Why Hearing Aids Cost So Much


#1

All: Interesting input copied from another Forum

References: <iu3o671vbp5ddhjoo8mvi9pc6obgltr1sl@4ax.com> <j4ioji$6gd$1@solani.org>
NNTP-Posting-Host: maya.rahul.net
X-Trace: blue-new.rahul.net 1315770825 8812 192.160.13.106 (11 Sep 2011 19:53:45 GMT)
X-Complaints-To: support@rahul.net
NNTP-Posting-Date: Sun, 11 Sep 2011 19:53:45 +0000 (UTC)
User-Agent: tin/1.9.4-20090211 (“Rieclachan”) (UNIX) (Linux/2.6.18-194.32.1.el5xen (x86_64))
Bytes: 5906
X-Original-Bytes: 5801

If I wish to buy a computer or headphones, etc, I can go to CNET, or
PCMAG, where I will find prices, comparisons, details, specifications,
recommendations, and etc. In fact there are many more places where I can
find this information including the manufacturers themselves. Tons of
technical information is available. That is because these items are in
competitive markets.

If I try getting details and specifications for hearing aids (like
detailed gain curves across the bandwidth) I hit a blank wall.
Comparisons between manufacturers – no way! I am an engineer and I find
it impossible to make a choice based on fast hard data. I am at the
mercy of the vendors (which I hate).

The hearing aid market is a closed cartel! You are at the mercy of the
audiologist and hearing aid vendors when you buy. If the market was open
and competive You would be amazed at how prices would drop and quality
would improve. There is no reason why a person should not be able to
obtain software to program his hearing aids himself. Patients who “want”
to do that should be able to do it without any problem. There is no magic
involved, although the manufacturers would have you believe so.
Constraints can be built into the software to prevent injury.

I’m an electrical engineer, involved for years in consumer products, I say
that hearing aid prices would be in the range of $200 to $500 if the
market was competitive – likely less. The quality would be better,
comparitive shopping would be easier, and your satisfaction would be
greater. That’s the magic of competive markets! Can the manufacturers do
this? Of course they can. Don’t listen to their excuses. Badger them
every time you go in for new hearing aids. They will find a way
to make even more profit at the lower prices! Pressure them! write your
congressman.

In my estimation the complexity of a hearing aid is less than that of a
hard disk. You can buy a terabyte hard disk for $100! The track
searching mechanism on a hard disk is far more complex than a hearing aid
will ever be. Don’t be fooled by the fact that hearing aids are small.
Lead spacing in a hard disk circuit board component is the same order of
magitude and the techniques for dealing with it are commonplace. The gain
and frequency of a hearing aid is likely controlled by programming a DSP.
The (digital filtering) algorithms are well known from the field of
telephony. What do you think Skype, Verizon, and AT&T do? Many
programmers know how to design the digital filters required. There is no
magic at all involved.

Google “write your congressman”. There are many websites that will tell
you who they are and how to write to them. Ask them to open up the
hearing aid market. Five or ten personally written emails to a
congressman on the same subject will flag the subject and do more good
than a thousand “fill it out” coupons. Action is needed to help us who
suffer hearing loss. Writing your congresman might save you $2000 the
next tie you buy hearing aids. Well worth the effort!

When you buy hearing aids complain about the price. Go to a vendor you
don’t like and just walk out when you hear the price. Do that even if you
have to go back later. Pressure them. Word will get around.

Mr. Watts is full of it! Everything he says is an excuse to keep the
price up. Don’t believe him. There are manufacturing ways around
everything he says. You will be rewarded when prices come down to $200.
Believe me they can! Competition and openess is the magic! I am an
engineer who has worked in competive markets. Believe me Watts is wrong!
He talks like a hearing aid vendor.

I see no real reason that you can’t go the mall and be fitted by a vending
machine! I am not in favor of that idea but I see no reason whatever to
prevent it. Everything rquired can be done with today’s
technology. Engineers are magic people who can do magic in the
marketplace!

Do write your congressmen. It’s time for us to take control!

Wayne


#2

. . . . And the physicist came up with a solution. But it would only work in a vacuum with a spherical chicken.


#3

Ah, a The Big Bang Theory reference, and now the forum is complete :wink:


#4

The Mr Watts’s referred to in the last paragraph above is apparently employed in the hearing aid business.

I look forward to hearing factual replies about this review. Ed


#5

Yeah, I’ll bite.

