My Experience Buying

A bit of a rant here. Just my opinion, others my differ and that’s ok with me.

Background, retired Electrical Engineer. Owned electronic manufacturing business. Age 75. Moderate to severe hearing loss with typical Ski slope. Heredity and old age. Seems to be stable for only moderate increasing loss for past 10 years. Hear well in quiet environment but crowds, movies, parties etc wipe hearing understanding out. Hobbies- Musician, brass inst.

I’ve been looking for a hearing aid that meet my needs for the past 10 years. Finally just found one for the first time and bought it. By my needs I mean one that worked.

Buying a hearing aid is akin to buying a car,new or used. It’s all a sales ,marketing hype and the dispensers who like to call them selves Doctors know absolutely nothing about electronics. Nothing seems to be taught on this subject and they are quite unable to make a good decision on who makes good equipment. No different then a car sales person selling selling the worst of the worst, they simply want to make a sale. Beware of the manufactures who sell though franchises is good advice in my opinion. High pressure, distortion and lies are my experience.

As I said, for the last 10 years I have been trying to buy a hearing aid that worked. Every 2 years I made a search. Finally a brand new unit just out had the design features I needed. Out of all the ones I tried only this one Brand worked for me. So I bought it after price shopping. Just like a car, the List price means nothing. Quoted $5K by the Hospital Hearing Clinic I bought it from an independent for $3k. Could have done even better but felt this dispenser was better at programming and played fewer games. The Dispenser at the Hospital was totally incompetent and couldn’t even run the tests correctly. One Dealer even tried to screw up the program on the model I liked to make their favorite brand sound better in comparison. Caught them red handed on that because I’m well familiar with the system. They claimed it was a simple mistake. I’m sure it was. The old bait and switch is alive and well by some dealers. Advertise a low price for one aid only is common or a low price and then say that one won’t work for you. Mail order specials, Try to buy the one you like and get switched. Your in a jungle here. Scary.

I worked in the industry a couple of times before digitals came out. Analog was hopeless and I didn’t waste time on them as a designer and found other employment. The last Analog chips I played with were from a Canadian Company, Gennum. I think thats the spelling as I remember. They just left the industry as Digital became to involved and analog died.

As I designer I decided over 30 years ago what was needed was a BTE unit with a receiver(speaker) located in the ear canal. A DSP was needed to do all the sound processing. The ear piece should be flexible silicon, no ear mold, and sealed. For many technical reasons this was not made until just recently. Not enough room here to get into the why of this.

So I bought the GN ReSound Dot 20. It works for me in crowds, parties and movies. Minimum feedback but not perfect yet. Lots of bands and the DSP software is the best available. imho. Brand new design and better on the way. In a few years the 3-4th generation design from now, kids will be buying these things to wear at the Clubs so they can talk to each other and understand. Cost? About the price of a Boise noise cancellation head set. Want to hear something neat? Listen to a good CD played through a Boise NC Head set. You have forgotten what good sound was.

I can find little info on the HA unit like number of bits. Would you buy a computer without knowing how many gigs? Can’t find out zip in the hearing aid industry. The brochures read like a car sheet. Lots of flash with pretty happy faces and that it. Strictly a sales/marketing hype. A Lexus or Chevy? Sales guys are all the same breed.

Why does a Hearing Aid cost so much? There is a very good reason or better yet a very bad reason why. Since I worked in the industry and know were the bodies are buried I’ll tell if you ask.

Hi Aaron,

Glad to hear you are fairly happy with your current aid, but sorry to hear you had to take the long way around. It sounds like you were prophetic in your desire for BTE with RITE. It just took the industry a while to get the chip size small enough to be practical.

I have been told by the various manufacturers that prices are high on hearing aids vs. other electronics because of:

  1. R&D
  2. Low unit sales

Who knows if that’s actually the case, but they do make a convincing argument.

