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Is There a Hearing Aid Price Bubble?
An anonymous reader writes "The price of a pair of hearing aids in the U.S. ranges from $3,000 to $8,000. To the average American household, this is equivalent to 2-3 months of income! While the price itself seems exorbitant, what is even more grotesque is its continuous pace of growth: in the last decade the price of an average Behind the Ear hearing aid has more than doubled. To the present day, price points are not receding — even though most of its digital components have become increasingly commoditized. Is this a hearing aid price bubble?"
Someone's parents are getting older.
"National Security is the chief cause of national insecurity." - Celine's First Law
This outrageous story will fall on deaf ears
It's absolutely disgusting how expensive these things are. I think it may be worth it to note that the site in question is in the business of selling their own hearing aids, though...
Insurance/Government pays for it. Why not jack up the price?
WHAT?!
I remember my mom and her husband went on vacation and had some trouble with his hearing aid. Basically, he plugged it in to recharge it and the charger burnt out; it could only handle U.S. voltages. The couple staying in the room next door saw the blackened charger sitting in front of their door and asked what had happened. They found the whole thing very strange. They were European, and their hearing aid charger could adapt to any global voltage, and they had never heard of one that worked otherwise. If I remember right, the woman's own hearing aid was also significantly higher-tech than my mom's husband's. It was not only smaller, but it fit deep into the ear canal (I'm not talking about a cochlear implant, this was a hearing aid). The important thing here is that my parents, living in the U.S., had neither seen nor heard of either technology. Their doctor had given them a couple of choices for a hearing aid and they chose the better one -- which obviously wasn't as good as what you could pick up in Europe. I don't know what they paid for the hearing aid, but it seems to me like something funny is going on.
Breakfast served all day!
This.
You're a temporary arrangement of matter sliding towards oblivion in a cold, uncaring universe
and it's a rip off on many levels.
I think 10 years is a fairly OK period for the price of anything to double. If there have been advances in technology, more so.
none
A story about hearing aids that links to the glorified blog of a company that makes...hearing aids?
I'm about ready to join the throng of sardonic malcontents who greet every new story with "This is what we get now that Taco's gone?"
It's just supply and demand. About 1/3 of the people I see on my daily commute have headphones on, and most of them are almost certainly too loud. This has been going on since the walkman appeared in the mid/late 80's, so those early adopters are now leading the pack in early adoption of hearing aids.
I wear hearing aids in both ears, as a souvenir of my time in the Navy back in '72. If my hearing loss weren't service connected I'd have had to buy my own, and there's no way I could possibly have afforded them. As it is, I got them from the VA (The biggest buyer of hearing aids in the USA.) for free. Hearing aids are overpriced because it's a seller's market and health insurance companies are willing to shell out whatever the manufacturer asks. And, of course, if your insurance doesn't cover them, you're stuck with two unpleasant choices: either you pay full retail price or you do without.
Good, inexpensive web hosting
2. It lets them do the "50%" bit. If you shop around and make it clear you are not using insurance, you can get these special deals.
3.None of them are really good enough. So when the technology improves, they keep the price the same and upgrade the quality.
excitingthingstodo.blogspot.com
I'm sure the average American household is well above that.
They may be counting single-occupancy dwellings as "households," but the important part is, probably a great many of the people who require hearing aids are either already on fixed income or are close to retirement.
And if there is a price bubble, the Chinese will be right there to correct it.
TFA claims the ones we're paying $2,000 for are already being manufactured in China for $100. The problem is that a hearing aid is technically a durable medical device. Many people prefer to consult with a professional to get the right model, correct fit, etc., and some states actually forbid hearing aids being sold by mail or by anyone other than a licensed professional. So that kinda puts a damper on the grey market for many people.
Breakfast served all day!
I can't speak for America, but, in England, it is possible to get standard non prescription ones for around £20-£40 that are very good. The basic ones work, and they do work well. The only real difference with the more expensive ones are that they are medically certified. They are nearly always the same specification. That being said, the medical ones usually always are personalised / they take a cast of your ear and are a lot more comfortable. However - even with castings and all, I don't think it is worth the cost! (I do not wear one, I have a friend who does and I had this chat a while ago when I couldn't believe the price!)
An article on how expensive hearing aids are from a hearing aid company that advertises their low costs.
GENERATION 9882463: The first time you see this, copy it into your sig & add a random number to the generation.
Everything has been going in price related to medicine over the cost of inflation, whether it is a hip replacement, basic painkillers, to hospital stays.
They are expensive because people have insurance and the government covers it. Therefore, free money = raising the price as high as humanly possible and expect Bernanke to pay for it by printing more money to Medicaid or having your $800 monthly HMO plan. Patents as well insurre monopolies on all parts so they can charge as high as the sky.
This is one of the biggest reasons why social security is in trouble. Not from hearing aids particularly, but because it is a common practice to price gouge and patent the hell out of everything to raise profits.
If no one had health insurance, I would bet the medical industry would make cheaper products. Alternatively, if we had a socialistic system with price controls where everyone was insured the problem would go away as well. Like that is going to happen with the Tea party in the US.
http://saveie6.com/
While hearing aids (and many other medical items and drugs) are ludicrously overpriced, the article is too shallow to merit the front page of /. - it's around what I'd expect of a USA Today slow news day item if only they didn't have ads from hearing aid manufacturers.
fencepost
just a little off
Why should they lower their prices? The cost to have the device approved by the FDA means that there are few players. All of the players know the game.
Seems like a great opportunity for a blue-tooth headset manufacturer to differentiate their product line. Don't even advertise it as having hearing-aid functionality - if anything promote it as one of those "big ears" gimmicks like in the backs of comic books. If a $100 headset is even just 50% as good as a $5000 super-miniaturised hearing aid, word of mouth will be all it takes for them to being selling like hotcakes within a year.
When information is power, privacy is freedom.
How so? It's fully self-funded, it's solvent through 2036 last I heard, and lifting the tax cap above $106k will fix it permanently.
One day I feel I'm ahead of the wheel / the next it's rolling over me / I can get back on / I can get back on
There is no inflation, according to the Fed. Just don't look at the farm prices which have increased 30% year over year, and never at energy prices. Or technology prices. The government justifies the cost of these new hearing aids as being the same as before because today's hearing aids are _so_much_better. This is called hedonics. So while your wage hasn't gone up at all, your standard of living is being flushed down the toilet. But don't worry the government is printing lots more money for you so that you can wall-paper your house with it in a few years.
Seven puppies were harmed during the making of this post.
I've been wearing the suckers in both ears since I was in 2nd grade due to a high level of conductive hearing loss. I'm lucky that my family can afford them.
I've been approached many times – both domestically and while abroad – by people who needed them, but couldn't afford them. This may make sense in third world countries where people may not have access to more advanced technology, but it makes zero sense in "first world" countries.
One possible reason why the technology is so expensive is that many of the leading companies (Oticon, Phonak, amongst others) are actually in Switzerland and Denmark, and manufacture them -as far as I can tell- in their home countries. Just a thought.
Either way, there should be some kind of government program for these. The Walmart and AirMall (seriously - look at the AirMall catalog next time you fly.) brands just won't cut it if someone has advanced hearing-loss.
And why?
My wife keeps yelling at me to get hearing aids - but I just pretend I don't hear her.
No. Healthcare costs are where they are because the CAPITALISM factor is involved.
With Single Payer Non-Profit, you can expect a 40-50% decrease in total cost to insure. Modeling after Canada's cost/person, a reduction from $1.5TR/250M-people to $1TR/300M-people is possible. That means the 250 million that pay for insurance are paying 1.5 TRILLION a year for shoddy, exclusion rich, insurance when the sum of all Americans, 300 million people, would be paying 1 TRILLION to cover everyone without any exclusions or b.s. trickery.
I've talked to over 40 canadians about how they feel about their single-payer system and NOT A SINGLE ONE agreed with the US-paid-pundits that lie about how canadian's don't like their healthcare. Matter of fact, more than 25% of them laughed when I first asked, knowing that I had been exposed to the US-paid-pundits and required truthful answers.
He said, "The sheriff is near"!
For justice, we must go to Don Corleone
well you pay for the medical professional's advice and consultation outside the already incredible price for the hearing aid, so charging $2000 for a $100 device is really just an incredible abuse of power. This is why for profit medicare sucks.
There are products like this on the market already - I've seen the infomercial.
take out a loan while you still can, and foreclose it when the bubble bursts.
This.
Say what you will about financial motivation, but for-profit healthcare is a morally bankrupt and ultimately self-defeating strategy. I'm fine with the doctors and professionals getting paid, everyone needs a job, but these people should not be greedy middlemen in the sales industry. They're not "adding value", they're double-dipping.
-Billco, Fnarg.com
Just get one on dealextreme for 5 bucks. Even better get a dozen, and pray for one of them not to be DOA.
Here's the Consumer Reports article on hearing aids
http://www.consumerreports.org/health/healthy-living/home-medical-supplies/hearing/hearing-aids/overview/hearing-aids-ov.htm
and here's a Washington Post article about it.
http://www.washingtonpost.com/wp-dyn/content/article/2009/06/22/AR2009062201623.html
Unfortunately it's 2 years old, and the ratings are behind a paywall (CR doesn't take ads, and they've got to pay the bills somehow).
Also unfortunately they only tested hearing aids selling for $1,800 to $6,800 per pair.
They said there's about a 100% markup, so there's room to negotiate.
What I was really looking for, and what I couldn't find, was an article from an audiology journal which rated the low-priced hearing aids. They said that there were $500 hearing aids that were quite adequate for most people.
Can anybody who follows this research help me out with some cites?
As the original topic was hearing aids, which are not covered by most "health insurers" in the US, your rant is pointless. Yes, one has to pay out of pocket to get these and a couple of grands for them is an outrageous amount of money for such simple gadgets.
I was wondering this myself since my grandmother is just about deaf and could really benefit from a pair. At this point they are worth more than their weight in gold or even diamonds. Theres nothing that fancy inside. The better ones are programmed to only amplify the frequencies where your hearing is effected. Its a racket pure and simple with inflated prices like diamonds.
Only the State obtains its revenue by coercion. - Murray Rothbard
If you're old enough, you get the joke.
Weaselmancer
rediculous.
If you think that hearing aids are expensive, consider the cost of cochlear implants. Cochlear implants cost tens of thousands of dollars, the surgery costs nearly $100k, and the external device (like a hearing aid, but a little larger) costs over $10k. That's just for one ear and the hearing quality is like 1/10th of a person with cochlear hair! Plus they only last for about 20 years (including the internal device) depending on the model and some other circumstances. $8k for a hearing aid is a steal.
This is one of the biggest reasons why social security is in trouble.
This is so wrong! You have bought into the shell game and misdirection that so many politicians have been leading. The Social Security trust fund holds over $2.5 trillion. Most of this has been lent to other under funded government projects. That's the problem. We don't want to pay back the the money we borrowed from the Social Security system and instead say the system is broken. It isn't. The systems is fully self funded. We've just been treating the huge Social Security surpluses as a giant piggy bank for so long that we find it easier to say Social Security is broken than pay back the money we stole!
Hm... seems like an opportunity...
well you pay for the medical professional's advice and consultation outside the already incredible price for the hearing aid, so charging $2000 for a $100 device is really just an incredible abuse of power. This is why for profit medicare sucks.
It may be an abuse of power, but I don't know that it's the doctor who's the abuser. Doctors are probably forced to buy everything through "the approved channels" -- they can't just fly someone to China and come back with a suitcase full of $100 hearing aids, and they're probably not even allowed to distribute literature to patients about shopping for a grey market hearing aid on their own. So if a patient has to go to a U.S. doctor, then the patient has to pay the U.S. price.
