Subject: (Fwd) Comment on HA article From: "Ward R. Drennan" <wdrennan(at)MAIL.KHRI.MED.UMICH.EDU> Date: Thu, 25 Mar 2004 13:33:28 -0500--Message-Boundary-22364 Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7BIT Content-description: Mail message body I wrote this comment to the editor of the Wall Street Journal and thought I would share it [Excerpt below] I appreciate the affordability problem, and I am all for development of a hearing aid of good quality for less money. I think the problem is representative of a larger health-care affordability problem in which low-income families can't afford good health care. I'm of the opinion that the hearing aid is device to treat a medical problem (hearing loss) and should be treated as such with appropriate medical care. After sending this letter, I read the thorough response by Gil Magilen, which provides many cogent arguments. Hear, Hear! This a comment on an article by Ann Zimmerman entitled Debate over hearing aid prices heats up I'd ... question the quality of device that can be obtained for $100. It is not merely a question of sound quality but mostly how much benefit the device provides in the environment in which the hearing-impaired person uses it. If it could be shown that this device provides equivalent objective and subjective benefit as the more expensive models in a variety of natural and cocktail-party like conditions across a large number of people with a variety of hearing losses without individual fitting of the shell or individual fitting of the amplification, then it might be reasonable. I think a researcher would be hard pressed to show this with a variety of hearing losses (a sampling that would encompass those that might buy an OTC hearing aid). In fact, with any kind of reasonable sample of hearing-impaired people, I'm almost certain that one would not be able to show an OTC device would perform as well because individual fitting of ampflication would be required to maximize the audible sound available to the user. Without this individual fitting, users might get benefit, but something less than is possible with individualized fittings. Finally, if a potential buyer has a hearing loss that's more severe than the model would be suitable for, how would the person know without proper medical evaluation? Such a device might be adequate for some, but without proper evaluation, the public will not know if they are getting appropriate treatment. Ward R. Drennan, Ph. D. Kresge Hearing Research Institute Ann Arbor, MI 48109 Phone: (734)763-5159 Fax: (734)764-0014 ------- End of forwarded message ------- --Message-Boundary-22364 Content-type: Application/Octet-stream; name="-"; type=Plain text Content-disposition: attachment; filename="-" Content-transfer-encoding: BASE64 VGhpcyBhIGNvbW1lbnQgb24gYW4gYXJ0aWNsZSBieSBBbm4gWmltbWVybWFuIGVudGl0bGVk