First off, the price you pay for hearing aids usually includes bundled service, and some are now beginning to offer a pay as you go model. Buy the aids way cheaper, pay for office visits, tests, etc. It’s a bit like when you buy that iPhone. Sure it only ‘costs’ $199, but you’re going to be giving a good $2,400 to your provider over the next two years. And if you want to buy that shiny new iPhone 5, they are going to slide in another $200 on top of the phone cost, and another 2 year contract for the privilege of buying a new phone early. And those things are literally made in prison like conditions by virtual slaves making $17 a day; or as little as $1.42 an hour, 12 hours a day, six days a week.

Secondly, there is NOTHING stopping Apple or {insert company name here} from creating your $200 hearing aids, that I presume you have the blue prints for, and selling them. They’d just have to call them something other than hearing aids. But you think that will stop someone buying them if word gets around that they work well and cost a fraction of current hearing aids? What’s in a name? Would you buy an awesome car if the manufacturer sold it as an uTransport?

So rather than whining about how these medical devices are sold, why not whine about the entire American health care system? It’s deeply flawed, the most expensive in the world, has bad access to poor people, and isn’t that effective or efficient. So why attack just one small part of this broken system?

This is the problem with what’s going on with our health care, most people only see the gaping holes in the system when they get sick, or they need help, or they get told a condition is pre-existing. Until then they are blissfully unaware of the problem.

In my liberal world, I’d like to see all Americans entitled to free hearing aids, along with all medicine they need. The answer isn’t deregulation, tax breaks, big corporations making profit. The answer is a responsible government using our tax dollars for the greater good, rather than the greater greed. So how about you write your congressman and tell him to support so called Obamacare, and demand that the plans to help Americans with access to health care go even further still.


#6

This is always a controversial topic. If it’s of interest to you then you should see the following thread:

Slightly different spin, but same basic idea and the debate is already in progress.

Whether we’re talking about prescription drugs, eyeglasses, hearing aids, or other similarly regulated industries there are always going to be two basic viewpoints:

  1. The industry should be less regulated and your average person should be free to buy whatever they want, even if there’s a large potential for them to get themselves into trouble if they don’t know what they’re doing.
  2. The industry should remain regulated or become more regulated to ensure protections are in place to keep people from being taken advantage of or improperly using something that has the potential to hurt them.

Generally, engineering-types and others who feel they are savvy enough to resolve their own ailments overestimate the abilities of others and are irritated that they have to have things “dumbed down” for their safety.
Generally, public policy makers craft policies with the safety of the least technologically sophisticated in mind and may in some cases underestimate the abilities of others.

If you’re reading this then you not only own a computer, but are also comfortable using one to the point where you’re able to navigate Internet discussion boards, install software on your own, and probably more likely to agree with viewpoint #1. It’s worth noting that I often try to assess how comfortable my patients are with technology when I first meet them. The vast majority don’t own computers and are very pleased that I’m taking ownership of their hearing problem and doing everything within my abilities to help them hear better.


#7

I agree with your assessment. I have worked near NASA, been to Austin, and other tech savvy places. And even among the engineering / scientific types I meet, most are happy to just have something take care of the problem.

It is a particularly arrogant viewpoint to think that you can buy a medical device and control it like a hearing professional with twenty years of experience can. Most good hearing professionals have spent weeks in training learning to program aids, on top of the extensive knowledge they had to learn before they could even get their license.

I know what the basic controls in a plane or helicopter are for. I’ve even taken a few flying lessons. Do I think I could borrow a plane tomorrow and bring it back in one piece alive? Of course not. Just because you understand the basic concepts of sound processing via a digital amplification system, and you know about computers, does not translate to being a qualified, licensed, experienced, hearing professional.

I’d also like to make another argument here too that is oft overlooked. Some have leveled criticism at the hearing professional, as being out of touch, lazy, ill-informed, etc. I personally am not opposed to a new higher standard to be adopted nationally rather than locally at state level. But lets say these criticisms are fair, and that a significant number of hearing professionals are almost useless. If it were possible for the manufacturers to dumb down the software so that even a trained monkey could program hearing aids, don’t you think they would? Every screw up by a hearing professional, that ends in an unhappy patient, is a potential return. A massive expense to the industry. So if they could make programming hearings so simple a cave man could do it, they would. Whether you choose to admit it or not, programming a hearing aid involves a lot of skill and some experience to get the results right. This is not something even 5% of consumers are going to want or be able to deal with.