It is funny, though. My parents, who are fairly Republican and were vehemently against "Obamacare," are already driving to Mexico to fill their prescriptions, where they cost something like 70 percent less. For some reason, my parents cannot see the doublethink of voting against healthcare reform despite the position they find themselves in. I think it's just the paralysis of fixed income -- you're so desperate to protect what you have right now that you will resist any change -- even though, deep down, you can feel the vice tightening around you.
Breakfast served all day!
Unless you lose your hearing in an accident caused by an insured party, odds are good that you're paying for hearing aids out of pocket. Most health insurance, even group plans for large companies, will not pay for hearing aids.
Here's my kind of guy. He sells a hearing aid for under $200.
http://articles.chicagotribune.com/2011-03-09/health/sc-health-0309-hearing-aid-20110309_1_hearing-aid-hearing-loss-hearing-loss-association
Now hear this
When it comes time to crank the volume on everyday banter, there are hearing aids that won't break the bank
March 09, 2011
By Barbara Mahany
Chicago Tribune
In 2007, when the iPhone came on the market, Cherukuri saw reports showing that the phone's components cost an average of $130 to $140. "I started thinking that if you can make a fantastic phone for under $200, I could make a hearing aid that's pretty good for about the same price," he said.
This article also recommends
http://www.hearingaidscentral.com/
which starts at $300.
I never said the doctor was the abuser - simply that the medical professional's advice was not a part of the $2000 cost - that's extra. I said that for profit medicare is wrong, and this is an example of that.
The availability of subsidized hearing aids varies from one state to the next, whether you're talking private insurance, or Medicare/aid. Medicare doesn't cover hearing aids, or regular hearing exams. Most insurance plans cover $1500, at best.
Too many people need hearing aids to spread the cost over a risk pool, so the user is usually covering most of the cost. The major cost center seems to be distribution and sales, with retail about an 800% markup from wholesale. So, I suspect there's a lot of cost that could be wrung out under a more efficient business model.
As an aside, contrary to the whining in on-line forums, Medicare doesn't just pony up whatever a vendor bills for, but what they consider a "fair rate". Hence, health care suppliers stereotypically moan about Medicare "underpayment". Medicare as a whole isn't expensive because the program is spendthrift, it is expensive because they can't ditch customers... except in a wholesale manner via budget cuts.
Luke, help me take this mask off
(1) doesn't control for inflation
(2) doesn't control for the transition from analog to digital that spiked prices in the late nineties/early 2000's
(3) barely touches on the tremendous increase in sophistication in hearing aid technology between then and now
As evidence of point (2), I bought a pair of digital hearing aids in 2001. They were $1,700 apiece. They were also the "low end" of the digital aids. Analog aids would have set me back half the price. Yet the "low end" digital aids from 2001 would be in the middle of the price spectrum TFA mentions.
Moreover, the digital aids now do quite a bit that my 10 year old hearing aids can't do. For example, most new hearing aids allow for multiple settings to get the best mix of uni-directional and omni-directional microphone input for various situations: concert halls, crowded restaurants, lecture halls, etc.
The other thing the article doesn't mention is that I can get my hearing aids "repaired" which basically means they're rebuilt from the ground up for $250 a pop these days. Prices have fallen, considerably for the same technology. What keeps pushing the prices up is new technology that, in most but not all cases, is definitely worth it.
Most of the hearing aids I know of costs from $1100-$3000. Not to say this isn't overpriced, but the article makes hearing aid prices seem much more sensational than they really are. This price range is for the BTE (behind the ear) models- not the super hidden in the canal models. Of course, your desire to hear is more important than your desire to be fashionable, right? People hardly notice BTE aids anyway. I've cycled through several BTE hearing aids in the last 10 years (due to loss or damage); all of them were prescribed by an audiologist. My most recent one, which is two years old, cost $1700.
Seriously. Except for the anechoic chamber in which to run the hearing test, there's nothing too exotic here.
Mostly random stuff.
Not covered by my insurance. And at $5,000, the current loss of hearing wasn't worth the cost.
[John]
Shit better not happen!
"General unchecked avarice" is pretty much a perfect definition of capitalism.
The only thing that would hold that avarice in check is a well-informed market that has a reasonable understanding of the products in the market, knows how to estimate things like cost to produce and profit margins, and actually cares enough to walk away when a transaction isn't a roughly equal exchange of value. I don't care how much government regulation you throw at a market, it won't a be a successful inhibition of that avarice in the absence of an educated market. The producers will always find ways to express their avarice in spite of regulation as long as there are enough Barnum-esque dumbshits willing to pay an unreasonable price.
Notice that I used the word "would": we don't have that well-informed market, and haven't for a long time. Such a market might have existed once before the Industrial and Information Ages, but not since then. Our regulated - socialized - capitalism is a poor substitute for either a true libertarian free market or a genuine Marxian socialist economy, but that mongrel is the best we'll get for now. The species hasn't evolved enough general intelligence for the former nor enough ethics and cooperativeness for the latter. To dream the impossible dream, indeed!
on the other hand where I live they send flyers out to get you to come into doctor X's office cause there is a over abundence of them and their offices are empty. In fact the last doctor I went to for an insurance physical was super happy to have me as their last patient before the closed the doors the next day.
Much like computer shops in the late 90's you cant go 3 feet before tripping on one and frankly there is just not that much demand.
I have a bill here from LabCorp. Price before insurance: $327.60 (for some routine bloodwork.) Price after insurance "adjustments": $14.88. So it's not just that they overcharge, it's that they deliberately overcharge the uninsured who have no idea what anything should cost.
"He who would learn astronomy, and other recondite arts, let him go elsewhere. " -- John Calvin, commenting on Genesis 1
First a disclaimer: in my household we have to buy high-powered BTE every 4 years or so, so I am close to the subject.
So, let's see:
First off, we should discern between medically useful features and convenience features, realizing that there is no sharp line between them. We buy fully digital, high-power BTE aids with complex programming capabilities, and those aids (which are pretty much top of the line when it comes to their intended function, i.e., help the wearer hear as well as possible) do not cost $8000 a pair. Not even close - try about half that. We forego bluetooth (but not FM), a gazillion programs, microscopic sizes the size of a fly head (not available of you are profoundly deaf anyways) and God knows what else for pooling our resources (= $$$) into maximum power and amplification/programming capabilities. I suppose we get the Ferrari, not the Lamborghini, if you wish. A lot of cost goes into stuff you may not need (but may want just as much as you want an iPad you probably don't need).
Second, there is significant markup when you buy retail - because you cannot just buy the aid, you also buy the service to have the aid fitted to you. That cost is never broken out, but you would be surprised how much your audiologist might charge you there. Definitely an eye opener. Seems a bit like a cartel, really.
Third, I will give hearing aid companies that they (at least some of them) do a lot of R&D. As I said, we need to get cutting edge aids, and so far I have seen significant improvements over the years. Now that may change (soon??), thoguh I have to say there is still plenty to be done to make BTE aids better performing. Same goes for convenience, but I do not want to pay that price.
Fourth, there seems to be an uptick in insurance companies to pay for aids (ours has not in the past). At least for children and young adults I think it is flat out a crime not to pay for aids.
Fifth: If you really want to be upset you should ask what the production cost of those aids is, and what the resulting markup is. Would want you to become a maker of BTE aids in an instant. But, fo course, that is where capitalism sort of fails: this is a very high entry market. To play, you need to invest a lot of money and a lot of time. And once you made it, you can fleece (ahem, charge) your customers accordingly.
So, are they too expensive? A lot of them are, but if you are smart about it, you can save thousands of dollars or euros (the story is identical in Europe) and still get the aid you want with full warranty. BTW, I heard they are (much) cheaper in Asia.
I do agree,however, in that I wonder whether the "digital gains" are now starting to peter off, and the main advances will be in software only. Well, I suppose I will find out again next year ...
Do your own thing. And overdo it!
My guess is that those of us who pay insurance, and those of us who carry most of the burden for medicare/aid (in the US, mind you), are doing most of the buying for a lot of the people wearing them.
Good guess! In fact, it's spot on!
But here's the secret: that's how _insurance_ works. You should look into it sometime.
b.g.
The reason hearing aids are so high priced is because there isn't much volume (unit sales volume). Sell as many of them as you sell iPads and you'll see the price come way down. I'll bet total sales of each model of hearing aid is fewer than 10,000 units. When GM sells only 10,000 cars of a model in a year, they look to discontinue it. You have to really mark the cost up to cover research and development, tooling costs and the overhead of the office where the guy checks how much correction you need.
If I used a sig over again, would anyone notice?
What we don't like are the long waiting lists for some surgeries, and in general the unreasonably long ER waiting times. Some affluent people do choose to go stateside and pay for their surgery in order to bypass the waiting list.
One thing that does suck is we don't have enough doctors to go around. I'm not too sure what's up with that, but it is one of the main causes of those long ER delays. In big cities it's not uncommon to wait 4-6 hours for an emergency consult, unless you roll in on an ambulance with a severed limb... Family doctors are also very scarce. I perceive that as a government failure, they're not providing enough incentives for people to suffer through med school. More family doctors = more early prevention = less burden on the hospitals, but since when has any politician bothered with the long term outlook ?
We still have group health insurance, but that's mostly to cover little extras like dental, eyecare and prescriptions, along with certain hospital upgrades - you get a shared room by default, or you can pay extra for a private or semi-private room. Sometimes this privatization works in the patient's favour, sometimes it results in massive industry wide insurance fraud and price fixing. Dental in particular is egregious, as dentists have been steadily hiking their prices to max out everyone's yearly coverage - or else the remainder is "wasted" :P. The last time I went for a cleaning and X-rays, two visits used up $2500 in insurance! Needless to say, I didn't go back to that scammer... but it is a growing trend as the only oversight comes from the dentists' association itself. Self-regulation ? Yeah right!
Eyecare is much more competitive, partly because there are more eye doctors, and also because you can get many basic services in pharmacies and at Costco very cheaply. The specialists focus on edge cases and LASIK surgery, which is not covered by the government nor most private insurance plans. We don't have as much bait-and-switch crap as you cowboys with your $99 LASIK (and $1200 add-ons), I think the latest price was around $400-500 per eye for most cases - about the same as a mid-range pair of eyeglasses so quite affordable.
Despite the criticisms, we're decently healthy and I think most people have good faith in the health system. It has its shortcomings, but the lack of up-front financial niggling means people are more likely to step up when someone is in need. We also don't end up suing each other over medical bills, and for the few cases where we do, it's usually handled by our auto insurance to cover lost wages and incidental costs - not the hospital visit! Less middlemen = more efficiency.
There is no system that can please everyone, but from what I understand of the U.S. healthcare situation, even a shitty "Single Payer" system would be better than none at all. For one, it would take power away from the private insurance companies, who seem to boss patients and hospital staff around like their bitches. It would also eliminate the situation where your insurance suddenly drops you on a technicality (read: because you're unprofitable). This doesn't mean you can't still have private clinics and hospitals if you have the cash, but these would have to go well above and beyond the current standard of quality. That seems like a good thing: decent care for everyone, faster/luxurious care if you're filthy rich... either that, or they will fly to some foreign country and pay their doctors, as is already done EN-MASSE!
-Billco, Fnarg.com
I lived in Canada for 8 years. I paid 100% full price for my medical coverage, which was $60/mo. That $60/mo meant EVERYTHING was free. Yes, everything, even elective surgery if I had a doctors recommendation. Yet oddly I still met many people up there who would say 'I wish we had privatized health care here like the states so I wouldn't have to wait 2 months to have surgery'. Then I would ask them if they'd prefer to be paying $200/mo AND have to pay 20% of the cost to have that surgery in one month. Then I'd bring up families I know here stateside that have to pay $1000+/mo to ensure their whole families and ask how they'd feel about that. After that the $175/mo family insurance ceiling and waiting an extra month for non-critical surgery sounds damn attractive.
