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Ask Slashdot: Why Are Hearing Aids So Expensive?
solune writes "You can get a tablet these days for a few hundred dollars, and laptops for a few hundred more. Gaming consoles, TVs, and smartphones are all available for under a thousand bucks. Yet, a decent hearing aid for my mom will go upwards of $3000! With ever-shrinking electronic components, better capabilities, and technological advancements, not to mention the rapidly increasing potential user base, I would think quality hearing aids should be coming in a lot cheaper than what we can find. Adding fuel to my fire is that a hearing aid will greatly improve my mom's life — not to mention the lives of millions of others out there. Currently, she suffers from frustration and isolation with having to ask people to 'speak up', and nodding her head to things her kids and grandkids say. We've tried the cheapies, and they're fraught with problems. So, can someone tell me why a hearing aid should be so expensive?"
'nuff said
They aren't a vanity item mass produced for everyone to consume, they are a medical device for people that are going deaf.
on this silly site
About 2 to 4 of every 1,000 people in the United States are "functionally deaf," though more than half became deaf relatively late in life; fewer than 1 out of every 1,000 people in the United States became deaf before 18 years of age.
However, if people with a severe hearing impairment are included with those who are deaf, then the number is 4 to 10 times higher. That is, anywhere from 9 to 22 out of every 1,000 people have a severe hearing impairment or are deaf. Again, at least half of these people reported their hearing loss after 64 years of age.
Finally, if everyone who has any kind of "trouble" with their hearing is included then anywhere from 37 to 140 out of every 1,000 people in the United States have some kind of hearing loss, with a large share being at least 65 years old.
So even at 140, even ignoring those that cannot be helped by hearing aids and those that cannot afford hearing aids, the truth is that far more than 140 out of 1,000 people buy the products you mentioned. If you move a higher volume, you can price them lower and approach their true cost as your design and overhead costs diminish with numbers. What's more is that "a laptop" will more or less work for me the same as it will work for you. We don't need to mold the laptop to put it in our ears or have it tuned to our needs.
You also seem to overlook two factors: as electronics get smaller they get more expensive. The second part is that as electronics need to power themselves and get smaller they get even more expensive. And on top of that, my cell phone puts out a lot of heat. The kind of heat I would not want in my ear. So you have to consider that the battery must be small and must not dissipate tons of heat and so therefore the electronics must have a very low power draw. There's not much of a conspiracy to find here, it's an unfortunate reality that prevents someone from storming the market with the new better cheaper hearing aid (pending tech advancements).
In my family, we look at chipping in to buy our elders hearing aids for presents, I know the nice ones are crazy expensive.
My work here is dung.
Daddy needs a new sports car, and your mum is paying for it.
There needs to be an open source project for this. A non-profit that produces quality hearing aids.
"Oh no, my poor insurance company shouldn't have to pay $3000 for this device. It's too high! I will not buy it!" You don't hear that all that often (no pun intended) so that's why the cost is so high. Econ basics, people. Cost goes up, sales go down. When you factor in "I don't give a crap what it costs, I'm not the one paying for it" that does tend to throw cost off a bit. I know hearing aids aren't as covered as other medical devices, treatments, and prescriptions but they're not 100% out of pocket very often either.
Oh and the million dollars or more in testing to get FDA approval plays a factor. I have a feeling Microsoft didn't even put a million into testing the Xbox 360 lol.
And they can... Medical devices are subject to very stringent standards and testing for approval. They are also tailored to boost some frequencies more than others.
You don't love your mother. If you loved her, it wouldn't matter how much it costs to make her happy.
They're expensive because people will find a way to pay for them. Don't try to make it more complicated than it is.
I think that one of the reasons that they are so expensive is that the quality has gone up so significantly. New hearing aids have bluetooth, rechargeable batteries, they are smaller than ever. and most importantly they can be customized to amplify the precise frequencies that someone is hard of hearing (i think they do 32 bands now). So while the cost has remained similar for 10 years the capability has increased multifold. Also included in that price is a excellent warranty, custom programming and sizing. One may spend several hours getting programmed/fitted so this is part of the huge cost.