To think that even a technically minded individual is just going to pick a box off a shelf, shove the content in their ears, and the with a few clicks of a mouse, have a world class hearing solution in their ears is deluding themselves. Oh and all for $200 I presume too?

I know from my experience that patients are pleased when an expert fully explains their hearing loss, solves their hearing problem, and then takes care of them in the long term. The market for self service is much smaller than one might think.


#8

It was a good political move by a few rotten apples, to have the Hearing devices declared medical devices. So much profit… "You want to hear, "said the spider to the fly … “How much money will you make this year and hand it over”. bam

One of my previous supervisors was a used car salesman. He enlightened me that it is a car salesman’s job to get as much money out of buyer as possible. The price of the car does not matter. He said his greatest sale was when he sold a 10k car for 30k Bam… Employee of the week for him. (Back in the 70’s when that was a lot of money).

My son and I still laugh about the time I was at an audiologist office and the receptionist said,“the doctor will see you now”…

Audiologist definition – One who wants to drain as much money out of one who needs a Hearing device, as possible . They believe they are Gods and the world owes them something. They feel because they have a degree in audiology, it is their right to suck all the money out of people. I put the usefulness of audiology degrees right up there with underwater basket weaving degrees.
“Do you not like the programming that only, I the audiologist can provide?, “too bad” . Go buy another aid…


#9

Dude. This is so inflammatory it’s not even funny and couldn’t be farther from the truth. I had a whole response typed and then realized that it’s not worth the effort. How unfortunate that you’re willing to lump an entire industry in with one person you had a bad experience with. I feel sorry for you.

And Yes, I use the title “Doctor” because I took a lot of time and effort to EARN it.


#10

Way off base here…as ZCT indicated your diatribe should be pointed at the dysfunctional nature of the US health care delivery system and NOT a specific element of it…actually , in my case, my audiologist (who is a Dr BTW) has made all the difference for me in understanding my hearing
impairment correctly, selecting an aid to fit my present lifestyle,
programming it for me, and allowing for followup access virtually on
demand…to me the actual device or ability for me to program it come
in a distant second to these things I’ve mentioned…the vast majority of
contributors to this forum, IMHO, know and appreciate the value of these
professionals…


#11

Do you have any evidence for this? Because actually it was consumer groups who wanted this to protect people with hearing loss from ‘hearing aid salesmen’ to make sure that those who dispensed these devices had some medical knowledge, some training, understanding of physics, acoustics, types of hearing loss and ear dysfunction. And these consumer protection laws gave people unprecedented trial periods, legal rights, the ability to complain to a licensing board about illegal or unethical business practices.

Oh, and they became a medical expense, which can be used with other medical expenses for a tax write off by many people.

I don’t see how that is relevant to anything. Except ironically back in the 70s, a hearing aid salesman probably could sell hearing aids for just about any price they made up, lie about the effectiveness of the aids, fit them incorrectly based on bad or no test results, and then vanish never to be seen from again. No service, no warranty, no support just a straight up con job.

Now that hearing aids are classified as a medical device every patient knows the license number of their hearing professional, they have a licensing board to complain to if there is an issue, they have state mandated rights. All pretty sweet.

Conversely even to this day car salesmen will try and squeeze every dime out of their customers with elaborate ploys (or cons), and does that customer have a 30 day trial, cooling off period worth a damn, or redress to a licensing board for an ethics violation? Of course not.

Is your world so black and white that only a person with a medical degree is allowed to be called doctor?

An audiologist will typically have done a three year qualification post graduate and actually earned the title of doctor. Many then have years of experience on top.

I don’t know why you are confused that there are many kind of doctors and specialists out there.

Well that’s almost too stupid to respond to. You could really make that kind of stupid argument about any medical, or semi-medical profession you don’t like.

The prices you so desperately hate are a product of America’s health care system. With little insurance or government assistance for aids, a hearing aid clinic has to make enough money from their sales to keep the place open, staffed, and available for your future needs. Who do you think buys all the test equipment, pays the rent, puts the ads in the paper, calls you to remind you of an appointment? It all costs money.

Someone elsewhere in this forum asked what hearing professionals typically make. On salary.com it shows the median income in the $50-$60K range. Is that really an excessive salary for a professional expert in a complex field? I mean I could get your God concept if they were making 20 times that and lauding it over people driving $100K cars, and wearing $30K Rolex watches. But that isn’t happening.

