearing tests and hearing aid fittings are available under the plan for a fee.
Hearing aids and accessories are sold and repaired at "reasonable" cost.
posted by furtive at 5:31 PM on October 16, 2006

The link claims "5-6 million people would benefit from a hearing aid" that's around 10% of the population of the UK.

I have a hard time believing that high a proportion of people would need a hearing aid.
posted by selton at 5:34 PM on October 16, 2006

The link claims "5-6 million people would benefit from a hearing aid" that's around 10% of the population of the UK.

I have a hard time believing that high a proportion of people would need a hearing aid.


The link said nothing about the benefit being to their hearing. Many people enjoy the soothing benefits of hearing-aid suppositories.
posted by docpops at 5:45 PM on October 16, 2006 [1 favorite]

So at 12 hospitals out of the ~3'000 in the UK, the time it takes to be upgraded to a digital hearing aid from an analogue one is over 200 weeks? I can't say I'm that shocked.

The 64 week average wait time for upgrades is a little more troubling.
posted by Olli at 5:59 PM on October 16, 2006

"5-6 million people would benefit from a hearing aid"

They didn't say the hearing aid was for them.
posted by smackfu at 6:02 PM on October 16, 2006

It has been argued that the NHS is the most efficient health care service in the developed world.

Compare the life expectancy of Britons against those of other countries. Now compare the percentage of GDP per head at PPP spent on health care.

Suddenly the NHS looks like OECD best practice.

And here it is worth noting that nowhere with universal health care will pay the whole cost of a hearing aid.

Also, is there anywhere in the developed world where you can't regularly read about 'the health crisis' and the reason some country's health care has to change?
posted by sien at 6:07 PM on October 16, 2006

I think if you include the developing world, Cuba has about the most efficient health care system anywhere.

Britain is excellent however. SES by SES, it exceeds the US in outcomes for about half the expenditure.

Of course, Australia ahd a modified British model, but is heading rapidly towards the US one (because it benefits shareholders).
posted by wilful at 6:16 PM on October 16, 2006

In what way would the US system be unacceptable to most British? Solely because you have to pay more for it? I'm happy to pay a lot for the most necessary of things: my health. I rarely have to wait more than 1-2 days for an appointment...anywhere. And I am almost always happy with the service of all of my doctors.

Oh and demanding a free digital upgrade to an already functional analog version is just plain humorous to me. "Most of these people are older, and in many cases very old." Man, that's a great argument. And, "...the biggest healthcare shock in Europe." You've got to be kidding me.
posted by markulus at 6:17 PM on October 16, 2006

There seems to be an interesting oversight on the part of american viewers. (Speaking as an american).

You cannot disparage the NHS service for having a 2 year wait for digital hearing aids, because the wait with our equivalent service here is infinite.

That's the comparison. Not the "Oh it costs more".

Most people here that are using medicare and social security for their income and healthcare can't afford to drop the 2500 per hearing aid. So they go without.

So while 2 years is a long time, it sure beats forever.
posted by Lord_Pall at 6:25 PM on October 16, 2006

This is so UK centric.
posted by fire&wings at 6:26 PM on October 16, 2006

Eh?
posted by keswick at 6:37 PM on October 16, 2006

Comparisons usually are something centric
posted by A189Nut at 6:38 PM on October 16, 2006

the NHS can be shit sometimes but at least you get it when you need it if it is life threatening. I know that you could pluck some examples that suggest otherwise but for the greatest common good its got to be better than a system where it depends how much you've got in the bank before you get treated.
posted by ClanvidHorse at 6:54 PM on October 16, 2006

men and women who have learned frugality from living through the Depression would rather force their grandchildren to scream at them...

So you've met my uncle, then.
posted by The corpse in the library at 7:04 PM on October 16, 2006

California's senior citizens and low income families are covered for hearing aids by Medi-Cal. My grandmother's general practitioner made an appointment for her to see a specialist and she had her hearing aid about 6 weeks after asking the GP for a referral.
posted by buggzzee23 at 7:09 PM on October 16, 2006

What wilful said, up there at the beginning. Questions belong over there. Over here, find the answers yourself and make a decent post out of them.
posted by beagle at 7:09 PM on October 16, 2006

this Google cached page has more information on Canada. A snippet:

Among persons with disabilities aged 15 and over who had unmet needs for assistive aids, nearly one in two (48%) cited the high cost of the equipment as the reason why they did not have it. Approximately one person in three reported that the equipment was not covered by his/her insurance (36%). Also, 13% of respondents did not know how to obtain the equipment that they needed, and 11% felt that their condition was not severe enough for them to have specialized equipment. Few reported that equipment was not available (4%). Nearly 19% said that they lacked assistive aids for reasons other than those included in PALS.
Persons aged 15 to 64 were more likely to explain their lack of specialized equipment by its high cost (51%) or its not being covered by their insurance (40%) than were persons aged 65 and over (44% of whom attributed this to the cost and 30% to their insufficient insurance coverage). There was no major difference between men and women as to the reasons for their lack of assistive aids.

posted by Kickstart70 at 7:16 PM on October 16, 2006

My mom is on Medicare/Medi-cal now, in Central California.