Chris
1) Demand is low
2) USA has private health care and to some people hearing aids are not an option
3) The incumbent manufactures use typical monopoly/lobbying tactics to crush any potential competition.
4) Since the incumbent manufactures crush competition through legal means, there is little reason for technical R & D.
Is this really that hard to grasp?
They need to be able to have FDA testing, certification, independent verification of testing, quality assurance and all the paperwork hell -that- involves. The certification needs certifiers to certify that the certification has certificates on the certifiers to do certifications and so on... There is a MASSIVE paperwork rats-nest involved in making ANYTHING that used in healthcare.
It's why healthcare spending is rapidly outstripping the US economy, to be completely honest.
I suspect that the price does not reflect the cost of producing the hearing aid but more the cartel that has established a racket to ensure the highest revenue on each item sold. If you could buy them at Best Buy, the price would come down but most of these are sold through specialty dealers with lots of markup.
The hearing aide companies sell less because of the target number of customers. Plus of those customers, some will either deny or refuse treatment, cutting down on actual "demand" value, raising the cost. Every 13 year old has a smart phone it seems, so they can be sold for less to more people.
HUH? I can't hear you!
Annoying old wife whines: "Does that TV have be so looud"
Eh, what's that? CV have been so howled? Eh?
Your recliner? Eh?
Sore diviner? Eh?
Or vagina.
http://idle.slashdot.org/story/12/06/11/1141253/raunchy-dance-routine-a-pr-nightmare-for-microsoft
Most hearing aids are vastly more complicated than just a volume increasing device. They actually take sounds received on certain frequencies and rebroadcast them on frequencies your mom can hear better on. Thus why they are prescription based like glasses.
Here is a more technical and probably more accurate description:
http://en.wikipedia.org/wiki/Hearing_aid
My Wife just woke up deaf in one a month ago and no hearing aide will help. Get to Dr. fast if you have any hearing issues.
Because they can! Profit $$$$$$$$$$$$
What are you going to do about it?
K Man
All the people that got brought up in the 80s and 90s (and to a much greater extent the 00s and 10s) were raised in the era of portable music players. That means headphones, that means unsafe volumes, that means in 40 years there is going to be an explosion of people who can't hear very well.
As "medical devices" hearing aids must by law be sold by licensed audiologists, and those same audiologists' trade organization lobbies governments at every level to keep up a very tight monopoly control of the marketplace.
FDA regulates their manufacture. Licensing creates barrier to entry to the market. FDA regulations impose strict requirements that drive costs way up.
Hearing aids may be expensive for several reasons: 1. They're often covered under insurance, so there are incentives to keep the retail price artificially high. 2. They involve a lot of labor. Audiologists generally tailor the performance of the hearing aid to the individual user. 3. They're not mass-produced to the same scale consumer electronics are. 4. They bear much more liability potential. If your laptop fails and you lose your Word document, you shrug and replace it. If your hearing aid fails and you don't hear the horn of the car about to hit you, you sue their pants off.
In the UK it's largely because the 'price' includes 'recovery' of all the audiologist's time and overheads which are misleadingly presented as 'free'. Try buying it used, and no one will set it up for you. Cartel point is valid too, similar reason.
Here's an article that attempts to justify the cost:
http://www.aarp.org/health/conditions-treatments/info-05-2011/hearing-aids-cost.html
Overall cost — $3,600
Costs for the manufacturer:
Materials — $360
Research — $1,080
Other retailer costs:
Rent/overhead — $450
Testing/diagnostic machines — $288
Licenses/insurance — $108
Salaries — $540
Marketing — $270
Continuing education/training — $180
Potential profit for the retailer (pretax) — $324
Approximate product cost for retailer — $1,440
I don't know how accurate it is, but I can believe that the actual parts cost of a hearing aid is around $350.?
I don't know where else you looked for hearing aids, but googling "hearing aid" brought up a number of devices in the $200 to $300 range. Hearing aids in the range you're talking about are typically custom made for the user which makes them very expensive. It's not the electronics, it's the labor.
