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Why Are Digital Hearing Aids So Expensive?
sglines writes "Over the last couple of years I've been slowly getting deaf. Too much loud rock and roll I suppose. After flubbing a couple of job interviews because I couldn't understand my inquisitors, I had a hearing test which confirmed what I already knew: I'm deaf. So I tried on a set of behind-the-ear hearing aids. Wow, my keyboard makes clacks as I type and my wife doesn't mumble to herself. Then I asked how much: $3,700 for the pair. Hey, I'm unemployed. The cheapest digital hearing aids they had were $1,200 each. If you look at the specs they are not very impressive. A digital hearing aid has a low-power A-to-D converter. Output consists of D-to-A conversion with volume passing through an equalizer that inversely matches your hearing loss. Most hearing loss, mine included, is frequency dependent, so an equalizer does wonders. The 'cheap' hearing aids had only four channels while the high-end one had twelve. My 1970 amplifier had more than that. I suppose they have some kind of noise reduction circuitry, too, but that's pretty much it. So my question is this: when I can get a very good netbook computer for under $400 why do I need to pay $1,200 per ear for a hearing aid? Alternatives would be welcome."
It's a guess but a solid one: competition.
Shh.
Are these thing require FDA approval?
Fuck systemd. Fuck Redhat. Fuck Soylent, too. Wait, scratch the last one.
I suspect if you called them "noise canceling earbuds" or added "do not use for weight loss" you could sell them much cheaper. But why would they want to do that?
Speak up, sonny!!
advisee 0.07 sec.
advisee (d-v-z)
n.
One that is advised.
It's not complicated, hearing aids need to be very small. Neither your 1970's amp nor your netbook will fit in your ear. Making something small and reliable enough for this kind of use is difficult and expensive.
I don't wear one nor do I know anything about the industry....but just a guess - do hearing aids need to have some kind of FDA approval or similar Health Dept. certification? Or is it the person (or doctor) prescribing/ calibrating the hearing aid similar to the optometrist (measuring your near/far sightedness)? After all, it's not all that trivial to figure out your prescription, but the eye doc needs to have such degree.
Again, I don't know what I'm talking about, but this is just an avenue to consider.
Its a medical device. Add in the cost of malpractice insurance for the manufacturer and everyone down the distribution chain and you have the answer.
Although the technology itself is not very new the packaging (behind the ear or in ear hearing aids are purpose built devices) is left to a few specialized companies. That in addition to the fact that the market will bear these prices, assuming statistically older people with generally more resources are buying, and you are left with the prices you are running into. I recently had a similar experience with a good friends mother and after 6K for the pair with a fairly heavy hit on the savings account she is happy as can be and would do it again in a heartbeat.
There are companies which refurbish hearing aids. You can find them on the web. They take the old hearing aid, sterilize it, and put it into an earpiece which is suitable for you ear. Google and you should find them.
It is a medical device which means that it is subject to insane levels of litigation. Mostly you are probably paying for insurance.
Like anything in health care most people won't be paying for this directly out of pocket; they can charge whatever they want.
Well, if you have software on your $400 laptop that can do the digital to analog / analog to digital just like you say, the solution is clear: hold one laptop up to each ear.
That's still going to be $800, but that's a lil' cheaper than the $1200 pair you were looking at.
Grab that netbook, setup ASIO for low latency audio in/out. Grab FFDshow, start a directshow graph which takes audio from the mic & sends it to the speaker. Addin FFDSHOW audio filter in between mic and speaker. Adjust the mixer of ffdshow filter, and possible turn on other noise reducders. Place some earbuds into your ears and ffdshow settings for correct noise levels.
You'll need graph edit for adding filters together. You may also need an external mic boom. And of course you'll have to walk around with a netbook. But it may work? You should probably work on this with a desktop you already own before investing any money of course. And it might not sound as good as the dedicated solution, but maybe you can save some money.
Could possible make an iPhone/iPod app as well.
If you're actually deaf, and live in a first world country, get yourself registered deaf and tell potential employers about it before you go to interview.
FGD 135
I too have to wear one and it's ungodly expensive. My argument is the fact I need them to have a normal life and work. So if people can get glasses for fairly low price and it's a item that people need then why can't insurance companies provide coverage too? Reason for that it's very specialized market and expensive.
Don't get one of those cheapie $49.95 hearing aids from the ads as they do not provide the proper specs to the type of hearing loss you have. In fact it'll make your hearing worse. It'll be like listening to iPod all day long.
See if they can offer a payment plan.
Good luck.
It's my experience that anything labelled medical, nuclear, or laboratory grade, usually costs several times (2x-5x) more than if it weren't.
I'd suggest that you contact your state's vocational rehabilitation office, which specializes in equipping people with assistive technology so they can be productive members of society (i.e., get and keep a decent job). My fiancée is deaf, and she got a nice Phonak digital aid, a Naida V if memory serves, from the State of Nebraska last year (she uses a cochlear implant in the other ear and only needed one, but two can be arranged as well).
Likely, there is an 'economy-of-scale' element at play here. If they have to develop custom hardware for such a device, then it can be a huge challenge for them to cover their costs. A surprising 18% of Americans have some for of hearing disability: http://disabilityhistoryinamerica.wetpaint.com/page/Disability+Statistics+In+America You have to look at the addressable market size for these companies; if there are other countries internationally who do not have a large percentage of their population who use hearing devices. Compare this with netbooks where almost any person is a candidate for a new machine. That's a much more large addressable market for a computer manufacturer. That being said, I'm with you, I wish these devices could be far more affordable.
"...why do I need to pay $1200 per ear for a hearing aid?
The answer to your question? Where do I start. Greed. Politics. Corruption. Lawyers. Lawsuits. Pick one. Pick all of them. They all are the reasons we pay so damn much for anything related to health care. (And for the record, NO, I do NOT believe that Obama-care is the fucking answer here.)
It's very sad, but also very true, and unfortunately, since you've already broken down the science behind the $183 worth of parts that make up your average $2000 hearing aid, a "cheaper" alternative I don't really have for you outside of the DIY realm. Although the thought of an open-source hearing aide is interesting, which something along those lines to offer some REAL competition is the only thing that is going to drive prices down where they should be.
Try complaining about a cochlear implant, which runs from $50k to $100k.
...I'd imagine basic rules of economics and capitalism are at work here, i.e.
:)
:)
If these things really cost so much less, someone would produce them and sell them for less. While you can get a netbook for a few hundred dollars, keep in mind that it is using largely shared/similar hardware and is not required to be ultra small to the extent that is can be worn. The degree of precision engineering to make a high quality hearing aid is understandably not insignificant.
You could walk around with a netbook, a microphone, and a pair of headphones if you like
It seems there are indeed less expensive models out there that might do the job -- I'd check out http://www.ncbi.nlm.nih.gov/pubmed/18519576 and http://www.amazon.com/MDHearingAid-Acoustitone-PRO-Hearing-Aid/dp/B002RH4SN4
Good luck
Humble suggestion: get a cheap analog unit to hold you over until you get a job with benefits -- insurance may cover them. There are cheap Asian knockoffs that may work, but one can only speculate how good (or bad) they would work.
On a recent flight, I heard an older man talk to the woman he was sitting next to about this same issue.
Hearing aids tend to be classified as DME (durable medical equipment). Medical equipment has a higher support cost than netbooks, and the insurance companies are happy to pay. The cost of entry in the DME market is much higher the netbook market.
Although there is a huge market for the product, the liabilities involved in selling these products significantly raises the risk, and therefore the price, in such products.
Stick your laptop in your ear.
Decent ones that your wear all the time are typically molded to the inside of your ear and hand-adjusted. This means a real person has to touch them and they can't be mass-manufactured, similar to dental devices like crowns and such (which are comparable in cost).
"I'm an old-fashioned type of guy. I worship the Sun and Moon as gods. And fear them."
I think you are right that there is no really good reason anymore for why these should be so expensive. The reason 20 years ago might have been state of the art electronics and cost of miniaturization. Looks like its time for an open source hardware project, just watch your step on the patents.
A quick search shows Walmart selling hearing aids for about $400
Why Are Digital Hearing Aids So Expensive?
What???
Hi,
No idea about pros and cons and so on, but figured it could be interesting to take a peek at these for a less expensive solution, even though different.
http://www.etymotic.com/ephp/compmic.aspx
Terje Elde
Design one, build a factory and start making them. I'm sure Costco would be happy to put in their hearing centers and undercut everyone else like they do with glasses now.
But this is why it's important to wear ear protection for such seemingly innocuous tasks such as mowing the lawn (or any loud task, really). So many kids back then and still these days listening to their personal music players via headphones where you can hear the music from across the street. It's just stupid and a few $ of protection today will save you $$$ in the long run.
I have relatives going deaf with age, watching TV with them is not fun. TV volumes set at a level wear I have to wear ear protection.
Stop complaining, you! That 1000% mark-up is nothing compared to the cost of a Tylenol in a hospital! You should be grateful they are so cheap!
OK, here's all you gotta do: get a netbook (or maybe a pocket PC device like an old compaq); install a minimal linux and alsa, buy a pair of high quality earbuds and hook it all up. Now you got a $400 digital hearing aid you can carry in your pocket. If you're really a geek maybe you can even get into the whole "box with wires" thing - think Gordon Cole... and, hopefully, it would work better for you than it did for him. WHAT THE HELL DID HE SAY, THERE, ALBERT? THAT'S SPECIAL AGENT DALE COOPER!
... I was. It seems maybe the price has come down some. I paid $8,000 for mine 2 years ago and they are 16 channel but I have 75% and 90% loss and couldn't get by without them. Inherited nerve deafness. I still can't here the keyboard though.. oh, wait! never mind. I hear Bluetooth is gonna be incorporated in the next generation.
First, it's a medical device, not a commodity consumer item like a netbook, so its manufacturer must prove both its safety and effectiveness, with independent tests, before it can be licensed for sale by the FDA in the U.S., or the corresponding medical regulatory authority in other countries. That process is time consuming, and expensive. Those costs must be paid for, and are reflected in the price. Second, its technology requires extremely low power circuitry, and a much higher level of miniaturization, than a netbook. These factors too, naturally increase the cost of the device.
Well, it seems like you have found an opportunity for a new business. Good luck with finding free engineering, manufacturing, marketing, and distribution services. Maybe you need to benefit from economy of scale. You may be able to expand your market by promoting free rock concerts at crowded subway stations.
It's a medical device - that means it's subject to more stringent controls and potential law suites. It can actually deafen someone if it fails in the right way. It can cause someone to not hear that car and get hit. These people can sue.
It's a specialty item made in more limited production runs than a netbook. Less people can be expected to purchase decent hearing aids (ironically in part because they're expensive). Bit of a viscous cycle there - if they were cheaper more people would buy them which would make them cheaper.
Finally our medical tech companies are greedy. The whole business is about cornering someone so that they need your product or end up with a shite quality of life and then milking them.
I'm the bread winner in my family. My wife wears 2 hearing aids. The model she uses are mid range. They cost about $3k each in Australian dollars on the Aussie market and have to be replaced roughly every 5 years. I'm still greatful she can hear me. I do wish they were cheaper.
These posts express my own personal views, not those of my employer
Price covers not just hardware, but also testing and getting certifications that this product is safe for prolonged use on people. Probably part of the cost is also an "insurance" against future lawsuits due to malfunctions.
Hardware (Cost of Goods Sold) is the least part of the price.
Probably along the same lines as to why it costs $120-300 for a pair of prescription glasses at a store, but you can get similar quality for only 40 dollars online.
When you can fit that $400 laptop in your ear, then you can stop wondering why hearing aids cost so much.
"If you make people think they're thinking, they'll love you; But if you really make them think, they'll hate you." - DM
Why do I need to pay $1200 per ear for a hearing aid?
