Boomers Crossing Into Golden Years Are A Boon For Hearing-Aid Industry

May 27--Steve Brisbois began having trouble hearing conversations about five years ago, but the Thousand Oaks man wasn't ready to admit it until two years ago.

His wife said, "I'm tired of hearing, 'What did they say?' " Brisbois said.

Not that his hearing loss surprised the 58-year-old baby boomer.

"This goes back years ago to when we stood next to a speaker as big as we were and listened to Jethro Tull while somebody else stood and yelled into our other ear," said Brisbois, who eventually got a hearing aid.

The tide of baby boomers crossing into their golden years is creating an explosion of age-related hearing loss, and a lucrative market for those who dispense hearing aids.

"The number of people with hearing loss is going up so dramatically that hearing-loss providers are ecstatic about the profits they will make for the coming years," said Ruth Pealer, chapter leader for the nonprofit Hearing Loss Association of Ventura County. "If you look in newspapers ... you'll notice huge, big glossy ads about buying hearing aids."

According to state Department of Consumer Affairs spokesman Russ Hemerich, the vast majority of hearing-aid dispensers are honest businesspeople, but there are a few who give the rest a bad name.

"There are some unscrupulous types, whether they be hearing-aid dispensers, auto-repair dealers or contractors who will try to rip off seniors," Hemerich said.

Thanks to baby boomers -- those born between 1946 and 1964 -- the number of seniors in America is at historic highs. And as people age, their chance of hearing loss increases, according to the National Institute on Deafness and Other Communication Disorders.

Of adults ages 45 to 64, 18 percent report some hearing loss. That number rises to 30 percent for adults 65 to 74, and almost half -- 47 percent -- report hearing loss at age 75 or older.

As America ages, the number of people looking to sell hearing aids is bound to increase, but not all are equally qualified, according to Dr. Akira Ishiyama, an otolaryngologist (ear, nose, and throat specialist) with the Division of Head and Neck Surgery at the David Geffen School of Medicine at UCLA. Ishiyama said he sees ill-fitting hearing aids all the time.

"We see so many patients out here who go to hearing-aid dispensers in the community," Ishiyama said. "It's sad because a lot of people are not qualified to dispense hearing aids. They do it simply for economic reasons, and the patients suffer."

The California Attorney General's Office investigates many complaints about hearing-aid dispensers allegedly violating a state civil code known as the Song-Beverly Consumer Warranty Act, according to Annemarie Del Mugnaio, executive officer of the state Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board, which oversees the industry.

"By virtue of the provider population growing and the elderly population continuing to grow and because people are living longer, we are seeing more cases," Del Mugnaio said.

Hearing aids are not covered by Medicare and can cost thousands of dollars. So Pealer and other professionals in the industry urge consumers to educate themselves about the business, the people who dispense hearing aids, and consumer rights.

"This is a major financial investment, especially for an elderly person on a fixed income or Social Security," Del Mugnaio said. "It's almost like buying a vehicle.

"Between understanding the hearing-aid technology, use and care of the equipment, the purchase agreement, right-of-return policies and just overall expense, purchasing hearing aids can be an overwhelming experience, especially for those declining in age and cognition."

TIGHTENING THE LAW

Ventura County hearing-aid dispensers and audiologists agree they're seeing more people in their offices, including baby boomers.

"I'm probably seeing as many baby boomers as I am older people," said Thousand Oaks audiologist Ellen Baker, who tests for hearing loss and dispenses hearing aids.

Baby boomers, she said, are coming in much sooner than their parents' generation because they're more comfortable with technology and haven't been discouraged by the older "big ugly beige things in their ears that whistle," Baker said.

"Especially with the economic crisis, they've got to be able to hear their bosses," Baker said. "They want to be able to hear their family, their grandchildren."

Camarillo hearing-aid dispenser Ron Roberts said he formerly only saw people from their late 70s to their 90s.

"Now I'm seeing people who want to correct their hearing in their 50s and 60s who have been to a few too many rock concerts or they've been in the construction industry," Roberts said.

As hearing-aid consumers multiply, the state audiology board is working to tighten laws and rules for dispensers, Del Mugnaio said. The Song-Beverly law covers a wide range of consumer goods -- from automobiles to medical devices -- and the board is trying to clarify it.

"In the act itself, the return and refund part is very unclear and has been interpreted many different ways," she said. "You have some providers who believe they are operating within the law."

Del Mugnaio said the board is currently supporting Senate Bill 1444, which would provide more clarity for both providers and consumers of medical devices.

Those in the industry believe there is confusion among customers about the difference between an audiologist and a hearing-aid dispenser. Audiologists must have a doctoral degree to enter the practice, which includes about four years of professional training. Some, but not all, dispense hearing aids.

Hearing-aid dispensers need only be at least 18, have a high school diploma and take the classes necessary to pass an oral and practical state exam.

Del Mugnaio said the number of people taking the state exam has fluctuated, from 90 in 2006-07 to 240 in 2007-08 and back down to 105 in 2010-11. She said the decline last year may stem from legislation effective Jan. 1, 2010, that allowed audiologists to provide hearing aids without a separate dispenser's license.

Audiologist Baker said there are excellent hearing-aid dispensers, but they need more training.

"I really feel dispensing should be allotted to audiologists," Baker said. "You're not selling a blender. You're not selling a TV. You're selling a medical device."