Fun facts:

The only doctors that take Medicare are immigrants (not born in the US.

The only doctors that take Medicare primarily serve the migrant workers.

Medicare doesn't cover many things, like MRI for her back problem.

Arranging to see a dermatologist to look at a suspiciuos growth on her arm was on the order of months, and would require a trip to Merced, 100 miles away.

People thinking we have any kind of quality socialized medicine in the US are going to be in for a very rude awakening when it's their turn under the wheel.
posted by Heywood Mogroot at 8:04 PM on October 16, 2006

markulus:

"I'm happy to pay a lot for the most necessary of things: my health. I rarely have to wait more than 1-2 days for an appointment...anywhere. And I am almost always happy with the service of all of my doctors."

How nice for you. I and most of my friends can't actually afford to pay a lot for the most necessary of things, our health. Our wait time for an appointment is infinite, although I'm sure we would be happy with the service of our doctors if we had any.

But I'm glad it's working out for you.
posted by kyrademon at 8:12 PM on October 16, 2006

Thanks for the sarcasm but it was completely unnecessary. Not really sure where you're coming from but by "paying a lot" I mean relative to the British. And yes, I feel lucky to be able to afford it through my company benefits. But just because you can't afford it doesn't mean its a terrible system.
posted by markulus at 8:27 PM on October 16, 2006

But just because you can't afford it doesn't mean its a terrible system.

Well actually...
posted by wilful at 8:39 PM on October 16, 2006

My mom is on Medicare/Medi-cal now, in Central California.
posted by Heywood Mogroot

Medi-Cal coverage varies by county in California but many counties allow you to transfer that coverage to an HMO where you will usually see vastly improved service and benefits. My grandmother is almost 101 years old, has a variety of ailments and we've yet to come across anything her HMO doesn't cover and there is no longer a deductible.

The longest she has ever had to wait for any appointment was 6 weeks and that was for an opthamologist who did her cataract surgery. They even offered to send a physical therapist to the house twice monthly, but we take her to the hospital instead as she needs the exercise. She's been hospitalized several times and was treated like gold every time. She (and we) love her HMO and would be pleased as punch if every Californian had access to that level of care.

The biggest surprise? It's provided by Kaiser-Permanente! Having heard bad things about K-P, we were apprehensive when she signed up with them over a decade ago, but have been nothing but pleased by the care she receives through them. Here's Kaiser's pdf brochure for Central California, give their member services a call and see if that coverage is available for your mom.
posted by buggzzee23 at 8:49 PM on October 16, 2006

For Americans below Medicare age with hearing problems, well I know of no insurance plan that covers hearing aids. I paid out of pocket for them. The best I have heard of is to pay a deep discount for aids which once belonged to someone who has recently died and willed their aids back to whatever clinic.

Insurance will pay for exams, surgery, etc. but not the aids themselves. At least to be best of my knowlege
posted by Danf at 9:18 PM on October 16, 2006

Since this is somewhat about health policy, it's worth mentioning that the reason why Medicare HMOs work better than Medicare is because Medicare pays the HMOs more than they pay per recipient that stays in the program. These subsidies allow the HMOs to offer more and keep doctors in the program. Thanks Congress!
posted by kenneth at 9:24 PM on October 16, 2006

It's provided by Kaiser-Permanente!

K-P ruined my mom's life in 1973 (she got strep in the bloodstream at their hospital, treatment of which ruined her insides; part of the experience was seeing her blood coat the distant wall from an ill-placed IV) so I doubt she would go for that, awesome care or no.
posted by Heywood Mogroot at 11:05 PM on October 16, 2006

But just because you can't afford it doesn't mean its a terrible system.

Wow...
posted by Heywood Mogroot at 11:10 PM on October 16, 2006

I agree. Geez.
posted by chef_boyardee at 11:24 PM on October 16, 2006

Oh hells bells, I just reread Make Room, Make Room by Harry Harrison. I hated it. The first time I hated it because I discovered that Soylent Green was not, in fact, people. (It's soy, lentils and green algae for those that need this kind of intel).

The most recent read made me hate it (it's a very good story, BTW) because while unbelievably depressing, Harrison was just off by a couple of decades. This thread just reminded me of that last read.
posted by quin at 11:28 PM on October 16, 2006

Well, it's all well and good to sit back and comfortably think "old people don't need hearing aids," or "why should people get digital hearing aids when they've got analog hearing aids?" or "I hate having to shout at grandma!"

But when you're 31 and have had a >60 db hearing loss since you were 4 years old, things look a little different. I can't hear most sounds, especially the human voice, until it approaches 50-60 decibels. Some frequencies, still in the upper ranges of human voices, have to approach 90 decibels before I hear them. That's loud. I didn't attend too many loud rock concerts as a 3-year old, the cilia in my ear simply stopped functioning. The doctors do not have an explanation as to why.