Because you need it.
obama-care? are you referring to the legislature creating in congressional or senate committee? what do you hope to accomplish by using this vauge slur? Do you think that present HCR (either senate, house, or reconciled versions) are worse than status quo? Can you please explain how? Please don't treat me as hostile; I probably agree with every complaint you have. however, I am curious about what role you feel you have in constructive reform.
medical device
So you heard it everyone. Geekmux has issues a challenge!
First someone start a wiki to organize the project.
Someone make the hardware specs. Some A/D, D/A converters, some processing. Someone write the software. How small can an Arduino be made? Someone contact Bre Pettis about cheap fabbing of the housing body.
It doesn't have to be commercially viable. It just has to work and be easy enough to make that the local hackerspace can make them for their friends and loved ones. The threat of competition alone will drive down prices enormously. Don't worry about patents and trademarks. We aren't going to be selling these, we're going to give the plans out FREE in so many places any hacker can make one.
This is the new world Cory Doctorow has been writing about.
GO!
- For the complete works of Shakespeare: cat
If you pay the rack rate listed, you're getting screwed.
An insurance company is going to have an agreement with the company, and will probably pay half of the sticker price.
The trick will be talking to the right person who can give you a discount in exchange for paying cash.
Welcome to the wonderful world of medical equipment billing.
Most of the time these devices are relatively inexpensive to build. Maybe 1-200 per if you figure in all the safety certifications.
But a lot of these are going to people with insurance that pays for this sort of thing. So the suppliers are charging 'what the market will bear'.
Chas - The one, the only.
THANK GOD!!!
why do I need to pay $1200 per ear for a hearing aid? In my country, you would get a $1200 hearing aid for free. If you want a more expensive model, the government pays the first $1200 and your insurance pays the rest.
Invest in yourself that money to start hearing. It wil help you get a job easier and may improve your relationship your wife due to clearer comunication although it's not clear if that's a problem :)
Back in 1982 I spent about $US5,000 on at the time a top of the line non PC computer for the work I was involved in.
To put that into perspective my house which I bought around the time cost about $US28,000.
I'm not sure if they will provide the amplification you need, but look at the electronic hearing protection offered for hunters. The in the ear models run anywhere from $30 to $400. As to why the medically prescribed ones cost so much. That is simple. Insurance pays for them for most people.
$3700 doesn't sound so bad for something that improves your quality of life so much. Comparing the price to a laptop is so beyond what's reasonable it's pointless to even discuss why. Let's move beyond that.
Ultimately it doesn't really matter if you can't afford it. So what are your alternatives? Buy something cheap that's likely to not work as well, or try to find some benevolent entity that will pay for all or part of your hearing aid. Government aid? Private charities? I don't know what's available, but others do. I'd start by dialing 211 (most of the country this will hook you up with United Way volunteers) and see if they can help you.
AccountKiller
..and you live in a country without universal healthcare
So where is the URL? More interesting mostlikely some geeks do end up with an unlimited spectrum modifiable low-latency digital device that natively supports remote connections instead of LF rings. Might be even as cool as directly doing a call with a remote device.
Support Eachother, Copy Dutch Property!
I would guess that the hearing aid is totally encumbered by patents and that the barriers to entry are huge. Leaving just few manufacturers to price (fix) as they like.
Also, product liability insurance is a big factor. Many years ago I was going to buy a Cessna 182. $150,000 new. After calling Cessna a few times, they told me that the product liability premium that they paid on that model aircraft was $75,000. Go figure.
I got both ears from around 800 in the DFW area.
Anyone can squeeze a microphone, an AD/DA converter, a 15 channel DSP driven parametric equalizer and amp into a box the size of a toaster oven. But not many can stick it in your ear, and have it fit properly.
---- Booth was a patriot ----
The manufacturing conglomerates in Big Hearing Aid are making those windfall profits in the billions of dollars. We need to raise taxes on them so they stop exploiting tax loopholes. Down with Big Hearing Aid!
I think it's because they're medical devices, and the makers charge whatever the traffic will bear. Insurance pays for most people, after all. Ever look at the markup on a pair of plain old eyeglasses? Even with the preparation of lenses with your prescription, it's pretty terrible.
The suggestion: If you've been diagnosed as functionally deaf by a physician, and if you're in fact unemployed, why not nose around and see if there's a benefit available to you from your state? It's an assistive device, and there may be some sort of loan, grant, or other fundage available to you. That might be especially true if you're not going to be able to locate and keep a paying job without one. Look at vocational rehab stuff.
"Here's what's happening. You're starting to drive like your Dad..." - Red Green
Just an idea, but if you can make the trip to mexico, I strongly doubt you've have to deal with such an expensive price tag on those hearing aids. I lived in El Paso, TX for three years and enjoyed Mexican medical care while I was there. Very cheap and surprisingly respectable quality.
There is the songbird brand of hearing aids that are far less than a traditional hearing aid. The disposable (400 hours of use) is $80 USD plus shipping. The permanent one is $280.
Secondly, I might would consider a pocket type hearing amplifier with a traditional earphone. It may save on expensive batteries and be easier on the ear physically.
The higher cost of hearing aids came from the miniaturization, and the price has stayed high. However, with surface mount components now readily available, I expect that there will be more competition in this space.
I commend you for taking care of this. I have a family member that refuses to admit to his hearing loss, and it truly can be a miserable experience being around him because he takes offense at things that people did not really say, but that he misheared.
Also, you are in my thoughts/prayers during this time of unemployment struggle for many of us.
Take the cheese to sickbay, the doctor should see it as soon as possible - B'Elanna Torres, "Learning Curve"
And, I hate to say it but I rather think lots of people are wrong.
The few who have basically said "because they can get away with it" - congratulations.
From the tone of your post (mentioning prices in $), I'm assuming you're in the US. Which is a bit of a shame because these people have just opened up with a view to putting the proverbial cat among the pigeons. Maybe you know someone in the UK who can post a hearing aid on to you?
Everyone is always spending someone elses money, so the part of the market (the consumer) that's supposed to lower prices doesn't do it's job.
Insured people are spending the insurance companies money. The insurance companies are spending the money coming in from premiums, which are usually paid by the company the insured person is working for. The health care providers are spending the insurance companies money. There is little to no market pressure to lower prices. The only party who is interested in lowering cost is the guy paying for the insurance, but their employees are telling them they want the best coverage known to man with price being no object.
You want to know why wages were stagnant since the dot com bust? Companies spend somewhere around 25% more on workers during that time, with almost every penny going to health care.
This is why every nation other than the US has centralized healthcare, do varying degrees. The government acts as the voice in lowering prices. They are literally hundreds of strategies they use, some more effective than others.
Why do hearing aids cost a fortune? You can blame the rest population for NEVER looking at prices.
Burn Hollywood Burn
Rule of thumb is add a zero to the price if it's medical equipment and two zeroes if it's surgical equipment. Why? Because they can and competition doesn't help because of a little tradition called price fixing. I can buy a surgical scalpel out of a hobby store I know for under $10, sterile and in it's packaging. Where as the same scalpel would cost 10X as much out of a medical supply house. I'm sure the company making them claims that they are selling the hobby store seconds but I'd bet money the same production line feeds two boxes one for the hobby store and one for the medical supply house. Why don't medical supply houses buy the hobby stuff? Some probably do and jack up the prices but others don't want to deal with uncertified equipment. Oh how do I get two zeroes? Check your bill for the surgery you just had. That $50 scalpel just cost you $250 because of the hospital mark up. Even worse some equipment is sterilized and reused but oddly enough you get charged full price just the same. It's a scam and it's why we pay the highest rates in the world.
Or some other backwards location :)
http://opencm3.net, http://www.nongnu.org/gm2/
Wow, crazy much?
I don't know about this "Obama-care" you speak of, but it seems like government subsidies for these sorts of less common medical devices (for which supply and demand will predict high cost) is the way to go. I've heard that similar subsidies exist for braille computer screens for the blind (which are also expensive).
By the way, I heard CBO says that tort reform won't drive costs down more than 1%. So you can cross that off your list of made up reasons why stuff is expensive.
AmericaHears.com provides a good direct market, self adjustment aid...that's quite a bit cheaper, if you have tests already done.
Hearingaidswholesale and Heareasy are also good alternatives.
http://www.consumeraffairs.com/news04/2008/03/fda_hearing_aids.html
http://community.livinglakecountry.com/blogs/hears_to_life/archive/2009/05/13/fda-regulations-on-hearing-aids.aspx
So not only do these things have to go through FDA testing but the FDA can also push around manufacturers at will.
It's so odd to me that the same people who bash the government on a daily basis are so willing to fold and blame "Big [Whatever]" at the drop of a pin when so many of these institutions are directly tied to government regulations. Don't you people see the real common thread here?
Chances are your hearing loss is limited to a contiguous range of frequencies. Probably a bell-shaped curve. If such is the case, you could probably design (or get an EE acquaintance to design) a low-cost amplifier with a band-pass filter.
I'm thinking a single 2907 quad op amp could handle the mic input amplification, bandpass filter, and output gain. Connect it to an LM386 400mW audio amp chip, and you're in business. While I'm not affiliated with them, I have used futurlec in the past, and they have everything you'd need to build such a circuit yourself. If you want a custom PCB, you can even use the free eagle software to lay it out, and Futurlec can have it printed (in China) for you. Expect about a six-week turnaround.
The society for a thought-free internet welcomes you.
Sorry, it's the price you have to pay for having the Best Healthcare System in the World (tm)
for the ipad! ;)
This is why when selecting earphones, I have always purchased the ones that block outside noise, so I can actually hear my music and still play it at a reasonable level so as not to damage my hearing. I get headaches when things are loud anyway, what's the sense of putting up the volume to match ambient noise?
Twinstiq, game news
They're free. Or at least they are under the UK's National Health Service.
The wholesale cost for basic hearing aid for a 60dB loss was around £70 five years ago,
Check out a hunting supply catalog, the same device NOT sold as a medical item cost 90% less....
You pay for the exam.
You pay for the hearing aid.
But you are also paying for the licensed technician who helps you chose the right hearing aid. Casts the earpiece for a proper fit. Adjusts the settings to properly compensate for your hearing loss.
Provides follow-up support and service.
You pay for the record-keeping.
Should something go disastrously wrong on the job, you just might be asked who installed your hearing aid.
The prescription hearing aid is a tax deductable medical expense. Topic 502 - Medical and Dental Expenses
because in america healthcare is about profit and competition, that includes overcharging most people for basic medication
Any medium size company can obtain an A/D, a D/A and a DSP and glue them together. Now add a microphone 4mm long by 2mm diameter that handles the frequency range 125-8000Hz, a speaker the same size that handles the same range with high power levels, and then run the whole thing off a tiny battery for a week of continuous use.
What people who compare these things to MP3 players and the like do not understand is this. Deaf people need a much higher in-ear volume than people with normal hearing. Furthermore, they usually suffer from selective hearing loss. This means that certain frequencies have to be output at levels just below that at which damage could occur. The sound quality and volume needed from a hearing aid reproduction chain is very much greater than that for an iPod or similar.
Nor is that all. It is not just selective amplification. Modern hearing aids can do tricks like identify refrigerator hum or hard drive noise and selectively reduce it so that the user can better distinguish other sounds. I had direct experience of this once in a meeting that took place in a room next to a large running Heidelberg printing press. I could distinguish other speakers because of the noise reduction, but the other participants could not and the meeting was abandoned. By switching between "music" and "speech" modes I could easily hear the difference.
In fact there is now a lot of competition in the hearing aid market with a number of new entrants, and as volumes increase prices are falling. But they are not easy toys to make. Small size, physical robustness, extremely low power consumption, high output, advanced digital signal processing and relatively low volume production means that $1800 is not really much to pay.
From scarped cliff or quarried stone she cries "A thousand types are gone, I care for nothing, no not one."
I think that is some of it, but that's not all of it. The price of a pile of parts just buys you: a pile of parts.
In-the-ear models are hand built into the ear mold taken from an impression from the user. It's not necessarily something that can be stamped out like a netbook, which millions of identical ones are made. I don't think the mold can be just any old epoxy either, it needs to be something found safe to be in constant contact with human skin for years on end. Also, these devices have to work for 16 hours a day, every day of the year for several years, the people that have them depend on them a lot. Mine have been working pretty well for about eight years, I don't have any hand held or smaller portable electronic device that's held up that well with that much use.
