Tonight I will be in a lawn chair with everybody else, watching the sky. I remember the Bicentennial. I was fourteen, and I heard every firecracker on the block.
Here is a small bet for the second hour of the show. Somebody in your row will lean over and ask a neighbor to repeat a sentence. The rockets are not the reason. The reason is the fifty years since, and what they collected in our ears.
The numbers on this are blunt. Two-thirds of Americans past 71 have measurable hearing loss. By 90 it is nearly all of us. And of the people a hearing aid would actually help, most have never worn one.
Put the need next to the market and the shape gets strange.
28.8M
US adults who could benefit from hearing aids (NIDCD)
1 in 3
Fewer than one in three adults 70 and over who could benefit has ever used one (NIDCD)
5.7%
Share of people reporting hearing trouble who have bought an over-the-counter aid (2025 industry survey)
Four years ago Washington opened the door. In October 2022 the FDA created a new shelf: over-the-counter hearing aids for mild to moderate loss. Sold at the pharmacy. No prescription, no fitting appointment. The old route could run thousands of dollars a pair, out of pocket, because traditional Medicare does not cover hearing aids. The new shelf starts near a hundred.
Then it got stranger. In 2024 regulators authorized software that turns a 249-dollar consumer earbud into a hearing aid. The gadget every grandkid already owns became the medical device few of us will admit to needing.
And still the crowd barely moved. As of last year, 5.7 percent of people who report hearing trouble had bought over the counter. The door is open. The line never formed.
Look closer, though, and the line is finally forming. Seven in ten first-time buyers now start at the cheap shelf. Overall use is climbing. The holdout was never really the price. It was the mirror, and mirrors lose arguments to grandchildren eventually.
Now the part most people miss. Five manufacturers make most of the world’s hearing aids. Many of the clinics that test you and fit you belong to those same companies. The device got cheap. The hallway that leads to it did not change hands.
The honest catch comes from below. The earbud makers are underpricing the front of the market, and some smaller cheap-shelf brands have already given up and left. Senators keep writing letters about devices locked to one repair shop. And if Medicare ever decides to pay for hearing aids, the pricing power gets a referee.
On our side of the counter the squeeze is plainer. Thousands of dollars out of pocket, or another year of asking the grandkids to say it again.
The arithmetic
JAMA Network Open, 2023 (National Health and Aging Trends Study): 65.3 percent of adults 71 and over have hearing loss, 96.2 percent by age 90. NIDCD: 28.8 million US adults could benefit from hearing aids; fewer than 1 in 3 adults 70 and over who could benefit has ever used them. FDA: over-the-counter hearing aid rule effective October 2022; first over-the-counter hearing aid software for a consumer earbud authorized September 2024. The 5.7 percent over-the-counter adoption figure and the 70 percent of first-time buyers choosing over-the-counter come from a 2025 industry survey reported by The Capitol Forum, June 2026, which also documents manufacturer-owned clinic networks. Traditional Medicare does not cover hearing aids.
Tonight, at the finale, run the small test. If the person next to you gets the joke half a second late, that is not a character flaw. That is the cohort’s next bill arriving early, and the whole aisle already knows the address. Happy 250th to us.
Andrew
Boomers Trade is written by someone getting older right alongside you, and watching who profits from it.
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