Sadly US news and propaganda is very prevalent in Canada and slowly Canadians are falling for the whole privatization is better bullsh*t. It makes me sick.
You really think the doctor is getting that $1900 gross profit. Feh. That goes to the actual middlemen, the insurance companies and the medical supply houses. And most of that goes to the lawyers.
"Thank you Barack, we already know your opinion."
Notice that Barack worked to get exactly the opposite of a single-payer system instituted (namely, more forced payments to private insurance companies). Personally, I would not mind seeing his butt kicked up and down the street a few times for that. You're seeing a certain color as its opposite.
We know where leadership by an anti-intellectual "strongman" who scapegoats minorities and likes boisterous rallies goes
No, most of it goes to the executives. Check the compensation disclosed in the medical sector and compare to net profits of the relevant corporations.
-- IANAL, this isn't legal advice, and definitely isn't legal advice for you. Also, Squee!
An education in medicine is overpriced because existing doctors control how many stutends a meed school is allowed to take.
It's artificially restrected even though the us has less doctors per capita than any developed nation. I'm curious what the hear aid price is in say canada or france.
Wow, sent an e-mail as suggested when clicking on "use classic" banner, and got a fast response that addressed my msg
Nice english, Senator. The FDA isn't the problem. The insurance companies are the problem. They are the ones that get in the way of consumers and producers. The FDA just sets a bare minimum of serviceability for the devices.
with free shipping
http://www.dealextreme.com/p/axon-hearing-aid-v163-4326
Who logs in to gdm? Not I, said the duck.
What about the bionic hearing aid that Lee Majors is selling on TV.
https://www.hearingaidtv.com/
I have no idea how well it works, but $15 is a far cry from $4000
In Soviet Russia, Trojan exploits YOU!
uhm.
how shall i say this politely.
you are a victim of an educational system that has not allowed you to discover the basic, fundamental truths of the world you live in.
before spouting off you 'suspect' and 'guess', how about gathering some evidence?
One thing that does suck is we don't have enough doctors to go around. I'm not too sure what's up with that, but it is one of the main causes of those long ER delays.
What's up with that is that there isn't enough money in practicing medicine in Canada. Most people smart and driven enough to become doctors are also smart and driven enough to make a lot more money doing something else, so they do something else. For those who are in it for reasons other than just money, which includes almost all of the doctors I know personally, there are too many other demands / temptations on their time. Some volunteer at specialized clinics (addiction treatment, etc.), and/or take frequent trips to third-world nations to spend a few weeks providing medical care to people who normally would receive none at all, etc.
For those who can be swayed by money (and there's nothing wrong with that, everybody has bills to pay), there's an everpresent temptation to moonlight doing something else. My own doctor runs a "cosmetic and aesthetic medical clinic" on evenings and weekends. I don't know quite what that means, but I think it involves aromatherapy, which scares the daylights out of me. I have visions of going into his office complaining of severe abdominal pain and hearing him say, "Sounds like your appendix. Here, try smelling this."
But I digress.
A bigger problem for the money-minded doctors (I stress, again, there's nothing wrong with this - few among us would turn down a raise) is the possibility of going somewhere where the system allows doctors to make a lot more money. United States of America, I'm looking in your direction. Because of our publicly funded single-payer heathcare system, the government has a lot of control over how much money doctors make. When the gov. is looking to cut costs, they often hint that maybe doctors are making a little *too* much money, and that may be a good place to cut back on expenses. When they talk like that, some doctors put their resume out (or, more likely, return the foreign headhunter's call) rather than take the pay cut.
Allowing capitalism and competition into the health-care market allows doctors to make a lot more money. There are downsides to that sort of system, yes, but there are upsides as well. One rarely hears of doctor shortages in places where doctors are paid based on market principles instead of socialist principles.
In the U.S. (and lots of other places), people die because they can't afford medical care. Here in Canada, people who could afford medical care die on waiting lists because there aren't enough doctors. I'm glad I don't run a country, because I don't know of a perfect solution to this (and doubt there is one). I think Canada probably should maintain the essentials of its current system but allow privately-paid treatment as well (which is now explicitly illegal), to end the need for medical tourism. I think the U.S. should run screaming from Obama's incoming system, which combines the worst aspects of both. (Buy private medical insurance or be a criminal? Really?)
Will it take a concerted effort on the part of someone to force the industry to bring down prices eg. One Laptop per Child project?
Could anyone explain why in this day and age of awesome signal processing, hearing aids are still crap? My dad has a pair and they still feedback and are virtually useless in even a lightly crowded room of conversing people.
"Consensus" in science is _always_ a political construct.
ignorant baggers who are actually dumb enough to believe that capitalism makes everything cheaper? Their stupidity ir responsible for most of the damage that we need to repair right now.
Hearing aids are a "medical device" and for most patients are paid for, or at least partially paid for, by insurance. As long as a person only has to pay a "$20 co-pay" or similar price that does not reflect the actual market cost of the device, the price will remain inflated.
... hearing aides are pretty damn expensive, and they were 6 years ago, too. I had to start wearing hearing aides in the 6th grade, due to some medical issues affecting my hearing, and they cost around $3,500. The audiologists predicted at that time that I would need to get a new pair around the time I turn 19, and that's not far off as I'm a senior in high school now. I'm really afraid of the price tag when I do have to get new ones.
In big cities it's not uncommon to wait 4-6 hours for an emergency consult, unless you roll in on an ambulance with a severed limb...
We have that in the US too. My medium sized city has a few of the best hospitals in country. Unless you're bleeding severely, giving birth, or having a heart attack you can count on a multi-hour wait at the emergency room. The only different thing from Canada is that patients get to walk out with fat bill. Something minor runs hundreds. Something major costs thousands.
"Liechtenstein is the world's largest producer of sausage casings, potassium storage units, and false teeth."
Capitalism makes things cheaper. Blame something else.
Per capita, the United States spends more money on healthcare than any other country in the world. The country paying the second most is Norway. The US spends 50% more money per capita than Norway. The US ranks 36th in longevity. The majority of countries which have longer longevity than the US have per-capita healthcare costs that are less than half of what the US pays.
Per-capita healthcare costs by country: http://www.kff.org/insurance/snapshot/OECD042111.cfm
Longevity by country: http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy
The idea that capitalism makes things cheaper is *generally* true, but it's certainly not true in all cases. There are plenty of reasons that things can be cheaper or more expensive. In general, people don't want to go cheap with their healthcare, for fear of the repercussions. This makes it a sellers market, even when spending half as much produces the same or almost the same results. And there are plenty of other reasons why US healthcare is so expensive.
I don't know about the medical supply houses, but according to finance.yahoo.com, for profit healthcare plans (i.e. the insurance companies) have an average profit margin of 4.5% compared to average profit margin of 13.2% for medical device suppliers. When the insurance company's contract requires the doctor to write down 30% - 50% of the listed fee, it's not turning into profit for the insurance company, it's a discount that is passed on to the insured in lower premiums.
The problem is that a hearing aid is technically a durable medical device.
That is exactly the problem. Because it is a "medical device" it is subject to a bunch of regulations. One of the things is that the company that manufactures it must meet various FDA regulations for the manufacture of a medical device. Then you have the various state regulations. The overall effect of these regulations is to limit competition.
The truth is that all men having power ought to be mistrusted. James Madison
Medicare pays for hearing aids.
There is no "-1 offended" or "-1 you don't agree with me" mod options for a reason.
Although it's called "healthcare reform", it's only reform in the sense that the form is new. It is not reform in the sense of improvement, it's naked tyranny.
True healthcare improvement would involve things like closing the FDA, ending licensure laws, prohibiting the extension or renewal of drug patents, and removing state restrictions on insurance companies.
A hearing aid is simpler than a radio, and radios can be had for $5 at Walmart. Hearing aids should be even cheaper.
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Er, price bubble? How much was most of the plastic surgery done today compared to years ago?
The cost of a doctorate degree in 1980 vs. now?
Insurance costs? (don't even get me started on the fucking lawyers, but their costs too)
It's called inflation with a healthy dose of capitalism for dessert. You either pay it, or you don't. Hear me? Are you listening? Because those things hanging off your head should be priceless to the average person. Here's a thought that's sickening. Look at the superficial bitch who just had to sport at least a 3-carat rock to be worthy of marrying, which is also commonly referred to as "2/3 months salary" in diamond marketing campaigns. A sparkly rock, or someones ability to hear. Hmmm...Which one should we be bitching about?
I can't imagine that the labor costs even remotely justify even the cash price for these. I just got custom remolding for some canalphones for around $200 dollars. And I know damned well there isn't more than $500 worth of electronics in most hearing aids.
"My head hurts, My feet stink, and I dont love Jesus." -Jimmy Buffett
I used to work for a hearing aid company in IT.
The most expensive programmable digital hearing aid with all the options topped out at around $1200. That's the cost to the hearing care professional. So yeah, that hearing aid would turn around and sell for at least 3 to 4 times that.
Also, the company had an extended warranty that we sold to the hearing care professional. Most of them don't turn around and sell that to the customer. Instead, they pay for it themselves and then when a customer brings a hearing aid back they sent it to us for free to fix and they charged the customer for it. It seemed like quite a nice racket. Especially when you consider they also charge for the hearing checkup, fitting, and all of that other usual crap above and beyond what the hearing aid itself cost.
I'm not sure what the rest of the medical device industry looks like, but it wouldn't surprise me if it was fairly similar. I know the markup on my glasses frames is pretty crazy.
My girlfriend and her sister each got a pair for about $1800 each. Sure, the batteries might die in a week or 2 depending on how much she uses them, but they arent all that expensive. But, I can definitely tell you that, to my girlfirend, they are well worth the cost. And she doesn't even have full hearing loss.
The only thing necessary for evil to triumph is for it to be pitted against a slightly greater evil
In the U.S. (and lots of other places), people die because they can't afford medical care. Here in Canada, people who could afford medical care die on waiting lists because there aren't enough doctors. I'm glad I don't run a country, because I don't know of a perfect solution to this (and doubt there is one). I think Canada probably should maintain the essentials of its current system but allow privately-paid treatment as well (which is now explicitly illegal), to end the need for medical tourism. I think the U.S. should run screaming from Obama's incoming system, which combines the worst aspects of both. (Buy private medical insurance or be a criminal? Really?)
There is also a significant shortage of primary care doctors in much of the USA as well. I recall seeing a statistic a few years back that one of the poor areas of San Francisco, with a population of about 70,000 was served by a total of two or three doctors at a single clinic. Peterborough Ontario at the time (2005 or so?) was one of Ontario's most medically undeserved communities, with a population of about 70,000, and hundreds (thousands?) of people without a primary care physician as there were only a couple dozen in town.
Both countries suffer from the artificial control of the supply of med students - largely set by the medical societies, in addition to the relatively low pay that primary care physicians (the "family doctor") get on either side of the boarder, particularly when compared to specialists of which in some fields I think there is a bit of a glut. Double or triple the number of spots in med school (to say the level per capita they were producing in the 1950s) and some of these issues might be lessened.
Remind me, which countries are scared shitless about current shortages of trained doctors and nurses? It's sure not the US. Why? Because in the US we're willing to pay them for their decade of intense studying and their specialized skill set, where other countries think that they should spend a decade of their life killing themselves in school for the same pay as the guy who went to a two year vocational school and spent half his time drunk with friends.
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants." ~Thomas Jefferson
Wrong. An education in medicine costs a lot because there are very few people in the country with the necessary skills to teach medicine. Doctors only comprise about 0.3% of the US population, and even if every one of them taught, there would still be a scarcity of resources.
But I'd guess you'd rather go with the USSR model and have unqualified people teaching others to be unqualified doctors who'll then cause large amounts of damage due to their incompetence just to get a "cheap" doctor.
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants." ~Thomas Jefferson
This is why for profit medicare sucks.