Only $30! IT all depends on the "medical device" classification from the FDA. http://www.msa30x.com/
If you try to buy them outside of insurance, suddenly they offer massive discounts.
excitingthingstodo.blogspot.com
I see a few people walking around with bluetooth headsets. Maybe "invisible" hearing aids are expensive, but another option would be to use(hack) these cellphone headsets, or even use an iphone (there noise cancelling sw built in). People are used to seeing them - just have to convince your mom.
Do a little googling, and you'll find lots of people writing about positive results using Walker Game Ear devices as cheap hearing aid substitutes. They don't have the frequency fine-tuning that medical devices have, but you can give a $200 Game Ear a try, and return it if it doesn't work. Try that with a $3k hearing aid...
http://www.cabelas.com/catalog/browse/hunting-hunting-accessories-hearing-protection-enhancement/walkers-game-ear/_/N-1100132+1000005098/Ne-1000005098?WTz_l=SBC%3BBRprd708259&WTz_st=GuidedNav&WTz_stype=GNU
-- This sig is only a test. If this were a real sig it would say something witty. --
senses opportunity - my lobes vibrate - thinking: DIY hearing aids. They're probably all made in the same damn factory in China. So, buy a crate of the parts and post instructions on how to build them.
Shoes for Industry. Shoes for the Dead.
Tablets, computers, etc., all can be machine-assembled, or assembled by half-way trained manual laborers in a factories that can achieve high throughput by economies of scale, division of labor, etc. And although they are densely packed, personal electronics are still, for the most part, macroscopic. The components in a hearing aid, by contract, have many miniscule components that are assembled very carefully, by hand, by skilled laborers using loupes and microscopes - more akin to watchmaking than assembly-lines. As such, the assembly labor has resisted outsourcing. Plus, the number of units being assembled by any one company (there are many players in the market) aren't large enough to support well-oiled assembly lines running 24-7. Finally, most hearing aids have some amount of customization to each patient (ear-insert moldings for some models, equalization tuning for others), which further increases cost.
Others have mentioned the addition cost associated with it being a medical device, which is not insignificant. Lastly, because many hearing aids are paid for by insurance, rather than out-of-pocket, there is less consumer-driven pressure to reduce costs.
I went in a year or so ago to have my hearing checked and found out my ranges but in general everything checked out as ok.
The doctor said I would benefit from getting a hearing aid due to the loss of hearing in one part of my range (bit higher than it should be but not deaf). She was going through the brochure and showing me the aid, a nice one about half the size of a bluetooth ear set. Her nurse checked my insurance company and it didn't provide coverage for hearing aids but I was still interested in the information.
As she was going through the pitch, she was saying "49" "95" as in $49.95. I'm thinking that's a pretty decent price and said that's not too bad, I'd like the one with the red shell. She didn't have any in stock having just sold the last one but could order one for me. She'd have to have a non-refundable $50 deposit though.
And I'm ..ooOO( 50 buck deposit on a $49.95 item? That sounds weird )OOoo..
So I asked and she said, "no, $4,995.00. You thought I meant $49.95??"
Ahh, no. Sorry. It's not all that bad, thanks anyway :)
[John]
Shit better not happen!
But couldn't we make these more like cell phones? I see a lot
of people walking around with bluetooth headsets. Rather than
making the hearing aide fit in the ear, make it something I can
wear on my belt, or on a lanyard. The problems of size, power
and heat all become easier to solve.
more cowbell
Total scam. That is all.
I know that the price of glasses has fallen in the last few years but they were a total ripoff before and still are if you don't shop around. I mean $200 for lens that cost $5 to manufacture? Come on!
My mom has some hearing loss and I've been thinking for a while of writing a smartphone/tablet application as a poor person's hearing aid. It would use a cheap Bluetooth earpiece and do audio processing in the tablet in her pocket/purse. It would be able to do equalization, frequency mapping, and all that fancy ass DSP stuff that $3000 hearing aids do, except it wouldn't fit in her ear (except the earpiece), it would depend on a remote hunk of electronics (the smartphone) and she'd only be able to use it a few hours without a recharge (that is enough to get her through a day) or use an external battery pack comparable in size to the phone. For $3000 savings it seems worth the nuisance.