Most hearing aids don't amplify (well, not as their primary purpose anyway) anymore. Back in the old days, sure, that's what they did (electronic equivalent of an ear horn).
Modern hearing aids shift frequencies (usually downward, high frequencies have the most energy so you damage the short hairs in your cochlea first) to a frequency range you *can* still hear.
So if you're thinking about making your own, *please* do the proper research first. It will work better, and you will be less likely to damage your hearing further.
Clones are people two.
probably it would also be cheaper for you to buy flight to Europe / Japan / S.Korea and purchase there the same or similar item ... or find the model you want on ebay, from seller outside US (set filter so that you see foreign sellers)
I'm 30 years old and have been wearing hearing aids for about 8 years now. Thankfully I've been able to hang on to the original analog pair of hearing aids that I got when I was 22. I've since purchased a backup pair of digital aids that I absolutely hate. I compare it to the age old debate between recording to tape and recording digitally. The digital is just so mechanical. Anyway, typically the cost is so high because an audiologist (who is in business for himself) has to build the support cost into them. It usually takes 4 to 6 months to get them tuned in just right and I don't pay a dime to him after I buy them, even though I come in every week or two in the beginning and take up an hour or two of his time. He's STILL supporting my analog set that I bought for 2500 back in 2002. As far as making the cost less painful, there are companies out there like CareCredit that will give you a 0% interest loan on qualified medical devices for 24 months. I've gotten 8 years out of mine and they are still going. Hopefully with stem cell treatments possibly curing hearing loss within the next 10 years, I won't have to buy another pair.
Corporations are holy. Anyone who doesn't want to bend over and take whatever a big corporation is giving them has an "entitled attitude," is an "activist," and is probably a "socialist" and hates the "free market."
Didn't you get the memo?
I don't know about this "Obama-care" you speak of, but it seems like government subsidies for these sorts of less common medical devices (for which supply and demand will predict high cost) is the way to go. I've heard that similar subsidies exist for braille computer screens for the blind (which are also expensive).
Really? Here, let me help translate "government subsidies" for you. It's commonly referred to as taxes. Who the hell do you think ultimately pays for those programs? Here's a thought, how about the prices get driven down to reasonable levels, and you don't need taxpayer-funded programs to pay for Grandmas $7000 hearing aid when she can just BUY the damn thing for $500. Crazy concept this "reasonable pricing" thing is, I know.
By the way, I heard CBO says that tort reform won't drive costs down more than 1%. So you can cross that off your list of made up reasons why stuff is expensive.
Tort reform won't be the only thing to ultimately drive down liability/malpractice insurance costs for doctors and hospitals(which are passed on to the consumer), but lawsuits with obscene payouts is damn sure one of the main reasons these insurance rates are at the levels they are at today.
You could just learn ASL and be done with the hearing world, We are a bunch of whiny asshats anyway :)
Here's a thought, how about the prices get driven down to reasonable levels, and you don't need taxpayer-funded programs to pay for Grandmas $7000 hearing aid when she can just BUY the damn thing for $500. Crazy concept this "reasonable pricing" thing is, I know.
The problem is, you allow private industry to set all the prices. If you had proper socialised healthcare like all the other first-world countries, what would happen is the nationalised health service would turn round to the manufacturer and say "You sell us ten thousand for $500, or you don't sell it at all. Decide."
All you're getting with private healthcare is the opportunity to pay for the director of your medical insurance company buying a new Jaguar.
"... So my question is this: when I can get a very good netbook computer for under $400 why do I need to pay $1,200 per ear for a hearing aid? Alternatives would be welcome."
Welcome to the world of for-profit health. Medical device approval process, litigation and because your insurance company will presumably pay a big chunk (not a reasonable assumption anymore, though) is largely responsible. Just one of the million reasons we need health care reform.
Probably the same reason a VERY simple device to assist my son with speaking costs thousands of dollars (not even a touch screen -- paper overlays, like a keyboard, and you press it and it says the words you prerecorded). They can get away with it, and insurance companies will pay it.
And yet an itouch with the $800 software to do the same is not covered, because it does other things besides help my son talk. Better technology, costs less, and it isn't covered.
We have pharmeceutical companies charging an arm and a leg for the same reasons. Oh yeah, research.
Blame our insurance system.
There's an app for that. http://www.appsafari.com/utilities/9527/soundamp
Bluetooth aids were avalible 3 years ago...
I agree If the hearing aid is such a small device and it has definitely a very low circuitry as compared to the notebook than why the hell a hearing aid is more expensive than a notebook !!! Regards http://www.saadstore.com/
Muhammad Saad Mubeen
go to the morgue and buy some "used" ones.
My sugestion to you is to look into non-medical hearing devices. search the cabelas website for 'ear' and it will return half a dozen hearing aids designed for hunters. I'm fairly sure that most of them are the same hearing aid you would get from a doctor, only it is not marked as a medical aid, thus not subject to the insane prices. There are many to chose from, in a wide range of prices, from as high as the ones your doctor had, to as little as 40$ One can assume you will get what you pay for, but if you can make a 140$ hunting hearing aid serve your purposes, then more power to you.
I've decided to Diversify my Holdings. I've divided my cash between my left and right pockets, instead of all in one.
Your problem is with the corporations, who drive the prices up seeking ever higher profit margins. Gonna be a socialist here, but I say we cap profits at a maximum of ten percent for ALL industries. They cannot charge more then 10% of what it costs to deliver the product, including all parts labor business costs etc. Ten percent ought to be plenty for the ceo to buy an 8 bedroom house, he doesnt need 24 bedrooms and 12 lamborghinis. Maybe now the poor people could afford to live without tax payer subsidies. Its surprising really, if we help the poor people help themselves, then maybe we wont have to give them tax money.. i mean WOW, what an interesting idea. Instead of curing the symptom, and harming everyone below the poverty line, how about we cure the disease (rampant advantage taking of the poor) and have less powerful ceo's, poor people who can afford to live, and more money in our pockets. The only way this is bad is if you own stock. At that point frankly your part of the problem because your actually profiting from the poor, so you should quit bitching about giving back what honestly you didnt deserve.
Perhaps someone could leverage the iPhone platform to develop a hearing aid? Everything required is there... I think. =)
BUT I WISH YOU GOOD LUCK!
I asked this question myself once. I was told: Supply and Demand. There aren't that many deaf people, per se. At least not at my level. (I require amplification at 120db in the "low to mid range frequencies with no high frequency capability", so yes, I'm essentially deaf.) My current BTE pair cost me $2400 EACH. I was given a $1,000 discount as a repeat buyer, so I still paid $4000 for a pair in 2007... $1200 would be cheap. I'm not really happy with the digital quality, either. These aren't high end in detail or capability, only high end in amplification. (Phonak Supero +). Since the purchase, I've completely lost hearing in my left ear... furthering the monetary wastage. I should get, maybe, another hearing aid for my right ear next year... Will obviously go Analog as the price on a single analog in my range is only $650. Taken into perspective: my hearing began to fade around 1980. The first pair of BTE's my parents bought cost $1,000 each (analog, obviously)... so this is not a sudden thing. Hearing Aids have always been very expensive, and are almost NEVER covered in any fashion by health insurance. YET... Health Insurance would have paid for a full dual Cochlear implantation that costs over $50,000 (except Cochlear implants do nothing when your auditory nerve is toast). THAT is even more ridiculous IMHO.
Huh? I've worked some decent jobs, and pretty much all give medical and dental. No vision plan ever. My wife's lasik, and contacts and glasses before, were all 100% out of pocket. What paradise do you live in where everyone gets free glasses?
-Clio
Karma: Bad (mostly from not giving a fuck)
Blog: http://clintjcl.wordpress.com
No, he's not talking about markets at all. He's talking about cartels, actually. Economics 101. Though in this case, they may be de facto cartels, instead of actual conspiratorial cartels.
-Clio
Karma: Bad (mostly from not giving a fuck)
Blog: http://clintjcl.wordpress.com
This is somewhat off-topic, but I've always assumed that hearing aids would lead to further hearing loss. After all, aren't you just amplifying sound and blasting it into your ear, which is what caused the hearing loss in the first place?
Does anyone know this is the case?
And let's not forget the commission that a audiologist gets for selling the products! I have spoken to one who got as high as 30% of the total sale in commission!!
this thread would be the best place to practice using it. Wow.
Please don't use "umm" or "err" or "erm".
The first thing I'll tell you is that fundamentally they're all pretty much the same. In general they're all made with equivalent components and the only real difference is Bells and Whistles. It's the only thing the companies can do to differentiate themselves from other manufacturers. Unless you've got some special type of loss, a basic simple model will probably work just fine compared to something fancy. The biggest choice comes down to size and how self-conscious you are about it. Generally, the smaller they are, the weaker they are and more expensive. You're paying for vanity.
You can probably forget about insurance covering it. Almost no health insurance will cover them. They're considered non-essential, "cosmetic" devices. My company provides very good health insurance and only once over the past 30 years have they ever covered -any- of my hearing aid purchases. 11 years ago (during the dot.com boom) I actually had a company cover part of one ( $1000 of a $2800 purchase ) but that was an anomaly. If you're lucky they might cover the hearing exam but considering most places give you that free as part of the purchase process it doesn't do much good. I've had a couple insurance companies tell me "no we don't cover them, but we offer these great coupons" which were basically a 25% discount off of something that was marked up 100% to begin with.
The most important thing I can tell you is to get a Costco, Sam's Club, or other shopping club membership. I have a Costco membership and have bought my last two sets of hearing aids there. They were 1/3 the price that I was charged at regular hearing aid stores. Costco had audiologists that were just as qualified as the regular stores, and sold the same models/manufacturers as the regular stores. As an example, my last "hearing aid store" model cost $2800 in 1999. The three I've bought since then ( the last two a couple of years ago ) cost $890-$1000 each and were far better than the $2800 model.
Sorry to break it to you.
Might be cheaper to move entirely.
They charge what they can get away with, that's what they can get away with.
If Google really cared they would fix Android Chrome to reflow text, instead of discriminating
Bluetooth aids were avalible 3 years ago...
Yeah, that makes me feel better and better about the price.
nonsense; the web is full of DIY protocols for using silicone molding and similar techniques
It would take a week or two, but I bet it would not be hard to come up iwth a simple process, eg
1) clean ear
2) wipe with release agent (pam)
3) fill ear with soft wax; allow wax to harden
4) remove wax, use as + to create a silicone mold that is a - (eg, take the wax, put it in a box, pour in liquid siliicone, let harden, slice silicone with razor, remove wax
5) put electronics into silicone mould; fill with plastic moulding compound (more silicone or polyurethane,lots of FDA approved items out there
Here's a thought, how about the prices get driven down to reasonable levels, and you don't need taxpayer-funded programs to pay for Grandmas $7000 hearing aid when she can just BUY the damn thing for $500. Crazy concept this "reasonable pricing" thing is, I know.
The problem is, you allow private industry to set all the prices. If you had proper socialised healthcare like all the other first-world countries, what would happen is the nationalised health service would turn round to the manufacturer and say "You sell us ten thousand for $500, or you don't sell it at all. Decide."
All you're getting with private healthcare is the opportunity to pay for the director of your medical insurance company buying a new Jaguar.
So when said company says, "Well if we sell it for $500 we lose money so, no, we won't sell it", are you going to prevent someone who has the $5000 and deems the product to be worth the cost, from purchasing it? If you can't make money off of something, what incentive is there to develop a product?
If there really is a lot of money to be made selling hearing aids, you'd have a lot more people working on making hearing aids to cash in on all the profits. The way I see it, there isn't as much profit once ALL expenses are considered, not just component costs, to justify lowering the price.
