HA situation from my prospective

Hello everybody!

I am new to this forum but not new to the problems associated with being HOH. I have hearing nerve damage from early childhood which has resulted in severe to profound hearing loss.

I am an Electronics Engineer (have a Masters degree) with the strong signal processing software development background. So, more or less I am familiar with the audiological terminology :slight_smile: And I have chosen the self-serving route out of outrage over the way current system works. (I usually buy higher end used HAs and re-program them myself).

There are my points of view on the whole situation with the HA availability:

  1. At he basic level, HA sales should be deregulated. Some as we have “prescription” or “over the counter” drugs, the basic HA should be available over the counter with the standard quality we are used to expect from the generic drugs. According to the Pareto’s Law, this should serve the need for around 80 % of people who suffer from mild to moderate hearing loss. I firmly believe that these cases only require a basic self-programming similar to what you do with your iPod.

  2. The remaining 20% high end HA devices which in fact do require an expertise of the Audiologist and require sophisticated equipment to fit them properly should be classified as “prescription” HAs. And this situation should be recognized as “medical” with sufficient insurance coverage.

Apparently, there is no simple “silver bullet” solution to the problem…

But the current situation is extremely misbalanced in favor of special interest profiteering groups…

Dude, will you program some HAs for me??? ((grins))

I have raved about this ever since I joined the forum about 4 years ago. I finally “gave in” and pd. the $4k for HA for what I would say is a mild hearing loss.
Instead of comparing HA to presciption/genieric meds -GREAT comparison- I would also equate it to buying a computer. If you are computer savy, you can do the whole set up your self. If not, you can hire someone to perform the set up parts you can’t do.
The mfrs. seem to have rigid controll over distribution and pricing. I am sure the same product could be bought much cheaper overseas - but I realize that I would need some professional servicing of the product here.
Eg. About 15 years ago was in Hong Kong. Everyone knew at the time that cameras and some elctronics were very cheap there. What I discovered, by accident, that eyeglasses were a fraction of the price that they were/are here. Not only that, they had “high index” lenses (which I had never heard of because they weren’t then allowed in the U.S. (They have been the last several years.) These lenses allowed me to have ultra thin, light weight glasses, instead of glasses with very thick lenses. I just bought some glasses here for several hundred $ and mentioned to the Asian sales optician that they are much cheaper in Hong Kong. Turns out she was from Vietnam and said “they are cheap in Vietnam as well”.
My guess is that HA are in the same category.

…mike

Hello, Melissa!

Just curious… What kind of issues do you have with programming? By the way, I am only limited to programming most Phonak and Oticon BTEs due to the fact that I only use those… Used some Siemens HA in the past: good overall, but feedback seems to be an issue with them…

Yes, the computer analogy is good. Most people have no problem whatsoever operating this sophisticated piece of equipment. And a modern HA is nothing more than a DSP (Digital Signal Processor) chip with few extras like Analog to digital and digital to analog converters, microphones, etc, etc. In fact, pretty similar to the sound chip in your PC.

The other optain is buy analog aids and a set of small screwdrivers

For me the biggest issue with analog HAs is feedback (whistling) as I need high gain. Could not even smile without whistling (some people will understand what I mean…) I am sure that for some mild hearing loss situations these analogs may help…

If anyone can do it, and you have a Masters Degree yet … how come you can only do the ones that you are familiar with? By your own words, shouldn’t you be able to do any hearing aid? And how many people do you think have masters degrees or have the know-how to do proper programming? Sorry, but you shoot down your own argument.

Not that simple. I have equipment/software to program limited amount of HAs (the ones I am wearing or plan to wear).
Another words, I could program other HAs if I purchase or make additional equipment (cables) and obtain necessary software. That’s the only objection because Hi-Pro interface box allows to program virtually any HA given correct cable and software.

I’ve really come to realize that digital aids are only as good as the person programming them. It sounds elementary, but it’s amazing how an audi or dispenser can try and fit me with a pair of Widex (example) and after a half hour of programming and fiddling they sound awful and tinny…then a different professional fits me with the same model and they sound good. This is the only fear I have with pros who offer ‘all brands’–I immediately wonder how proficient they are with so many software programs.

Actually, the computer analogy is pretty poor; both hardware manufacturers AND retailers have very small margins (manufacturers < 20% unless you’re Apple and retailers 2-10%). And yes, you can save some by building your own - assuming that you don’t value your time…

You would be amazed at the profit markup on a pair of glasses. Ever wonder how some stores can sell you 2 pairs of glasses for $69.95 and another sells you a single pair for $500? Granted one may get their frames from China and the other from Italy, but they are both made from plastic and cheap metals. And most lenses these days are also made from Polycarbonate plastics.