The same reason that between myself, my insurance and Medicare AirWay Oxygen has been paid over $26,000 over the past seven years for a machine that costs $2,000; The pain in the ass to get FDA approval (both real and imagined) for a "medical device" prevents many would-be manufacturers from entering the market, and none of the players wants to ruin their golden goose by starting a price war. We used to say the same thing about military equipment when I was an Army Mechanic... In 1982 I couldn't understand at all how the little M151A2 "jeep" cost over $75,000 a pop!! Especially since the assembly lines have been running since 1968 and a lot of the expensive magnesium pieces had been replaced by steel. The adage is the same: "Paint it green and quadruple your profit" or "Paint it white and put FDA on it and quintuple your profits"!
change it.
WHAT??!!
I watch "How its Made" on Netflix, so take my 'expertise' with the appropriate amount of salt, but when creating a hearing aid, the first step is to make a mold of the ear canal. The components must then be inserted into the custom fabricated casement made from this mold.
As soon as you are getting 'custom fit' stuff, it gets expensive.
Find the nearest Lions Club and talk to them. Helping absorb the costs of hearing and sight loss is a large part of how they use the money the raise. If you're in the U.S. look up the state Lions organization rather than contacting individual clubs. Outside the U.S., I'm not sure.
http://www.embracehearing.com/
Just add {In Space!} to anything.
Hopefully fewer hearing aids catch fire then Xboxs.
We should also ask why prescription eyeglasses are so expensive. In the age of computer controlled machinery, it should be both quick and cheap to automatically cut and grind a pair of lenses. But the average set of spectacles will cost several hundred dollars, especially if a strong prescription is required -- and not everyone has optical insurance.
I just bought two state of the art power aids from Costco for 2k, so 1k apiece. They seem to be working just fine for me. They probably would have been 3X the price from a conventional hearing aid dealer
For pretty much the same reason that a small piece of soft foam as a filter for my CPAP -- not magic foam made from unicorn testicles, just bog-standard foam, about 2" square -- is billed to my insurance company at 25.00.(Seriously, due to a paperwork snafu, at one point, I got the itemized bill instead of my insurance company getting it, and it's ridiculous what they charge.) Because they can. (My insurance company, I'm sure, just laughs and pays them a buck, at most, but having the item be "worth" 25.00 is probably a lot of use to accountants at every stage in the transaction.)
Why did a simple ultrasound of my heart, performed by a technician who was not a doctor, not a nurse, just someone who'd completed "Be an ultrasound technician!" at night school, and which took about 15 minutes, cost over $1000.00? No reason. It's a random number. They bill the insurance company, or the government, depending on if you have private health insurance or medicare/medicaid, and then the people they bill pay whatever amount THEY decide to pay for an ultrasound. This doesn't work, of course, if the hospital has to bill YOU -- you have to pay what they ask. Sucks to be you. Or me, when I didn't have insurance.
It's because there's no market control; there's no shopping around; there's no way anyone can (legally) just start making hearing aids and having them sold at Wal-Mart. If eyeglasses followed the same rules, you couldn't buy even a pair of reading glasses without going to a licensed optometrist and paying 250.00, minimum. As it is, I can go to the aforementioned Wal-Mart and try on a few quickly, then pick whatever I like best and walk out having paid less than I'd pay to go to the movies.
Medicare doesn't pay for hearing aids or hearing tests. Carry on with your foaming at the mouth, though.
...and buy a pair of "Hunter's ears". If her loss is broadband, and doesn't require special tuning, the bog standard hunter's hearing assistance device will do what she needs for less than $200 an ear. Mead Killion, the audiologist who started Etymotic Research has written about this problem and has compared off-the-shelf "hunter's ears" with leading hearing aids and, in some circumstances, the hunter's ear was better. As well as a tenth the price. Here's an article from the Wall Street Journal about it.
http://www.youtube.com/watch?v=7wp9tTr2oXk
Pure and simple... economics. There isn't a billion hearing aids sold a year. Compare the number of hearing aids sold to the number of gaming consoles or tablets or any other electroic device. Companies are out there to profit and not just keep the doors open. If you have a staff of 100 and have to keep the doors open selling 100,000 devices a year instead of 100,000,000 how much do you have to charge. I bet you you complain about how much you are paid, but don't realize the economics behind how much you are paid and why and don't care you just want to get paid. Well so does the guy selling you a hearing aid, groceries, gas, tablet, etc. Ohh and you have the government and insurance companies involved in hearing aids... There's your sign.
