A Little History

Prior to 1977, anyone could sell/fit hearing aids. There were severe rip off’s and incompetant fitters. The industry petitioned the FDA to declare a little amplifier/sound conditioner (better known as a Hearing Aid) as a Medical Device.

The state legislatures then were lobbied to restrict sales to state licenced practioners.

The rest is history and we now have $100 worth of Knowles parts retailing for $6,000.

What do you want? Rip-off’s Let the buyer beware…or licenced reliable loveable local professionals and $6,000 hearing aids in most cases properly fitted. Note: If aids were not classified as a Medical Device by the Feds, the states would be violating the Constitution probition of Restraint of Trade.

Note: The reason advanced as justifcation for declaring hearing aids to be Medical Devices is phony, It was said that improperly fitted aids would be so loud that they would cause damage to the hearing system…So will loud music and guns, etc. Ed

Good thing you’re not a history teacher Ed,your history is off just a bit.

The impetus behind the FDA classification of hearing aids as medical devices came from activist consumer groups NOT from the industry itself. Most of the mfgs wanted the government out of the HA business.

I remember about the same time the FDA decided to declare reading glasses as ok to be sold over the counter and today you can buy them for less than $10, prior to the law change my parents had to go to the eye doctor and get reading glasses and the cost was several hundred dollars. And since the change I can’t remember one person destroying their eyes with over the counter glasses. I believe the downgrading of reading glasses was also brought on by consumer activist.

Clarification…anyone EXCEPT Audiologists. They thought it was a conflict of interest. When it was determined that audiologists, by way of their education and training, were very well suited to provide hearing aids and included in the distribution model that previously had excluded us.

I do believe that there are some non-certified people that could do a good job of programming their own HA’s, if they take the time to study and learn what is needed. I probably could, since I am the type that reads manuals from on line sources before I even get any electronics. But unfortunately, the great majority of the world don’t even read simple instructions that come with electronic products. I am regularly helping neighbors with their computers and TV’s for simple fixes. They are intelligent people, but everyone doesn’t have the aptitude for doing things like that.

I also appreciate the technology that the manufacturers have developed and put into HA’s and am glad to pay for that and a trained professional to program them. I am glad that the programming service and regular adjustments come with the HA’s, since I don’t have the time to properly learn the necessary skills and to keep current on changes in the technology.

My being quite content with the current state of the HA industry, as a consumer, I am sure that many people would be helped by having a cheap HA that just controls the volume and bass/treble, which would require no knowledge of HA’s.

I am surprised that an iPhone app simulating an HA hasn’t been developed, since it would probably be very popular, even though not as good as an HA.

All and DocAudio:

Prior to 1977 (thereabout) the professional Audiologists’ organizations considered it very unethical for Audiologists to SELL products (Merchandise).

It is like a Medical Doctor (MD) proscribing a medication, then selling you the most expensive version.

\The conflict of interest is obvious.

I am sorry to say that the hearing aid profession is a poor business model from the consumer’s point of view. And considerning the strength of the industries’ lobby, I doubt it will ever change in the USA.

Please, don’t think that I feel the professionals in this industry are dishonest. From my experience most are sincere honest people earning a living but certainly not getting rich.

What’s wrong with the industry is the Government regulations that dictate a conflict of interest between the consumer and the manufacturers/practicioners. IMO Ed

Sorry Ed,bad analogy,

there is no conflict of interest,but there is a potential conflict of interest.

How about the doctor who recommends surgery and then profits by performing the surgery?

Or the lawyer who says “yeah you have a case” and then profits by racking up hundreds of billable hours on the same case.

ANY professional could be guilty of a conflict of interest under your definition Ed,

The truth is that the people who are MOST knowledgeable about hearing aids and their capability are those who work with hearing aids. That does not mean they are honest, just knowledgeable.

And the crack about $100 worth of parts in a $6000 set of aids,kind of like $00.50 worth of tin in a set of $3000 braces ???

Ed, you seem to have an insight as to how much hearing aids should cost,lets say your in the HA business, what wou;d YOU charge for an aid??? Assuming $1500 wholesale for a premium aid

ed, we all know your opinions on this.

Why start the ‘discussion’ yet again?

The answer to the question of what is the proper retail price:

The price is whatever people are willing to pay for any item in ordinary commerce unfettered by restrictive regulations that restricts competition.

