This months AARP magazine has a pretty good article on hearing loss and buying a hearing aid. Not much new information that most on this Forum doesn’t know already. It does mention the average markup on new aids is about 117%.:eek:
I’ll try to find the article. That means the $4K Phonaks I bought cost the dispenser $2K. That means that if I spend a total of 6 hours with the audi/dispenser in the course of a year - that’s $300/hr. (In my case I had the test done and paid for by my HMO. The audi/dispenser was separate and I had to pay the $4k.) That is a little high, in my mind.
What is high - are the mrfrs. getting $2K for less than $300 worth of electronics.
As long as all aids are goverment classified as medical devices that require all dispensing by licensed practioners prices will be high.
To my mind there are two classes of hard of hearing: the majority with simple age related high frequency loss and the more severe complex losses requiring skilled highly trained fitting practicioners.
Why should the majority pay these high prices? Ed
Well put. I am not clear though what the practice is in other countries.
I do know eyeglasses are a fraction of the price we pay in other countries. I am quite near-sighted, so for most of my life wore thick (heavy) lensed glasses. Even when plastic became available, they were still thick and somewhat heavy. When in Hong Kong 15+ years ago, besides cheap electronics, I discovered cheap eyeglasses. They could read my prescirption by “raeding” my present lenses. Not only that, they sold glasses made with high refraction plastic that allowed thin light plastic that wasn’t allowed in the U.S. for some years later. And the price was a fraction of what I paid here - less than half. And they were ready the next morning. Glasses are still much more expensive in the U.S. than elsewhere.
The AARP article is in the monthly bulletin sent to all members I think. Its conclusion on the 117% markup was you have room to negotiate.
I understand the manufacturers wanting to keep the audi in business, but I bet more than half of the people could do their own follow up adjustments if they had access to the programing. That would free up the audi’s schedule. Less of their time should mean a lower cost to the consumer. And I bet people would be happier with the outcome.
I agree 100%. My audie showed my the latest software for my new Phonaks (Target?). It really simplifies the adjustments. From a quick look, it looked simpler than the software I got with my America Hears aids. I think after an initial setup I could easily do my own minor tweaking and would then be a lot happier with the hearing aids.
This is because many audis (certainly NOT those on this board) don’t understand the technology and how to make proper adjustments when presented with too many options (especially the technical compressor controls). Thus, the manufacturers have been slowly removing options and converting others to pull down menus with a few selectable choices.
The HS and AH aids have many more options available as they have not been “dumbed down” in this manner. Despite my personal preference to make all of the options available to the user, it’s also true that, most of the time, the patient doesn’t take the time to learn and understand the technology himself/herself. Thus, often only the manufacturer reps (helping you fit the aid after you receive it) are the only ones who can use these controls to property adjust the aid.
The aarp article says to get a Real Ear test. What is that? I have heard the phrase elsewhere on this forum. Can any audiologist offer it? Do I make Real Ear a condition of working with a new audi?
But I bet only 1 in 10 people who meet with an Audi for adjustments ever have a Manufacturer Rep in attendance. My Audi hates to call Phonak for adjustment advice since she holds on the phone for 5-10 minutes for them to answer.
With more program documentation from the manufacturer and reasonable cost for the hardware, most patients could do a pretty good job. A retired person sure has more time to tweek his/her aids than the Audi. Plus, you can trial the adjustment in real time. It’s very easy to go back to the previous setting if you don’t like the adjustment.
A real ear test is a very simple test that is done with the hearing aid in place in your ear and a very small tube is also placed into the ear that is connected to a real ear measurement device. A short burst of sound (in seconds of time) is then ‘heard’ by the instrument and a display of the results over a wide range of frequencies is given.
What this does is:
Takes into account the acoustic properties of your ear AND the hearing aids are correctly working. (Just because the programming software is setting your hearing aid to a specific setting that in fact the setting is being properly interpreted and set to your hearing aid).
A good audi who wants to know what is happening with you, your hearing aid, and their adjustments uses REM. Other who are not as caring don’t. These are my opinions.