I dunno, that's the model that's followed in veterinary medicine and their prices are lower, their equipment up to date and the waits are shorter than most human-care systems.
My God, it's Full of Source!
OUTSIDE_IP=$(dig +short my.ip @outsideip.net)
I can't speak to the surgery wait, but in the U.S. we get a 4-6 hour ER wait and a big bill.
Capitalism is the economic aspect of the enforcement of rights (or more simply but less accurately, the existence of freedom). How you can confuse the illegality of unlicensed medical care as freedom is beyond understanding. Tax laws and wage restrictions also drive up healthcare prices, and neither of those is a part of freedom or capitalism.
You clearly have no idea what capitalism is, nor what it implies.
Contribute to civilization: ari.aynrand.org/donate
isn't wanting something cheaper just as greedy as wanting something more expensive?
If I demand a $5 hearing aid how is that less greedy than charging $5k? Value is set by the individuals on both sides of a transaction.
Paying taxes to buy civilization is like paying a hooker to buy love.
Educating people is an exponential growth situation, with every successful teacher producing many more potential teachers. Rampant numbers of unqualified teachers and students are a potential short term problem if the field is very new, but modern medicine is hundreds of years old.
The only possible limitations are a shortage of students, or artificial controls on the growth of the field.
There is also a significant shortage of primary care doctors in much of the USA as well. I recall seeing a statistic a few years back that one of the poor areas of San Francisco, with a population of about 70,000 was served by a total of two or three doctors at a single clinic.
That's a function of the same phenomenon. There isn't enough money in practicing medicine in poor areas, or in places like Canada where artificial price controls keep the price of medical care artificially low. You'll get a few altruistic diehards, but the majority of doctors, like the rest of us, will follow the money.
Both countries suffer from the artificial control of the supply of med students - largely set by the medical societies, in addition to the relatively low pay that primary care physicians (the "family doctor") get on either side of the boarder, particularly when compared to specialists of which in some fields I think there is a bit of a glut. Double or triple the number of spots in med school (to say the level per capita they were producing in the 1950s) and some of these issues might be lessened.
This is an interesting idea, and one that hadn't occurred to me. I don't know anything about med school admissions. If I had mod points today, there'd be an Insightful or Informative coming your way.
I agree, open med school admissions up, and let the market sort this problem out. That raises another question in the short term of where we get the doctors to teach all these new doctors (you can't be in your office treating patients and in the classroom teaching at the same time), but that's relatively minor. And if we wind up with a bit of a glut of doctors a decade later, well, that's a bit of a nice problem to have.
Canada has another problem, although a somewhat understandable one: we don't recognize many foreign medical credentials. I've read too many articles about people who were surgeons in their home country who had to get out when the place fell apart, and are now driving cabs in Canada because their medical credentials aren't recognized here, and won't be until they repeat their training in a Canadian program.
I'm sure that sometimes that's justified, but I think a lot of it is probably protectionism to benefit Canadian medical schools. I could be completely wrong about this, but I assume there's some medical equivalent of the legal profession's bar exam. I think immigrant doctors should just be allowed to "challenge the test", and take whatever exams / tests (I would certainly expect some sort of practical component) are administered to Canadian doctors. If they pass, then they can practice here. If they don't, they can't. That should weed out the quacks and aromatherapists, and let us put the surgeons to proper work.
Just to come back on topic about hearing aids: make them like eyeglasses, where my optometrist will give me a written copy of my prescription, which I can then take to any number of Lenscrafter-type places, who compete on price, to actually get that prescription filled. Once you have the specs for your optimized hearing aid, it should be trivial to order the unit online. Sorry to keep saying it, but it keeps being true: if it's allowed to, the market can sort this problem out.
This is very typical of any and all medical devices. So long as Medicare and private insurers are willing to pay the increased costs they will keep raising them. It's all about the money, not helping the sick.
Not exactly. Obamacare is only the 1st step toward single-payer, which is what he and all the other socialists on Capitol Hill want. Here it is, in his own words: http://www.youtube.com/watch?v=p-bY92mcOdk
in the last decade the price of an average Behind the Ear hearing aid has more than doubled.
A decade ago, a loaf of white bread cost about $0.50, now it costs about $3.00.
A decade ago, a tank of gas cost me $10, now it costs over $40.
I think we've stumbled on to a pattern. Clearly the Illuminati are manipulating bread, gas and hearing aids. If only there was some term for this pattern of "inflating" prices.
When she got it, we were fairly well off - just sold a company and to be frank, I didn't notice how much it cost.
recent problems with it put me on the front lines - and getting a bill for $800 just to fix is gave me a lot of angst. I have to say I railed at the person on the front counter quite a bit considering I know a lot about analog, digital, integrated circuits, and such - and basically told her that IMHO the components she was quoting as retail in the $3000 range were worth about $10 or less.
Then she loaned us an "over the ear" unit while the in-the-ear one was out for repair - and when I went to give it back, said "keep it" - so confirming that the actual hardware cost is trivial (unit is about 3 times the size of the current one but otherwise similar capabilities - and given the progress in IC units, represents maybe 3 years' progress)
So... when I heard an ad on the radio last week for an in-ear hearing aid for $500, I figured "about time" and so the poster is correct - there is a revolution coming.
Question is - what patents will be held over the heads of those trying to break this cartel - because it truly must be a cartel.
Note that I can now (despite the eye-glass cartel of yesteryear) purchase more than useful eye-glasses in various basic diopters at the local dollar store - to the point where I have enough around the house that I have achieve "maxiumum vapour pressure" of eye-glasses (i.e. there is a pair at hand any time/where I need them)
richard
Been there, done that, paid for the T-shirt
and didn't get it
A long time ago members of the American Medical Association wrung their hands about how many doctors there were, and how doctors like them were losing face because competing philosophies didn't kill their patients nearly as often. Bloodletting and Quicksilver (mercury) were the tools of their trade, and anyone who suggested otherwise was a fool.
So, like any competent guild, they started lobbying the legislatures to make competing medical philosophies unable to practice medicine without a "license" from the State.
By the early 1900's, the AMA began the process of weeding out "substandard" medical colleges... But they couldn't do it on their own, so the Carnegie Foundation (which was a proxy for the drug trusts) stepped in to help.
Flexner Report --> closing of 1/2 the country's medical schools --> doctor shortage.
But I'd guess you'd rather go with the USSR model and have unqualified people teaching others to be unqualified doctors who'll then cause large amounts of damage due to their incompetence just to get a "cheap" doctor.
Overtraining doctors makes it easy for them to "miss the forest for the trees"... Like my friend's kid, who had hundreds of thousands of dollars spent on his case, over a 2-3 year period. Just recently his mom, who's been reading and reading and reading, took initiative to start Vitamin A and Vitamin B12 supplementation. And many of the kid's problems started going away. She's rather pissed that the supposed "experts" couldn't figure it out. :)
The Carnegie Foundation made sure that doctors trained in their schools use pharmaceuticals as a first resort (high blood pressure medication, for example), instead of something that you might use temporarily while figuring out the specific cause of the undesired condition.
In the great flu of 1918 (or whenever), conventional doctors turned their hospitals into death wards by suppressing the patient's fever. They didn't even bother to separate flu patients from everyone else.
Osteopathic hospitals were much more survivable... Osteopaths separated flu patients from everyone else, and allowed the temperature as the body's natural response to the pathogen. And their manual treatments helped too.
An excellent history of modern medicine is covered in Steinreich's 100 Years of Medical Robbery.
hth.
Learn the rules so you know how to break them properly.
www.teslabox.com
1 - custom fit? I got 8 different ear moulds for the basic unit - pick one and suffer while my ear adapts
2 - custom frequency response? - Are you telling me that a 1+ GHz processor can't do the math for umpteen different frequency bands and adapt if/when needed?
3 - patents? Digital signal processing has been around for a lot more than 20 years - we used to use the Telebit Trailblazer modem (M68K processor and signal processing chip) back in the mid 1980s - and it broke the audio spectrum down into 256 discreet bands at that time!
So... if you can't afford an in-the-ear unit, someone please do up an ap for the smart phones and bluetooth!
Been there, done that, paid for the T-shirt
and didn't get it
Interesting. I wanted to go see a doctor to make sure my immunizations were up to date. I called about 10 offices and no one could see me within the next three months. Thats here in the midwest.
On the other hand, they have to last for 4-6 years through daily use, sweating, banging, being dropped, maybe going through the washer (yes I'm guilty! That bartender special in New Orleans really fscked me up) and do all of this without being repaired. Technology has to be researched and developed. Also, the price includes the use of the audiologist's time and expertist often up to a year. Still, they are expensive and you either have them or you don't. I've been severely hearing impaired all of my life. I have a bag of old hearing aids. Sometimes I paid for them, sometimes I had to get financial help. I think about the expense of them and the ding they put into my retirement. Still, I'm grateful I have them. I would be pretty much deaf without them.
Have you fscked your local propeller head today?
And costs at Wal-Mart are ridiculously high because the CAPITALISM factor is involved, right?
Hint: More than half of US health care expenditures already come from governments (state and Federal). Federal tax law means that it is cheaper for companies to pay for employees' insurance than to do anything else, and that insulates those price negotiations -- and the associated impact on expenditures -- from consumer feedback. Employees tend to think that they have no input into their insurance options, and negligible impact on the costs, so they might as well milk their insurance for all it is worth.
Which is why you can buy a pair of cheap glasses from lens crafters for FAR less than that. In fact glasses are like any other fashion accessory, the consumer pays more for the name, the perceived style/value and modest exclusivity. You couldn't be more off the mark in your comparison.
If anything you could compare hearing aids to something like excessively expensive audiophile stereo equipment. I'm sure that there are advances made through R&D but the real question is: Is the current march of progress worth continuing? Would the consumer benefit more from slightly better technology or significantly lower costs? If these manufacturers significantly cut their R&D operations or if a start-up business was able to license last year's tech like a "generic" the prices could drop significantly. Ultimately the cost comes down to recouping / funding future R&D, not the actual manufacturing and material costs. There is plenty of room for prices to go down if the improvements made year over year are not worth paying for.
Fear trumps hope and ignorance trumps both
The real driving factor is that the prices are set high and then insurance companies bargain them down somewhat, but not nearly low enough. I had a $200,000 hospital visit to ER and ICU, and the insurance company leveled that down to $48,000 by telling the hospital f$^*- no. Hearing aids should be far less expensive but the American medical $y$tem is quite happy to jack them up.
As someone who looked into making a novel hearing aid system, I'd say prices are driven by an absolute minefield of patents.
It's different because of the motivation.
There's a very slight and subtle difference between "This (necessary item) should cost customers more so I can buy a second Ferrari" and "This (necessary item) should cost me less so I can make my mortgage payment this month".
Am I greedy for wishing that my (required) textbooks cost me less than $1200 a year?
blah blah blah free markets blah blah Milton Freidman! Ayn Rand!! Freedom!
What is the "best they can at their job" mean for an insurance company?
It means achieving excellence in raising prices and not paying claims while simultaneously limiting quantified regulatory and legal liability to an acceptable fraction of revenue.
I think US health insurance companies are very good at their jobs.
One thing you can do, if you have hearing loss (I have ~90% hearing lose in my left ear, yay genetics!)... and perhaps this may not apply to everyone owns personal... taste, especially if you have money and other options and don't mind wasting lots of cash. But their is not a Hearing Aid Price Bubble occurring. This is only a problem if you are very squeamish, but a cheaper solution exists.
If you don't mind looking through the obituaries in your local paper, you can find recently deceased. Give them a couple weeks to get through some of there pain of lose, and then look them up and give them a call. Ask them if their recently deceased was using hearing aids. It seems as people age, many end up needing hearing aids, and more than a few have, REALLY good ones. Explain your own ear issues to them, and how you wouldn't mind giving them some money for them. The lady I contacted was just going to throw her recently deceased husbands hearing aids away, not knowing what else to do with them. Being near deaf in my left ear (never having past a hearing test in that ear), it was a wonderful thing to find.
