Now you are just being intellectually dishonest, and making a straw old lady argument. Apart from anything else it is a very patronizing take on the HoH community.
Yes again and again you have spouted this, and again and again I have explained to you as a very experienced hearing professional with a license to test hearing and fit hearing aids on two continents, that you are wrong. Just because you term a loss as mild or minor does not mean it is easy to fit. Often the severe cases are pretty easy to fit as many just need a good boost of power. Conversely a mild loss with a sharp drop at the high frequencies can be very tricky to get right.
Make no mistake too, your whole reading glasses analogy is also deeply flawed. The most common loss we encounter is a nerve deafness, which is more akin to macula degeneration than being a bit long or short sighted. If you had macular degeneration, would you really just head down to Walgreens and pick up some reading glasses or would you consult with an eyesight professional?
Here’s the deal Ed. I’m a man of science. You were making bold claims and banging the same drum over and over (and over) again.
I asked you for evidence. Since one typically presents evidence when one is making a claim.
You presented some Chinese company that is presenting Class B and D technology as new, hasn’t updated their website since 2009 (which is one hell of a faux pas for a technology company - imagine if Apple did that), and is flat out lying about the effectiveness of their technology. They are making medical claims that would be illegal in the US, and trying to look legit by putting logos for various standards agencies on their site.
You were the one that claimed that a $135 hearing aid from this outfit would be similar to a $2,000 hearing aid here in the US, and frankly you disproved your own argument. $2,000 hearing aids available here would make anything on their site look like a joke.
As for your personal opinions, you are of course entitled to them, but we are of course entitled to reject them when all you do is spout the same old rhetoric you made up over and over, and when asked to provide some evidence you show us some Chinese outfit selling 20-30 year old technology and lying about it. How is this relevant to the discussion?
I am completely open minded, but you have to present actual facts to support your viewpoint, or I will have a hard time accepting it.
Equally Kev, this same comment could be made for retailers and manufacturers alike. The markup can be so obscene you want to puke, but if the profits are reasonable, and they are providing good and improving technology to improve people’s quality of lives, so be it.
Well in the UK you have the NHS. Here in the US, the company I work with has a charity wing that has donated about half a million hearing aids to people all over the world. I myself have fitted lots of free hearing aids through the Hear Now program, volunteering my time, while Starkey provides the aids.
There are other avenues too for those who cannot afford hearing aids.
But being realistic, America isn’t big on socialized medicine, or government programs that help people. When the President tried to close some of the loopholes health insurance companies were using to let people die rather than give them life saving treatments, he was compared to Hitler by many vocal detractors.
You’re welcome Kev. You seem like a nice guy, so I’m sure he had a full and fun life, which is all any of us can hope for. Human or dog.
As I mentioned before, it’s even worse than all that.
A sensorineural hearing loss is by far the most common issue we see as hearing professionals. The closest eye sight analogy I could give is that it is like macular degeneration.
What person in their right mind would notice the early symptoms of macular degeneration and trot down to Walgreens and pick up a $9.99 pair of reading glasses?
It is patently absurd to try and draw a parallel between hearing aids and glasses, and doing so shows a fundamental misunderstanding of hearing loss, and hearing health care.
When you see a hearing professional they are trained, qualified and licensed to help you understand the problem, and also they know the danger symptoms that could reveal a more serious underlying pathology. This is why they exist, and why they should not be replaced by the clerk at your local Walgreens.
I don’t believe anyone? wanted you guys/gals replaced, rather another option for those of us who can help ourselves be able to do that. In my case I buy HA from an audi but due to the distance traveled for readjustments/tweaking to get the damn things right I cannot afford to travel that often so I do all the fine tuning myself. Is there something wrong with that?
Yes, and I guess the actual purchase price of $135 is not evidence enough. Instead you try to pry at minutia on why the evidence is irrelevant. There is no doubt in my mind that the patents from your beloved Starky have many similar ‘prior art’ ideas, but that certainly does not prevent a patent from being filed. I could most certainly patent a push pull amplifier, and if you don’t believe me, you don’t understand how the patent process works.
