I think @greg.smith’s post touches on a couple of salient points that reflect what’s been going wrong with our economic mindset for a long time. The post alludes to the reality that companies’ missions are no longer customer-centric and consumer service orientated. They are investor-centric and profit-orientated.
Don’t get me wrong: I know that companies have to turn a profit. It’s when those profits end up defining the companies’ focus of activity that their raison d’être drifts from what benefits their customers in particular, and their industry, in general. It’s then that oligopolies are seen by dominant industry players (like the Big6) as meritorious because of their enhanced ability to generate profits, rather than as the incestuous and obscene subcultures that they are.
Make no mistake: the purpose of the hearing device subculture is to service the profit motives of the priestly class, rather than the performance needs of supplicants. (We - end users and HCPs, alike - are called upon to regularly, and without resistance, pay their tithes in the form of bloated prices for products whose obsolescence is choreographed by the makers, cloaked in the “marketing speak” of “technological advancements” whose real benefit to the user are described as “incremental progress”.
Many of the behaviours of the dominant force in the HA industry (the Makers) about which we complain are, in fact, those of a priesthood of closely-held companies that have no qualms about making the distributors and users of their products pay top dollar for top quality, while offering little transparency or objective information that would empower their clients to truly understand why a pair of devices is priced at $7,500 (what the Makers claim is their fair market value), as compared to the $350->$500 these same devices cost to produce. Buyers are asked, like members being initiated into some cult, to take it (largely on faith) that the [price - cost] differential is due to “Holy Mystery of the Brand X Automatic Suppressor/Optimizer”. If the individual charges and fees that drive “bundled pricing” up to stratospheric levels are legitimate, why not just be up front about it and itemize them, rather than playing a shell game with the end user?
[Even less comprehensible are the ethics that allow makers to withhold value from those who are unable to pay the premium they demand for access to their “Tier1” features. Tier1 is simply the term for “fully-functioning”. The other “Tiers” are simply marketing terms for “intentionally broken by the manufacturer, to a greater or lesser degree”. My opinion is that the basic model hearing aid should be offered as the core product. The “core product” should be capable of serving the day-to-day needs of the average customer, and should not be just the minimally functional form of the hearing aid device being taken to market. This core product should be offered at a basic price, along with “Add+” window panes, per Apple’s purchase checkout model, that clearly state what each added function does, and what it costs. It would then be easier for purchasers to comprehend how a hearing device “starting at $x” ends up costing them ($x+$1,500) at the checkout window.]
Not long ago, the world and its communication channels weren’t so highly evolved, and the economic environment was conducive to the keeping of arcane “technological secrets”, the existence of which justified manufacturers’ magical claims about the efficacy of their wares. Today, however, we live in a different world: one in which devices that, heretofore, could legitimately bear the moniker of “medical devices”, but which are today, to a greater and greater extent, being exposed for what they are - generic electronic devices - most of whose “scientific and engineering features” can be understood and manipulated by anyone who has owned a high-end sound system, a home recording studio, or a killer guitar-player’s pedal board.
So, perhaps the OTC market will benefit the 80% of those who require relatively straightforward treatment of a hearing deficit, while there will still be the 20% whose impairments are beyond the layman’s ken, and which will require an audiologist’s training to address. However, it may also be true that hearing aids, as a class of device, now share lodgings with the pantheon of consumer electronic devices, where they (arguably) belong.
The question is: whom will we empower to draw the line between the 80, and the 20?
[ADDENDUM: I apologize for the multiple edits and also for the one that, unintentionally, transplanted part of @greg.smith’s post into the middle of my text. I find the Discourse software to be quite frustrating and user-unfriendly, betimes!]
(and the “post must be at least 30 characters…” 
)