DQpEZWJhdGUgb3ZlciBoZWFyaW5nIGFpZCBwcmljZXMgaGVhdHMgdXANCg0KVGhlIGJlZ2lu bmluZyBzZW50ZW5jZXMgb2YgdGhlIGFydGljbGUgYXJlIGF0IGZpcnN0IG1pc2xlYWRpbmcg YmVjYXVzZSBhDQpwYWlyIG9mIGhlYXJpbmcgYWlkcyBjYW4gYmUgcHVyY2hhc2VkIGZvciAk MTIwMCBhbmQgbGVzcyB0aGFuIHRoYXQgSSdtDQpzdXJlIGV2ZW4gd2l0aCB0aGUgYXBwcm9w cmlhdGUgbWVkaWNhbCBldmFsdWF0aW9uLiBBICQxMDAgcHJpY2UgaXMgcXVvdGVkDQpmb3Ig b25lIGhlYXJpbmcgYWlkLCB3aGlsZSB0aGUgJDIsMjAwIGlzIGFuIGF2ZXJhZ2UgcHJpY2Ug cXVvdGVkIGZvciB0d28NCmhlYXJpbmcgYWlkcy4gVGhpcyB3b3VsZCBpbmNsdWRlIHRoZSBo aWdoLWVuZCBtb2RlbHMgaW4gdGhlIGV4dHJlbWUgcHJpY2UNCnJhbmdlLiBTbywgdGhlIG1h cmdpbiBvZiBkaWZmZXJlbmNlIGlzIG11Y2ggbGVzcyB0aGFuIHRoYXQgd2hpY2ggaXMNCmlt cGxpZWQuDQoNCkknZCBhbHNvIHF1ZXN0aW9uIHRoZSBxdWFsaXR5IG9mIGRldmljZSB0aGF0 IGNhbiBiZSBvYnRhaW5lZCBmb3IgJDEwMC4gSXQNCmlzIG5vdCBtZXJlbHkgYSBxdWVzdGlv biBvZiBzb3VuZCBxdWFsaXR5IGJ1dCBtb3N0bHkgaG93IG11Y2ggYmVuZWZpdCB0aGUNCmRl dmljZSBwcm92aWRlcyBpbiB0aGUgZW52aXJvbm1lbnQgaW4gd2hpY2ggdGhlIGhlYXJpbmct aW1wYWlyZWQgcGVyc29uDQp1c2VzIGl0LiBJZiBpdCBjb3VsZCBiZSBzaG93biB0aGF0IHRo aXMgZGV2aWNlIHByb3ZpZGVzIGVxdWl2YWxlbnQNCm9iamVjdGl2ZSBhbmQgc3ViamVjdGl2 ZSBiZW5lZml0IGFzIHRoZSBtb3JlIGV4cGVuc2l2ZSBtb2RlbHMgaW4gYSB2YXJpZXR5DQpv ZiBuYXR1cmFsIGFuZCBjb2NrdGFpbC1wYXJ0eSBsaWtlIGNvbmRpdGlvbnMgYWNyb3NzIGEg bGFyZ2UgbnVtYmVyIG9mDQpwZW9wbGUgd2l0aCBhIHZhcmlldHkgb2YgaGVhcmluZyBsb3Nz ZXMgd2l0aG91dCBpbmRpdmlkdWFsIGZpdHRpbmcgb2YgdGhlDQpzaGVsbCBvciBpbmRpdmlk dWFsIGZpdHRpbmcgb2YgdGhlIGFtcGxpZmljYXRpb24sIHRoZW4gaXQgbWlnaHQgYmUNCnJl c3Nyb25hYmxlLiBJIHRoaW5rIGEgcmVzZWFyY2hlciB3b3VsZCBiZSBoYXJkIHByZXNzZWQg dG8gc2hvdyB0aGlzIHdpdGgNCmEgdmFyaWV0eSBvZiBoZWFyaW5nIGxvc3NlcyAoYSBzYW1w bGluZyB0aGF0IHdvdWxkIGVuY29tcGFzcyB0aG9zZSB0aGF0DQptaWdodCBidXkgYW4gT1RD IGhlYXJpbmcgYWlkKS4gSW4gZmFjdCwgd2l0aCBhbnkga2luZCBvZiByZWFzb25hYmxlIHNh bXBsZQ0Kb2YgaGVhcmluZy1pbXBhaXJlZCBwZW9wbGUsIEknbSBhbG1vc3QgY2VydGFpbiB0 aGF0IG9uZSB3b3VsZCBub3QgYmUgYWJsZQ0KdG8gc2hvdyBhbiBPVEMgZGV2aWNlIHdvdWxk IHBlcmZvcm0gYXMgd2VsbCBiZWNhdXNlIGluZGl2aWR1YWwgZml0dGluZyBvZg0KYW1wZmxp Y2F0aW9uIHdvdWxkIGJlIHJlcXVpcmVkIHRvIG1heGltaXplIHRoZSBhdWRpYmxlIHNvdW5k IGF2YWlsYWJsZSB0bw0KdGhlIHVzZXIuIFdpdGhvdXQgdGhpcyBpbmRpdmlkdWFsIGZpdHRp bmcsIHVzZXJzIG1pZ2h0IGdldCBiZW5lZml0LCBidXQNCnNvbWV0aGluZyBsZXNzIHRoYW4g aXMgcG9zc2libGUgd2l0aCBpbmRpdmlkdWFsaXplZCBmaXR0aW5ncy4NCg0KRmluYWxseSwg aWYgYSBwb3RlbnRpYWwgYnV5ZXIgaGFzIGEgaGVhcmluZyBsb3NzIHRoYXQncyBtb3JlIHNl dmVyZSB0aGFuDQp0aGUgbW9kZWwgd291bGQgYmUgc3VpdGFibGUgZm9yLCBob3cgd291bGQg dGhlIHBlcnNvbiBrbm93IHdpdGhvdXQgcHJvcGVyDQptZWRpY2FsIGV2YWx1YXRpb24/IFN1 Y2ggYSBkZXZpY2UgbWlnaHQgYmUgYWRlcXVhdGUgZm9yIHNvbWUsIGJ1dCB3aXRob3V0DQpw cm9wZXIgZXZhbHVhdGlvbiwgdGhlIHB1YmxpYyB3aWxsIG5vdCBrbm93IGlmIHRoZXkgYXJl IGdldHRpbmcNCmFwcHJvcHJpYXRlIHRyZWF0bWVudC4NCg0KV2FyZCBSLiBEcmVubmFuLCBQ aC4gRC4NCktyZXNnZSBIZWFyaW5nIFJlc2VhcmNoIEluc3RpdHV0ZQ0KQW5uIEFyYm9yLCBN SSA0ODEwOQ0KUGhvbmU6ICg3MzQpNzYzLTUxNTkNCkZheDogKDczNCk3NjQtMDAxNA0K --Message-Boundary-22364--