And without the requirement of a licence to sell aids the market would support practical aids that are self-adjustable. Today’s hearing aids are designed to be fitted by a licenced professional. they don’t have to be designed that way.

I maintain that todays deaf population contains a high percentage that are competant to self adjust their own aids. Of course little old ladies with no dexterity or computer illterates would require skilled professional fitting. (Assumes that they first visit an ENT).

Aids could easily be designed to allow a $25 remote control that would program the aids. Such a wireless remote control would be less complicated than an ordinary TV remote.

Sorry, I don’t have the audacity to think that modern HOH are unable to tell if they have adjusted their little self-adjustable electronic amplifiers correctly (hearing aids).
Of course there are the children, the very old, and those with complex severe losses that need a skilled professional.

Just my opinion based on almost 50 years of using aids and being a professional in the acoustics field. Ed

Based on what? I’ll be generous here and say you know 50 people with a hearing loss. Any of the professionals on here will have seen over five hundred in the last year and ‘most’ of those are only interested in tuning their aids to a very limited extent.

Even Unitron are moving away from the remotes with the self-modifying comfort clarity balance. The manufacturers run collective data on this every few years, and there’s no big push in this direction. Lots of people prefer the aid to be ‘fully’ automatic as they don’t want the stigma associated with adjustment of their hearing device. Even English Dispenser above is not pushing the self-programming side, due to a lack of demand.

Now, your experience is probably different from other peoples’ out there, given you experience and vocation, but you might not appreciate that statistically you sit at one tail of a very big bell curve. The responses from this board are atypical in respect of the general population, as the board represents a very small, motivated, tech-savvy, sub-set of the general aided population. Broadly speaking people still ‘need’ a go-to person to fit and fix their hearing aids - the SERVICE element is an important part of the cost. Unfortunately this leads some ‘sales’ people to assume that there is a large profit to be made without adequately backing-up the process.

It’s not a conspiracy, it’s just the way the industry works. As I’ve explained to you before, the current (quality-based) model is based on the ideals of a man called Lars Kolind - read his book if you want to know more. It is moving slowly to a more quantity based model, but the transition is limited by several structural factors: not your FDA.

If you think that price is the limiting factor in people wearing them, why is it that in the UK where NHS hearing aids are free at the point of supply, that 3/4 of them end-up in the drawer?

I am just a user, but I agree 100% with this post. Well stated.

You hit the nail on the head. You are responsible for your health, not your doctor(s). You cannot expect to have the full knowledge of every medical care provider you will need. However, you will need to know enough to ask the provocative questions and also to be able to separate yourself from the bottom feeders.

When I was first diagnosed with hearing loss, the ENT I saw attributed it to “listening to rock music too loud as a teenager”. Forget the fact that I told him there were several generation of my family that had otosclorosis and at the time most of my loss was conductive. If I stuck with this guy, I’l probably be totally deaf!

Well said as usual.

And price has unequivocally been proven NOT to be the main obstacle in obtaining amplification. A google scholar search will provide tons of supporting articles. It usually falls 4th or 5th in a list of reasons why people do not obtain amplification when needed.

And if price was truly the case, undercutting my competition would work beautifully, which any professional will tell you it does not.

dr.amy

A recent study shows that the market penetration of hearing aids in countries that GIVE the hearing aids away at $0000000 cost is about 40%.

A tad better than ours,but not that much better.

So Ed,when you say that more people here in the US would obtain hearing aids if they were less expensive,how do you account for the above statistic???

Obtaining a license to fit HAs is hardly restictive ED,in most places, its a one day exam…the bar to getting a license is pretty low.

Or,Ed,maybe you are not the typical HOH . Maybe, because you have taught yourself a lot about hearing and hearing aids,you assume EVERY HOH can and will do the same.

Let’s put it another way Ed,how many hours have you spent educating yourself about your hearing and hearing aids. I’ll bet you have spent a good many hours doing so. Probably more than most HOH can or will do.

Wow. You folks have solid evidence…I have conjecture.

But there are two factors not usually considered. That is the entrenched way aids are dispensed in a semi-medical environment and the old age stigma.

As it stands now buying an aid involves going to a medical type professional and…

admitting to yourself that you are defective (the old age stigma.).