No, Obamacare is a complete sellout that ensures a single-payer system will never happen.
Note that the linked video has him saying opposite things to different groups of people. (AMA vs. AFL-CIO). So yes, he's a liar. The fact that he sold out any chance at a single-payer system is unforgivable. Just like the rest of his all-appeasement-all-the-time domestic policies.
We know where leadership by an anti-intellectual "strongman" who scapegoats minorities and likes boisterous rallies goes
In the USA, average people are much more exposed to the financial costs of their individual medical procedures (even with insurance, there are deductibles, HSA's, HRA's etc etc) than any other developed nation. The notion of "medical bankruptcy" is preposterous anywhere else, and it is common in the USA.
And yet, US health care costs are much, much, higher for little or no better quality.
And some people say that the reason for this is that average American people aren't taking on enough financial risk with their health care and they should take on more.
Does the empirical evidence support such a conclusion?
My Oticon 380P bone conduction hearing aids costed about $1K and the funny thing is that it is the latest analog model that came out in 1994. Oticon stopped researching and making better ones because they went digital. If I want digital models, then I would have to surgeries due to implants. Frak that. I prefer things to be external, so I can take it off to enjoy being mostly quietness and avoid technical internal problems. Also, being able to cut down loud audio like in loud theaters, concerts, games, parties, fire alarms, etc.!
Ant(Dude) @ Quality Foraged Links (AQFL.net) & The Ant Farm (antfarm.ma.cx / antfarm.home.dhs.org).
It's all a scam. Just search for Hearing Aids in ebay and you'll many for less than $100 from China and they are just as good as the $3000 scam ones. You can buy a lot of batteries for the difference.
Consider that a laptop can be brought for under a $1000 dollars or even a very powerful computer for $3000. Then consider the amount of electronics and materials that are contained in both. Then compare these items with a pair of hearing aids. This is not taking into account that hearing aids may have to be individually fitted and those associated costs with doing so. Starting to get the picture? Regardless of what medical system that is being used either social, or capitalism, the price of hearing aids is just not price gouging, it is not just an exorbitant price for them, but just plain EXTORTION.
Yes, destroy this over inflated bubble once and for all and of course tear it to shreds so that it never grows again.
Kind regards
Slashdotgirl
The more I know, the less I know
Is that, last I checked, the relevant literature doesn't agree on a definition.
PS: I don't reply to ACs.
Call me when you can euthanize grama because her surgery is too expensive.
Chris Mesterharm
The difference between Canadian and US is two very different things. In Canada the FEDERAL government has near to 0 involvement in your healthcare unless you're either a native, live in a very remote place(aka resolute), or you're in the military. Each province is responsible for the healthcare in their province. The most that the feds get involved is ensuring that each province has the same basic level of care.
Now if you live in Quebec, you'll probably get more than someone in Ontario. That reason is simple, Quebec gets an ass load of bribe money to stay in the country, thus can spend an ass load more on people for various things. If you live in Alberta you'll probably see the same, because it's a very rich have province with lots of oil. Ontario up until a few years ago the same thing, now you're seeing a decrease in the level of non-basic care because all the money went poof when the manufacturing sector went away.
Now in the rare event that a province can't afford the care, Newfoundland for example you get equalization payments specific to healthcare. We like our healthcare in Canada, in general. But we sure the hell don't don't do single-payer system here. It's group, at the provincial level. I'll tell you this, my American friends you are fucking dense as a brick if you think Obamacare is a good idea. No one at the federal level should ever determine the level of care. The state or province must always determine it, as they're the best suited to know where and what should be built where.
After all...should some nameless bureaucrat decide a hospital gets built? Or should the person in your state? And the same goes for critical care centres and medical treatment. You *should* be up in arms. Remember the Canadian healthcare act at the federal level can fit on 1 sheet of paper.
Om, nomnomnom...
Add to it the fact that many get hearing aids through health insurance or paid by the government (varies by country) and the issue that there's little competition in the area of hearing aid availability.
Computers and cars - there's a surplus of them, hearing aids not so much.
And each hearing aid needs to get tuned individually which makes it harder to get into the market.
If builders built buildings the way programmers wrote programs, then the first woodpecker would destroy civilization.
Large portions of the U.S. have doctor and nurse shortages.
I don't always use unix-like operating systems; but when I do, I prefer FreeBSD.
Yeah, we're "willing to pay" them. We pay twice as much as any other country for healthcare, and we get crappier results than most of them, "doctor shortage" or not. That's a real free market success story.
Liberty, responsibility and sound economic policy - My ass.
Actually, if in fact hearing aids are overpriced, it's only because of interference in the market by the government, making it more difficult for people to get into the market with regulations.
Thanks for proving my point.
"Osteopathic hospitals were much more survivable..."
Dr. Bob, is that you?
This makes me curious
In your opinion, does the FDA serve no purpose (from a patient/consumer point of view) at all? And if it does, what do you suggesting doing with those purposes?
Just to be clear here, $60/mo sounds a lot like the MSP "Premium" we pay in BC. That's only a small fraction of the cost of health care in Canada. A large percentage of our income taxes go to pay for health care too. We're still way cheaper overall than the US, but we're not at a $60/mo level. Plus, when's the last time a major drug or medical technique was developed in Canada? We should thank the American's for footing the bill for the R&D that we all get to piggy-back off-of.
I wear two hearing aids with DSP processors built in. Let me tell you a little bit about why they are so expensive. The largest supplier of hearing aids in the USA is Starkey in Minneapolis. I've been to the factory, and have experienced the process from start to finish courtesy of the president of the company.
1. Because hearing aids, especially BTE and ITC types use a single cell 1.5 volt battery, which can drop as low as 1.3 volts through its useful operational life, the circuits must be of extremely low power consumption and low voltage. The only chip material that works for this is germanium, which has a diode junction breakdown voltage of ~ 0.3V as opposed to the ubiquitous silicon used in consumer electronics. While germanium was once very common for transistors and some early integrated circuits, it has fallen out of favor in the microelectronics world. There are only a handful of sources and companies now that work with germanium, thus the base price is higher due to this scarcity. You can't just take an off the shelf silicon chip and put it in these aids. Each one is custom designed in germanium.
2. The process of properly fitting a hearing aid is labor intensive. Custom ear molds must be created from latex impressions, and these need to be fitted for comfort. A small variance or burr can mean the difference between a good fitting mold and one that is painful to wear. Additionally, if the mold doesn't maintain a seal to the inner ear properly the hearing aid will go into oscillatory feedback. Sometimes it takes 2 or 3 attempts to get the fitting right.
3. On the more expensive aids, labor is involved in doing a spectral hearing loss analysis of the user's hearing problem, so that the aid doesn't over-amplify in the wrong frequencies. Just throwing in a simple linear amplifier is destructive to the remaining hearing due to the sound pressure levels involved.
4. Construction of aids is done by hand by technicians, especially with the popular ITC (in the canal) aids. At the Starkey company, a technician is assigned to create the aid from the ear mold, fit the chips and microphone/receiver and battery compartment, and connect it all with 32 gauge wire and make sure it all fits in the ear mold. This can be a real challenge, because human ear canals aren't often straight, but bend and change diameter. Imaging a room with a hundred technicians sitting at microscopes assembling these. Each is a custom job. There's no mass production possible and thus none of the savings from it.
5. After the aid is created, then there's the fitting. This process is also hands on. Getting the volume and the audio spectrum match right is a challenge, and audiologists have to have chip programming systems onsite to make such adjustments withing the limits of the aid. Sometimes aids are rejected because the user isn't comfortable with the fitting, and then the aids go back to the factory for either a new ear mold, new electronics, or both.
6. There's a lot of loss in the hearing aid business. Patients don't often adapt well, especially older people. There may be two or three attempts at fitting before a success or rejection. Patients only pay when the fitting is successful. If it is not, the company eats the effort and the cost of labor and materials. Imagine making PC's by hand, sending them out to users, and then having them come back to have different cases or motherboards or drives fitted two or three times, and software adjusted until the customer is happy with it. Imagine 4 out of 10 PC's coming back permanently after trial and error with a customer.
7. Early hearing aids weren't anything but simple amplifiers. Even until the mid 90's there was very little spectral customization. Now many aids are getting features like frequency equalizers and DSP noise reductions that we take for granted in even the cheapest silicon based consumer electronics. Hence, prics has increased with complexity, but there's still the high cost of custom special chips, and lots of labor.
Hearing loss typically isn't uniform for all frequencies -- there can be ranges where you hear quite well, and other ranges where you can't detect anything. A good hearing aid doesn't amplify everything uniformly -- if it did, it would probably contribute to more hearing loss. Instead, they transfer information on the dead frequencies to bands where you hear better, and thus don't have to amplify very much. Of course, such hearing aids must be tuned to your exact pattern of loss, which requires a trained audiologist. Moreover, as another poster pointed out, they can adjust to the characteristics of the external noise, and they are highly miniaturized.
So that they should be expensive than mere amplifiers is not at all surprising.
In my country, the inflated price pays for the 'free consultations' with 'qualified audiologists' (who do indeed have families who must eat, and who must expect many 'free' visits from grumbling oldies in their high-overhead retail stores). Good luck if you buy a used appliance (lots of users die soon): no-one will re-tune it to your frequencies (or to default), no-one will mould an earbud for your own ear. A good direct-sell Swiss product was forced off the market because it challenged the legally-backed scam.
If by "crappier results" you mean "the most advanced medicines and treatments" and "thousands of people fly to the US for surgeries that they can't get in their 'superior' country with government run health care", then sure - you're right.
Not only are those other countries medical systems going broke (the US is not, medicaid and medicare are due to promising people the world and realizing that they can't jack taxes enough to cover it) because they don't pay the full bill and just tack it on to the national debt - but they freeload by using medicines and techniques discovered by US companies, with several of those countries ignoring patent laws and flat out stealing the formulas for those medicines.
But go ahead - fuck doctors and the people researching ways to treat cancer and other diseases in the ass and see how fast they say "Fuck you asshole, you can go die - we quit". Just because you're a greedy little shit who thinks that someone who spent a decade of their life becoming an expert should provide you with everything you want for little to no cost doesn't make them "bad" - it just makes you an ass who, if it wasn't for the Hippocratic oath they take, they'd toss out on your ass to die a painful death.
Jesus christ, take some damn responsibility for yourself and realize that the world doesn't exist to serve your whims. If you want to live in a collapsing society where you don't have to be responsible for yourself, there's plenty of countries in Europe you could move to (well, except you can't because while they yell that the US should welcome illegals with open arms, they heavily restrict immigration to the EU).
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants." ~Thomas Jefferson
And EVERYTHING was way overpriced. The excuse was always the same, small market.
Almost none of the devices were open source, and therefore had VERY limited support for languages. If you don't use one of the top 4 languages you are SOL.
The assumption is that most of the cost is absorbed by the state, and since technologies like this are increadibly vital people will want to spend a lot of money on them (think designer spectacle frames).
By far the sickest thing I found was a man named Kurzweil. His products are INCREDIBLY over priced, and these are products for the blind or with other disabilities. Where do these profits go? He spends millions and millions of dollars trying to extend his own life.
What a sick bastard.
You do realize that things aren't free just because *you* don't pay for them, right?
In big cities it's not uncommon to wait 4-6 hours for an emergency consult, unless you roll in on an ambulance with a severed limb...