The problem with our current health care system is that it isolates people from knowing the true cost of what they are doing. If everyone had more of a stake in their own health care, we wouldn't have a massive explosion in health care costs because there would be more exposure to true market forces due to people having to make decisions that have financial impact on them. Generic drugs are a great example. I bet you anything if you tell someone they can buy their generic Rx for $20 or buy BrandName Rx for $450, they'll spend the $20. But now you if you give someone insurance with the option to pay $10 vs $25, now the insurance company has a much greater risk of being stuck with a $425 bill that their participants have to collectively cover. That means costs go up for everyone.
I am not for national health care in any way, shape or form, but if it were to happen, I think the only fair way for it to happen is model health care on the FSA/HSA+High Deductible Model. Every citizen (including children, via their parents) would have to pay an equal sum of money into the government health care fund (say $4000 per person per year). Each year, every citizen would be given an allowance of say $1000 to spend on health care. If they don't spend it, it rolls over and becomes available in future years. Then to protect against a catastrophic event, there would be an cap to out of pocket expenses (say $5000 per year). Obviously this is greatly simplified but until people stop wasting money on unnecessary doctor visits and prescription drugs, there is no way to lower costs. There just aren't enough 'profit' dollars in the market to take away from the people who are doing the real work.
Scott
Why does $5 worth of plastic and metal frame cost $1000?
If they're running a franchise in a strip mall, more likely than not they're running something far closer to a snake oil reseller than to a traditional audiologist that resells a number of brands of hearing aids at a rather minimal profit.
Rare is the insurance policy that will cover hearing aids. And if, like me, you already wear hearing aids, its a preexisting condition and you're fucked to an even greater extent. When I was buying private insurance rather than being part of a group plan, I was paying a 10% premium on a plan that explicitly denied any coverage of anything hearing related.
My guess is they could triple the price and still sell a lot. People want to hear.
The price is probably at some maximum level that insurance companies will pay and people can actually scrape the money together for.
Are you kidding? Those lawyers are protecting them from other lawyers. It's cheaper this way in the long run. What you really want is tort reform.
(A great many lawyers on both sides of every potential lawsuit will get payed a lot less; Congress is full of lawyers; Ergo, real tort reform is every bit as unlikely as real health care reform. It does make a good talking point for the GOP, but most of them don't mean it. Sorry for the rant.)
I won't join Slashcott. OTOH, If Beta goes live, I just won't be back until it's fixed. Sorry Dice.
There's no market for these like netbooks. The government should be paying, not a private individual. These are public sector items. If you were a government worker buying 20,000 of these you could get a reasonable price. Most of the price you're being asked to pay is going to fund the act of selling them to you, not the items themselves. It's expensive to procur funding on a case-by-case basis. The fact that you're comparing them to private sector purchases yet finding them curiously different shows this is a different kind of item. You don't want a hearing aid, you have been prescribed a hearing aid. It's not like shopping for rugs.
The government (everyone) should be paying for these. The cost per year to fund all medicine is less than the cost to fund all defense. There is no benefit to people going without hearing aids, but a large measurable benefit to people having them. It's the same as preventing houses from burning down. The fact that this is hurting your chances of getting a job makes this very immediately obvious in your case. Some will say you should get funds from a charity but health care, like cops and firefighters and defense, is not charity. These are non-market-driven human endeavors that create conditions in which market-driven private sector interests flourish.
So what to do? I don't know. If you are in the US there is very little hope. I have a friend who needs medicine also and we don't know what to do about him either. By 2012 we'll be in the same place as Dickensian England if current trends hold. You're just one of many Tiny Tims if you are in the US. Some ghosts have to visit a rich guy before you get cured.
You don't need to do the step with the wax ... there are products out there that let you form a custom mold around earphones.
Have different laws than the USA that do not protect the right to charge $1500.00 for $12.00 worth of electronics and $1.98 worth of plastic.
You can probably get one in Mexico for 1/10th what you pay here.
I killed da wabbit -Elmer Fudd
Comparing assistive devices to hunters to hearing aids is like comparing the `reading glasses' in the checkout aisle in the pharmacy to glasses made to the prescription of an optometrist. There are people for whom the OTC solution may very well work. But for people with significant hearing or vision loss, it's not even close.
You have a wife?
Take people with next to no loss in the bass range but a profound loss in the high range. Now amplify all sounds across the board to where they can properly hear the high range. The bass range gets amplified so much that not only can they not hear the high range but their hearing is further damaged. Great `solution' there. Then there is the problem of feedback. People with significant hearing loss need a seal in their ear mold to prevent amplified sound from leaking back out to the microphone. This is why people with hearing aids get refitted with new molds every year or so. The shape of one's inner ear changes over time. A device that amplifies enough for people with significant hearing loss will cause feedback if the ear mold is not properly fitted. And did I mention a combination of directional and omnidirectional microphones and telecoils yet?
Got my mother a mail-order Swiss 'Lynx' from a local supplier (neat kit but no frequency matching - good result for non-cheap but moderate cost). When I tried to order the second the locals had been closed down. My theory is that all the costs of fitting, tuning, replacement, retail storefronts, are piled onto the tiny device. Undercut that, and some Professional Union will see you dead. Time for some 'unbundling', Mr. Regulator, and let's see the true costs of each element of service. This is NOT the usual medical-devices, beware-litigation domain.
http://earmall.com/theoriginalihear-b.htm?gclid=CL2e8LfetqACFSFy5QodmRXCTw
I don't know what its worth and if it suits you but my opinion is that your practician is trying to rip you off
I have little sympathy for a voter who for 50 years voted for the lowest taxes, then when he needs government support, it should all be paid by the people working.
It is the heart of socialism, to vote now for what might happen to you in the future. Vote for unemployment benefits because it might be you on the dole in the future. Vote for hearing aids on healthcare, because it might be your hearing that is going to give out.
Quit blaming those in power when you are the one who put them in power.
MMO Quests are like orgasms:
You may solo them, I prefer them in a group.
Those prices are obscene. A hearing aid is an amplifier with some filters to shape the output.
Google the following for your area:
- Deaf & Hard of Hearing services
- Center for the deaf & hard of hearing.
- Center for independent living.
They can advise you and in some cases supply needed equipment; hearing aids, TDD support, etc.
They also help you avoid being ripped off.
Doing anything as low-power as a hearing aid needs is bloody complex and expensive. Your $400 netbook probably would't run more than a few seconds on the kind of power reserves that a hearing aid has. And your '70s amplifier, well, give me a break. Didn't you need half a power plant to power that thing? It wouldn't even turn on on a hearing aid battery.
These things contain mostly custom chips designed for a single purpose - that is delivering the computing power necessary for a hearing aid with the least power consumption possible. We're talking microwatts here. Designing such a thing costs a lot, and they're not selling in numbers as huge as netbook hardware, because, well, everyone wants a netbook, but most people sure as hell don't need or want a hearing aid if they still hear just fine.
Widex, Soundex, Sonic Innovations, Siemens, and Amplisound are the ones I can think of off the top of my head. There are probably a couple dozen other manufacturers. A good audiologist will deal with a number of vendors are suggest the brand that makes the product that best meets a given patient's needs. The insurance angle is also a dead end. Most insurance policies specifically deny coverage for hearing loss. The small market angle also doesn't cut it. The market is huge, numbering in the millions.
*scnr*
IANAL, but if you live in the states you *might* be eligible for social security (SSI) and the associated government insurances that may cover these expenses. You can apply right online. I don't have experience in this area but have seen some disabled friends go through it.
Best of luck!
There are a number of things commenters here seem not to know about the hearing aid racket. I have a profound hearing loss and have been wearing hearing aids for most of a decade now, let me fill you in on just a few of the things I have learned.
For all of you championing some sort of cheap or build it yourself aid - unless you have a very light hearing loss, forget that. I once thought the same thing, and tried a number of them, and found that they're basically crap. Just amplifying all sound that hits the microphone doesn't work well at all. A door slamming or a dish clinking can be VERY PAINFUL if overamplified, even if a person without hearing loss barely notices them. After this consideration, there's the problem of the sounds you want to hear being buried under a bunch of sounds that are present but not bothersome in daily life: cars driving by, computer and HVAC fans running, refrigerators humming, crowd noises, air and hair moving over the microphones, and so on.
I'm not an audiologist or in any way connected to the industry other than as a customer, but what I've learned over the years from wearing high- and low-end hearing aids (I have one pair that cost almost $7000) is, human hearing is far more complex than most people realize. Most folks out there swim in a sea of sound that they are well attuned to, but like a fish, give little thought to the navigation of. It just works, like magic. When your hearing starts breaking down, though, it's an incredibly hard problem to selectively amplify the sounds you want to hear in the many situations you will encounter throughout the day. In a crowded room you want to 'focus' your ears on the person in front of you; in the kitchen you want to be able to hear several people who may be moving around as they speak yet filter out extraneous noise like the bacon frying in the pan, the refrigerator hum, the fan over the stove, the dishes rattling around. A healthy ear does all this effortlessly; hearing aids are only now getting enough processing power to do it maybe half as well.
I cannot stress this enough, by the way. NO hearing aid will bring your hearing back to what it was. At their BEST, hearing aids are about as good as a cheap car radio tuning a weak station. If you don't need hearing aids now, protect your hearing, because losing it sucks in about a jillion ways.
In the US, most insurance plans do NOT cover hearing aids. The VA does, and they are the number one hearing aid dispenser in the country. Costco is #2 and they don't even bother handling insurance claims for the patient - he will have to do the insurance paperwork on his own. (I know; I'm wearing a new $3k pair of Costco aids right now and am lucky to be one of the few in my area with a plan that covers part of the cost.)
Many if not most states have laws which require the hearing aid dispenser to take back the aids and provide a full refund with no questions asked within 30-60 days of first receiving them. And when that happens, that set of aids can't be re-sold unless (at minimum) they go back to the factory to be completely rebuilt. This creates a number of people who will comparison shop by wearing multiple aids for most of the trial period, then returning them. In their defense, that's about the only way to know if a hearing aid and audiologist/fitter work well for a person. But even so, this creates a lot of wasted time and investment for audiologists and fitters. They have to make up the loss somehow.
Usually the price of the hearing aids includes months or years of followup visits to the audiologist or fitter. And if you wear hearing aids, you'll need them. Everyone has a different hearing loss and everyone has a different set of situations they need to hear well in. So the audie/fitter will need to make a number of adjustments during the lifetime of your hearing aids. Additionally the aids are subject to a lot of moisture and earwax (your ear canal is actually a pretty disgusting place) so the audie/fitter will have to clean and recondition the aids more often
I have worn hearing aids for about 20 years. the first ones i had were analog in the ear type. i that type until this december when i got some behind the ear digital phonak's. sure they were expensive. $1500 for main one, $800 for the other side that just sends the signal to the other aid (im totally deaf in one ear and half in the other). But man they are amazing! the sound quality is just amazing. i really can't tell that i have them on.
Also i can get blu-tooth addons to connect to my phone and MP3 player! heh
I don't complain about the cost at all. i think it was well worth it.
There are several factors
- Hearing aids are medical devices, regulated by FDA. This means that companies have to spend time and money to get their devices approved. Quality assurance, traceability, reliability of components etc contribute to the higher cost of medical devices.
- Some really clever engineering, algorithms, materials and manufacturing are required to make a modern hearing aid. Not many companies can make an original design that is competitive.
- Not only processing power is limited in the small size, power consumption also needs to be minimized. I wouldn't be surprised if batteries cost more than the appliance over a few years time.
- You also pay for a professional to personalize the hearing aid, to adapt it to your specific hearing loss
- The performance increase per dollar is small in the premium range. The best performing hearing aids can charge much more than the second best ones, even if performance is only slightly better in normal situations.
However, I doubt that the fact that insurance companies often pay would impact the price. They are extremely cost-aware and would demand a cheaper device providing the same performance if it were available (or limit their contribution to the cost of the cheaper competitor if it was as good).
i'm in australia and paid $3900 for a SINGLE hearing aid - all out of my own pocket. it's quite clever how it constantly does noise suppression and only amplifies the needed ranges, but it was darn expensive. what's annoying in australia, it's only $1200 to have a cochlea implant do and medicare covers the rest, whereas a hearing aid is not covered at all. even private health will only give you 1k towards a set and only every 5 years.
having said that what price do you put on hearing?