I would guess a majority of the people over 60 aren’t capable of self programming. I would say much more than half can’t do simple programming on a computer. These are the people whose VCRs flashed 12:00 because they couldn’t do anything but turn the VCR on and off - much less program recording. This is especially true of people over 70.
Of course younger people who need an HA are mostly familiar enough w. computers to where they can use moderately complex programs, can program their DVR, use their BlackBerry, etc. They have to program their GPS and many appliances in the kitchen. Most of my contemporaries (70+) can’t do anything but the basics on a computer. I would guess more than half can’t use anything even moderately sophisticated in their “home theater”. Most can use their DVR, but most wouldn’t be able to use a modern Blu-Ray player that connects to the internet.
IOW - how can these people be expected to use an HA that requires self programming? In my case, I figured it was worth paying “the price” and not take the time to shop for a do-it-yourself system. Also, there is a learning curve for any new software - even just upgrading to the latest version of software you use every day like Windows, Word, the new Firefox etc. Even our new cable box took a very modest amount of time to learn the new features.
I would like to see a system where the user pays for the level of service that is required for their individual case. Now, everyone pays top dollar - so users like me who need minimal service pay the same as those who, for physical or mental reasons, need lots of an audis time.
I agree with you on the pay for service aspect of buying HA. But, I don’t think your giving enough credit to us “Older folks” who are still able to learn. The new programs from the manufacturers are very user friendly and easy to master even at 72.
Of course the fact you and I (I am 72) are on a forum may put us slightly ahead of our contemporaries.
I agree…paying by level of service, along with a reasonable price for the hardware, would be nice, second only to DIY programming. I’m just a kid…62…but after 40 yrs as a software engineer on everything from microprocessors to mainframes I think I could handle it. The instant feedback and being able to do programming in situ would be really nice. It was what I liked most about the America Hears HA’s I had.
Just for clarity (in case you were responding to my post), I was referring to the companies who sell directly to the public then have their reps help you over the phone/computer.
My $0.02 is that everyone should have the option to self program. Those who can do it will and those who still have their VCR clocks blinking 12:00 (as mentioned above) won’t, it’s that simple! In other words, if you are the type of person who is interested in learning about it and feel comfortable attempting it then, IMHO, you should have that option.
Here, Here! (or is it Hear, Hear!? )
From a hearing aid commercial viewpoint, the people who earn their living selling and fitting aids probably oppose self adjusting as it takes away from their professional status.
Why pay for fitting services if you can adjust them your self. Remember that the average markup on aids is in excess of 100% at retail. That means a $6000 pair of aids cost your pro about $3000. If they spend say 10 hours with you that’s $300 per hour. But that’s not net profit. There are heavy expenses involved in running an office…rent,heat, light, receptionist(s), advertising, phones, amortization of technical equiptment, taxes, ect. So the net profit is much less. I don’t see any of the pro’s in my area sporting a yacht.
Point is: The audis should charge by the hour after the initial fitting. Like my computer, if I can service some things myself, I’ll do it. If some things are beyond my level of competence, I let a pro do it. HA users should at least have that option. I am not required to have my car serviced by Mazda, or my computer by Microsoft or HP.
My main complaint is, using your example, the electronics/mfr. cost is not anywhere near $1K, much less $3K. Electronics and computing power these days is small and cheap. Your cell phone has a GPS, multi-band radio (for voice communications) a still camera, a HD video camera, heavy duty computer - all for a few hundred dollars. As the population ages, the development costs are spread over a much wider base.
I’m not required to have my Hyundai serviced at the dealership either, but because of the service package included, if I do then its at no charge. I can take it to anywhere to be serviced, just like you can take most hearing aids to a multitude of audis to be cleaned or adjusted, but it’ll cost me.
And there is a flip side to bundling - more of my patients DONT want an unbundled price than those that do. My practice offers bundled pricing for new users AND if patients have purchased LEGITIMATE aids online and need service, then they can pay per visit and repair. Out of thousands of patients, I have exactly 2 patients who pay per service. Although there is a section of the population who want unbundled price structures, there are far more who do not.
As far as manufacturing costs, the audis are the ones making money hand over fist due to minimal manufacturing costs, it’s manufacturers. And the manufacturing costs are only a slice of that pie, R&D is a bigger slice.