The base manufacturing costs (that is the cost of the components, plus assembly and test) is very inexpensive. I guess you’ll have to trust me on the following data. I have our corporate database for components open, here are a few prices of components:
1K 5% 402 resistor $0.0004 (yes, thats 25 of them for a penny)
1000pF 10% 603 X7R capacitor $0.0051
There are many DSPs in the database as well, but it is unlikely that we would have one in a hearing instrument on corporate purchase. I personally have never used an imbedded microcontroller or DSP that costs more then $9.
The sand used in hearing aid DSPs is no different from the sand used in an iPOD DSP. Get over it. If you want to defend a ~$100 piece of hardware delivered with a few hours of professional services for $2500, try using something other then hardware costs as your defense.
Er, it wasn’t evidence, it was simply something someone wrote (on a forum on the Internet no less). The same person then used the name of a company as proof, and upon checking them out, their website is littered with lies and medically inaccurate claims. Unless for $135 they have treated tinnitus and cured all hearing loss with a 2 channel hearing aid - in which case they should be commended for their unparalleled and some might say magical breakthrough, they are lying. If they are not lying, you’d think it would have made national news headlines. “Chinese find cure for Tinnitus, and construct a 2 channel hearing aid that solves all hearing problems.” If you believe the crap on their website, I have some magic beans I can sell you.
My point was merely that Class A, B and D amplifiers are not new, as this Chinese website was claiming. They are in fact old, they are obsolete, pretty much. Presenting this as new technology is a lie. Patents were irrelevant, I simply used that to gauge how long ago this stuff came out. I knew they had been used for many years prior to my obtaining my license in the UK, I just wondered how long.
In case you hadn’t noticed, I have never claimed that it might be possible to construct a good hearing aid for $200. I might even believe the $100 for very low end stuff. But the issue has never been what they cost to make, because that is just one piece of the puzzle.
My ‘beloved Starkey’ for example, has close to 500 scientists and engineers developing new software, hardware and hearing aid designs. There’s extensive field testing with hundreds of patients. People with PhDs and AuDs working hard. Cutting edge audiological science that simply didn’t exist five years ago. So this is why it is utterly false logic to claim that hearing aids are constructed for $200 and then marked up to $2000 or whatever. Because even if we accept that they can be made for $200, that is only after they painstaking process of developing them.
And all these comments are regarding non-custom products. Custom aids are made with a machine that cost $250,000. It can make 40 shells at once, from a liquid plastic that costs thousands of dollars. A human has to laser scan each impression, design each aid on a computer. Each aid has a two process nano-coating at the end which makes the aid virtually waterproof and resistant to wax and oil; unique in the industry. And this whole process had to be invented in the first place.
The technicians who build these aids are sitting right there in Minnesota, not in some sweatshop in China. They are highly experienced, and are certainly not minimum wage grunts. Other workers have to receive the orders, process them, track the progress of the aids from start to finish, ensure they are FedEx’d out on time and to the right place.
What many people here are failing to grasp is just how painstaking the process is, and ignoring the considerable cost of R&D, which Starkey claims is around $80,000,000 a year at their company.
So it is possible that you could have a RIC or BTE constructed in China for $200. I’m not saying that happens, but I’m conceding that it’s possible. But the other 50% of aids have to be made here in the US, and are custom designed. Then someone has to pay for that $80,000,000 a year they spend on designing this stuff. That money doesn’t just magically appear, it has to be generated from the sale of hearing aids.
Even if they were made for $100 (as some claim) and sold for $200, there is no way that $100 margin on each unit would yield the money necessary to support the infrastructure.
Which takes us right back to where we were when we actually analysed two big players in the market and found that in their SEC numbers, that their overall profit when all is said and done was in the low 20% range. Perfectly in keeping with any normal business practice.
Bleating on about transistors, capacitors and DSPs will not alter the facts that were discovered during this discussion.
Many people on here know more about electronics than I do, but clearly some need to go back and revisit Business 101, or simply admit that they are ignoring some aspects of reality just so they can make false claims to anyone who will listen.
After all this detailed discussion I see that ed121, Alpine1 and others critical of the pricing of hearing aids still have not answered my question : If the hearing aid has a cost of $200 and all of the services that I detailed in my post were included what is a fair price to sell the hearing aid for ?
I should also state that in nine years in this industry I have never sold a set of hearing aids that cost $6000 !! I fit digital aids that start at a cost of $750 each (including all services) and go up in increments of $100 to $200 depending on features and additional accessories. The average hearing aid that I dispense is sold for $1200 to $1500. I have tried to bring the entry level below $750 but do not have the volume to do so (yet).