And I still maintain that $3,000 to $6,000 outlay is a major deterent.

I cry in the wilderness of entrenched custom. By that I mean the whole industry from manufacture, design, to the dispenser/retailer is the opposite of efficient distribution.

I further maintain that it doesn’t have to be that way. Aids could be designed to be self fitted (by the average loss person the majority)… And with normal commercial advertising and the resultant mass acceptance be sold by efficient mass retailers.

I claim the whole present industry and government regulation perpetuate the present inefficent ethos. Again just my lonely opinion, Ed :smiley:

Ed, there are some people who make up their minds AFTER gathering all the evidence they can,I guess you’re not one of them,

When you say that the price of HAs is a major deterrent to obtaining aids, your comment flies smack dab in the face of statistical evidence to the contrary. Earlier I asked you that if you’re correct about the cost being prohibitive,then how do you account for the fact that the mkt penetration of HAs in countries where they are given away is scarcely better than ours. You answer is “I dont care about the reality, I still believe what I believe”

The comment about having to go to a medical facility to get aids is also not true, HAs are sold at CostCo, in HA offices in strip malls, in HA offices in shopping malls, on the internet at America Hears, Hearing Planet etc etc.

The thing about age is correct, there is a correlation among some folk that HAs are a sign of age or a disability.

You seem to think that a direct to the consumer system of HA distribution will somehow cause most, if not all, HOH to FINALLY obtain properly fitted aids for less than the cost of an Ipod.

You have never worked in a HA office, never worked for a mfg, never fitted other HOH with HAs,yet you have all the answers,

Ed,do you really think that just because YOU understand this stuff, that other people do as well,and you have no, zero, zilch, nada evidence to back up your claims. You just keep repeating yourself over and over

Starkey released a remote, T2 (telephone programming - both self programming, and programming remotely by a hearing professional), and SoundPoint (an iPad based app that allows a patient to adjust their own aids with a simple adjustment program, at the hearing professionals office).

The same company also has some interesting statistics about the number of patients using said features (based on millions of sales world wide). It’s a tiny number. Not even 8%.

This hunger you think there is for self programming aids really doesn’t exist like you think it does. I’ve traveled all over the country, and worked too in another country in my field. And outside the world of retired engineers, most people like simple and automatic.

Ed, you’ve stated this opinion so many times, it’s like you have hearing aid tourettes.

I ask you the same question I always ask you (and you never answer). If it’s so easy and cheap to make these $100 hearing aids, why aren’t you making them with your 50 years of experience? Or why not Motorola, or Apple?

Apple could make the iHear for $199, sell it as a personal amplifier, and they’d sell like hot cakes right?

But no one is doing this, out of the hundreds of electronics companies, no one has decided to offer cheap hearing aids, and simply call them something other than hearing aids (to skirt the FDA issue you harp on about). And I ask, why not?

We know the market is there, some one in ten adults or more. You claim it is as easy as slapping a few parts from China together. So either you are the only one in the world with this brilliant idea (which maybe you should license to Apple). Or maybe, and more realistically, it isn’t as simple as you might think.

Perhaps that’s because all an HA user can do with T2 is adjust volume & switch programs. That is NOT programming the aids. It is also very inconvenient and does not work consistently. I know. I have tried it and even purchased Starkey’s Android app.

I believe SoundPoint only works with the wireless Wi Series. What percentage of Starkey users could actually benefit from this app?

You are purposely confusing the difference between minor adjustments and programming the aids. I say purposely, because I know you know the difference.

Soundpoint only works where the programming software is connected to the wireless unit.

What I would like is an iPad or iPhone app that I can take out into the real world and play with some settings.

What goes on in the real world and the audi’s office is different and since I don’t have the vocabulary and definitions down, it makes it pretty hard to describe these things to an audi.

That is what is causing the level of frustration with users, some of it is psychological, I’ll admit that. The descriptive language and its interpretation by both patient and audi is the barrier.

Maybe because of my lifelong hearing deficiency, I have always responded to “Let me show you.”

That is the problem as I see it.

Agreed.

Also, Starkey appears to be much more restrictive in their software distribution. I have heard of other vendor software being available, though not properly licensed. Starkey software appears to be totally unavailable

Starkey does not seriously consider user self programming to be an option.