BTW, here’s an interesting article on Gennum in case you missed it (doesn’t sound like you did): Gennum Abandons Hearing-Aid Market With DSP Chip and Headset Spinoffs

:slight_smile:

it is rather true, if you look at phonak and oticon. at least 20 of gross sales
goes to randd

Prices are high not because of RD and low volume. They are high because the Hearing Aid Lobby keeps our Government involved in a product that should be developed and sold in the free market. Can you imagine what an i-Pod would cost if Apple was regulated by the FDA? It never would have seen the light of day if all the FDA paper work had to be filled out and approved. There are no numbers to support the claim of RD costs or Low volume sales by the manufactures. Bogus claim. You know what the market is on an Aid. I have to work backwards on this but it appears to be around very very high. $5000 aids are being sold for under $2500 or less. That means the dealer is doubling the price from the manufacturer. Why don’t you give some examples of the items you sell and your mark up if I’m wrong?

Small DSP chips have been around for years. They were not used because the big manufacturers really have no R/D. Starkey just sold off their R/D chip design to On Semiconductor. They are not interested in Engineering but in marketing as I see it and the poor product shows it. The latest design a BTE with open ear was developed by two engineers in CA. Now everone has copied this method. No R/D that I can see by the big boys.

Just what to you pay for a face plate? The parts that make these up including the speakers and mikes from Knowels and the DSP from Gennum used to cost under one $100 US. I jusrt saw a news release for a new DSP for $32 each. 24 bit which is powerfull.

I see comments about reliability problems caused by sweat. Salt water will kill an electronic device. These devices should be potted to protect them . They are not. No reliability built in that I can see. The life of an hearing aid is around 5 years I’m told. Not good. If your TV set had that sort of problem no one would buy them. An easy fix.

This industry makes a very good example of how special interest groups can distort and hold back progress in the market place. Open the field to The Pacific and prices would be a fraction of what they are to day and reliability and quality would be far superior.

This will happen when the younger generation who is growing up with computers ages and needs Hearing Aids. They will not stand for the present stus quo. About 10-15 years off left in your business. Plan ahead.

Aaron,
I’m also an electrical engineer and was equally appalled at hearing aid prices and the completely closed marketing / distribution system. This entire industry has been kept in the dark ages!

Every other segment of the electronics industry is wide open and bubbling over with information that details performance comparisons among different manufacturer’s offerings. But not the hearing aid segment!

You can search this forum for weeks and not find a single independent product review that compares different aids using objective measures. Instead, the “high priests” of the industry (A.K.A audiologists) dole out their opinions, with few or no facts behind them. Hardly objective! We, the hard of hearing, desperately scramble to gather these “pearls of wisdom” to make our buying decisions.

The worst part of it is that the audiologists actually sell the hearing aids. Talk about conflict of interest!

However, there is hope, now that several companies are successfully selling and serving customers over the Internet. I’ve actually found specifications and real performance data (e.g. frequency response curves for Speaker in Ear models). No independent tests, yet, but this is a good start. These are mostly 32 channel digital units and are priced about $1000 (per ear) - way under audi prices. The units come with connectors, cables, and software so that users can adjust HAs themselves. See http://www.AmericaHears.com

Of course, the audies are quick to cluck, disingenuously issuing dire warnings of hellfire and damnation :slight_smile: should anyone actually dare to adjust his own unit. :eek: IMO, these guys are writing their own epitaphs.

Here is an excellent presentation on the future of the hearing aid industry http://www.hearingcentral.com/HearingAidOpportunities.ppt

Thanks for your reply JC. Very good points. I wish I had seen America Hears. The Brand I just bought uses Bands and won’t disclose how many channels it uses. For those who are not technical, Channels are tiny individual separate amplifiers used to break the frequency up into small parts. Only the frequencies that are needed to have their sound level increased are processed by the individual amps. 32 is outstanding. I wish I had tried it. If you do make sure its a BTE open ear with a closed dome for best results in crowds.

I don’t know what their return policy is but if it’s at least 60 days at NC I would order one by a credit card for a test. How could you go wrong for $2000? Don’t like them? Send them back. You could have a Dot 20 at the same time for comparison at home. That’s the only way to buy.

Channels are simply passive equalizers like you see on some Audio stereo systems. Not the best way to solve the problem in my opinion. Probably used because it’s cheaper.

The System I bought is a Dot 20, incredulously expensive for what it is. However out of all the ones I tried nothing was close for sound quality in crowds. I cringe when I see some posters here talking about buying the junk I tried that didn’t work.

