Sara Blair Lake, JD, CAE is the Managing Director of the American Board of Audiology, a member of the ASAE Health Care Committee, and future chair-elect of the ASAE CAE Commission. ASAE is pleased to share her insights into the health care debate.
1. In your opinion, what is the biggest issue that Congress and the Administration must address in health care reform?
There are a myriad of issues facing Congress and the Administration as health care reform is tackled. However, what is clear is that in order to succeed, health care delivery models must be extremely efficient. Currently, this is not always the case. To cite one example, Medicare currently requires beneficiaries with hearing loss or balance disorders to obtain a physician referral before seeing an audiologist for an evaluation for the services to be reimbursed. Bipartisan legislation being introduced would allow Medicare beneficiaries the option of going directly to a qualified audiologist for hearing and balance diagnostic tests. Such direct access to audiologic services has precedent. The Office of Personnel Management (OPM) allows federal employees and Members of Congress to directly access audiologists through the Federal Employees Health Benefit Plan (FEHBP).
2. What is most important issue that the media does not cover in the health care debate?
The media does a fairly good job focusing on the overarching issues in health care, but perhaps could give a more complete picture by also focusing on specific aspects of the subject that have profound impacts on peoples’ lives and the quality of their lives. In this regard, one area receiving inadequate media attention is hearing health.
Approximately 36 million American adults experience some degree of hearing loss and that figure is expected to rise to 78 million Americans by 2030. Moreover, hearing impairment is one of the most common conditions affecting older adults, with approximately one-third of Americans aged 60 and over and 40-50% of those aged 75 years and older with hearing loss. Clearly, this is a widespread health issue, and, given the demographics of a graying population, one that will only become more pervasive, yet it is rarely mentioned in the context of overall health care reform.
3. How does audiology and hearing health fit into overall health care reform?
Audiologic services and hearing health must be part of comprehensive health care reform. Children with hearing impairment can be fitted with hearing aids soon after birth. Children who do not receive early intervention can cost schools an additional $ 420,000 and are faced with over lifetime costs of $1 million in special education, lost wages and health complications. However, children identified and enrolled in early intervention within their first year of life experience language development parallel to their hearing peers at 5 years of age.
Clearly, in order to effectively manage long-term health care and other governmental costs, early audiologic intervention must be part of the overall health care strategy. Additionally, given the aging population, in order to help people remain productive and effective members of the workforce, access to hearing technology and audiologic services must be contemplated, and included, in any effective health care reform plan.
4. The average ASAE member’s association has 10 full time employees, and is thus a small business. As a member of the ASAE Health Care Committee, how do you think association executives can balance providing health care for employees with their bottom line?
A number of ideas have been introduced in Congress to address this issue. Proposals for tax credits, purchasing pools and the creation of association health plans have all been presented as ways of easing the economic burden that many small businesses face in providing health insurance for their employees. We may see a version of one or more of these proposals included as part of the overall health care reform package.
Sara Blair Lake acknowledges with deep appreciation contributions to this piece made by James Beauchamp, Au.D., Chair of the American Board of Audiology as well as by Cheryl Kreider Carey, CAE and Melissa Sinden with the American Academy of Audiology. For questions or references in this article, please contact Ms. Lake at 800.881.5410.
