When insurance will pay, why not?

Last week I wrote about a misunderstanding with an audiologist at the office that sold me hearing aids three years ago. When the hearing aids came back from a factory check, she asked me to get a referral from my primary care physician. I thought that was because the devices needed reprogramming; she thought I wanted new hearing aids.

““When you have an insurance benefit that entitles you to upgraded technology, why not use it?,” she said. My Medicare Advantage plan pays $2,000 a year toward hearing aids.

I’ll give her the benefit of the doubt about wanting what’s best for patients, but I still put her comment down as typical of our consumer society: If you can get new (and at a great price), why keep the old?

You’ve stood in lines for hours to buy each new iteration of the iPhone as soon as it was released.

You tire of driving the same car, so you trade in every two or three years.

Your down parka suddenly can’t keep you warm enough, so you buy a $1,000 one made for the Arctic.

You never noticed your computer was slow until the ads for an upgrade promise lightning speed. You decide to replace the old model.

Admittedly, that insurance would pay for new hearing aids makes me think about replacements more than if the cost would come out of my pocket. But should we consent every time we’re told “insurance is paying, why not?” Twenty percent of insured patients receive unnecessary medical services, according to a Harvard study. And that drives up healthcare costs.

Since I have no complaints about my current ones, “unnecessary” would describe new hearing aids for me now. The current ones do what they’re supposed to do — help me hear better on the phone, across a table, in front of the television, at the theater. As for better technology, I’ve never even used some of the features — the application that adjusts the volume from my phone, and the telecoil that works with loop systems in public venues to transmit sounds directly into the hearing aids.

What more would I get with newer ones? A “reduction in listening effort in challenging situations where there are multiple conversations going on,” according to the manufacturer of the brand the audiologist pitched. The amount of time I spend in such situations is small. I don’t hang out in bars. Maybe they would help in noisy restaurants, but I’ve been trying to avoid those.

Technology changes constantly. The promotion of every new iteration makes us think what we have is obsolete, even if the product hasn’t reached its life expectancy. Following the audiologist’s reasoning, I could take advantage of technological advances with new hearing aids every year because my insurance would pay. Yet according to numerous expert websites, the devices should be good for four to six years.

Also, let’s not forget the downsides of frequent replacement — the environmental cost of disposal and the increase in potential problems with more sophisticated technology.

In a couple of years, when my hearing aids are nearing the end of their expected useful life, I’ll be open to arguments about why I should replace them. When a new model delivers a significant benefit — a solution to a problem — then it’s time to upgrade.



“President Donald Trump had about three times as much free time planned for last Tuesday as work time, according to his private schedule. The president was slated for more than nine hours of “Executive Time,” a euphemism for the unstructured time Trump spends tweeting, phoning friends, and watching television. Official meetings, policy briefings, and public appearances — typically the daily work of being president — consumed barely more than three hours of his day.”
Politico report

“‘Executive’ is the last thing I would call unstructured time.”

— Yuval Levin, vice president of the Ethics and Public Policy Center and former domestic policy aide to President George W. Bush

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