The mail order suppliers are still feeling their way. I tried to order the Dot 20 by mail order. Got down to the final line and it turned out they couldn’t supply it. Tried to sell me another well know brand that I tried and was a turkey. Could have been a bait a bait and switch deal.I don’t know.

To get it done properly I think it will take an Apple or Boise to pull it off and of course our Government won’t allow that.

The FDA claims the China Heparin situation where many people died happened because they didn’t have enough people to inspect China factories yet they screw around with hearing aids less dangerous then a iPods. Go figure.

Petition after petition by US audio manufactures who want to make hearing aid are turned down by the FDA. Money speaks though the Lobbyists.

be aware speech intell. is maximize with 4-5 channels…

Would you please cite some independent test data that supports this statement?
(Note, I don’t doubt it but I just haven’t found much hard data regarding HA performance…)

You really cannot compare an iPod to a hearing aid. The latter is a medical device, and people with a hearing loss sometimes have a medical issue that needs treatment. As a hearing professional, I have in my career spotted serious medical conditions such as acoustic neuroma and referred appropriately to medical professionals.

If it were not for that medical referral, those people would probably already be dead. If a hearing aid were something you could pick up at Best Buy, some people with a serious medical condition would buy one and be happy with their new hearing, right up until their untimely death.

We may only be talking about a small fraction of hearing aid users here, but it is a real issue. Hearing professionals are taught to look for medical conditions and to know when to refer. I’d rather a licensed professional be doing this as opposed to an 18 year old working at Walgreens at the weekend.

So I have to say, I think it would be irresponsible to allow people to purchase medical devices without some kind of examination. If you follow your logic through to its conclusion, why should I need a prescription to get medicine? If I think I have some kind of infection, why can’t I just go and buy some antibiotics?

Honestly, you could make that argument about anything. If I go to the store and buy a Hugo Boss coat, six months later it is 50% off in a clearance sale. If the store was not making an insane markup, how could they offer that discount? Have you ever seen a sale price of something being offered at 80% off? I have. I purchased a really nice Ralph Lauren sports coat a year ago. It was $99. I’ve seen the same coat at $299, when it first hit the stores. Do you believe that the store is losing money at $99? I don’t think so.

People like you talk about hearing aids, like it is some dirty little secret, and hearing professionals are driving around in their Ferrari’s laughing all the way to the bank.

I now own my own business in this profession. I’ve looked at the P&L statements of similar hearing aid businesses. They make a reasonable profit, but on no level are these businesses making any more than any other kind of similar business.

What you have to analyze is the bottom line. Not what you think a chip for a hearing aid costs, versus what a finished aid is sold for.

If you listen to some people on here Starkey is but a small independent, compared to the ‘big boys.’

But let me tell you, I’ve just received their final technical specs on the Zōn aid and it is astonishing. My rep confidently claims he has seen one of these aids dropped in a glass of water for 45 minutes, and it still works.

Innovations like this don’t come cheap. Of course I am not privy to what a company like Starkey spends on R&D, but I know what I’ve been told by the executives. To claim that they don’t spend much on R&D is just nonsense, pure and simple.

I’ve watched this industry grow from 1994 when I qualified, until today. The breakthrough technology I’ve seen in this industry has not happened because a magic pixie waved a wand.

If a TV only lasted for five years, everyone would still buy them. In fact people would buy a TV if it lasted 2 years. Are you serious? Everyone has a TV, and they don’t buy them for their perceived reliability. Plasma TVs definitely won’t last all that long, and the picture fades over time. Yet people still buy them. In fact I guarantee if you buy a $5,000 plasma TV today, and run it 16 hours a day, 365 days a year, it won’t last five years. Just read Consumer Reports and news articles about the longevity of plasma TVs.

As for hearing aids, I can tell you that I have seen many hearing aids that are ten years old and still working. Considering it is a device worn perhaps 16 hours a day, 365 days a year, that’s not bad.

No one uses the other consumer electronics you have mentioned for such long hours.

Maybe, maybe not. Time will tell. But honestly, I think your caustic attack on the industry is unfounded. I really wish I was making the killing you seem to think hearing professionals are.