How difficult would it be to create an android/iphone app to accomplish the same effect with a bluetooth headset? Not very, in fact it should be completely obvious public knowledge to any professional in the field (thus not patentable). Most phones today have the CPU power to filter noise and level volumes. How much would consumers be willing to pay for the app? Would they be willing to wear the bluetooth headsets? How many man-hours would it take to program? For now those answers lean toward making 100s of variations of stupid games instead, but as smartphone and bluetooth adoption grows this may change.
How can you talk about this stuff when Germany is up 2 nil over the Netherlands at the half?
Yep. No market pressures to lower the price. Sucks if you don't have or can't get insurance.
Am I the only one that read this as two completely contradicting statements? Surely, you must see the logic that if there are people forced into paying out of pocket to hear, that there is some market pressure to make lower priced hearing aids!
Not as long as they're a minority. And even then - think about it this way - if you have a 100 patients needing one and only half have insurance... would you still rather sell 50 hearing aids at $3,000 each or 100 at $500 each? Plus it's not like some startup can easily flood the market with cheap alternatives either - hearing aids are Class I regulated medical devices... I can only imagine the amount of bureaucracy that must be involved to obtaining that classification.
Bow before me, for I am root.
hearing aids only cover kids in specific instances only.
As an adult, guess what? Insurance doesn't cover them at all.
2,000 dollars, including 1st Class airfare and our lux 7 night hotel package, and hearing aids....
I work for a company that makes medical devices (but not hearing aids). Even hearing aids must go through clinical trials to prove effectiveness. This means there is a ridiculous amount of documentation during device development and for production. While the component costs are actually very small, the government and insurance overheard is the majority of the cost.
and used a registered account, you could have just copied and pasted all the +5 comments and went from 0 Karma to +1000 in one thread!!!
But no. You had to post as an AC.
Don't sell it as a "hearing aid" - getting around governmental regulations. And provide an application that allows you to "personalize" it to your specific needs (frequency shifting, amplification, etc). You could sell a complete in-ear unit for well under $1000USD, that would make current products look like the throwback to neanderthalia that they are!
MOST insurance policies do NOT cover hearing aides. As a person who's been wearing hearing aides for the last 30+ years, I can guarantee you this. Only if you work for a much larger corporation with a VERY nice benefits package, will you find an insurance policy that will cover your hearing aides - or even a portion of it.
My last pair cost me just shy of $4000. I paid out of pocket since my insurance at the time didn't cover this expense. This is, to date, the second biggest expense I've ever paid, after my car. They were top of the range 11 years ago. I can buy an equivalent model now with the same features from Costco's hearing center now for about $500 each.
Maybe your mum doesn't need the top of the range aides? Try looking for some with fewer features - say only six channels and two or three programs each (one program for normal environment, one for noisy environment, and one for telephone use if she should so desire). You'll save a ton of money.
The other reason why hearing aides are usually so expensive is that not everybody has the same ear shape. All in-the-ear aides are made from a custom mold, which does increase the cost. My dad recently got a behind-the-ear pair that didn't include a custom mold. The tips fit into the canal, similar to a pair of newer earbud headphones. (They still cost him $1200 for the pair though.)
Your mileage may vary. I highly suggest you shop around. Just remember though - you get what you pay for, and always buy the insurance plan on the li'l buggers.