So I wore over-the-ear hearing aids for many years and kept them functioning (thanks to my frugal, just-on-the-edge-of-Depression-era parents) for 14 years. That was the longest my hearing aid technician had heard of a single pair lasting. I got a pair that fit more in my ear after that and eventually my mom decided (bless her heart) that she wanted to buy digital hearing aids for me. The difference has been NIGHT and DAY. As someone who has been a cognizant adult for the entire time of the trial of my hearing aids and simply could not hear without them, I can tell you that there is a quite appreciable difference between different levels of hearing aid. For the analog aids, imagine if you were given glasses that were permanently covered with a film like Vaseline. You might be able to see better, but they wouldn't be the same as clear glasses. Then imagine you find out that there are clear glasses out there. And you get to try them. And then you're told, as some in this thread have suggested, that you should just use the filmy glasses, rather than the ones that actually provide clarity.

As you can tell, it has times frustrated me that glasses are such a ubiquitous technology that they are often covered by insurance and most people have access to them on the order of $100 for every 3 years or so. Yes they can be cheaper and last much longer or even more expensive and so on. A good pair of hearing aids (and why would you want low-quality where your senses are concerned?) costs around $5000. My current pair has lasted for about 8 years although my repair total in that time has probably been over $1800. All without the aid of insurance. Really, only thanks to my mother and father could I have had these. I now have a job as an upstanding member of society (college professor), but the insurance won't cover hearing aids, and I will struggle to get the $5000 for my next pair. And why won't insurance cover hearing aids? Because it's a luxury? Because you should just shut up, Grandpa? Imagine needing them to have any kind of job, to talk on the phone at all, etc.

None of this was intended to be a sob story, nor am I first in line for nationalized health care, although the number of Americans without insurance, and I was one of them for many years, is appalling. I just wanted to provide a picture of a hearing aid wearer that's not the stereotypical senior citizen wanting to hear their soap operas better.
posted by Slothrop at 1:18 AM on October 17, 2006 [1 favorite]

shouldn't this be in askmeta?
posted by wumpus at 1:32 AM on October 17, 2006

In what way would the US system be unacceptable to most British? Solely because you have to pay more for it?

Because we'd have to worry. Worry about getting poor. Worry about getting ill. Worry about leaving the less fortunate to suffer.

If I get sick, I book an appointment with my doctor or go to a hospital. At no other time do I have to give the merest thought to healthcare. The NHS is an absolute bargain, despite its flaws.
posted by malevolent at 2:11 AM on October 17, 2006

The waiting lists issue is pretty complex. I was put on a waiting list once, for an eye condition. I felt my condition was more serious than their assessment (rightly as it turned out) so I just went to a hospital. I received triage within thirty minutes and treatment from an ophthalmic specialist within the hour.

I get the impression that this is the case with a number of NHS waiting lists, if you make a bit of noise they will just deal with it right away. In some ways this is a little unfortunate, people who aren't as motivated have people like me jumping the queue and can wait longer than they should for treatment.
posted by Olli at 3:09 AM on October 17, 2006

Absolute bargain? Hardly. You've just been conditioned to think that it is "free". Let's say you've always paid for you own healthcare whenever you needed it. Then the government tells you that it will now start taking money out of your paycheck every month to cover you're health issues. When they told you that magic figure (which you can probably calculate), you would flip! There is no way that you would think its a bargain.
posted by markulus at 6:33 AM on October 17, 2006

The thing is, markulus, that the amount taken out of my "paycheck" (ahem) is zero or vanishingly close to it, and yet I still get healthcare comparable to yours.

Also, the amount of conditioning required to think that refusing someone routine medical care because they can't afford it is accapetable behaviour is just beyond me.
posted by cillit bang at 6:59 AM on October 17, 2006

I wouldn't say the amount we all pay for the NHS is insignificant but it's certainly much smaller than the US per capita figure.

As far as I can tell the US Per capita figure is $6'200 / £ 3'330
And the UK per capita figure is $1'600 / £850

So yeah, I'd say the NHS is a bargain. We could make it even cheaper if we didn't provide for the poorest 15%, but fortunately thats not how it works.
posted by Olli at 7:21 AM on October 17, 2006

Well, the last 2 posts are quite contradicting. One says $0, the other $1600. Not sure which, if any, is correct considering there are no sources listed (I have none either). However, the former ignores basic "there's no free lunch" economics....unless you seriously just plain don't pay taxes.
posted by markulus at 4:25 PM on October 17, 2006

unless you seriously just plain don't pay taxes.

Ding ding ding. (Well, don't pay a lot in tax)

(also the NHS budget is £96 billion, which I make $3000 per capita)
posted by cillit bang at 5:20 PM on October 17, 2006

Well it looks like I was completely wrong. $3'000 does seem to be the correct figure.

For what its worth I was using an amount I saw in a BMJ study I happened to have lying on my desk, turned out to be a couple of years old.
posted by Olli at 2:11 AM on October 19, 2006