Well old people can get a bit caustic as you know. So I apologize if you think it was an attack on you. It wasn’t. My last remaining Aunt is 105 years old. Her filters are gone and she says exactly what she thinks. This comes across as humorous to me. Some others are horrified, I laugh which makes it worse. Last time we saw her she pointed at my lovely wife and said- my, you have gained a lot of weight my dear. I got in trouble again by laughing.

I never made a claim that dispensers are getting rich. Personally I don’t see how anyone makes a living in this industry. How many old people can afford $6000-$8000 for an aid? Not many where I live. Small town with over 30 dispensers in the business. You probably spent $10-20K on test equipment, maybe more. All caused by Government rules and regulation. I made my own test gear for under $1000 that makes your stuff look like junk. What if I told you I could sell you a tester for $500.00 that would brain scan and give you digital hearing results in 15 minutes instead of the subjective 1-2 hours you have to do now? Hooks up to a Vista or XP and prints out the result in 1/4 octaves. Optical business is the same way. Japan makes eye scanners for glasses that does a much better job that our "does this look better " method. Not allowed in the USA. I get my glasses when we visit Hong Kong. $50.oo and a perfect fit. Takes 5 minutes for the optical test.

I can’t market it or sell my audio tester of course because of FDA laws. They would instantly fine me and maybe jail me. Freedom in this Country no longer exists in a lot of fields.

Glad to see one brand seems to have come out with a water proof, ie potted, system. Others will follow. That will have a big effect on reliability as I have mentioned in a previous post. However sticking an aid into a glass of water to see the effect means nothing. Ye ol vacuum cleaner sales trick. The voltage used is only 1.4V and water alone won’t damage it. The damage is caused by electrolysis and corrosion. This takes a while, sometimes weeks or months. This is almost impossible to repair. My Dot is wide open for water damage. A really bad design fault. It has a 3 year warranty and I’m not going to worry. 3 years from now this unit will be totally obsolete with the fast changes now taking place and I’ll replace it. Next up fuel cell batteries that last 1-2 years.

I just saw a post complaining they sent their aid in for repair and it ran only one day. Back and forth to the factory time. Sounds like corrosion to me and nothing can be done except replacement. I won’t wear mine in wet or humid environments and keep it in a desiccant dryer. I bought the desiccant at Michaels used for drying flowers. Dirt cheap.

Your industry is in really bad shape and until our Government backs off nothing will change the high prices and bad designs.

PS- I have audio gear 20-30 years old that run 16 hours a day and never a failure. Even good computers with their hundreds of parts can do this. A hearing aid should never ,ever fail except for the small ,what we call infant mortality, of new units.

As far as the FDA go, there is clearly a problem with it. But I don’t think the answer is to disband it. I’m rather sick of Republicans and politicians telling me that the government doesn’t work, and it needs to be made smaller. How about make the damn thing work? If my car doesn’t work, I get it fixed, I don’t just abandon it on the side of the road.

Regarding my audiometer, I’d just settle for one where the headphones and accessories fit in the damn case properly! Brain scans! Ha! We’re still using headphones designed in WWII.

I don’t think it is really fair to rubbish the hearing aid in a glass of water ‘trick.’ There are not many aids on the market today that would withstand that kind of punishment. So while it may not be up to your exacting standards, you have to concede that it is a step in the right direction.

Regarding your PS. Your audio equipment is not tiny and does not sit in a moist warm ear all day. At least, I imagine it doesn’t.

In doing more study on the Zōn today, I also found out the circuit has a life time warranty. I’ve not seen that before, maybe others have. But it’s another nice touch.

Oh, and finally I didn’t see your post as an attack on me. But I do feel that professionals should defend what they do in the face of the kind of accusations you were making. I feel that this forum is a place where everyone can voice their opinions in a courteous and respectful manner. My apologies if you felt my response was overly blunt.

I apologize if this seems like an attack on you but you have placed yourself in the position of defending the HA “Establishment” position that it is perfectly OK to price their products an order of magnitude higher than the rest of the high tech electronics market. It is not OK – period.

Oh, yes we can and yes we will compare iPods to hearing aids in terms of function, value and price.