The american system does nothing to alleviate this specific issue. We have just as long of emergency wait times, depending on the severity of the illness (a child with a head injury can get in pretty quickly). But in our case, not only do we have long wait lines, we end up with a multi thousand dollar bill when we leave (which may or may not be covered by insurance).
http://www.amazon.com/gp/product/B000RKABHU/ref=pd_lpo_k2_dp_sr_2?pf_rd_p=486539851&pf_rd_s=lpo-top-stripe-1&pf_rd_t=201&pf_rd_i=B001BF70LA&pf_rd_m=ATVPDKIKX0DER&pf_rd_r=072R2NAWYWXWHJMR9QAR
That's a two-fer.
...has always made me uncomfortable. I always get the feeling that the people and companies involved were either selling aluminum siding instead last month or will be next month.
I see even classic Slashdot is now pretty much unusable on dial up anymore.
In America, health care costs so much because it can. It has a (seemingly) bottomless pit to tap from with the insurance companies, and now it's been mandated by the Gubbermint. People-- the consumers of health care-- are not the people who pay. Nameless and faceless and 'inexhaustible' companies pay for health care by the billion. And if they can't afford it the government's good for a trillion or two of Chinese debt. This isn't rocket science people. Market economics. What if the sellers of health care had to bear real, un-artificially-altered market pressures? But I've been smoking again....
Just did a quick check, a top of the range hearing aid will set you back about 2500 euros.
You should be upset that your teachers are willing to cater to the dirty tactics of the publishing industry. You're not their real customer, after all...
On the flip side of the coin, there are lots of people out there who can't "make [their] mortgage payment" even if they aren't being gouged because they haven't learned to manage their money. Wanting something to be cheaper so they can get by is a frequent invalid excuse of the spendthrift.
I won't join Slashcott. OTOH, If Beta goes live, I just won't be back until it's fixed. Sorry Dice.
2500 euro's is about 4000 dollars... 4500 dollars...5000 dollars...5500 dollars... 6000 dollars.
Of course that EU price includes a high VAT and better consumer protection so that also helps explains the lower price... eh what?
If you really want to upset the Americans, mention how socialized obama care means that the standard hearing aids are free and if you want a top of the range one you just pay a max of 500 euro's for it, the base price being covered by your insurance.
America, the land of the silly.
MMO Quests are like orgasms:
You may solo them, I prefer them in a group.
I think Canada probably should maintain the essentials of its current system but allow privately-paid treatment as well (which is now explicitly illegal), to end the need for medical tourism. I think the U.S. should run screaming from Obama's incoming system, which combines the worst aspects of both. (Buy private medical insurance or be a criminal? Really?)
That's how it works in Australia. The public medical system is a mess. For a little while you could get good private care if you paid. Now that's becoming a mess too - the only difference is you end up spending hundreds for every bit of blood work and x-ray they do when they admit you to the ER and you get bills for weeks or months after the visit. Unfortunately I know this first hand.
The reason medical professionals are scarce has as much to do with how medical associations and accreditation is run as the lack of incentive to become a doctor.
These posts express my own personal views, not those of my employer
"General unchecked avarice" is pretty much a perfect definition of capitalism.
You sound somewhat intelligent (at least). I hope you're just being cynical, and haven't drunk the cool aid. Despite what liberal ideologues would have you believe, there is a world of difference between capitalism, and anarchy.
The only thing that would hold that avarice in check is a well-informed market that has a reasonable understanding of the products in the market, knows how to estimate things like cost to produce and profit margins, and actually cares enough to walk away ...Such a market might have existed once before the Industrial and Information Ages, but not since then.
I agree that it would help, but I'm not convinced that it would be sufficient. If we knew that each and every producer of Widget X was ripping us off, and by how much, we wouldn't be able to walk away. If it's electronics, we'd become information hermits. If it's transportation, we'd not be able to get to work and we'd lose our jobs. If it's healthcare, we'd die.
Knowledge driven balanced capitalism relies on the availability of competition. Natural monopolies and inherent high barriers-of-entry prevent this without malice, per se. Some of the highest costs of the medical industry fall into this category. (not hearing aids, granted)
No, what we truly need is the government to work for the people, and not those with the deepest pockets. Regulation should provide meaningful protection to the public (either to their health or their wallets), and not provide artificial barriers-to-entry or cost of doing business. Yeah, I know. I can dream, at least.
I won't join Slashcott. OTOH, If Beta goes live, I just won't be back until it's fixed. Sorry Dice.
They seem to be about £50 in the UK for a rechargeable BTE hearing aid. There are cheaper ones too. Can't folk just get their medical professional to recommend a model and then buy it online themselves (eg shipped from China)?
My wife is getting hearing aids and insurance is NOT covering it. :(
Sorry, but gray text on gray background is making my eyes bleed.
Why do hearing aids need to be regulated anyway? You can buy all kings of headphones/earbuds that don't need to be regulated, What's so special/dangerous about hearing aids?
You're a temporary arrangement of matter sliding towards oblivion in a cold, uncaring universe
Value is set by the individuals on both sides of a transaction.
Yep, but the goal, as I was taught in Business Law 101, is to achieve an equal exchange of value... not PERCEIVED value, but actual value.
I wonder if you really understand the capitalist dynamic very well. A capitalist economy WILL CHOKE AND DIE eventually if rough equality is not maintained in transactions; historically the choking and dying gets cut short by a revolution of some sort. We don't have that equality now, which is precisely why there is an increasing concentration of material resources in the hands of a decreasing number of people. It's an economic version of the plot of Highlander.
But we do - we pay in our taxes. Some people get more because they need more - this is the nature of how insurance should be. Instead, the US has a vast apparatus designed to bilk the policy holder out of payments as often as possible.
Pure capitalism really is anarchy: it's called a black market. There are no rules, no regulations in a black market. Capitalism is a de-scriptive economic system: it's the economic law of the jungle. It's what any and every pre-scriptive economic system reverts to when the prescription fails (e.g. non-Marxian Communism). Pure capitalism is ethically neutral; ANYTHING goes if you can get away with it.
Of course we don't have a pure capitalist economy: we've added multiple layers of pre-scriptive ethics and rules and regulations on top of it, in a desperate attempt to control that anything-goes behavior. Libertarian free market and socialist economies are also prescriptive and not descriptive; the whole point of both is to achieve a consensual voluntary ethic (moreso in socialism) that doesn't naturally exist. Human beings aren't well adapted to either system yet.
From http://en.wikipedia.org/wiki/Garrett_Morris:
Another recurring bit, used in the newscast segment "Weekend Update", involved Morris being presented as "President of the New York School for the Hard of Hearing" and assisting the newscaster by shouting the main headlines, in a parody of the then-common practice of providing sign language interpretation in an inset on the screen as an aid to the deaf viewer.
I listen to both RIAA and non-RIAA stuff if I like the music, tangential business/politics nonwithstanding.
What leads to not enough doctors is two fold:
1. Doctors don't tend to get 'rich' like in the old days (cost of malpractice insurance being a key factor), and that's ignoring the hours most doctors have to put in (cosmetic surgeons working the least btw). If someone works 60 or 80 hour weeks one expects to come home with a nice reward for it (IT has this issue as well).
2. The cost and time it takes to go to medical school. It's very very easy to have huge loan debts in the US (& Canada among others) to get your medical degree (which also factors into number one). This includes the long 1 or 2 years new doctors spend as low paid interns.
Solve these two things you get more doctors. Personally I'd like to see a better path for nurses to become doctors since we pump out nurses like crazy (and their are plenty of jobs for nurses). Nursing training could be layered to add in the things required for an ER style doctor in layers. In a sense we see this already with RN's filling in on doctor's visits and in clinics, but I'd like to see a clear path from the training of the most basic nursing positions to the physician. It would let someone start out in the healthcare field and given say... ten years, advanced from an orderly to the stage of an RN. In 20 years they could be full fledged physicians.
we are all invisible unless we choose otherwise
Or just go down to the local sporting goods store... http://www.basspro.com/webapp/wcs/stores/servlet/Product_10151_-1_10001_9598_425006009_425000000_425006000?cm_ven=bazaarvoice&cm_cat=RLP&cm_pla=9598&cm_ite=productname_link
The US healthcare system is not capitalism. It is a marketplace that has been captured by rent-seeking insurance companies who probably started out trying to do good, but have ended up being leeches. They've run up the price of medical care up so high that nobody (with any money) would dare not purchase their protection.
If you'll do something stupefying for 50hrs a week, consistently, then someone will give you a fistfull of cash. I wonder - if people worked half as much, there would be twice as many jobs and we'd have more time to become informed consumers?
No, the effect is that the manufacture is 100 USD instead of 3. The rest is the stupid healthcare system, low number of doctors and the stupidity of people who should realize that at this price, a round-trip to Europe, including the doctor and hearing aid would be cheaper.
Canada has another problem, although a somewhat understandable one: we don't recognize many foreign medical credentials. I've read too many articles about people who were surgeons in their home country who had to get out when the place fell apart, and are now driving cabs in Canada because their medical credentials aren't recognized here, and won't be until they repeat their training in a Canadian program.
It is an issue in the US as well - in both the US and Canada foreign trained doctors (including those from English speaking high-standards places like the UK and Australia) need to do an internship at a local hospital just like graduates of local med-schools do - regardless of their experience or qualifications (I think they also have to sit for some soft of qualifying exam in order to be eligible for that). Not only doe this add a lot of time to the process - spots for internships for these candidates are in short supply - also artificially in my estimation.
In Ontario recently, the provincial Liberals have suggested that they would provide incentives for new immigrants to be hired by employers - and I think much of the proposal is focused on this type of foreign credential issue. Of course the other parties are jumping all over that and characterizing it as a nefarious plan to steal the jobs of "Canadians" and give them to "Foreigners". I am disgusted by the parties, and the media, constantly fear mongering rather than speaking to the real issues surrounding anything in the public sphere.
If by "crappier results" you mean "the most advanced medicines and treatments" and "thousands of people fly to the US for surgeries that they can't get in their 'superior' country with government run health care", then sure - you're right.
Yet despite this, people on average die sooner here than most other developed countries. You have to look at bottom line results, nut just anecdotes about miracle treatments for a few lucky individuals. The bottom line here is: FAIL.
As you point out, our healthcare system looks like 4-star hotels in Cuba: only wealthy foreign tourists seem to be able to afford it.
>>precisely why there is an increasing concentration of material resources in the hands of a decreasing number of people
Only if you look at percentages. If you look at constant dollars, there is an increasing concentration of material resources in the hands of an increasing number of people.
In other words, if you buy into the liberal talking-point version of history, the middle class reached its zenith in the 50s and 60s, and it's been downhill ever since since then. Reality, however, disagrees.
Seriously, how many companies make them? It could be an effect of that, or just be ( unwritten cooperation ) price fixing between retailers.
---- Booth was a patriot ----
Do you also think you're some how morally superior those people who work for a profit instead of a "wage"? As to stock holders not doing any work in the classic sense you're somewhat correct. However, where do you think the money they use to invest comes from?
Their rich parents.
I think it depends on the cost to manufacture the item. Wanting someone to sell you device for $5 when it costs $1000 to make and you can afford to pay $1000 is certainly greedy. But I don't think its greedy to prefer to pay $1000 instead of $5000 for an item that that only costs $800 to make. I also don't know if it is greedy to prefer to pay $800 for a device when you can only afford to pay $800 but it costs $1000 to make. Especially if you need said item for a medical reason.
President Obama tried other-than-appeasement. Republicans filibustered any attempt at other-than-appeasement.
I edit and mix sound for a living and have done so for 20 years. My hearing slowly degrades and I try to keep it well protected so it doesn't go any faster than it needs to. Apart from that my training and experience is the only thing different from anyone less experienced listener. I've had my share of blunders like a few night at clubs without ear protection. For the last 20 years I've had less than twenty such nights, but it was enough to do some damage, so I've got a drip here and there in my testing curve.