Many states only allow audiologist to sell hearing aids. Most states require that audiologists be state licensed. Many manufacturers will only sell their hearing aids through state licensed audiologists who then charge a premium. In addition, some audiologists will refuse to sell you only one hearing aid and require test costs and follow up costs. In fact, a lawyer in my family challenged his audiologist when she suggested it was state law that he must get a test prior to purchasing a hearing aid and he must purchase two hearing aids and could not purchase only one. He looked up the state code (law) and showed her that was not true, called the manufacturer and finally bought his one hearing aid without a test after signing some bogus document statement the audiologist was not liable. Some people call this a racket. Others think it is justified. In his case he saved $2,500.
http://www.aarp.org/health/conditions-treatments/info-05-2011/hearing-aids-cost.html
For those who think it is a racket they can try some cheaper hearing aids from Costco.
http://shop.costco.com/In-The-Warehouse/Hearing-Aid-Center.aspx
Supply... meet Demand
Searching google patents for "hearing aid" returns 29,600 results. There is no way for anyone to invent a hearing aid that would not infringe on one of the thousands of active patents. That is, unless you buy from a country that doesn't give a rip about US patents.. I would check Alibaba http://www.alibaba.com/showroom/china-hearing-aids.html .
At a $100 you could buy several spares each trip
Hearing aids that you get via your medical providers are tuned for the patients hearing. I purchased the "Symphonix Personal Hearing Device" from RCA for $300. It is a good device with excellent battery life. It is, however, a general sound amplifier and though it works well, it is not tuned for my region of hearing loss, which is the higher frequencies. It has 3 levels of amplification, plus a larger diameter tube that amplifies the sound as well. I can turn down the tv late at night so that the sound doesn't bother anyone else in the house.
clancey
Like any medical device, hearing aids are an important source of income for rich assholes who don't mind screwing over taxpayers and senior citizens.
Look into buying one used from someone who doesn't need theirs anymore.
What I don't understand is why everybody thinks hearing aids are covered by insurance. I have a REALLY GOOD package from my employer which doesn't cover them. No insurance I've had in the last 15 years has covered them. As an aging ex hippie who spent far to many hours at rock concerts I am a prime candidate but superficial research so far says that hearing aids are, one way or another, some sort of scam. There are online outfits that sell aids but you still need an audiogram. So far I have not found any "independent" audiologists. I'm sure there must be some & just need to look harder, but where's the "LensCrafters" equivalent for hearing?
The converse to this, assuming the veracity of the above observation, states that good ones are expensive.
QED.
File under 'M' for 'Manic ranting'
http://www.youtube.com/watch?v=nb-SlbL_cJg
The device has to be custom fitted, custom calibrated, and hand made for each patient. It needs to fit perfectly in your ear. Custom medical appliances are expensive. You can have a cheap one that doesn't really work, or you can put a horn in your ear like in an old cartoon, or you can pay experts (doctors and engineers and skilled labor) to make the right device to cure your problem. It isn't a scam, or a flaw in the market economy.
I just got a new Oticon 380p bone conduction hearing end of last year. It was $1,300! Crazy. I assume it is because they are rare since most are digital these days. I refuse to get an implant for digital hearing aids!
I bought the same analog model back in the end of 2004 and it was about $900. Prices keep going up even for old analog ones. :( This specific model has been around since 1994! You can read more about this in details on http://aqfl.net/node/2320 ... :(
Ant(Dude) @ Quality Foraged Links (AQFL.net) & The Ant Farm (antfarm.ma.cx / antfarm.home.dhs.org).
This! Wearing them myself for the last 30 years and have had the same issues with insurance. The only thing I have ever been able to do is write them off with taxes as a medical expense and/or using a Flex/Cafeteria program if my employer has one.
$1,000 and end of 2005. Stupid brain! So $300 more after seven years! :(
Ant(Dude) @ Quality Foraged Links (AQFL.net) & The Ant Farm (antfarm.ma.cx / antfarm.home.dhs.org).
Comment removed based on user account deletion
Most insurance companies offer no coverage for hearing aids. Either you're covered by VA or you're pretty much out of luck.
As an aside: some of them also have 3.5mm jacks. I busted a buddy of mine once listening to his iPod that way during a really long and boring meeting, but only because I saw him try to switch playlists under the table. I don't know about the Bluetooth.