You have a complex multi dimensional hearing loss, with differences between the ear. Your loss is so complicated, most first year audiology students would screw up that test. It involves extensive masking and extra steps not present in a simpler loss. These hearing professionals that you so easily scoff at had to study very hard for a very long time to figure out how to help you, and test you correctly. And when they try to help you, you throw it back in their face, sneer at their credentials, and get bitter and angry because no technology exists that can solve your hearing problem to your satisfaction.

It wouldn’t matter if hearing aids cost $20 and came with a laptop, and the world’s most advanced programming software, you still would not be able to achieve results that make you happy. But this is a function of the hearing loss you have, not the incompetence of those who are trying to help you.

And if you don’t like their prices, lobby the government to provide free hearing aids for citizens, or to require insurance companies to provide coverage. Stop attacking the very industry that invests millions to move technology forward and help people.


#12

Another intelligent HA user who is frustrated with the poverty of data available about hearing aids. His point us well made.

However, I take issue with his cost estimation. If I can’t buy a pair of great quality headphones for under $400, how does he think a device can be created that also does EQ and dynamic processing for a few hundred bucks? Quality in ear monitors for musicians are $1000+. I still think private market HAs would cost $2000, with no services attached.

I am willing to pay for quality HAs and quality service. I just want to make an informed decision.


#13

No, the present model of controlling the distribution works to benefit both the manufacturer and retailer (audie). The ‘autofit’ routines have indeed gotten much better over the years. When someone comes in and says ‘when a dish lands in the sink it is too loud’ would you’re retuning of the instrument be any different then that which would be done by manufacturers software? In fact the AH software does exactly that, asks questions and tunes appropriately. The limiting factor in a perfect adjustment is in most cases the users inability to articulate what is wrong in a manner that is actionable. An expert system (software) or audie would be irrelavent to the tuning.

For severe or profound losses a pro is certainly warranted for tuning. An expert system would also not be able to diagnose mold/tubing/canal problems. For most other tuning parameters, software written by the manufacturer would probably be able to get the user to a better fitting then a pro. Oh, and let’s give the pro one more advantage, when it comes to health care, a lot of people need to have ‘face time’ with someone who is helping them.


#14

It is interesting that only one contributor to this thread has disputed the original claim the HAs could be marketed and sold for $200 to $500 if the market was more competitive and users could make a more informed choice.

I accept that the fine tuning of the instrument to each individual’s needs, together with the aftercare and routine maintenance must cost more than the original hardware - it might be double or treble and obviously it will vary. But is the hardware really only 5 to 13% of the total cost?

Perhaps vendors should offer an itemised invoice which shows how the total - $4000 or more - is made up?

Problemsolver1
250 500 1000 1500 2000 3000 4000 6000 8000
L 30 20 30 50 65 65 70 90 ∆
R 25 25 35 50 50 50 100 100 ∆


#15

ed121 , you have been making the claim that the volume of HA sales would go up if the price went down. And your target price is $200-500 per aid.

I responded to one of your previous posts by pointing out that the HA mkt penetration in the socaialized Scandanavian countries is not that much better than ours. And the HAs in those countries don’t cost $200 or $500 dollars. The govt pays for them. The consumer pays nothing.

If you are right, then how do you account for the fact that HA sales ( per capita ) in those countries is not much higher than in the US.

The obvious answer is that the price is not the MAJOR limitation to more HA sales. But that would fly in the face of your " let anyone sell HAs and they would only cost $200 " mantra.

In addition to that Ed ( Wayne), there is nothing to keep an individual from dispensing aids at whatever price they want to.

In fact,if you wanted to do it, or fund it, you could. Just set up a HA biz. Hire an audiologist or HIS and you can buy aids wholesale for $200-400, add $100 fitting fee and sell them for $300-500 out the door.

I think you would go broke within a month. But if you’re right,then you’ll make a fortune AND provide a sorely needed service to hundreds of HOH.


#16

Couple comments:

Hearing aid manufacturers have only one type of customer (by law)…the professional audiologist/HIS. Hence aids are designed to be fitted by these generally competant professionals.

Technically, it doesn’t have to be that way.

Aids could be designed to be self fitted…for the vast majority of loss types. Law and custom in this industry are anachronistic. But as it stands now, if a manufacturer were to develop a self-fitting aid how would they market it? By law only licenced professionals can legally sell aids,and if you think the pro’s are going to buy self-fitting aids for their patients (customers) you need to go back to school and take Economics 101.

