You seemed to be relaying anecdotal (made up) info, anyone can do that.
The whole problem (USA) with marketing and dispensing hearing aids starts in 1977 when the FDA classified hearing aids as Medical Devices. This was a response to fraud and misleading promotion of aids by a number of rascals. Why the FDA instead of the Federal Trade Administration, I don’t know.
Anyway this classification effectively eliminated application of various commercial laws on the books. As a Medical Device they are effectively beyond restrain of trade laws. The local state lobbies representing the established MD’s and Audiologists were then able to get the state legislators to pass restrictive legislation that required sales only by state licensed persons. Ordinarily, such laws would be unconstitutional.
This had the effect of turning a miniature amplifier/sound conditioner into the inefficient manufacturing distribution system we have today. The system is grossly inefficient as evident by the over the counter sale of slightly more complex electronics, the in the ear BlueTooth Devices, sold by the thousands at stores like Radio Shack.
Technically aids today are designed and manufactured for their only market…the professional licensed fitters.
By the way no way did any small hearing aid manufacturer spend $100,000,000 on R&D. That sum is probably promotional hog wash. The guts of today’s aids the main chip is designed and mfg by large chip factories which supply most of the firm ware free with the sale of their chips. Yes developing the algorithm costs some bucks but not in the league of $100 million…,…,more like a couple million.
Today,technically self fitting aids could easily be mass mfg’d and mass retailed for less than $400. Ed
This is a refreshing post - real content that is appreciated! I was searching and found that the chips (digital signal processors) are available with the programming interface, so anyone with some free time and bit of technical skill can attempt to build and program their own aids. You can depend on this calculation for most top of line aids: base wholesale cost times 2.8 equals the retail cost we are paying.
Here is some additional real content: the DSP data sheets for New Sound NSG275DOA and America Hears hearing aids. Both companies supply the self-programming software with the hearing aids.
Edit: Hear Source is another distributor of excellent quality hearing aids that come with self-programming software.
This is an interesting thread! The whole concept of selling hearing aids over the internet is a double edged sword.
First, I need to be up front and mention I’m an audiologist and also wear hearing aids - Before I studied I remember going into a clinic about 14 years ago (I was in my early 20’s) and paying $7000 (had to get a loan) for a pair of hearing aids - But I needed to hear!!!
So now after years of study, working for a number of hearing aid chains and a manufacturer I have my own independent hearing clinic.
The constant struggle I have is how do I provide the best service possible, keep prices as low as possible and still manage to earn enough money to pay the mortgage feed the kids etc?
The problem I see is that no one likes to pay for services so the only way to make money is by charging more for hearing aids… The big hearing aid chains even offer “free” hearing checks just to get people in the door.
So, should I start selling hearing aids online? I could definitely sell them cheaper that way - I could potentially sell heaps more hearing aids - I wouldn’t have to spend hours testing peoples hearing (some other poor sucker could do this for me for “free”), demonstrating how hearing aids work, advising on the difference between various models, ordering and letting people trial various models, ensuring the hearing aids fitted well and the tubes and domes etc were the right size, teaching communication strategies, measuring insertion gain (measuring what the aids actually do objectively while they’re in the clients ears), objectively measuring client outcomes etc etc. I wouldn’t have to pay and train my receptionist, heck I could even shut the clinic and work from home saving heaps of money!!!
Trouble is many of my clients are elderly; they need someone to clean their hearing aids and generally give them reassurance - they like the face to face contact and the reassurance that comes with seeing a professional that looks after them. Should I charge old people more and young people less? Should people who need extra assistance be disadvantaged?
I know this post is a bit “rambly” but I just wanted to share my thoughts. The cost of buying hearing aids from a “bricks and mortar” audiologist is high - but it’s not all about greed and ripping people off. If anybody has suggestions as to how I could provide high levels of service at low cost I’d be really grateful 
my only problem is that they are so much higher at an audi. I Could justify somebut not that much. Audi’s and the manufacturers need to go after volume. There are just too many people that have hearing loss that can’t afford them. As I have posted before, this is thousands of dollars difference, not hundreds.
It is a tough pill for me to swallow.
1965mt - I completely understand your frustration (remember I had that too paying $7000 in 1996 for a pair of aids - things seems to be more expensive here in Australia than the US)
Some of the prices I see on ebay are even cheaper than the wholesale price that I can buy hearing aids for - I suspect something dodgy might be going on.