When it comes to industry questions, I find myself going to Quora first.
http://www.quora.com/Hearing-Aids/Are-hearing-aid-manufacturers-price-gouging
"Tushar Katira, Industry Pro" knocking one /. talking point:
Affirming another:
And a silver lining:
You have to factor in support costs into what you pay. I pay my audiologist one flat fee when I buy my hearing aids. That cost covers fitting, tuning, and all future support. Every time i go back and see my audiologist, I don't pay a dime. I've had my current pair for 10 years and I haven't had to pay him a thing other than the original fee, even though I've probably seen him more than a dozen times.
Well, not exactly a supply and demand issue, unless you are talking about the supply of Funds available.
As soon as you can get a tablet or cell phone covered by medical insurance the price of those items will
go thru the roof as well.
In some markets, the price of goods expands to absorb the available funds, especially when artificial
barriers to entry keep competition to a minimum.
Sig Battery depleted. Reverting to safe mode.
Well, I like to learn lessons like I manage my servers: with massive flaming failures that I neve repeat. :)
I admit that I'm not familiar with USA regulations but if they're anything like here in northern Europe, not getting proper certifications mostly means that the government won't participate in the costs and possibly that they can't be marketed with certain words. Sure, the certification might have a minor effect on price, but if the difference would be massive (e.g., 3000 vs. 1000), it would still be cheaper to buy the one that's not certificated and doctors would still recommend it as an option (even though they might cover their asses with some disclaimer).
Also, if the effect of regulations would be too high, it should be reflected on the prices in countries that require less bureaucracy. If large companies try to cover cost of certification in expensive countries by also rising prices in other countries, other companies should dive in and only operate in countries without too heavy bureaucracy.
Comparing the price of tablet computers to hearing aids is not a like to like comparison. "Cheap" tablets, PCs and laptops all have one thing in common: crapware. Manufacturers are paid by the producers of said crapware to install trial-mode versions of their software in the hopes of getting the end user to pay for the full blown version. Other tablets are subsidized by wireless retailers to get you into a wireless contract where the additional cost of the tablet is hidden in your wireless plan. Maybe if hearing aids came with advertisements pasted all over the exposed end and gave the user a paid advertisement every 15 minutes or so, the cost for those would come way down as well.
These don't look too expensive.
For older generations it's *embarrassing* to show a disability. Also, for them, wearing tech is lame and geeky. Perhaps a few of you remember the days when wearing a calculator on your belt was tantamount to social death (and it probably still is). But wearing a smart phone, well that's different.
Anyway, it costs money to create the teeny tiny packages that the vanity of previous generations requires.
We have to protect our phoney baloney jobs here, gentlemen! We must do something about this immediately! Immediately! Immediately! Harrumph! Harrumph! Harrumph!
about half the cost of a hearing aid goes to the dispenser, basically a commission. Go to Costco. Same and maybe better service, a life time of follow ups, and close to half the retail cost of hearing aids. bernafon and rexton are their out of house brands and both are excellent aids. I have the Rextons... BEWARE: BEFORE you buy any hearing aid, knwo this: you will be tied to the dispenser for the life of the aids, so make sure you know that the dispenser is competent, has good "bedside" manners, and is efficient, and patient. I have been through several types of aids, so I am speaking from experience..
Republican leadership = Idiocracy
Kickstarter, anyone?
Hearing aids don't just amplify the sound they take in, they are specially designed to be able to amplify specific ranges of sound and to be tuned to the wearers specific hearing deficit. Good ones can manage lots of ranges, cheap ones only a couple.
Don't think of those cheapo "As seen on TV" sound amplifiers. Think complete equalizer, high end microphone and high end speaker all rolled into tiny package.
Working in the medical device industry, I can tell you that making a medical device is HIDEOUSLY expensive.
The cost to produce a hearing aid (microphone, amplifier, audio tube, speaker, battery, silicone tip) is pretty tiny. If you were just producing this assembly you would probably be able to crank it out for less than $1000 with a fairly tidy profit margin - maybe as high as $500 (assuming you build them in quantity).
