ILike many professional writers, I sometimes have to write not in a quiet studio or library but in noisy environments. So years ago I bought a pair of Apple’s AirPods Pro, sleek little devices that have a limited degree of noise-cancelling ability. They’re not as effective as the heavy (and expensive) earbuds that seasoned transcontinental airline passengers need, but they’re much lighter and less obtrusive. And they have a button that lets you turn off the noise-cancelling and still hear what’s going on around you.
I remember once wondering whether a version of these hearing aids could also function as hearing aids, if supplied with the appropriate software. But then I dismissed the idea: after all, hearing aids are expensive, specialized devices that are usually prescribed by audiologists and which also signal to the world at large that one has hearing problems.
But guess what? On September 12th, I open my laptop, click on the Verge website, and… Find the headline:“Apple Gets FDA Clearance to Turn AirPods Pro Into Hearing Aids.” The new generation of earbuds will be able to serve as clinical-grade hearing aids later this fall. More importantly, they will be available to purchase over-the-counter (OTC in healthcare industry jargon) and will sell for $249 in the US (and $259 in the UK). £229 in the UK). Compare that to the prices of hearing aids sold by, say, Specsavers. starting at £495 and goes up to £2,995 for the Phonak Infinio Sphere 90.
Of course, price comparisons can be misleading. Conventional hearing aid sellers will emphasize that customers receive the exclusive care of an audiologist, etc. And for customers with severe hearing difficulties, 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 customization software provided by Apple will be adequate.
Here’s how it works: You take an on-demand hearing test in the Health app on your iPhone, which causes the earbuds to beep in each ear at different frequencies at different volumes. You tap your phone’s screen if you hear the sound. After a few minutes, the app will generate an audiogram that graphically represents your hearing deficits, and this audiogram can be used to program AirPods Pro as hearing aids. Alternatively, you can upload an existing audiogram if it was generated for you by an audiologist.
Cool, huh? And a good example of engineering ingenuity, too. But as with most things, 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 inserted into the human ear requires a prescription. As antitrust expert and activist Matt Stoller said, points outSince 1993, activists have called on the FDA to relax its stance on these devices, and the calls grew louder over the years. In 2015, the president’s council of advisers on science and technology released a report seeking to make these devices more widely available. The following year, the National Academies of Sciences, Engineering, and Medicine published a similar report.
But finally, in 2017, Congress passed the Over-the-Counter Hearing Aids Act, proposed by Senators Elizabeth Warren and Chuck Grassley, which requires the FDA to allow over-the-counter hearing aids. And Donald Trump signed it! The law imposed a 2020 deadline on the FDA, but the agency continued to evade its claims until 2022, after the Biden administration forced it to act by executive order. Only then did the dam that had been building since 1993 break.
The moral of this 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 they interact with the law — in this case a law that fostered a headphone cartel and then a different law that dismantled it. So it’s not far-fetched to say that Joe Biden designed Apple’s new AirPods, with help from Elizabeth Warren, Chuck Grassley and Donald Trump. It’s just what happened.”
This may be a bit of an exaggeration, but it reflects an essential truth that Silicon Valley would rather ignore: Technology does not exist in a vacuum, and the ways in which it is deployed and developed are determined by social and political forces. For example, social media companies escape liability thanks to a 26-word clause included in a 1996 law. And millions of people in the United States who suffer from hearing problems could have had affordable hearing aids at least a decade ago. The problem was not that the technology did not exist, but that it was not in the interest of the health care regulatory system to make it available.
After the newsletter promotion
What I’ve been reading
Bad press
Jeff Jarvis, the veteran journalist and professor emeritus at the City University of New York, has an insightful analysis on his blog titled What has become of The Times & Co? on why the mainstream American media has gotten it wrong.
Marx at the top
The Enduring Influence of Marx’s Masterpiece is a wonderful introduction by Wendy Brown to a new translation of The capital.
Head case
A beautiful essay by Erik J Larson is Left Brain Deliriumwhich maintains that we are too governed by one side of our grey matter.