My previous post was just my thoughts - not a justification per se. But as an independent audiologist it’s hard to go for high turnover to reduce prices (there’s only so many hours in a day - and lets face it, hearing aids aren’t consumables like other electronic devices - mobile phone kiosks might sell hundreds of phones in the time it takes me to “sell” 10 pairs of hearing aids) - hence my ethical dilemma regarding internet selling. I guess if we follow internet selling to its conclusion there’d be no need for audiologists - the hearing aid manufacturers could sell directly online - even conduct hearing tests online!
While I admit fitting hearing aids isn’t the same as brain surgery - it does require some training and knowledge. I guess the analogy of building your own house could apply here… I for one would rather pay a builder to build my house (knowing that I’d completely stuff it up if I did it myself) and obviously spend more for a professional job. Others more handy than me could save money by doing it themselves
I’ve been toying with the idea of “unbundling” prices. For example, I could sell hearing aids for close to wholesale price (even on the internet) - then like any other professional charge for my time and expertise. But I’m not sure how consumers would react to that…1965mt… maybe you could ask your local audiologist if they’d consider that option - I’m sure I would if you asked me! Good luck!
In most states it is legal to buy hearing aids online or via mail-order: 11 states ban it.
The big crackdown is on sales to end users who are not getting a face-to-face fitting . If the seller sends the aids to the final fitter, who must be licensed to do the fitting, the manufacturers are ok since they are protected ( and one hopes the hearing aid wearer is as well).
Interesting note: MD’s are exempt from most state laws related to fitting hearing aids. So, if I were enterprising, I may sell aids to people in every state were it is not specifically banned and send the aids to the client’s family doctor. Sure, they may not know a thing about the aid, or how to program them, but what if I do and I guide the MD?
I’d love to see PAC’s, or manufacturers, or special interests of any kind, try to stop this from happening-the AMA will kick butt and take names.
Personally, it seems to me that change is coming and it’s going to be great not to pay $6,000 for a good hearing aid.
The British National Health Service buys in most “catalogue” hearing aids for costsunder $200 per unit by agreeing to purchase several million of the same thing. If the US could somehow organise its resources to allow large purchases from state sources then costs could be brought down, but at the price of choice. There are only 17 different actual hearing aids in the catalogue (it is quoted as having several hundred as they count each colour and each battery door configuration as a differet hearing aid) and most areas do not dispense all of them anyway! My area, for instance, dispenses one particular type of Siemens aids in Lite, Moderate, Power and Superpower versions, with special orders only being placed for very small children (Phonak Nios Micro) or profound losses that need an ultrapower aid which is a Phonak Naida UP. There is no choice, but there are hearing aids for low-income families. This is the first NHS hearing aid I have had that made my hearing better rather than worse, and I have worn aids for 20 years, so it’s not a panacea by any means, but for people who have a choice of put up with it or go without it’s fantastic. What you cannot do is say I’d like that one with the £50 upgrade option in it and I’ll give you £50, you either take the “free” one or you buy your own at full retail. Annoying if you then have to pay £2,500 for a T-coil! You also cannot just get these things fitted privately as the aid is not your property, it’s on loan.
So perhaps more of a two-tier system same as we have, people who cannot afford all the bells and whistles of choice can at least purchase a “state-ordered” hearing aid at costs of a few hundred bucks, and the fitting cost really should be an insurance reimbursement, it’s specialist medical treatment after all, if you got it on your teeth that would be a dental insurance claim, right? It’s pretty criminal that the FDA says you must see a hearing aid professional to get a hearing aid but it’s not a reimbursable medical device and the fitting is not reimbursable medical treatment! People who want wide choice could still go to the private market, but of course it would immediately shut down a good proportion of the current market as there would be far fewer people wanting a $3,000 hearing aid if there’s a $500 hearing aid, and margins for dispensers go out the window. Since you can’t just shut off a business’ revenue stream overnight you have problems. The states would find it tricky to purchase these aids only for the people who really really can’t afford any other sort because then the volume or orders is not there. It’s a catch-22, if Medicare/Medicaid (sorry, I don’t know what’s what in state insurance) cannot afford to pay for hearing aids then the price stays high. If Medicare/Medicaid started to pay for hearing aids then the price they paid for hearing aids would be much lower, but you have to order them first!
It’s like it’s a middle ground just now, either this is a medical device that needs specialist fitting and FDA controls or it’s not, and if it is medical then medical insurance should cover it, if you’re saying it’s not a medical device for insurance purposes then stop telling people they have to see a medical professional to get one! Reimbursement needs to be in some kind of sensible proportion also. I have a private medical policy here in the UK. The optical cover reimburses about 60% of what I pay for glasses, the dental covers almost all my dental work, the hearing aid cover is 75% of what you paid up to a maximum limit of £150. What?? What is £150 going to buy you in the way of hearing aids?