A few years back a friend of mine had a bunch of teenagers in his studio where he records bands. He played them a few test tones. A quarter of them couldn't hear above 15kHz, some even 14kHz. I need to crank up 17kHz very high so I can still hear it, but these kids could hear less than I can now.
Some of them started crying. Some wouldn't believe it. All of them were quite shocked.
If you don't protect your hearing, you'll be a cripple twenty to fourty years earlier than you need to. A pack of one-time use foam protection knobs or whatever they're called where you live is less than a latte at your favorite coffee shop. You just need to handle this in a smart way, read up about it and take comon sense precautions. Or be crippled.
€600 ($820) for a basic device, about €1200 ($1640) for a good device, and up to €2500 ($3420) for a superior hearing aid in Holland:
http://www.hetgehoor.net/info/hoorapparaten-prijzen
http://www.optiekvangorp.be/index.php?id_wp=46&id_ws=1
The US price situation looks like a cartel to me then.
Three reasons:
1. Because you won't get that five dollar hearing aid, but the company will sell a five thousand dollar one. If it's not actually possible to set the price you want, that's not actual practical greed, it's just wishful thinking.
2. Because the people who want the five dollar hearing aid have a real disability which would be cured by the hearing aid, whereas the producer presumably already has a hearing aid if they need it. This is generally seen as being less greedy - it's not so much a matter of I want it for cheap, it's more I need it and it's too expensive.
3. Because people gauge greed based on presumed cost to manufacture vs price asked on the market; if people think it was really cheap to make your product but you're asking five thousand dollars for it, they'll think you're greedy. I mean, how expensive do you think hearing aids are to make these days? It's just a teeny little DSP with a microphone, battery and speaker, for goodness sakes. Sure, it's all miniaturized, but even then I'd have a hard time believing the thing costs more than fifty dollars to make and ship. Of course, people say that it's expensive to comply with FDA regulations, but I really don't think that costs thousands of dollars per unit.
Except when you have a captive market. When you have a product that people need, and a virtual monopoly on the supply chain, you can effectively set the prices at whatever you want, and people have no choice but to pay.
As the adage goes, everything is worth what its purchaser will pay. But that does depend on the purchaser having the choice of paying somebody else for the product if he doesn't like the price you're charging.
That said, $3000 isn't unreasonable for a hearing aid, when you consider the technology and miniaturization that goes into the current generation of them. If you were charging that for a 1960's era over-the-ear hearing aid that ran on a cr2025 and lasted about 6 hours on a full charge, and produced a staticky hissy mess of the sound that was louder, but was crap, then I'd tell you that you were nuts. But even over-the-ear hearing aids are much improved in technology, and considering the patents and regulation involved, that cost is reasonable.
You're kidding, right? Regulations are NOT part of free market capitalism.
And yet regulations are necessary.
So, as I suspected, true free market capitalism is impossible. Thus, a faith-based belief in it as a solution to all problems is irrational and counterproductive.
Pffft. You've got your lies and you're sticking to them. I hope you're very rich, else your ignorance hurts you(us).
Wages have not increased with inflation since the late 70s. Debt is rampant, and few are able to invest as our parents did. Real property and ownership (wealth) is amassed and enforced to the richest, and the wealth disparity among people expands. This is the truth. Lie all you want, but you know you're full of shit.
All of these posts about how your countries give hearing aids to elderly and poor is just rude. If the U.S. was a AAA country we would do it too. Showing off your wealth is lame.
Having to work for a living is the root of all evil.
Finally, for those who note that in countries with socialized medicine, they do not have to pay much for hearing aids, I must point out that they have actually paid more. With higher tax rates than in the United States it is likely they have paid more over time. The difference is that in the U.S., people are able to keep more of their money and odds are, the money that would in a country with socialized medicine be spent on a hearing aid, went to the person's family, car, house, been spent for a vacation, or a whole host of other options.
-Art
The facts take issue with your assertions. The following is lifted straight from http://en.wikipedia.org/wiki/Comparison_of_the_health_care_systems_in_Canada_and_the_United_States with sources in support:
In the United States, the various levels of government spend more per capita on health care than levels of government do in Canada. In 2004, Canada government-spending was $2,120 (in US dollars) per person on health care, while the United States government-spending $2,724
A 1999 report found that after exclusions, administration accounted for 31.0% of health care expenditures in the United States, as compared with 16.7% of health care expenditures in Canada. In looking at the insurance element, in Canada, the provincial single-payer insurance system operated with overheads of 1.3%, comparing favourably with private insurance overheads (13.2%), U.S. private insurance overheads (11.7%) and U.S. Medicare and Medicaid program overheads (3.6% and 6.8% respectively). The report concluded by observing that gap between U.S. and Canadian spending on health care administration had grown to $752 per capita and that a large sum might be saved in the United States if the U.S. implemented a Canadian-style health care system
However, U.S. government spending covers less than half of all health care costs. Private spending for health care is also far greater in the U.S. than in Canada. In Canada, an average of $917 was spent annually by individuals or private insurance companies for health care, including dental, eye care, and drugs. In the U.S., this sum is $3,372.[11] In 2006, health care consumed 15.3% of U.S. annual GDP. In Canada, only 10% of GDP was spent on health care.[5]
So Americans pay more for less care than socialized countries do. The reason is plain to see. There is no free market in health insurance. You only find out it is any good if youre sick, and then you cannot change. The insurance companies self interest is in higher medical costs, because they set their rates by the costs they are under-writing. The HMO alternative incentivises providing no care, since reducing costs improves profitability. And then Americans bring out the rationing bogey man, which is precisely equivalent to an HMO. At Its base, there is no free market method that I have heard of that aligns the financial interest of the health provider with getting someone health care for the least possible cost. There is no cost discipline that comes into the story without it coming into conflict with the patients' interest.
so profit-driven health care costs more, provides less, and places the US at a disadvantage. You know why Canadian auto workers cost less than Americans even when the currencies are at par? Thats right, add up the numbers and you see an employee in Canada costs on the order of 5,000 $ less per year, because non-profit health care costs less.
This peculiarly American all guvimint bad, all private sector good mentality is tantamount to a religious belief. It's ok, I dont expect your truthiness to get the least flustered when face with mere facts.
Speak up son!
If Google really cared they would fix Android Chrome to reflow text, instead of discriminating
Agreed 100%. I'm the same kind of U.S. city and my pregnant wife sat for 2+ hours in the ER waiting room, with a bleeding that left a pool of blood on the floor. The wheelchair she sat on was obviously a biohazard at that point :) Then she had an ultrasound done by an intern who I had to politely advise that she was looking at the bladder. That's at a major academic hospital, mind you. I could do a freaking ob-gyn ultrasound better than her -- admittedly, that's because we would wait for so long in for ob-gyn ultrasounds that I got plenty of time to play with the equipment -- nothing like running a doppler on your brachial artery to pass the time. Eventually you can't but get a hold of it and start to recognize anatomical features. An arm is seemingly more complex than female reproductive organs (to me at least). Every time I'd be told "you're not supposed to touch that". And every time I'd politely answer that "you're not supposed to keep us waiting for 45 minutes either".
In the end, everything was fine - some women bleed while pregnant, nobody knows why (so much for advanced medicine). They should have done an ultrasound, found a viable fetus, and sent us home in 15 minutes tops. I wouldn't count on them catching low blood pressure in time anyway, as my wife arrested in the very same ER, when they restarted her and put a central catheter in, the BP was around 45. That was sepsis, by the way. She walked to the ER in the afternoon, and they managed to almost let her die a couple hours later.
I think that if any one of us has to go to the ER again, we'll shoot ourselves first. That gets their attention, usually
A successful API design takes a mixture of software design and pedagogy.
Ayn Rand would be so proud.
Luckily, you can step out from under taxes in the USA. Just leave the country, and renounce your citizenship.
Consider Somalia as a destination, as they have a general lack of taxes, and very lax borders. The government doesn't interfere with your life at all over there.. and medical care is very cheap.
The real problems are complex, with a bunch of strange pitfalls.
Waving hands and spouting a nebulous ideal is only appropriate in a small circle of people who are passing around a bong.
http://en.wikipedia.org/wiki/File:United_States_Income_Distribution_1947-2007.svg
Damn... it must hurt to be so wrong.
And the reason the price was so high to begin with? Because the hospital knows the insurance company is going to pay a fraction of the cost. Healthcare is broken in this country. I don't know that a government run system is the answer, but what we have now certainly isn't working.
Call me when you can euthanize grama because her surgery is too expensive.
You theory is that because euthanasia is available, surgery is less expensive? Huh?
My God, it's Full of Source!
OUTSIDE_IP=$(dig +short my.ip @outsideip.net)
Medicare pays for hearing aids.
Is that supposed to be a good thing?
For every problem there is a solution that is simple, obvious and wrong.
You can still say you have pure capitalism with basic laws. For example, I can't sell something that I don't own. That is illegal. That law does not interfere with pure capitalism. Truth in advertising laws (sometimes) don't interfere with pure capitalism. Anti-fraud laws (typically) don't interfere with pure capitalism.
Pure capitalism amounts to: You've got stuff; I want stuff; You want to sell me stuff; I want to buy stuff; We work something out, and the government stays out of it. As long as that dynamic is preserved unfettered, you still have pure capitalism.
Now, I'm not arguing that we actually have pure capitalism, nor that we should in every industry. I am arguing that capitalism isn't the boogeyman that certain agendas make it out to be.
I won't join Slashcott. OTOH, If Beta goes live, I just won't be back until it's fixed. Sorry Dice.
A valid point. But the balance is tipped here towards the consumer, as they don't "want" the device, they want to continue to live their life in the fashion they have up to that point, rather than as a deaf person. To capitalize on that need by insisting on a huge profit margin is a lot more easily seen as greedy than the same situation for a luxury good.
Doctors aren't the issue, it's the medical equipment and supply companies and there are few enough of those that collusion IS happening.
upon the advice of my lawyer, i have no sig at this time
Inflation! Inflation! Inflation!
Graphs like that one are completely worthless because they don't account for inflation. Assuming an optimistic inflation of 2% annual, that chart would actually prove you wrong.
I won't join Slashcott. OTOH, If Beta goes live, I just won't be back until it's fixed. Sorry Dice.
I'm not arguing that it is, but the incumbent problem is that we have an economy in which far too many of the transactions taking place are not exchanges of equal value, and if that continues it will ultimately wreck the economy. Before that actually happens we'll wind up with a revolution or civil war. It will be a "class conflict" of the same sort that has happened so many times before, for exactly the same reasons. Marx wasn't wrong in his analysis of the flaws of capitalism, and he correctly identified the problem was not the system itself but Homo sapiens; what he got wrong was his imagined solution that relies on human behavior that simply isn't possible with enough consistency.
Any economic system, regardless of the type or underlying theory, MUST have these equal exchanges of value in order to function correctly. Unequal transactions cause an imbalance that magnifies with time. Without sufficient controls/checks/inhibitors, capitalism allows this to happen. Marxist socialism, being entirely dependent upon voluntary consensual behavior, also would allow this to happen if people don't cooperate. The libertarian free market system also allows it in the same way as our current form of capitalism, perhaps even moreso. So no matter what system we choose this will continue to happen - cyclically - given the nature of human behavior, unless we constantly step in and interfere with the process. So there's no "set it and forget it" economic system, as long as humans remain the marginally social creatures that we are.
in a world where iPlods are common place I don't see why hearing aids have to be small or expensive. A quick and dirty app would give similar functionality to equaliser type hearing aids and it could easily include DIY tuning by playing a series of tones and allowing the user to adjust the levels so that they sound about the same. First person to the patent office wins the prize.
There was an unknown error in the submission.