These are medical devices. There are ways to control costs, but hacking something up may not be a good idea given that QC is often the last item on the to do list.
Just put a caps lock key in your ear. It should make all text seem louder.
My webcomic
Many people don't want their hearing aids to be seen. The big expense is designing something that will fit into your ear canal but not be visible to others. A lot of what you're paying for is vanity. If they could just put the microphone and speaker in your ear and run wires to your shirt pocket or belt where you would have a device the size of a cell phone, then it could be a lot cheaper.
The other factor is volume of sales. If I design a device like an iPod, I might sell several million units. A hearing aid? I'm guessing, but I doubt they sell more than 10,000 units per model. You have to spread the development cost over a lot fewer units.
That said, if I were younger, I would design the ultimate hearing aid. It would have Bluetooth so you could adjust it yourself using your computer and update the software on a periodic basis. Sure you would still see a licensed professional to dispense it, the the professional would be required to come up to date on electronics (no more crude drawings on paper of your hearing loss). And all tests would be to 20,000 Hz because many of us can hear those high frequencies. But I'm a dreamer...
If I used a sig over again, would anyone notice?
Most hearing aids don't amplify (well, not as their primary purpose anyway) anymore. Back in the old days, sure, that's what they did (electronic equivalent of an ear horn).
Modern hearing aids shift frequencies (usually downward, high frequencies have the most energy so you damage the short hairs in your cochlea first) to a frequency range you *can* still hear.
So if you're thinking about making your own, *please* do the proper research first. It will work better, and you will be less likely to damage your hearing further.
There are bluetooth headsets that are small enough with a decent battery life that could be modified to do the job (bigger battery).
Now if you could just get your mobile phone app. to do the frequency / volume correction you could make talking direct or on the phone better. Just get the hearing aid center plot your profile so you can apply the correction for yourself.
The only big problem is making sure it doesn't make the loss worse if you set it too loud. Particularly at narrow range of frequencies where it might not sound loud.
I can't fix a defect without having the defect entered as a bug, and then tracing that bug back to a requirement.
Mozilla has the same policy for code checked into its Mercurial server. Every patch is attached to a bug in bugzilla.mozilla.org, and each bug cites a requirement or gets marked INVALID.
I have a friend who is an audiologist, and let me tell you, it's the best bloody profession to get in to. All you need is a one year post grad on top of any degree. This friend of mine had a three year degree in music. The guy earns twice as much as me (as a developer), and gets to go home at three most days! His base is good, but all the money is in the commisions from the hearing aids. There is a lot of cream to go around. My advice? Go back to University and get in on the action! It's only one year, and all you do is look in oldies ears and sell them hearing aids.
Ah, but in the hands of a lawyer, the word "reasonable" is quite malleable. Unreasonably so, in fact.
I won't join Slashcott. OTOH, If Beta goes live, I just won't be back until it's fixed. Sorry Dice.
A hearing aid amplifies frequencies according to the hearing loss at that frequency. This is set up by an audiologist or similar professional, the match is never perfect but the more channels in the h/aid the closer the frequency response can be to an individuals hearing loss.
There are extra things like what MrFlannel referred to, frequency transposition, but the main features aside from # of channels are ones that increase comfort in noise ('noise' can be a real pain in the ass for h/a users) and automation.
What you pay for is the R&D behind the aid (size, sound processing), rehab and fitting and testing costs, and yeah probably some profiteering by the h/a company though im not sure how much, as there are certainly a few h/a companies around. . The moulded ear piece (mould) only constitutes a small part of the cost maybe $50 or so.
So yeah the components of the h/a aren't what make them expensive - as you said its just a few electronic parts.
Less competition, smaller market. Also, these devices need to be developed. So the developement cost has to be regained from the small numbers of devices sold. Plus they have to make some kind of win. Laptops and mobile phones are so incredible cheap because they are sold so many times in huge quantities...
SLASHDOT blocks postings that are in ALL CAPS. If they allowed ALL CAPS in postings, this guy may be able to hear us without a HEARING AID.
Very low latency?
Economies of scale, in microeconomics, are the cost advantages that a business obtains due to expansion. They are factors that cause a producer’s average cost per unit to fall as scale is increased. Economies of scale is a long run concept and refers to reductions in unit cost as the size of a facility, or scale, increases.
http://en.wikipedia.org/wiki/Economy_of_scale
I am assuming that more people buy laptops than hearing aids...
The device my company makes is about as complex as an iPod, has similar materials costs to an iPod, but sells for several thousand dollars per unit.
Are we ripping our customers off?
No.
Apple sells millions of iPods, in a good year we sell a few thousand of our product, and we do a lot of R&D, so our cost per unit is quite high.
Quidquid Latine dictum sit, altum videtur (anything said in Latin sounds important)
Insurance that covers hearing aids is rare.
As a person who has used hearing aids since age 8, I've never had insurance that covers hearing aids. With many group insurances, there isn't even an option that covers them.
Ear Trumpet
And most of this is a complete waste of digital circuitry. The microphones on most hearing aids are *crap*. And part of the big expense is a fancy "automatic gain control", a rather expensive analog chip that turns the gain down quickly for "plosive" sounds, like the "p" and "t" sound, to try and teduce those sounds into your effective hearing range, but increase the gain more slowly to accomodate longer, quieter, like schwas. The result is, unfortunately, an amazing amount of distortion, strangely frequency associated phase delays, and temporal smearing of what were crisp sounds into the equivalent of playing the sound through speakers being swung past your head in time to speech. It's horrible, and what's amazing is that the way around it was shown by a guy called Lickliter in the 1930's: simply give the person a gain control to turn up volume and especially soft sounds enough to be noticeable, and a separate control to set clipping to occur at their maximum comfort level. Even one-bit clipped information is plenty to understand more than 90% of speech, as long as that "one-bit" has all the actual timing information because it's not sampled, it's simply a +/- signal set by amplifying the original waveform and clipping it.
Unfortunately, most digital designs sample the actual waveform so infrequently that they've eliminated most temporal information, like the difference between "ts" and "st", and spend expensive amounts of microprocessor power to try and invent information out of nothingness to justify new patents, and distort the hell out of it to jam it into the reduced range between too soft to hear and too loud to tolerate that deaf people have. (There are other reasons for that as well, involving loss of the reflexes that reduce the sensitivity of your hearing as people go deaf, which is why people who are only slightly deaf get quite bothered by loud noise.)
The result is a $10,000 piece of what is effectively solid gold plated, digital, patent encumbered crashing monkey cymbals. It has exciting advertisements and bouncy, healthy, friendly sales reps with body parts that bulge in whatever way the audiologists happen to find exciting, but the poor sampling frequencies and poor analog pre-processing stages have already eliminated much of the important data. And the art of fitting them well is just that: it's an art, it's not well taught, and at most facilities new staff who just graduated from late-night commercial subscribed "medical technologist" diploma mills are used instead of experienced personnel because the experienced people take longer to do a much more thorough job, and that doesn't look good on cost analysis by bureaucratic paper pushers.
There are plenty of countries where you will be given a hearing aid for more or less free if you need it. Just move.
He can't afford a $1200 hearing aid because he can't get through an interview because he can't hear because he's had significant hearing loss and can't afford a $1200 hearing aid.
Can you be Even More Awesome?!
I was able to get a pair of 6 channel hearing aid (with 3 programs) for a lot less than I could with my insurance alone. Insurance had a maximum payout of something like $250. The hearing aids I got were over $6,000. I found out that we have a government program in our state (through the Bureau of Vocational Rehabilitation) which can pay for most of the cost of a hearing aid. Without lying about my income, which is nowhere near poverty level, I qualified for the coverage and we worked out a plan that my insurance would pay $250, I would pay $250, and the state would pay the rest. The amount you pay is somewhat negotiable, I found out, so I offered to pay the $500 and get $250 back from my insurance. I could have applied my part to my flexible medical spending account but I usually have no problems using it up in a year's time. See if you have such a plan in your state (I live in Ohio), and if you do, maybe they can cover some of the cost of your hearing aids.
I went round and round with Kaiser Permanente for years with all visits ending with something like, "Oh, look at the kitty. Have a nice day." When I retired and moved out of state, my insurance was changed to Blue Cross with about the same hearing aid coverage; mostly little to none. With Blue Cross' annual deductible, various co-payments, etc. going up every year, I made the decision to make the VA my primary care provider. I did have to pay the VA but it was a lot less than I was giving Blue Cross. To the point, I received my hearing aids in less than a month. If you are a vet and can't hear, go to the VA.
NHS, free, blah blah.
I mean seriously, people pay for medical equipment? Crazy stuff.
windy isn't it? nope. thursday me too. let's get a drink.
and buy the $20 Chinese items. Job done.
If you were blocking sigs, you wouldn't have to read this.
When Grandpa left his hearing aid (only 1 of his 2) on the window sill in our spare bedroom, our dog chewed it up. Our USAA homeowners insurance policy covered the entire cost of the replacement hearing aid. When I spoke with the claims representative at USAA, they said this happens all the time as dogs are drawn to the high pitched sounds emitted by hearing aids. Grandpa was disappointed as the new hearing aid was much better than the remaining old one the dog didn't chew up. I have had USAA for 22 years now and they have been great in every claim we have had. Note that membership is now open to ALL veterans of the US military whereas until recently it was only senior soldiers and officers and their immediate descendants. KEEP OUT OF REACH OF DOG.
In principio erat Verbum.
they would be FREE!! In Australia and all the other first world countries that have national public healthcare, if the doctor says you need hearing aids - guess what - you get hearing aids for absolutely nothing.
I hope your medical insurance will help you if you are insured. If you did military service they may pay as loud noise and combat or certain positions often result in hearing issues. If you can get Medicare a supplemental plan may cover your issues. You might even try for a disability check as deafness just might be a qualifier.
I do not know your age but you are only seeing the tip of the ice berg. We need national health care. There is absolutely no excuse for anyone to even consider the cost of hearing aids. This is a medical issue and everyone deserves the best care available at all times. Money should never set care limits.
Good luck and God bless you.
You hit the nail on the head. Thank you.
Just don't call it a medical device. Call it a novelty spy toy or something. Or else the FDA will be in the picture in a heart beat.
The price reflects an extreme niche market. First, it's a therapeutic device, which similar to a drug has to be proven it works better than a placebo before you can sell it as such. Which means you need to fund a study to demonstrate its efficacy. Second, it takes people with certain experience to build devices that integrate well with diagnostic procedures. Third, the medical and drug market isn't very open to newcomers. Fourth, and most important, the prices are all bogus. If you walk in off the street to a hospital, uninsured, and ask for a cholesterol test they will quote you about $750. This is the price the provider always begins their negotiations at; an insurance company negotiates a discount based on that (or if it's medicare they simply state what they're willing to pay, take it or leave it). An insurance company might pay $125 but you will pay $750 because the hospital isn't going to negotiate their prices with you. Same with a $4000 hearing aid. An insurance company might pay $800 for it (which is a reasonable price for such a niche product) and you have some deductible, say $250. The purpose of the ridiculous pricing scheme is to make you feel you're getting a $4000 device for $250, while the insurance company ends up paying $550. If you were told you got an $800 device for $250 you might wonder why you're paying for insurance. And this is the same reason you can't walk in and buy the device for $800 yourself - because helping the insurance companies sell insurance helps the hospital stay open.
the people making and selling hearing aids can get away with charging as they do; it called capitalism.