This is precisely why there will always be the need for professional fitters. It is an interesting point you bring up that some clients take up a disproportionate amount of time, in this aspect unbundeling would level the playing field.
That is worth looking into.
Just be careful, I have heard that it against the audiology code of ethics in Australia to sell hearing aids online.
Unfortunately that means the people with the greatest need also end up paying the most, rather than averaging the cost across all the heraing aid sales.
In my practice, Pareto is usually followed, with 20% of the clients requiring 80% of the management - it would be unreasonable for that 20% to absorb 80% of the costs: you’d end up marginalising the sales for that 20% and it’s unlikely that your advertising/referral stream would replace them.
Without wanting to sound disingenuous, the prices are set by the customers not the dispensers anyway. We charge what people are willing to pay for hearing aids and a high standard of serivce. The market dicates whether we are successful, by buying our product or not: if we pitch the price too low - we’ll not make enough to cover the costs of the shop/receptionist/wages, if we pitch it too high, then nobody will buy our hearing aids. The market model establishes the price between supply and demand levels.
The reason that hearing aids are ‘cheap’ on ebay is that they come without any implicit service agreement - rarely would you find a bricks+mortar dispenser who doesn’t off/isn’t obliged to offer a degree of follow-up.
Others are also offering a product that although it has been made by a major manufacturer it’s been produced for their developing world markets, so it is a genuinely inferior product to the ones that are selling for higher prices. Things that spring to mind are e.g. the Siemens Lotus that is all over eBay just now. If it is all you can afford and you want a hearing aid with 1-4 channels, as most of these offerings are, then buy one, but unfortunately most people don’t know what they are buying.
It is almost in the interests of the public for state laws to allow charging for a consultation only service, for someone to come in and say upfront I really cannot possibly afford what you have, I have seen this on the internet, can you support it, can you repair it, will it be any use to my hearing loss. I’d pay £40 to have that conversation with an expert before parting with any money. It’s knowing how to draw the lines up so that people don’t feel they will be charged just to talk about the possibility of a hearing aid but they are not disbarred from having a converstaion with an expert that does not lead to a sale.
What’s missing in the above otherwise excellent comments, is the innovation factor.
Aids at present are primarily designed for the only legal market …i.e.: the government licensed purveyors. They are designed and made to require the fitting services of trained specialists. All the R and D money goes in this direction. No manufacturer can sell their products to mass marketers. They must not alienate their only customers…
If aids were designed to be sold in mass market stores to the majority of hard of hearing persons, those with mild or moderate uncomplicated losses, specialized fitting by professionals would not be needed.
Aids would come with multiple snap on inserts and push button loss curves similiar to in the ear BlueTooth devices available at Radio Shack for under $150 each.
The technology is available…the anachronistic government regs are what is holding back innovation.
Ed
I bought (1) pair of dot 30 aids from a well known ebay seller of hearing aids for $500 per pair. I just bought another pair of the new dot (squared) 30 aids for $900 a pair. I was upfront with my local audiologist and we agreed with $100 programing fee good for unlimited adjustments within that month.
I think my seller is buying returns some how. My doctor ran the serial numbers and Resound has no record. The ebay seller also has Widex, Phonax and other brands.
I also have a pair of America Hears but prefer the dots for they sound better.
How hard is everyone else laughing at the sales of second-hand custom instruments? Like people are actually selling moulded ITE hearing aids off, what is the next person going to do with a hearing aid that is in the shape of someone else’s ear?
Lol!
Dot 30 aids are open fit.
I have severe loss in one ear and moderate-severe in the other due to explosive. I’m also poor and old. After audiologist exam and trip to Costco, I went to ebay. Could not believe differences in prices and took a gamble on 2 aids deal with ebay seller “premium-hearing-aids” and have been really pleased with price and service. The follow-up emails are from Amanda Witter. I assume that’s a real name. Was really surprised that the company is in England (I’m in North Carolina). I thought I had really messed up, but it turns out that “she” is sending me some extra tubes, domes, and tulips free. Her email gave directions on repairs, should that become necessary. In all, couldn’t be happier.
Just out of interest, did you have to pay for your audiology trip? If it was “free” then that price gets rolled into the next person who makes a purchase of a hearing aid. There is no easy answer, but it is going to be ever harder for people at the front line to make ends meet if they have to offer certain office services without making sales, and prices will only get further and futher apart.