Roberts, a hearing-aid dispenser locally for 17 years, agreed "there's a lot of people out there doing the work and they're not experienced or well-trained. They fit people with inferior instruments and then charge them."

LOCAL INVESTIGATIONS

A Grover Beach hearing-aid dispenser with offices in Ventura, Port Hueneme and four cities in San Luis Obispo County was arrested in February 2011 after Department of Consumer Affairs investigators uncovered evidence of grand theft.

Loretta Walker, then 68, pleaded guilty in a Ventura County court two months later to a lesser charge of misdemeanor grand theft.

Ventura County Senior Deputy District Attorney Chris Harman said Walker was charged with selling a warranty on a hearing aid to a senior citizen, then saying there was no warranty when the person tried to return a damaged device.

"Her grandson's dog decided to make the hearing aid a chew toy," Harman said.

Walker sold the woman another hearing aid and sent the damaged one back to the manufacturer for a replacement, which she then put back into her stock, according to Harman.

Harman said this is the only case of its kind that he has prosecuted, "but having looked into this case, it's definitely an area ripe for fraud." And senior citizens may suffer cognitive decline or health problems before a case goes to trial, potentially complicating their testimony, he said.

A regulatory case decided this year involved Ventura County hearing-aid dispenser John Kiely Ball. Ball agreed in January to a settlement and disciplinary order in which his license was put on a four-year probation. The decision took effect in February. Meanwhile, Ball continues to sell hearing aids.

In February 2009, retired orthodontist Leon Rossman, now 79, of Encino, went to one of Ball's offices in Thousand Oaks, AHC Hearing. A technician fitted Rossman with $5,000 worth of hearing aids, but they didn't work properly, Rossman said.

"So he adjusted them once, then twice," Rossman said. "Then I realized these hearing aids were not for me."

Audiologist Sandee Saurmann, a family friend of Rossman and a doctor of audiology at Glendale Adventist Medical Center, "advised him to return the hearing aids if he didn't like them," she said.

Rossman and Saurmann said they both tried to return the hearing aids and Ball refused, even though the Song-Beverly Consumer Warranty Act says consumers have 30 days to seek a full refund.

Saurmann made a video of Rossman returning the hearing aids and picketed the Thousand Oaks office.

"I picketed for hearing-aid rights," Saurmann said.

Rossman eventually was refunded $5,095, but Saurmann was not satisfied. Saurmann, who works with hearing-impaired children, found and interviewed former employees of Ball's, she said.

"I heard the exact same thing from them," she said. "Any time a patient wanted to return hearing aids, Kiely would either talk them out of it or not give them their money."

The state audiology board found merit in a complaint Saurmann filed in November 2011 and asked the California Attorney General's Office to investigate, according to records. The board found Song-Beverly violations involving nine customers.

In the settlement, Ball agreed to pay the board $25,000 to cover costs of the case, plus $45,000 in restitution to clients. Ball also had to attend an ethics training course, which he said he had completed by March.

Ball said Saurmann has a vendetta against him.

"I believe this entire thing is a campaign to besmirch my name," Ball said in March.

"Hearing-aid dispensers and audiologists are very competitive in this industry and have been since the beginning," Ball said. "I believe this is why Miss Saurmann has been able to gain so much traction."

Saurmann, however, said she does not sell hearing aids, which employer Glendale Adventist Hospital confirmed. She refers her clients to qualified hearing-aid dispensers, she said.

INTERNET SALES

Because Medicare does not cover hearing aids, consumers may be tempted to get them at a discount online. One insurance company sparked a flood of protests when it began offering low-cost hearing aids via the Internet. It's a controversy that continues.

In October, UnitedHealth Group began offering hearing aids through its hiHealthInnovations.com. It also began offering an online hearing test.

According to UnitedHealth spokesman Will Shanley, consumers can expect to pay $749 to $949 for a high-quality hearing aid.

The International Hearing Society, Academy of Doctors of Audiology and American Academy of Audiology were among those sending letters to UnitedHealth and the U.S. Food and Drug Administration. They raised questions about the legality of online marketing of hearing aids and expressed concerns about the elimination of health-care professionals from the process of testing, fitting and following up on hearing aids.

In March, the FDA ordered UnitedHealth to stop offering its online hearing test. The company now provides hearing test kits to physicians and directly offers free hearing tests in some cities. It hopes to bring the online testing back in the near future.

Del Mugnaio said the state audiology board is working with the FDA to develop and enforce rules for online hearing-aid purchases, but "states have limited authority in terms of developing and enforcing any provision that is more restrictive than what the federal government requires."

Hearing-loss experts urge consumers to educate themselves, shop carefully, and above all -- take hearing loss seriously.

"Only about 20 percent of the people who could benefit from hearing aids are actually seeking treatment," said audiologist Anne Oyler, associate director of the American Speech-Language-Hearing Association, a professional organization for audiologists and speech language pathologists.

Oyler said untreated hearing loss is reaching epidemic levels in America, and that will have serious consequences.

"People, once they need a hearing aid, may take 10 to 15 years to actually do something about it," Oyler said. "This can lead to social isolation, depression and difficulty at work."

Hearing loss doesn't just affect you, but everyone around you, hearing-aid customer Brisbois said. "There comes a point where your spouse becomes your hearing aid."

A 2011 study out of Johns Hopkins University found a strong link between hearing loss and the risk of developing dementia. But for people like Brisbois, there is plenty of reward in simply being able to hear once again.

"Now when I'm in a room with other people, I'm not alone anymore," he said.

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