We hear with our brains as much as with our ears. Simply buying hardware to compensate for the roll-off is NOT the solution. Hearing is tremendously adaptive and interactive. When you buy HAs from a reputable source you are actually buying a lot of visits for measurement/modification to allow you to adapt to the augmentation as well as possible. This is unique to each individual. This easily adds up to MANY (10-20/year) office visits over the life of the device(s). I too used to think that simply measuring the roll-off and applying compensation was a solution. It emphatically is NOT. Before you all attribute the cost of the hardware to greed, take a look at the service and also look around and find evidence of overly-fat audiologists. I don't find them around where I live... n6gn
Did anyone else see the humor in this appearing twice in Google Reader?
--<Mike>--
Even if the software needed a professional set-up to calibrate for the individual surely this would drive the price down.
And think of the PR - all those people claiming MP3 players make you deaf - what if you made one that helped the deaf to hear?
Please, no jokes about the iEar or Google Cyborg.
Don't go to a brothel if you want to buy broth
Hearing aids are totally unlike other electronics. First of all they need to be fast enough. Have you ever seen a movie where video and audio goes out of sync and people open the mouth a moment before the voice is heard? It's really annoying and it makes aiding yourself by reading lips next to impossible. This means hearing aids has a limit for input to output delay and it's one, which is quite hard to meet.
On top of that the batteries needs to be as small and light as possible while they should last forever. This means the electronics needs to use as little power as possible (low power is a speed killer!!!)
Everything needs to be on the same chip because the whole device needs to be small.
All that can only be done if it's using a custom designed chip. Chip design is quite expensive and development of such a thing costs millions and there is only one way to cover the loss of research and that is to make the customer pay enough.
You also pay for the examination and setup of the hearing aids. I don't know how it works everywhere, but here they spend like an hour testing all sorts of stuff and coding the hearing aids, feeding them with different programs for different situations (like no background noise, crowds...). Such a setup takes around an hour. In addition to that they add 4 years of warranty. This means they fix/replace broken stuff but also they state that they should fit the ears they are bought to fit. This means if the ear changes then they will give a new examination and coding free of charge and they haven't set a limit to how many times they will recode it.
Bottomline: sure it's expensive, specially if you are short on cash, but it's really hard to lower costs more than they have already done. The competition is quite hard and nobody can charge overprices and expect to keep selling anything.
The VA has a program for vets who can document that their hearing loss is service-related. Contact a VA counceler from the VFW, Am Legion, or elsewhere to get on board.
It really depends on the line and model.
3700 sounds like a luxury model.
Advanced hearing aids include artificial intelligence, noise reduction, Bluetooth support.
The AI is so it can learn your voice so that it doesn't amplify your voice.
Also they can figure out who it is you're talking too to that only one voice in a crowd is amplified.
There's hundred of millions of dollars in research required.
If you have two hearing aids, chances are the communicate with each other wirelessly to create a better sound map of the room.
Inexpensive hearing aids are getting into market
http://www.hearinglossweb.com/tech/ha/inexp.htm
This one: http://www.dealextreme.com/details.dx/sku.4326 for $13 shipped has decent reviews... It might be on par with the ~$50 hunting ones, and if it doesn't work for you, well, you're out just $13 ;)
Violence is the last refuge of the incompetent. Polar Scope Align for iOS
I know there's this myth that Canada has this wonderful healthcare system where any and everything you need is given to you for free but it just isn't the case. In the case of Canada (since that's the nation I visit all the time and have a dual citizenship with) the stuff that is both free and good is general preventative care and critical care. Your normal doctors visits and such are no cost and pretty timely. Also, should you get in an accident, they'll save your life and all that for no charge.
The rest? Well different story. Eyeglasses for example, are simply not covered. Canadian insurance doesn't pay for them, (at least not in BC, could vary slightly per Provence). So it is all an out of pocket thing. But, without evil insurance companies it is much cheaper right? Wrong. Way more expensive, nearly double in some cases. Mom is planning on coming to my optician next time she's down to get her glasses because it costs so much less.
So no, sorry, just hopping over to another country doesn't magically fix everything. Canada's plan is different than the US's not necessarily better. It is better in some areas, but not in others. Quality of life type things, it is generally not better at.
A hearing aid helps me hear better, must be fitted and can potentially cause serious accidents. Track shoes help me run better, must be fitted and can potentially cause serious accidents. There is no medical difference.
The pricing of hearing aids is simply because foolish people will pay for it, there's price fixing going on and the FDA bureacracy has arbitrarily decided to treat hearing aids and shoes differently.
---
Modern marketing - a great substitute for a quality product.
So suppose you just want high quality in ear monitors. Your want headphones custom made to your ears that have good quality and high SPL potential. Turns out, a company out there will make those for you, Ultimate Ears has made a big part of their business doing that. That's what their top of the like UE 10 Pro IEMs are. The cost? About $900 today, and that doesn't include the cost of having your ears molded. They also are a little bigger than you are talking about with hearing aids, you can still see them.
Seems to me that if you are dropping near a grand just for headphones that maybe the cost for the hearing aids isn't so unreasonable since they do a lot more and since any medical device is subject to loads of extra regulation.
High end equipment can get pricey, and that goes double if volume is low.
I'm not saying they couldn't potentially be a bit cheaper, but it seems to me as though their price is in line with their hardware/requirements.
They are expensive artificially. If you paid manufacturing charges and a 20% profit, it would cost about 25$. My uncle paid 30$ about 20 years ago for hearing aids in a 3rd world country. In USA, they tag on billions of dollars of supposed research (basically executive mgmnt air travel and limousine services and gold toilet cost) . You want cheaper hearing aids. Make friends with someone from mexico or a south american.
Regards,
I think this has a lot in common with the saying "The USA spent millions developing a pen that could write in zero G for space missions; the Russions just used a pencil."
Besides the basic hearing aid parts, there are some hefty computing going on. The hearing aids have to distinguish between ambient noise and voices. This is more difficult than it first appears. I used to know someone who designed the filtering algorithms that run inside one brand of hearing aid. What did he do before? He designed the filtering algorithms used by the Trident submarines to listen for enemy vessels. I'm told he had the highest level security clearance of any civilian contractor.
I'll donate to this project.
Millions long for immortality who do not know what to do with themselves on a rainy Sunday afternoon. -- Susan Ertz
"It's a specialty item made in more limited production runs than a netbook. Less people can be expected to purchase decent hearing aids (ironically in part because they're expensive). Bit of a viscous cycle there - if they were cheaper more people would buy them which would make them cheaper."
To a certain degree although I do know some who will not wear a hearing aid more due to doing so acknowledges one is getting older. Yes, vanity can be one reason.
A hearing aid is specifically designed, manufactured, marketed, and dispensed, for one and only one purpose: to treat a human disease. It is not intended to be used, nor can it safely be used, by people with normal hearing.
By its very nature, it modifies the function of the human body. It is not in any way comparable to an article of clothing, or an mp3 player, whose fit and function can be ascertained by a layman, and which can be worn or used safely by virtually anyone.
Using an improperly made hearing aid, or even a properly made one that isn't specifically prescribed for you, would certainly cause you harm, including potentially irreversible nerve damage, and hearing loss. And a layman, end-user, who bought one over the counter, is not qualified to determine whether it is functioning correctly, or appropriately for his hearing deficit. It could be producing levels at certain frequencies that cause long-term damage, and he would never know it, until it was too late. So, it is absolutely in no way analogous or comparable to a pair of track shoes, or an mp3 player.
A hearing aid is obviously a medical device, and correctly regulated as such, in my opinion, because it must be dispensed properly, and must perform correctly, or it can cause serious adverse health effects for its user.
The argument that the hearing aid market is too small for mass manufacturing doesn't hold water.
There are around 30 million americans with total hearing loss and only 25% of them have hearing aids (www.hearingcentral.com/HearingAidOpportunities.ppt).
The causes indicated are:
In any case, market size does not justify the premium prices.
I'm a Programmer. That's one level above Software Engineer and one level below Engineer.
If the $4k hearing aid is designed with modern circuits, then I would imagine that it's programable as well. Which means that if something doesn't happen to them, (like you go for a swim with them in), then they should be able to update them later as necessary. As a result, they should last you for another 20+ years, which means that you'll be paying about $200 a year. Unlike a car, you likely wouldn't have to replace it every 5 to 7+ years.
Awk! Pieces of eight. Pieces of eight. Pieces of seven... ERROR: General Protection Fault. [Paroty Error.]
when I can get a very good netbook computer for under $400 why do I need to pay $1,200 per ear for a hearing aid?
Bunch of reasons. Here are just a few:
... you're going to have to save up enough to outbid the insurance companies for a few dozen congressmen.
My wife says one possible reason for why hearing aids are so expensive is because the queen of Transylvania has decreed it.
Ask me about repetitive DNA
My understanding is that they are not able to be mass produced. The components maybe, but the fittings are fitted to the ear canal. To go back to your laptop analogy, it would be like computer manufacturers building each keyboard to fit your fingers exactly. I would think this would increase the cost of your laptop. I'm in the same boat as you though and will probably be complaining about their cost within the next few years. Best of luck...
i thought i had lead poisoning until i stopped browsing at -1
That's fine by me. I also recognize that if I go deaf or blind, I can rely on some support.
I think the GP was talking about the form factor of the electronics, not the earpiece. Really small PCBs with surface-mount components aren't that easy to do in your home workshop.
-jcr
The only title of honor that a tyrant can grant is "Enemy of the State."
I wear a set of Siemens Centra SP's BTE's (http://hearing.siemens.com/uk/04-products/11-centra/02-instruments-features/instruments-features.jsp#bte) .. Cost in Canada per ear:
~2400 for the hearing aid
~675 for fitting (mandated by the gov't)
~80 for the hearing aid mold
~1000 for the extra two years warranty
Total is about 7k for both ears.. The Ontario gov't pays for $500 per ear, so cost to me was 6000. It's my understanding the hearing aid cost in Ontario is set at the cost of the device by the govt, and the fitting agency makes the money on the fitting and warranties.
Ontario gov't will fully pay for a single cochlear implant should I wish to go ahead with it, I've already been approved.. At this point my hearing is still mostly better than a CI would give me (www.compwizrd.com/hearingtest), but should that change I might go ahead with it.
A decent digital hearing aid is much more than just an equalizer.
Mine shifts the higher frequencies down into lower frequencies, and leaves the lower ones alone.. I hear better in the lower frequencies, and almost nothing in upper frequencies, so the hearing aid is programmed to work with that.. if i couldn't hear lower frequencies, but could hear higher, then it should shift everything upwards.
It also amplifies differently according to what the input is.. soft sounds get amplified more, louder very little.. makes it hard to tell exactly how loud something really is, but deals with what i can hear.
Also has wind noise cancelling, feedback cancel, sharp noise reduction(sharp noises get smoothed out so they don't clash).. dual microphones.. it listens behind and ahead of me, and whatever is behind, is subtracted from what's in front, so that i don't hear background noise. telecoil link, remote control.. battery that lasts about 3 weeks.
I could build you a hearing aid for a lot less, but the extension cord may limit you movement somewhat.
I've abandoned my search for truth; now I'm just looking for some useful delusions.
In the US go to a Costco warehouse with a hearing center. It will be cheaper.
I think the way to go is a bluetooth earpiece containing a microphone and speaker, with a ipod sized cpu module to handle the math. The high power cpu part can use AA batteries while the low power earpiece gets watch batteries or rechargables. Might be possible to use transmitted power to run the earpiece, it would save a lot on batteries- especially if the main unit is rechargable. With the way things are going you might even get away with special earphones (on cords), but with the microphones built in as well.
Size Matters
cursethedarkness
Insurance may help in some countries.
Maybe something like this is more up your alley? Granted, they're still expensive (for the higher end models, at least) and likely are not as multi-functional, but they would help in the interim until you could find a job and get something better.
They're all over the place and work really well for hearing conversations in loud areas (conversations at a ball park), so I imagine the utility would be similar for a deaf person.
I grew up with a close (legally) deaf friend. While it may depend on the state, he was able to get a large portion of hearing aid costs paid for by the state. I know there are other services many states provide for deaf/hearing impaired people. Additionally, it is illegal to discriminate against a person with a disability - and being hearing impaired is a disability. (Though, it's also possible you didn't get the job because you were under-qualified, too expensive/expected too much, or some other factor. BTDT.)