The largest company making glasses today, Luxottica, (http://www.luxottica.com/en/) make their own frames, make the lenses, sell the equipment that make the glasses, own the retail stores that sell them, and even own the largest eyeglass insurance company in the world. They own the entire process from one end to the other and can control the price. And they still charge that kind of money!!

And Hearing Aid companies are trying to do this by copying the Luxottica Model! Such as ReSound owning Beltone.

I’m in the production side of advertising and I’ve seen over the years how technical experts and craftsman (typesetters & film house employees) who were paid large sums of money for their expertise are now distant memories because of the rise of the computer chip. I think the hearing aid is now catching up to the technology and the time is ripe for some innovation and transition.
You still will need the experts for certain applications because the tools are very complex and sometimes you need the expertise and wisdom from an experienced professional and off course we all need the hearing test on occasion.
I would think that the HA and software can be designed to be consumer friendly. All we need is a radical rethink of the HA. I would love to see what Steve Jobs would come up with if he were given the task to produce a hear aid for the masses.

No doubt he’ll charge a monthly service fee to activate the aids. If you don’t pay the low monthly service charge of 99.95, they’ll automatically shut down.

I could see the aids costing double what they cost now even though the actual purchase price may be only 500.00. :slight_smile: Oh, and don’t forget a mandatory periodic hardware upgrade every year. He may have started off in a garage but there’s no way he’s going back.

Don

I agree! If you look from historical prospective, the Aids were becoming less and less user friendly. Especially after the transition from analog to digital. Now every profit-oriented party would argue that you need to have an university degree in order to fit a hearing aid. I remember doing all the fitting with a small screwdriver back in the school years. I would say that the sound quality of modern digital hearing aids a perhaps a little bit better for high end models. The only advance that I really appreciate is virtual elimination of very annoing feedback which is now standard feature of digital Aids.

So… Yes, it will be an uphill battle for the consumer. I cannot imagine for a second that disability profiteers will retreat without a battle!

Better educate yourself how to survive without them (or at least use them minimally).

iHear, anyone? :slight_smile:

Now that statement, just there, is utter nonsense.

In this industry, one thing that has been apparent for many years, is that the refinement of hearing instruments has led to significant improvements in customer satisfaction: google ‘Marketrak’ if you don’t believe this.

We can all take the Rose tinted view that stuff isn’t as good as it was and using emotive language like ‘disability profiteers’ just clouds the debate.

Most of the professionals on here will be able to prove to you certain factors like: the degree of gain vs occlusion, the performance of noise controls, directionality providing greater signal to noise. More than this we can also give you some pretty good empirical data of how our input helps the social mobility, psychological state and relative wealth of successfully aided people.

So before you decide to write-off an entire industry on the back of a sweeping generalisation about dubious business ethics, perhaps you ought to remember that it’s not wrong to expect to earn you living while helping others, though doing just that is hard enough at the moment with the state of the economy.

Are you implying that Apple computers are low cost or cheap? Steve Jobs has the most expensive computers that you can buy, premium prices and especially now for the same CPU that sells much cheaper in PC’s. I totally agree with the other poster that if Steve Jobs was given the task … very few would be able to afford aids … and NO ONE would be able to adjust their own. His computers are use them as they are, they are perfect for everyone as he designs them.

Actually, I almost bought an iMac until I looked at the price and saw that I could pick up Intel’s newest quad core machines for much less than the old dual cores they were shipping in the new iMacs. And I could load Linux if I wanted a comparable operating system. <LOL>

It would be pretty stupid for them to argue that you need a university degree, since you don’t need one NOW to become a hearing aid dispenser. But I get your point!

You can dismiss my point of view (based on personal experience only, I am not speaking for everybody!) as “utter nonsence”. Perhaps I should clarify a little:
For my lifestyle choices (mostly quiet surroundings) I have very little benefit of many features of modern Aids (excluding feedback canceling). For other persons this will be different and I am not arguing with that.

Perhaps indeed I am using too strong words and please excuse me if I offended you in any way.

The problem (again, this is my personal opinion only) is that the control over hearing aids adjustment is taken away from people. Perhaps, this is bad analogy, but will you go to the doctor if you have a slight headache and need aspirin or tylenol? In the other hand, if a all the person needs is a small adjustment to hearing aid, he should go to the fitters office and pay a hefty fee.

All major manufaturers of hearing aids should provide a “do it yourself” kit to the people who are willing to educate themselves. But I can imagine what kind of protests there will be from the other parties.

Your observations are right on target. And you can purchase relatively inexpensive, high quality hearing aids over the counter, like the Acoustitone Pros, without the need for an audiological evaluation. Most consumers simply are not aware that they can purchase hearing aids online and save money and not have to deal with audiologists or hering aid dispensers who are only interested in maximizing their profits. Gerald