ILike many professional scribblers, sometimes I need to write not in a quiet study or library, but in a noisy environment. So years ago I bought a set of Apple AirPods Pro, neat little gadgets with a limited amount of noise cancellation. They’re not as effective as the bulky (and expensive) headphones that seasoned transcontinental flight passengers require, but they’re much lighter and less intrusive. And they have a button that lets you turn off the noise cancellation and hear what’s going on around you.
I remember wondering if a version of it could also function as a hearing aid, given the right software. But I dismissed the idea at the time: hearing aids are expensive, specialized devices often prescribed by audiologists – and they also signal to the outside world that you are hearing impaired.
But guess what? On September 12th, I open my laptop, click on the Verge website, and find the head: “Apple gets FDA authorization to convert AirPods Pro into hearing aids.” The new generation of the headphones could serve as clinical-grade hearing aids later this fall. More importantly, they can be purchased over the counter (OTC in healthcare parlance) and will retail for $249 in the U.S. (and £229 in the UKCompare that with the prices of hearing aids sold by Specsavers, for example, starting at £495 and go all the way up to £2,995 for the Phonak Infinio Sphere 90.
Of course, price comparisons can be misleading. Conventional hearing aid vendors emphasize that customers will receive the undivided attention of an audiologist, etc. And for customers with severe hearing problems, that’s fine. But for people with “mild to moderate hearing impairment,” even the U.S. The FDA (Food and Drug Administration) has concluded that the custom software provided by Apple will be sufficient.
Here’s how it works. You take an on-demand hearing test on your iPhone’s Health app, which causes the earbuds to ping each ear at different frequencies and volumes. You tap the phone screen when you hear the sound. After a few minutes, the app generates an audiogram that maps your hearing deficits, which can then be used to program the AirPods Pro as hearing aids. You can also upload an existing audiogram if you’ve had one generated by an audiologist.
Neat, huh? And a fine example of technical ingenuity. But as with most things, the technology is only part of the story. The US healthcare industry is tightly controlled by the FDA, which has insisted for years that any device placed in a human ear requires a prescription. As Matt Stoller, an antitrust expert and campaigner, points outSince 1993, campaigners have been calling for the FDA to relax its stance on these devices, and the calls have grown louder over the years. In 2015, the President’s Council of Advisors on Science and Technology issued a report calling for these devices to be made more widely available. The following year, the National Academies of Sciences, Engineering and Medicine issued a similar report.
But finally, in 2017, Congress passed the Over-the-Counter Hearing Aid Act, proposed by Senators Elizabeth Warren and Chuck Grassley, which required the FDA to allow hearing aids to be sold without a prescription – and Donald Trump signed it! The law gave the FDA a 2020 deadline, but the agency kept delaying until 2022, after the Biden administration forced it to act with an executive order. Only then did the dam that had been building since 1993 burst.
The moral of the story, in Stoller’s words, is simple: “How we use technology is not so much a function of engineering and science as it is of how it interacts with the law, in this case a law that kept a hearing aid cartel going and then another law that broke the cartel up. So it’s not a stretch to say that Joe Biden designed Apple’s new hearing aids, AirPods, with help from Elizabeth Warren, Chuck Grassley, and Donald Trump. It’s just what happened.”
That may be a bit of an exaggeration, but it captures a fundamental truth that Silicon Valley would rather ignore: Technology doesn’t exist in a vacuum, and the ways in which it’s deployed and developed are shaped by social and political forces. Social media companies escape liability because of a 26-word clause in a 1996 law, for example. And millions of people in the U.S. with hearing loss could have had hearing aids at affordable prices at least a decade ago. The problem wasn’t that the technology didn’t exist; it was that it wasn’t in the interest of health care regulators to make it available.
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What I’ve read
Bad press
Jeff Jarvis, the veteran journalist and professor emeritus at the City University of New York, has an illuminating analysis on his blog titled What happened to The Times & Co? on why the American mainstream media has gone wrong.
TopMarx
The enduring influence of Marx’s masterpiece is a beautiful introduction by Wendy Brown to a new translation of The capital.
Main thing
A nice essay by Erik J Larson is The left brain delusionwho states that we are governed too much by one side of our gray matter.