Yes, and the fact that the US has the worth diet for the typical person and the highest obesity rates has NOTHING to do with a lower life expectancy *rolls eyes*. Give it up man, you have no ground to stand on. Normal people (yes, even those making less than $30,000 a year) get high quality medical care in the US all the time without going bankrupt. Just because some people have shit luck and get something insanely expensive to treat or are too stupid to get insurance (and considering that even McDonald's provides insurance AND that you can buy insurance on your own directly from companies - which I've done before when working a job that didn't provide insurance, so it IS a choice to not have insurance) doesn't mean that there's anything wrong with the system.
Just because you're butthurt that in the US you're (not quite as much anymore thanks to our increasingly socialist government) expected to pay your own bills instead of leeching off someone else and forcing them to pay your bills for you doesn't show a problem with the US - it shows a problem with your laziness and greed.
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants." ~Thomas Jefferson
Reminds me of Winston Churchill: "Indeed, it has been said that democracy is the worst form of government except all those other forms that have been tried from time to time."
Same for capitalism, and for similar reasons.
I won't join Slashcott. OTOH, If Beta goes live, I just won't be back until it's fixed. Sorry Dice.
My guess is that those of us who pay insurance, and those of us who carry most of the burden for medicare/aid (in the US, mind you), are doing most of the buying for a lot of the people wearing them.
You would be wrong. Most health insurance does not cover hearing aids.
They don't grade fathers, but if your daughter's a stripper, you fucked up. --Chris Rock
I've talked to over 40 canadians about how they feel about their single-payer system and NOT A SINGLE ONE agreed with the US-paid-pundits that lie about how canadian's don't like their healthcare. Matter of fact, more than 25% of them laughed when I first asked, knowing that I had been exposed to the US-paid-pundits and required truthful answers.
I think Canadians are trained from birth to love their health care. One of those "if you repeat it often enough it must be true" type of things. If they love it so much, how come my Canadian friends bitch and bitch about it all the time?
One friend had (I shit you not) a broken toe, but refused to seek medical attention because it would have meant a 7 hour wait in the ER just to see someone and she didn't want to take a day off of work. Another's kid had a huge bump on his head, and also refused to seek medical attention for the same reason. Another one is in a huge amount of pain waiting for some type of surgery on his back but is on a waiting list because it's not "urgent". Yet all of them love them their Canadian "free" health care. I can't figure out why. I really really can't figure out why.
They don't grade fathers, but if your daughter's a stripper, you fucked up. --Chris Rock
The problem is that people are not paying for their own hearing aids. If people paid for their own hearing aids, and other health care, then they would object to over pricing and shop more carefully. With the way the system is setup with third party insurance (private or government) paying the costs go through the roof since nobody cares how much it costs, just that they get what they want.
If people have to pay out of their own pocket then the price will drop.
There are also at any time thousands and thousands of animals (I don't even know how many, honestly, but it's an incredible amount) waiting in shelters who are euthanized if they aren't adopted. Sick animals requiring care are euthanized first. The shelters themselves largely exist because of charitable donation, or government support. So not a wonderful system to compare to how we want to treat human beings.
Yes, and the fact that the US has the worth diet for the typical person and the highest obesity rates has NOTHING to do with a lower life expectancy
Part of the job of a healthcare system is addressing those issues before they cause big problems. Once again, in the US we get epic failure at twice the cost of other countries. (We do a great job treating erectile dysfunction, though.)
AND that you can buy insurance on your own directly from companies
You're deluded. Try buying full coverage individual insurance if you or any member of your family has *any* health problems. You can't, because there is NO free market solution for that.
I assume that you support Obamacare, because it does exactly what you want: Make people responsible for buying insurance. Am I wrong?
UC Davis Med Center in Sacramento, CA: typical wait time 9-14 hours. During one exceptionally hot week in July of '07 when I worked there at least one person waited 26 hours to have a dislocated shoulder looked at. It's not better here, it's much, much worse.
Strive to make your client happy, not necessarly give them what they ask for
In fact, someone else in this thread posted a link to a site for FDA approved hearing aids that start at $300: http://articles.chicagotribune.com/2011-03-09/health/sc-health-0309-hearing-aid-20110309_1_hearing-aid-hearing-loss-hearing-loss-association
Hearing aids cost so much for a single reason: it's the price that the market is willing to pay. That article mentions an interesting fact, only 22% of people that buy hearing aids have a health insurance policy that helps with the purchase in any way. In other words, over three-quarters of the people buying hearing aids are buying them entirely out of their own pocket. So what you've got is the market equilibrium price.
Note something else about the above linked article. Those low cost hearing aids (the $300 to $800 dollar ones) are only good for people with mild to moderately severe hearing loss. I'd be more than willing to wager $100 that the Voxom aid is only good for people with a mildly severe hearing loss, if that.
Did you even bother to read the description?
It's in "constant 2007 dollars", which means it is adjusted for inflation.
But good try, though - shame you're completely wrong.
So not a wonderful system to compare to how we want to treat human beings.
What does that have to do with the cost of medical procedures?
My God, it's Full of Source!
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No. America's health system is not capitalist. I don't even have words for what it is. I live in Australia, and while the government does offer health insurance, pretty much everyone is on private health insurance because (shock, horror) capitalism actually works. The health care is great, and private health insurance is not much more expensive than the government option. The American system is a clusterfuck of regulatory capture and perverse incentives. It's a miracle that monstrosity ever worked.
The sum of the intelligence of the world is constant. The population is, of course, growing.
it just shows how inadequate it is as a system. Those that can afford to pay the exorbitant fees get surgery, and those that can't, or weren't a member of a wealthy family, get euthanized. You can't say "well veterinary systems are for profit and they work fine." without taking into account the entire system for ALL of the animals including ones that are sick, abandoned, whose families can't afford surgeries and treatments, etc, not just those few who can afford to pay for either the expensive medical procedures or insurance. If you wanted to compare the two honestly, you'd have to have accept people going without any healthcare, and people being euthanized. Is that the way you want to run healthcare? Because that doesn't sound very humane to me.
So, the disparity in costs, say open heart surgery at $12,000 vs $200,000 is entirely due to the $200,000 (human) cost being used to pay for people who can't afford open heart surgery? I thought that's what Medicare and Medicaid were for.
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We have plenty of specialists, but there are areas of the country with shortages of GPs, mostly because becoming a specialist is the only way to pay off the massive debt incurred to get an M.D. in the first place.
The right to protest the State is more sacred than the State.
no, it also costs in greed. There are a lot of middlemen in the insurance company that have to be paid, then the shareholders have to make a profit, etc. Which is why for profit healthcare is evil.
no, it also costs in greed. There are a lot of middlemen in the insurance company that have to be paid, then the shareholders have to make a profit, etc. Which is why for profit healthcare is evil.
But for-profit veterinary medicine does not have those cost problems. Why would the 'greed' be lacking there?
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I have several points, but yes veterinary care is less expensive because euthanasia is an acceptable alternative to an expensive life saving procedure. How many dogs get quadruple bypass surgery? How many cats get two rounds of chemotherapy? Since the demand is limited for expensive life saving procedures, they don't frequently happen. In fact the really expensive procedures aren't even an alternative because there is not enough of a market to do the research.
Chris Mesterharm
I'm not entirely sure what you're arguing. It's pretty obvious from the state of HUMAN healthcare that there are is a lot of middlemen, greed and abuse involved. That is the point of for profit medicare - to turn a profit. That the US spends the most on its healthcare per capita, but doesn't get the best results is published fact. Your arguments that since treating dogs and cats doesn't cost as much, for profit healthcare isn't evil and detrimental is on its face retarded, and when actually thought about incredibly stupid. I'm talking reality, not some sort of fiction you've invented in your mind. you aren't a furry, are you?
Yes, when the GP is complaining that people who generally need hearing aids can't afford them because they are old and on fixed incomes, i.e. retired and living on Social Security and any savings they have. Medicare, which said people qualify for, pays for the hearing aids. And, remember, many hearing aids are hand made to a custom fit, which is one reason they are so expensive.
There is no "-1 offended" or "-1 you don't agree with me" mod options for a reason.
In fact the really expensive procedures aren't even an alternative because there is not enough of a market to do the research.
You can go to a university medical center and get open heart surgery for your dog if you want to. Here's the first one that shows up on a search.
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It's pretty obvious from the state of HUMAN healthcare that there are is a lot of middlemen, greed and abuse involved.
Right.
That the US spends the most on its healthcare per capita, but doesn't get the best results is published fact.
Sort of, but unrelated to the matter at hand. It's very expensive on average, but it does have the best outcomes at the extreme upper end. That's why world leaders ship to the US for complex care.
Your arguments that since treating dogs and cats doesn't cost as much, for profit healthcare isn't evil and detrimental
I don't understand why this is so hard for you to understand. Veterinary medicine is for profit and it's not evil (pricing wise) and it's not detrimental. Do you disagree with any of that?
Their business model is superior. What's not to get here? It has the outcomes you seem to want without the waste and greed.
I'm talking reality, not some sort of fiction you've invented in your mind.
Reality is the status quo. Are you advocating the status quo or have you invented some sort of alternative in your mind?
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2 things for you. 1) 99th percentile is far more exacerbated, and 99.9th percentile moreso... factors not in your graph but more fitting with our topic.
2) the gap even between the 95th and all others is increased, so I am still correct even when you try to include dentists and doctors (95th) with CEOs and bankers (99.9th, my actual point of discussion).
Eat your foot.
Nice attempt to move your argument, and to ignore both your claims that "Wages have not increased with inflation since the late 70s." and "The graph doesn't include inflation" have been shown to be complete bullshit.
Everyone has been doing better since the 50s and 60s. Everyone. The fact that the rich are rising faster is simply an artifact of the fact that the top 1% of people (the capitalist class) derive their income from corporate earnings (which are not capped on the upside) instead of W2 wages (which are).
You sound like a sniveling liberal born of well to do parents. Not all parents were able to invest as yours may have. There were far more poor in the 50-70s than you let on.
Paying taxes to buy civilization is like paying a hooker to buy love.
why not sell the hearing aid for $50k $500k $5M then?
Ohh yea, cause you're wrong.
If hearing aids are so cheap and easy to make lets get together and start making them. $50 to make each we could sell at $150, still be really cheap and make a killing at it. Wonder why nobody else has thought of this.
Paying taxes to buy civilization is like paying a hooker to buy love.
You can't discern the difference between you and us? My point stands, even if you need to pretend all of our parents had to have investments for me to be right. They don't. They only have to have invested more, just as I said. Eat foot.
The data presented in wikipedia is not robust or in any way representative of actual inflation. I urge you to examine Elizabeth Warren's analysis of the middle class and ACTUAL cost inflations; you may be surprised to find that 40k in 2007 or 1970 (adjusted) has much different purchasing power.
Inflation is twofold. Basing solely on money supply and not actual value in practice is not representative of the situation at hand.
Good luck on waiting for the elites to piss that golden trickle down onto your face.
>>you may be surprised to find that 40k in 2007 or 1970 (adjusted) has much different purchasing power.
CPI is always hard to adjust for. But for things that I care about (computers), I'd much rather be living now than in the 70s, in both price and power.
>>I urge you to examine Elizabeth Warren's analysis of the middle class and ACTUAL cost inflations
I've actually pulled the actual numbers from federal sources. The middle class really is better off now than at any time before by pretty much any measure. And by "now", I mean "right before the current recession".
>>The data presented in wikipedia is not robust
I'm rather disappointed that you would prefer to believe your incorrect beliefs over facts, but that's just how people of a certain political mindset are wired, I guess.
One BIG factor I can show you by phone is housing. Even postv bubble.
http://www.census.gov/const/uspriceann.pdf
You see a 10-fold increase between 1970 and 2010. You inflation adjusted wages aren't even 2fold
>>You see a 10-fold increase between 1970 and 2010. You inflation adjusted wages aren't even 2fold
Do you even know what inflation-adjusted dollars means?
And why comparing it against unadjusted prices, in just one category, accomplishes nothing more than your ignorance of economics?