~/ssh slashdot.org ssh: connect to host slashdot.org port 22: too many beers
Mod me down or whatever, but the best way to have cheaper hearing aids is to have a cheaper health system overall.
That means....Nationalised...Health...Care...
That's right - the whole nation under one banner, with bulk negotiation rates that bring down drug costs and hardware costs.
Works in the rest of the developed world, so why not try it USA?
I have a similar problem to you. A few years back I purchased some siemens units at a hearing aid clinic. They cost me $5400 for the pair! About 2 months later my dad purchased the same set - from Costco. The part that got me is he paid $2400, literally for exactly the same set! By the way, batteries are about $10 for 30 at Costco as well. Finally, at least if you are in Canada, you can claim them on your taxes as medical expenses.
Government regulation means only a few elite mega-corps can have permission to produce medical devices, and those corps know they'll make more money by lobbying the government for ridiculous sums of tax-victim money. If the market in medical devices was as free as it was in consumer electronics, then innovations would happen just as quickly. Socialism kills - whether directly or by merely reducing your potential life expectancy by a decade or two...
Because they can! My son wears hearing aids and I got him the best available. Insurance on the aids isn't too expensive and they pay off on loss or damage for a small yearly fee. I'm also hard of hearing in my right ear and because of vanity got one of the small in the ear models. I was stuck with it because like ear buds they loosen and whistle and fall out.
Think of how stupid the average person is, and realize half of them are stupider than that.
You can use open source software (GEDA, pcb, etc.) to create custom PCBs that you can get printed pretty cheaply on-demand through a variety of online sites. 2 layer boards are pretty cheap, though 4 layer boards can start getting pricey (though still not horrid). You can then populate the board with SMT components in a toaster oven. Tools for the population: spare toaster oven (don't mix with food), soldering iron with a fine point, syringe with flux and tweezers. A magnifying glass or pair of reading glasses would also be helpful.
You are completyely right, it is rediculous what you are being asked to pay. If you start from scratch you can make a hearing aid for under 100 usd.
You take two of these http://www.donberg.ie/catalogue/semiconductors/semiconductors_b-bc/ba_3812.html
This gives you 5 channels, but combining two can make 10 channel equalizer http://www.electronic-circuits-diagrams.com/audioimages/12.gif
Then you find a chip amplifier like this http://focus.ti.com/lit/ds/symlink/lm158.pdf
And a noise gate http://media.photobucket.com/image/noise%20gate/kupervaser/230.png?t=1233685653
And you could add a microcontroller to add some controls.
It could be a small box you carry with a 9v rechargable battery or mobile phone battery..
The Earpice can be moded from silicon and simple walkman headset..
Medical devises are rediculously expensive
5$ - parts
100$ - engineering
1095$ - litigation expenses.
You can buy reading glasses and hearing aids online for a fraction of the over the counter cost:
http://perfecthearingaids.com/
If you did not think to use Google for this, then you need to have your Geek license revoked...
Excuse me, but please get off my Pennisetum Clandestinum, eh!
...to tape two microphones on your head, and a backpack to carry your stereo. Problem solved.
You pay for the bottom line of the equipment manufacturers: I recall being told by a person who knew that heart pacemakers cost US$ 250 to make, and were sold for US$ 20,000. This did not include the cost of fitting them.
[ http://www.usnews.com/money/blogs/flowchart/2009/08/25/why-health-insurers-make-lousy-villains.html ]
Medtronic (medical equipment): 14.9 percent
Baxter International (medical equipment): 17.5 percent
Covidien (medical equipment): 12.3 percent
I was recently in Egypt where the plastic molding of my digital hearing aid cracked and broke. I went to the local hearing aid specialist who took a new impression and had hearing aid back to me in three days. Cost: 72 Egyptian pounds or approximately US$13. Yes, we do get ripped-off for this kind of thing and I live in Canada too where not everything is covered by government health insurance. But it is not necessarily the electronics manufacturer who is to blame rather the intermediary laboratories and "hearing aid specialists" who all take a nice cut.
Given that everybody nowadays seems to have an IPOD, mobile phone or whatever equivalent device with earphones then hearing aids no longer need to be small an unobtrusive so hopefully we may be able to get cheap ones , maybe even plugged into our IPOD or whatever
If I had better hearing, I could have gotten a job with homeland security, but I could not afford the $1400 hearing aid. some of the newer ones can also do frequency shifting, that is shift from an octave you can't hear down to one you can. If you had good hearing to start with I guess you could possibly hear above the normal human range.....
I will pay $3000 to the first person to provide me with an open-source hearing aid design that I can build from a kit, which meets the following specs:
1) full open source firmware/programming/interfaces
2) secure protocol for updates
3) fab-able in a fablab/hackerspace environment
4) spam filter.. I hate commercials. identify and zero-volume any advertisements
5) control of spamfilter/volume/frequency shifting via bluetooth from smartphone
6) acts as bluetooth headset/microphone
I don't *need* hearing aids, but I have some hearing loss. And I'm not going to pay a whole bunch of money for something which only does half of what I want.
I was going to go ahead and register a domain for this, but I really have other stuff I need to do today. -- hozer at hozed dot org
Welcome to Slashdot, where every insane statement can and will be made about subjects most commentators know nothing about! ;-)
Yes, I post anonymously in order to avoid drawing more attention to myself. Working as an industry insider, I can tell you a few of the things that I have personally observed:
1- Yes, there are cheaper devices, but you really do get what you pay for, in part because:
2- There are between 4 and 6 companies in the industry that effectively control it, making it very hard for the smaller competitors to get their feet in a statistically very small door, and the smaller companies cut corners by implementing devices with larger form factors or less desirable features, and in some cases without investing in any real engineering time, instead packaging off-the-shelf solutions and trying to get them to work without understanding them. This is a real bugbear for me personally as I often find myself supporting such customers.
3- The volume of sales compared to most other industries is comparatively low. While it might be estimated that between 50-65% of people might benefit from the use of hearing aids, it's likely that only 5-10 percent of those people would actually purchase one. The reasons for not doing so vary from I'm not old enough, through to I don't like how ugly the cheaper ones look!
4- Hearing devices are very heavily patented. You can't even deploy a single new algorithm without deriving some or all of it from someone else's patent, and you can bet that every single inventor in the chain gets their piece of the action too.
5- Wholesale prices are therefore quite high, and while I'm sure there is an element of profiteering that goes on (as in nearly any industry), the actual sales volumes per outlet tend to be very low, with a lot of additional support provided without incurring additional charges to the client for the labour.
Having seen the effort on the software/dsp engineering side of things personally, it doesn't surprise me that the costs are high, because it can take anywhere from 12-24 months to create a new device from scratch, and then there is all of the additional testing required in order for the devices to be registered and sold as medical devices, where other government and industry bodies take their cut also.
There is also a very marked difference in the sound quality between the cheaper and more expensive devices. Good quality miniaturised hardware costs money, especially when it has to perform at a comparable fidelity of your favourite hifi system
Salesman: Sir, that hearing aid is $100
Customer: How dare you talk that way about my mother!
Salesman(A Little louder): No no sir. That hearing aid right there is $100.
Customer: I'm not interested in dog collars you idiot!
Salesman: (Shouting at this point, frustrated, and speaking slowly): Five-hundred-dollars!
Customer: That seems a bit high. Alright, I'll take it.
Move to Canada.
Pretty certain you don't actually pay that yourself. You likely have a non-profit organization which can help you. I live in a small town in Illinois which has one that helps people in this area. You probably have something similar near you. Here's a link to give you an idea of what to look for:
http://www.optionscil.com/
Just a note: The people at this organization and similar ones do not directly provide funding to my knowledge. They provide expertise in navigating all the available options. Being a person with a newly diagnosed disability I would be amazed if you already knew of all the different types of funding available to you.
http://www.amazon.com/dp/B000WCBJA6
http://www.soundbytes.com/Merchant2/merchant.mvc?Screen=PROD&Product_Code=HED056
I can build one for you at the same price but it can go up to eleven
The cost break down for a high end hearing aid is:
$91 in components
$800 OEM
$2000 retail
Basically, you are purchasing a relationship with the audiologist and all of your batteries. Moore's law won't help you with digital power because the scaling related leakage. I took a company around the academic business plan competitions last year that looked into hearing aids, and you basically cannot take digital much further unless you get better batteries or some new way to make a cost-effective processor. We are taking the analog signal processing route because you get more processing for the power. If you google around for Audiallo, there should be some of our recorded presentations that breakdown the industry nicely, or you can email me at degs at ece dot gatech.edu and I can send processing/power/cost breakdowns.
Let me add that the environment these aids must endure for that 16 hours a day that you mention is very harsh on electronics. Close to 100% humidity in a crevice of your body that is cleverly designed to repel foreign objects. It's rife with dry skin, body fluids and a mechanical system (jaw movement) that's very good at pushing all those things into the end of the aid. Also, if you're healthy, it's always at least 98.6 degrees...higher if you have a fever.
While I'm sure that there are valid arguments that the medical licensing process, liability, and form factor play a role, the simple answer is that MOST people in the US don't pay for them, their insurance does. Or Medicare. But it's seldom out of pocket, so they feel free to charge way too much. Insurance companies probably negotiate the price down, and keep you from getting the very highest end devices for free, but just like software that's only purchased by large companies, so it costs a great deal, the price sensitivity of the insurance companies is such that they'll bear the freight, and make it up on the other end. Which is to say they will screw all of us.
Another argument for meaningful healthcare reform. Whatever that means.
You'll have to go to an eye doctor to get measured, but you can get good eyeglasses cheap on the internet. Mine happen to be prescription reading glasses, but the prices aren't significantly different for nearsightedness glasses unless you need very heavy correction. Depending on frames, you can easily pay under $10; this time I splurged and spent $20 for fancy titanium ones.
Bill Stewart
New Fast-Compression-only CPR http://preview.tinyurl.com/dy575ks
Yes, as a hobbyist I'm not going to be designing or building any miniaturized earpieces, but for a professional manufacturing job, it's not that hard - compare to Bluetooth headsets which retail for $29, or fancy ones for $100. The audio design is a bit fancier, but it's still a small DSP and software, and you don't need a radio so the power requirements may be even lower.
Bill Stewart
New Fast-Compression-only CPR http://preview.tinyurl.com/dy575ks
I have one digital hearing aid (unilateral hearing loss) that set me back $3178.
I initially thought this was expensive. I think there are a lot of factors that go into the cost though and have since changed my opinion.
First you have the hearing aid itself. Sure it's just a piece of plastic, a couple microphones, a speaker, and some subminiature electronic components that process the sound and amplify it. Maybe you could design such a thing in your garage for less but I'll speak of this more later.
There are R&D costs associated with developing new algorithms and technologies. Even if the technologies exist shrinking them/being able to fit them can't be free. Maybe this is partially an excuse for me to justify why I had to pay such a cost for an amplifier.
Marketing and distribution by the hearing aid manufacturers.
I think the biggest cost is from what happens after you have the hearing aid. Programming and after sale service. After I received my hearing aid I made 6 trips to the audiologist for fine tuning. And I could use more (I'm out of the country so that's not reasonable right now). The $3178 cost included the time the Audiologist spent testing my hearing, discussing options with me, taking a mold, tweaking the fit of the aid physically and then programming. It was a time consuming process.
People of /. are not your average person. So yes a large percentage could potentially design and build a hearing aid.
That would be the exception and not the rule though. Are you building it for yourself or someone else? If for someone else how much do you know about hearing loss and how are you going to tweak the amplification curve for the person's hearing? How are you going to adjust for annoying sounds like silverware hitting a plate or crumpling plastic?
Since I'm out of the country I wanted to be able to program my aid myself. I have an advantage over most since I have unilateral hearing loss I have one good ear to compare the programming to. Even then it's tricky because an aid is only and aid. It's not a cure. I cannot make a program to make my damaged ear be "normal". It's a balancing act between enough information to hear speech and information overload that turns into a muddy mush of unintelligible garbage.