Value and Price
Anyone who has seen an iPod or used an iPhone knows that these are light years more functional and sophisticated electronic devices than a mere digital hearing aid. They should also be fully aware that these devices are appropriately priced at several hundred dollars rather than several thousand dollars for hearing aids. You are evidently asking us to willingly suspend our observations and judgement about the world around us.

Function
The function of a hearing aid is not special! Hearing aids are little more then audio frequency equalizers with selective gain controls. Fancy tone controls. Many of us bought commercial equalizers and implemented them in home stereo systems, decades ago. Nobody can claim prior art like this to be, ex post facto, “special” in some way that allows its sale to be restricted or its price to be artificially inflated beyond all reason.

Oh, your establishment claims an audio equalizing amplifier is a medical device? And therefore justifies a price that is ten times higher than any other electronic device? This logic is clearly flawed because hearing aids use the same circuit technology as other electronic devices. As others have pointed out, hearing aids don’t even bother to pot the circuitry to prevent moisture corrosion.

Moreover, your appeal to saving lives is specious and hollow. Please post statistics on the number of deaths due to esoteric ear diseases that have been prevented by audiologist interventions. Good grief!

Bottom Line: There is something rotten in the state of Denmark (to coin a phrase…:smiley: ) The entire hearing aid industry situation is preposterous and worthy of a congressional investigation into possible predatory sales practices and possible collusion to fix prices. Its time to kick butt and take names…:eek:

I changed over to insert phones, and love them. I do still have a pair of headphones, but rarely use them. Also, I’m using the Interacoustics Equinox audiometer which is computer based. Word lists are right there in the software, no more live voice testing.

To jchunter:
I do feel that hearing aids are a bit more sophisticated than just frequency equalizers or ipods. On some of the entry level hearing aids that may be a fair comparison, but the more advanced aids are closer to small computers. They have the equivalent of sound level meters to monitor the surrounding environment, and they use artificial intelligence to determine the appropriate settings for that particular moment in time. They can sense when they are close to an electromagnetic field from telephones, and change to the phone programs when necessary. There are other features which are also automatically activated when necessary.

Hearing aids must perform all this but still be cosmetically attractive, use small batteries, and be exposed to sweat and earwax. Also, they often get dropped on the floor, worn in the shower, or chewed by pets.

iPods and iPhones are much larger than hearing aids, so you would really have to compare hearing aids to the iPod mini to be fair size-wize. Minis have very limited controls, so are not really all that sophisticated when compared side by side with hearing aids (unless you want to wear a hearing aid the size of an iphone - I’m sure they could get lots more features in there then!).

Also, once you buy an iPod you are on your own and do not go back to the store for adjustments. There is a movement underway to start unbundling charges for hearing aids. You would pay one price for the device itself, and then pay for other services (audiological evaluation, hearing aid evaluation, heairng aid fitting, adjustments, cleaning, warranty service, etc.). If this becomes reality, then people who do not want extra services will not pay for them up front, where others can buy a package of services. The American Academy of Audiology has a task force working on this right now, so it will be interesting to see what happens.

audiogal, do you use insert phones plus the client earmolds?

The meat and potatoes of a hearing aid lies it its ability to compensate for hearing loss in certain frequencies. The other features remain just marketing bells and whistles until independent testing agencies use objective measures to show exactly how well they work. If you know of such tests, please post some links.

You are correct about the fact that HAs use tiny stored program computers to process the sound. However, these are commodity computer chips, made by semiconductor companies, with standard CMOS production processes, that are available at very low prices. This is how I know that the manufacturing cost of hearing aids is extremely low (and the profit margins and sales commissions, no doubt, extremely high :eek: ).

Hearing aids can be tiny because the chips are tiny - not because of contributed value by the HA manufacturer. Small batteries can be used in HAs because the chips operate on amazingly low power - not because of contributed value by the HA manufacturer.

Thus, the HA manufacturer has become an integrator of purchased, inexpensive commodity components. As such, its profit margins will have to shrink, drastically. Sorry.

As for upkeep, every product we buy in this world requires periodic maintenance and repair. Cars, TV sets, kitchen appliances, etc. iPhones and hearing aids are no different. You either buy an extended warrantee or you pay the repairman.:slight_smile:

Nope, for hearing testing I just use the inserts. If I am testing them in soundfield, then I don’t use headphones or inserts, just the speakers.