As stated before 90-95% of my clients would not or could not “self fit” their hearing aids. Under all of these conditions ed121 does not understand business and cannot explain how his business model of dispensing hearing aids would work (at least with any detail) regardless of how many years of exposure he has to the industry.
Honest I really did buy a digital 6 channel aid direct from Newsound for $135 each…;…honest, really, cross my heart. Not an old analog but a digital modern aid.
I never claimed it was the equal of a top of the line big name brand. Just that it was a pretty good digital aid that could handle the majority of SNHF loss types.
Denigrating Newsound is not the point. The point is that free and unfettered commerce can build and wholesale an mediocre aid and sell it for $135 to the trade. That translates in normal commercial practice to a retail of about $200.
I understand the average retail price of an aid in the USA is around $2,000. So from $200 to $2,000 or more has got to represent an inefficient health care delivery system. This ain’t heart surgery or knee replacement. It’s a few hours of office time by a skilled person.
You professionals out there are not getting rich, so what is the problem in your view?
It is quite possible that some of them may be on this forum. I have written down the website url for them to access more information on hearing loss and hearing aids if they choose to. I also find it is a good resource for them to compare information from hearing aid wearers. Unfortunately many of my clients do not have a computer or are interested in acquiring one. I have nothing to hide but I do have to ask where are you going with this question ?
I should also state that my initial question has not been answered yet : If hearing aids had a cost of $200 what is a reasonable selling price when including all of the services I have previously listed ?
The OP for this thread is about the high cost of HA. Given the price range of product you offer it would seem your clients would not have a need to be here for that reason;)
Thanks for your concern Seb. You can bet that I see my opthamologist very regularly and have the full deal with detailed retina exam and visual fields. You can also bet that I will be just as compulsive about follow up for my fairly mild hearing loss. Even at this level, I didn’t realize how much I missed until I got my hearing aids.
Despite the monomanias of some posters this forum has been a fantastic resource for a newbie.
Your script sounds exactly like the one a good friend of mine who works for Pharma recites…“Without these high prices we cannot fund research”. So we looked up the numbers from his company, for every $ spend on R&D, 4 were spent on SG&A. He works in sales and did’nt like the answer either… Are hearing aids any different? Unlikely, R&D are likely <10& of gross sales. Probably much less based on the following info…
So the single google in did on SG&A on hearing aid companies turns up the followin stats from resound that show a 60% gross profit margin, 3x you number!
While have found this discussion interesting…I’m starting to wonder what the point of the continued arguing is.
Really, all the individuals with such frustration at the cost of hearing aid are preaching to the choir here. I know that I would love to not have to pay what I pay for hearing aids so that I can sell them for less. I imagine most of the other professionals on this board would feel the same way. I guarantee you that we are not paying $200, or $300, or even $700 or $800 for every high-end, premium technology hearing aid we sell.
What is the end goal of this discussion at this point? We, as professionals, can’t change the amount it takes for us to run a business. Nor can we change the amount we have to pay for each hearing aid. So we have to take what we pay and set our prices accordingly. When I have patients who could qualify for programs designed to help those that would have difficulty or be completely unable to purchase hearing aids on their own, I refer them to programs designed to help. I don’t hide that information so that I could make money off them by selling them a product. And I just as easily could. As a health professional, my end goal is to help every person that I can. If that means that I don’t sell them a hearing aid or that I end up receiving far less for the same devices then so be it. I will tell you I basically break even on people who I refer to our Voc Rehab program. I send quite a few people to the Hear Now program and Lions Club when it is obvious that purchasing a hearing aid is completely out of their means. Do I like making money? Absolutely. Would I feel comfortable doing it knowing that my patients were either unhappy or wearing something/paying more for a device that was above what they needed or could reasonably afford? No. Most of the audiologists I know feel the same way. Many of the hearing instrument specialists I’ve met also feel the same way. Unfortunately, it’s the ones that see dollar signs on every patient that make us all look bad.
If you want to change things…railing on and on on this board will get you no where.
