So you are right that some good mics, earbuds, and a DSP could mostly replace hearing aids, with the right programming and calibration. The issue would be size. Those expensive hearing aids fit all that in or around your ear, and get pretty good battery life to boot.
So sure, I could design you something using off the shelf components, but it would be large. It takes some pretty advanced manufacturing to pack it all in to that tiny a package.
You are right that tunability would be a good feature. I'm not sure why they don't have it, may be a mixture of regulations (medical devices have pretty tight restrictions on them), anti-competitiveness, and just lack of adaptation.
So if you want to geek out and roll your own, go for it. Just realize it will end up being a bit bulky. In terms of software implementation it depends on what you want. Good hearing aids work like multi-band dynamics compressors/limiters. They bring up the frequencies you have problems hearing, but make sure to compress things so that loud frequencies don't cause more damage. If you are doing it on a device with a lot of power you might go multi-stage, do noise reduction, EQ, multi-band compression, and brick-wall limiting in that order. That would give you sound superior to any hearing aid out there, and require a fairly beefy processor (by mobile standards).
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