The device that I purchased to program my aid was about $700. Finding the proprietary cables to connect my aid to the programmer was next to impossible. The manufactures of the hearing aids don't provide the cables to the public. They tightly control who is able to get them. They'll provide them for free to the dispensers (audiologist) in hopes that the audiologist will sell their product. Even though there are a number of hearing aid manufacturers, audiologists tend to favor one manufacturer over another.
There are a lot of parties involved in the final product and they all take their cut. I've seen a number of people make posts about insurance paying for the aids. Everyone I dealt with (a couple of ENT specialists and 3 audiologists) were all very surprised that my insurance provider (BCBS) provided any coverage at all. I'm not sure of the reasoning behind it but most providers offer no coverage for hearing aids.
On the surface it's a piece of plastic with some bits of wire and electronics in it. There's more to it to than that though.
I'll try and draw an analogy. I used to be a locksmith. I'd go somewhere and unlock someone's house or car. They'd see me do it (and make it look easy) and say "What the... I paid $50 for that?? I could have done that!!"
My response: "But you didn't"
(Actually I never said that but I always wanted to)
At the end of the day I think it simply comes down to... hearing aids cost as much as they do because consumers are willing to pay that much. What the market will bear.
As an Audiologist, I am well aware of the large margins made in the selling of hearing aids. However, it saddens me when people who would benefit from hearing aids cannot get them because of the prohibitive cost of hearing aids.The cost of hearing aids, and hearing aid prices vary widely, based on multi-factoral reasons, some of which has been discussed in this forum. I believe that a change is needed in the distribution model of hearing aids, and online distribution is the next step on bringing down hearing aid prices. Companies like Blue Sky Hearing (www.blueskyhearing.com.au) are providing such a service. Buying online isn't for everyone, and I still recommend that new users still seek advice from face-to-face consultations with an audiologist. But for experienced users, simply wishing to upgrade their hearing aids, then online purchasing is a viable option.
Hearing Aid Manufacturers are very worried by this trend, as some companies like Oticon, have publicly announced that they will not sell their hearing aids to audiologist who sell online. I believe this behaviour is anti-competitive and maintains high hearing aid prices. We are all consenting adults, and should be given options to how or where one gets their hearing aids. Even public health organisations like the FDA, whose role is to monitor and protect the well-being and health of it's citizens, allows the distribution of hearing aids via the internet, as long a a waiver is signed stating that the client is aware of the risks involved.
I've never tried it, but if you have an iPhone, you can try SoundAMP. It's an iPhone app that uses the microphone and headphones and some signal processing to make a hearing aid.
Much larger than an in ear hearing aid, but, if you already have the hardware, it's much cheaper.
I got a pair of digital hearing aids with really good specs for $900 each. Kit included a pile of accessories. Still not cheap, but I' satisfied. Company: America Hears, in PA. they do business on line. Ask for Susan, Tell them Rogers George sent you. They might remember who I am, and they'll appreciate the wom....
Best wishes, Rogers George
Maybe easier to just buy a set of headphones and plug it in one laptop ? That'll be $480 - inclusive headphones (stereo!) and laptop.
--- I am known for the ones who want to find me on the net. Is that a privacy risk or a privilege? One might wonder..
Why don't you call it OpenEar?
A "noble charity" you create, while giving the death of capitalism thunderous applause.
Asshole.
This is what I could find after a few minutes of googling.
http://www.widexindia.com/Products/Widex%20hearing%20aids/Price%20lists.aspx
For US$ conversion, divide by 50. So approx $200 for the cheapest one but only two channels. The most expensive ones run to $3000.
Ganesan
Not so fast. Hearing aid sales in the United States aone are around 2 million. Add international sales (no need for language localized version :), the relatively slow product cycle, etc. and the prices are hard to defend.
The hearing aid is not an obscure device, and many millions of people will need one. It is also relatively recession-proof.
It appears that the industry both suffers from a lot of regulation but also is, frankly, crooked. See this Wall Street Journal article.
There is software for your iPhone (about $400 also) that can turn it into a hearing aid. It is called SoundAMP and costs $10 http://reviews.cnet.com/8301-19512_7-10281062-233.html
Come to Denmark (any other modern society) and get hearing aids for free through our state-driven Health Insurance. We get free visits to hospitals and doctors too :)
Specifically size, economies of scale/competition, and subjective value (people value restoration of their hearing more than having a teensy weensy computer they can Facebook on).
Go ahead, cram that notebook in your ear. I double dog dare ya...
I'm surprised there hasn't been more mentioned on State Rehabilitative Services. I had to use the Texas one a couple of years ago to get new hearing aids and based on my income level, I didn't pay a dime. There really weren't any requirements, the agency/people wanted to confirm that you were successfully placed in a job for a 3 month period and they were happy.
Did it suck that I had to swallow my pride and get state help? Yes. But it was so worth it.
Also, I haven't seen too many people mention that hearing aids typically need to be replaced every 5 years or so. Or really just the ear mold part because our ears do continue to grow and THAT is the cause of the feedback nowadays.
If the OP opted for a BTE (behind-the-ear) hearing aid, and got the inner ear molded every 5 years or so, you would be out the initial 2-3k for the pair but the molds should only be about $300 a piece. Then the hearing aid should last you quite a long time, barring any other loss over time. If your hearing is still going down, get the most powerful one you can today, and you should still be able to bank a few years with it.
And - find an Audie that doesn't charge for sittings, tests, cleanings and other crap. I've known my audie for 15 years and he never charges for any of that. He's a decent human being that really wants to help others.
As a Coward, I strongly recommend looking into American Sign Language. The Deaf community is very welcoming and supportive and you may find a expertise in your field and being able to communicate with the deaf and hard of hearing.
Be well, as we are all temporarily able.
If you look up VESID = Vocational Education Services for Individuals with Disabilities you may be able you get 100% funded hearing aids from the State you live in like I did a few weeks ago. I am wearing brand new Phonak Digital Hearing Aids that was completley paid for by VESID. So inquire. It may take a few months to get them.
A hearing aid is specifically designed, manufactured, marketed, and dispensed, for one and only one purpose:
That sounds impressive but doesn't actually mean anything.
to treat a human disease.
Most hearing loss is due to age or physical injury, not disease as such. Just like legs and feet.
It is not intended to be used, nor can it safely be used, by people with normal hearing.
Exactly like shoes of the wrong size or fit.
By its very nature, it modifies the function of the human body.
Like any personal effect, including shoes.
It is not in any way comparable to an article of clothing, or an mp3 player, whose fit and function can be ascertained by a layman
It is directly comparable actually. Laymen are perfectly capable of determining whether something is too loud or not. Just like earbuds.
and which can be worn or used safely by virtually anyone.
Like properly designed hearing aids, shoes and earbuds.
Using an improperly made hearing aid, or even a properly made one that isn't specifically prescribed for you, would certainly cause you harm, including potentially irreversible nerve damage, and hearing loss.
And improperly designed or fitted shoes and earbuds listened to too loudly can do the same.
And a layman, end-user, who bought one over the counter, is not qualified to determine whether it is functioning correctly, or appropriately for his hearing deficit.
Of course they are. Your so-called expert is just recording what the "layman" patient is telling them when they do a hearing test.
A layman is perfectly capable of doing a self-administered computer based hearing test, answering a few multiple choice questions, pressing a button and having a hearing aid programmed with the appropriate response curve. Or failing that just have off-the-shelf hearing aids with adjustable sensitivity with frequency response curves typical for various categories such as aging or music loss.
It could be producing levels at certain frequencies that cause long-term damage, and he would never know it, until it was too late.
It could be. That's why you don't design them that way. Same as shoes and earbuds.
So, it is absolutely in no way analogous or comparable to a pair of track shoes, or an mp3 player.
Actually it is. You haven't given any reason to say otherwise.
A hearing aid is obviously a medical device, and correctly regulated as such, in my opinion,
Not really in my opinion.
because it must be dispensed properly,
Which is a fancy way of saying "sold"
and must perform correctly, or it can cause serious adverse health effects for its user.
Just like shoes or ear buds.
Face it, the markets for hearing aids (and glasses also) as currently structured are just a racket. "Specialists" add a tiny amount of value by optimizing hearing aid fitting in ways impossible for a mass market item however they charge like a wounded bull for that privilege. I wouldn't mind but in addition engage in what should be wholesale anti-trust to block real competition and a mass market developing.
---
"I know that most men, including those at ease with problems of the greatest complexity, can seldom accept even the simplest and most obvious truth if it be such as would oblige them to admit the falsity of conclusions which they have delighted in explaining to colleagues, which they have proudly taught to others, and which they have woven, thread by thread, into the fabric of their lives." --Leo Tolstoy
I've done a bit of work in hearing aid development (master's), and there are a few issues that make them so expensive. Most decent (digital) hearing aids are not just simple audio gain. Aside from possible loss from occlusion (which can be fixed surgically) hearing loss normally doesn't happen in all frequencies equally. Sometimes you can get away with a simple gain hearing aid, but it's not really matching what your loss is. As mentioned above, the gain has to be adjusted in bands, which requires a dsp capable of performing banding and gaining in real time so the lip sync doens't get off. Now, this doesn't seem like a hard task, but have you ever seen the size of the chips they use in hearing aids? Compare the size of a simple BTE aid and the space it has for the hardware. The newer ones are fully hidden, making them less than the size of a finger. If you're ever seen the chips, they're maybe the size of a few pin heads, if that. And, they have no fans to help heat dissipation and the power comes from an unbelivably small battery. It is NOTHING like a computer. If you can fit a computer chip and board in your ear, more power to you, but most people can't.
Not only that, but many digital aids also include noise reduction, because background noise is a big problem - it's amplified directly into your ear. Plus, there's feedback. A hearing aid can be designed to be open, so you need to repress the feedback, or closed, which has it's own problems - ie, it's forming basically an echo chamber in your ear. For example, stick your finger in your ear. Sound strange? Same thing with a closed aid, only now imagine your finger is talking. So there's that, and the sofware development costs that go along with it.
Not only that, but you have to pay a trained audiologist to fit the device physically, and do the appropriate band gain settings and whatever else the hearing aid needs.
Anyway, to sum up, they're expensive because:
- hardware costs - very small size, low power, low heat
- software costs - banding, noise reduction, feedback comp
- audiologist costs
- possible licencing costs (wasn't too involved in that end, so I'm not sure)
...no two people are not on fire.
Disposable hearing aids are very inexpensive. In most states audiologist lobbying groups have pushed through certification to limit competition. Compare the price of hearing aids in Europe to the overpriced models available here. The high price of hearing aids has nothing to do with the national health, insurance, etc. It only has to do with state-level politicians and their need for campaign cash.
I'm not sure why hearing aids are so expensive, but my father recently found out that it is really worth shopping around for them. The place where he had his hearing tested tried to sell him hearing aids for more than three times the price for which the same brand and model was available from a competitor down the road.
I've been slowly losing my hearing for a number of years, and now have an added medical challenge that causes my hearing to fluctuate. I feel your pain....
Keep in mind what goes into the cost when you are pricing hearing aids:
-I can go back to the audiologist at any time and get them cleaned, adjusted, tuned or repaired.
-They came with a total replacement warranty if they ever totally die.
-The lawyers are everywhere.
-It's not really a mass market.
mine are of the $1500.00 variety (each). When giving them a test drive, the audiologist asked if I wanted 'more features'.... It seems that these are the Chevette's of hearing aids. the Cadillac's are $5000.00 per ear.
After 18 months of use I say they are worth every penny.
How little you know. You all refer to hearing aids as a 'medical device.' Yet, most insurance companies do NOT cover hearing aids. Most of the ones that do provide coverage, insure only children and the elderly. And why not the people in between?
Comparing a heart stent's usefulness to a hearing aid? Suppose a deaf person gets run over by a car because they didn't hear it coming? Not to mention the increased stress levels from hearing loss contributing to a heart attack!