It seems the argument is with the hearing aid manufacturer themselves and even though it’s been pointed out that their profit margin is no more than any other major corporation, people refuse to acknowledge it holding firm to the thought that their profits are “obscene”. Why not take it to them? Start a campaign against what they charge to us…I’d love it to be able to sell a high-end product for $1500 or $1600 each. Until my prices decrease to about half (or more) of what they are though…I can’t do that…
So what is the end goal? What, exactly, is the hoped answer to all this arguing back and forth???
Hi DocAudio, thank you for your post, it has been rather timely and I have been waiting patiently for one of you Pro’s to ask, “So what is the end goal?”
My aim for this thread is rather simplistic and simultaneously complicated… I do apologize for the rather sensational title and the slight stratagem; Namely, to force out into the open the actual costs of Hearing Aids, the prices paid by the Audi’s and HIS of this world and highlight this to the HOH public! And thereby, give the HA’s Manufacturers some scope to actually increase their business, not that I think it will move them one iota at present, but it could change their pricing/markup policy in these austere times, it may perhaps make them sit up and listen a little as I am sure they read this forum to gauge the market!
My reasons, tis time to fight back folks as individuals we are nothing, but collectively we could be very strong, we are 1 in 7 of the worlds population and as such we are disabled people whom are being exploited for profit, we have no choice in the matter if we have a severe/profound loss, we have to buy from a market that has went way over the top with regards to pricing policies, many of the HOH needy in the severe threshold are out of this market to the severe detriment of their quality of life and job prospects!
Now perhaps this is a “Pipe-dream”, but some food for thought, so here is the rub; tis time for some of you to become proactive, especially in the larger population areas, there is a niche in the market for starting up your own not for profit organization or charity, perhaps call it, “American Low Cost Hearing Aid Dispensers Society” (ALCHADS:D) employ your own Audi’s and other staff, employ yourself as an admin or better still, get the training and become a HIS as the finest HIS/Audi’s I have come across are those with an actual hearing loss, they understand implicitly your problems! Now, I’m well aware this will put a few noses out of joint on this forum, but I say enough is enough, if the hearing industry cant or will not regulate itself then over time collectively YOU could do it for them! Rome was not built in a day folks and this would take a fair bit of time to set up something like, “ALCHADS”… But, ultimately it could be done! Think of the buying power your individual “ALCHADS” centre would have, when they hooked up with everyone else, if the there were a chain of these in every large city in the States, prices would tumble, that $1200 HA manufacturers price as quoted by a HIS on this thread would at least half? For the more competent end user, you could have training days on self programming on those whom want it, I’m sure the manufacturers would gladly develop some software for the likes of something like “ALCHADS”, if you were giving them a lot of business! On the manufacturers profits, think about it, you would be the only show in town if you could bring these prices down to more affordable levels, say $1500 or $1200 per high end aid or less to the end user, then you are going to be busy as it comes into many more peoples price range and ultimately the demand would be higher, thereby production for the manufacturers would increase, a far smaller price, could actually increase their profits?
You could start a scheme for your members and have a steady cash-flow, say $100 a month, every month, guarantees you a new set of high end hearing aids every 3 years, the used HA’s could go to the 3rd world? Run a free drop in centre/hub for small repairs, adjustments, tubing, perhaps advice and maybe PC’s set up for self adjustments, training, sell far cheaper accessories, cheaper batteries, environmental aids, etc, etc, etc?
Lastly, think of how much joy you would bring to your fellow HOH sufferer, their quality of life and their families, their job prospects would increase and perhaps their outlook in life…
Now, where would this leave you Pro’s if it ever came to fruition, between a rock and a hard place at a rough estimation? You would sink or swim via lowering your prices or change your job? But, I’m sure many of you might join something like this scheme, if your aim in life as hearing aid Pro is to help us HOH, might mean a wage cut though?
So there is your answer DocAudio, I reiterate my apologies for the slight subterfuge!
I’m not sure it would work here in the UK as we have a free NHS service, which might not be ideal or state of the art HA’s, but at least the HOH get some form of hearing aid…
Yes, that’s the answer. Let’s fire the scientists who invent better hearing aids. Good plan. It’s like the Republican plan of laying off teachers to save money. Because nothing saves money like lowering education standards…
Dude. You are preaching to a liberal! I believe in universal health care for all humans, as a right not a privilege of the rich. I am not pro corporation, I think they need tough laws to stop them taking the piss. And they should be made to pay their fair share of taxes.