Sergei Kochkin’s MarkeTrak survey shows that patients do better with more advanced technology:
In a double-blinded comparison of three levels of hearing instrument technology, 74% of consumers preferred the second-generation digital over a single-channel analog programmable and a firstgeneration, two-channel DSP. The advanced digital was rated significantly higher on word recognition, need fulfillment as measured by the Client Oriented Scale of Improvement (COSI), numerous listening situations, situational preference (i.e., speech in noise), and overall preference.
http://www.betterhearing.org/pdfs/M7-satisfaction.pdf

Some of the manufacturers and hearing providers have started to document hearing aid benefit of different features with objective testing:

http://www.audiologyonline.com/articles/article_detail.asp?article_id=1358
http://www.nokiaaccessibility.com/images/HABenefitsFromInductionLoop.pdf
http://www.audiologyonline.com/articles/article_detail.asp?article_id=2016

jchunter,

What type of hearing loss do you have? How severe is it? I am just going to go out on a limb and assume that you don’t have a severe/profound loss when I write this reply.

Those extra features that you claim to be marketing tools are often imperitive to the success of a hearing instrument for a user with a severe/profound loss. Frequency transposition/compression can provide important speech information, amazing feedback controls are so important in order to acheive the gain required to effectivly amplify sounds. Wind noise reducers help to ensure that the user is only getting important sound information, water resistancy is more than required because for severe/profound users, without our aids we hear nothing - having to take them off in humid/wet weather is horrible.

Yes it is true, I could get a hearing aid that just pumps out gain. It would squeal, I would get all kinds of useless sound information, and my speech discrimination would be no better. That doesn’t sound good to me. I will pay for the features.

Hi there Jenny,
My hearing loss at this time is mild. My most important meter for determining this is my wife, who frequently suggests that I look into hearing aids. :wink:

If I come across as critical of the hearing aid industry, it is because science and engineering advance only when people stick to hard facts, good designs, and measure the results objectively.

I haven’t yet run across much factual data that lets me compare hearing aid quality (except manufacturer’s specifications) and I’ve seen no comparisons between different HA products by independent testers.

You are quite right about the futility of maxing amplifier gain without regard for distortion.

But your question is about the features that I referred to as “marketing bells and whistles” which seem to have even less data regarding their effectiveness. Yet, these are qualities that are possible, now that HAs are digital. However, their effectiveness depends on the quality of their software implementations. For example, different units could offer different degrees of improvement in speech recognition in noisy environments. Ditto, noise cancellation, and feedback control, etc. Audiogal’s links (thank you!) provide good general information on the effectiveness of different algorithms but are light on specific products.

In the end, an independent, impartial tester is the only way to answer the question: Which ones are best and how much better are they? So far, I have found no independent tests. I will probably try to contact Consumer Reports to urge them to do some tests, which will help buyers in the long run.

Bottom line: I’m looking for an excellent quality hearing aid at a fair price.
Edit: Note that the words “fair price” depend strongly on “how much better”, as well as the price standards of the rest of the electronics industry.

JC, This is my first post here on HA Forum, and I have been lurking for some time now, reading as much on this site as I can. I appreciate reading your comments posted here…
I have read in several places in this forum that the TRUE independent and impartial testing can ONLY be successfully accomplished with our OWN ears. True independent, impartiality really does not exist as everyone’s daily environment is different and therefore, the NEEDS in those environments are different.
Most of the HA providers online that I have investigated offer free or little money down to test their devices for 30-45-60 days. Take your audiogram, compare to the adjustment envelope of HA’s offered and pick a set to trial! Hell, with SO many providers out there and models from which to choose, you shouldn’t have to actually PURCHASE a set for several years! You have to start somewhere now with your hearing loss, as I do, regardless of where the ‘industry’ is at now. Work with what is out there now. If you find a set in a “fair price” that your willing to tolerate, and you are getting the benefits you think are worthy your time, buy the damn things. There are several options to affordability, and yes, I am struggling with this “affordability” issue as we all in the health care field have to. I hate hearing people say we must be creative in order to afford health care when the “health care” pricing is the problem!
OK, stepping down off this soap box now. Back to more research!
All of this ‘opinion’ is IMHO, of course.