Hence the whole ethos of this industry is driven by the status quo… Vested interest virtually guarantees that law makers are not going to mess with this situation.

Don’t bother to bring up that old answer that there is no market for $299 self fitting aids. Any computer literate could program them. How many deaf computer literates out there…millions now and increaing every day as the baby boomers age.

IMO Ed


#17

Here ya go.

Sam’s Club

CIC Engage 64 Channel Hearing Aid List Price = $4,197.80 for the pair
Base price of the aid from the factory = $1529.15 Each
%15 markup = $269.85 Each
1 year Loss and Damage Warranty = $99.95 Each
3 year extended repair warranty = $199.95 Each

For this price you have:

  • 4 years total factory warranty for repairs.
  • Free maintenance, cleaning and programing at any Sam’s Club hearing center for the life of the device.
  • 1 year loss and damage policy
  • Walk in access to a qualified professional to answer questions and help with any issues.

Now, you want a factory breakdown of how much the hearing aid itself cost to produce? I am afraid I cannot help you all that much. But the cost of production is only part of the story and this is something you deal with in every industry. How much do you think it costs Apple to produce those Ipads? Or their computers?

Also, for everyone who complains that specs on the hearing aids are not available, a Google search tells me that you did not look all that hard. Full ANSI spec sheets and readouts are available in .pdf from for Otion and Starkey products. That was all I did in the 15 seconds I looked.

Edit* this is in reply to Problemsolver1, I had a patient in the middle of my writing.


#18

I am trying hard to no get embroiled in this argument again, but it will just not go away! I wonder why…lol:D Suffice to say the original copy/paste from ED is much on a par with my own thoughts! Most, but certainly not all of the hearing industry will present you with smoke and mirrors, they will deny, refute, deflect, tell you this industry is unique and take umbrage at your audacity to suggest you are being fleeced … Yeah, I have to say it is unique with its license to print money and BTW, this is disabled peoples money!!!

Now, do I blame the Audiologist or H.I.S., no I most definitely do not… The blame should be laid squarely on the shoulders of the “Hearing Industry Cartel” the Manufacturers, whom in collusion, they keep their prices artificially high, the Audiologist or H.I.S. prices mainly reflect what they are charged, but I have to say, some do go a bit OTT!

And yes Problemsolver1; “is the hardware really only 5 to 13% of the total cost?” your assumption is very much correct…

Cheers Kev;)

PS, Fellow HOH… don’t let anyone tell you can’t or are not capable of programing your hearing aids, tis all BS! If I can, then most of you whom have some computer savvy, can do likewise!!!


#19

So, the aids cost 75% of the list price ($1529.15 x 2 aids), not 5 - 13%.


#20

Well, the list price is just a made up figure. He’s saying they are marked up 15% from their cost of $1529, but a 15% markup from $1529 would be $229. I think he added the markup, then took 15% of the sales price, which is not the way to figure markup.

Costco also claims that nothing in the warehouse is marked up more than 15% but in Costco’s model, everything is already added. The Kirkland Signatures (Rexton Cobalt 16+) sell for $1999 a pair and that includes 24 month loss and damage and 36 month warranty, plus hearing test and followup visits.

If I had to guess I would say their cost for the warranty would be around $150-200, so take $200 off the Costco price and the price of the bare aids would be $1800. Marked up by 15% would make their cost $1565 a pair.

Cost = Price / (1 + markup%)

A Costco Hearing Center has no real estate or utility costs and no advertising (and no commission). A private audiologist could not operate that way.

The Sam’s and Costco models provide some benefit to customers in that they wring some cost out of the process while keeping the quality of the experience high. A couple of the HA manufacturers are both publicly traded and are in the hearing aid business only so anyone can look at their financials. They appear to me to be healthy and profitable but not overly so. We do want them healthy and profitable so research continues, and like others have said, when you make hearing aids free it doesn’t change the use very much, so here we are. I just don’t see any dramatic changes in the delivery and price models on the horizon. The only thing I see possible is if other big box retailers get into the act, like Wal-Mart, Target, Sears, JC Penney, or, if nationwide chains spring up like in the eyeglass business (America’s Best, Pearl). Those developments might drive higher overall sales and allow the manufacturers to spread their fixed costs over more units. But, if any of those things develop it will probably take years.