Now onto that cost add the FDA-Mandated record keeping (design history, a history of each device from manufacture to end-user distribution, including records of any time it came back for service/adjustment), performance testing, IEC/UL safety testing (to make sure it won't shock Mom's eardrum, or over-amplify and blow it out), IEC/UL electromagnetic compatibility testing (to make sure it won't cause Mom's pacemaker to go haywire), biocompatibility testing (what if someone is allergic to silicone?) and staff to oversee all of this, and all of a sudden your $1000 device winds up costing the consumer $3000, and you're still only making $500 in profit.
Hearing aids also aren't a growth market: There are only so many people who are hard of hearing and need the devices, and if they buy a good one and they'll keep it for years, so there's not a huge amount of recurring revenue for replacements, so now we need to make enough money off them to coast along until the next person needs to buy one.
Bottom line: Complying with regulations costs lots of money, and the cost of devices are inflated as a result.
Lest someone take this as an anti-government rant, it's not: The FDA regs do serve a purpose, though perhaps said purpose is not 100% appropriate for all classes of medical devices.
Also the FDA is not the only government agency that introduces a price-inflating regulatory burden. Consider these two identical aviation headsets:
http://www.mypilotstore.com/mypilotstore/sep/4680 (Non-TSO)
http://www.mypilotstore.com/MyPilotStore/sep/5284 (TSO)
The key difference between these headsets is a piece of paper. They are materially identical in all other respects.
/~mikeg
Greed.
I wonder, however, if there would be a market for a hearing aid in a bluetooth earpiece form factor with a mic optimized for picking up external sounds and using your cell phone's processor for selective frequency boosting.
my son has hearing problems. The problem is at the genetic level. In my province, the heath care system (which all Quebec resident pays with their income tax) pays for that sort of thing and not me. This is a good thing because my son would own me around 4500$ because it broke around 2-3 times. he's rough with it but what can I say...he's a kid afterall. On the funny side, I own his ass lol. Seriously, what hawguy (1600213) says makes lots of sense. But this is a good question and I will ask my audio prosthesis about this. I only love Quebec about this...the rest, I hate Quebec
Buy from here:
www.americahears.com
Great product, great service, much lower price than from elsewhere since
there is no middleman.
As described here:
The market for these devices is old and stale, dominated by a few key players who have cushy exclusive deals with doctors that allow them to charge exorbitant prices (averaging around $3000), but a year-old startup called Embrace Hearing is beginning to shake things up by selling $300+ hearing aids directly to consumers. They discovered that 75% of Americans who qualify for hearing devices don't actually use one, and the number one cited reason is high price.
I've been through this a few times. It does not always pay, and if it does,
it will not necessarily cover the entire cost.
So, can someone tell me why a hearing aid should be so expensive?"
Two reasons. One is that as others have mentioned, insurance is usually involved so there is less pressure to contain costs. The second and probably more important reason is that the volumes are low. There is a LOT of fixed cost that goes into design, tooling, and production of these units. This has to be recouped over a number of units and if the volumes aren't large enough the price HAS to be high. Given that the state of technology in these things is advancing, I suspect that the fixed costs simply cannot be amortized over sufficient numbers of units to cause a significant price drop.
I actually am an accountant and $3000 for a hearing aid produced in even moderate volumes (like personal computers 20 years ago) sounds like a rational price once you factor in a profit margin. My company assembles custom wire harnesses and many of our products cost hundreds of dollars because the complexity is high and the volumes are (relatively) low.
I'm a very satisfied customer.
Probably the same reason that TI still charges the same rate for graphing calculators today, that have the exact same technology as 15 years ago.
Because they can.
In full Disclosure I have in the past worked for Amplifon, Miracle Ear, Sonus, National, (manufacturers and sellers) along with their respective franchisees.
Hearing Aids are expensive for three reasons:
A: Insurance companies do not normally cover a pair of hearing aids, only one usually. In addition while an audiologist may bill the insurance company for the cost of the hearing aid, the insurance company may only choose to pay 1/10th of the invoice because that is what they feel like paying. I shit you not, they just decide instead of paying the $1000 may only pay $100 bucks. So while the audiologist may have paid the $800 from the manufacturer, they only got $100 from the insurance company. Then the lawyers have to get involved. They start out down -$700 bucks. The last franchise owner I spoke with bluntly stated 50% of his revenue goes to pay bill collectors and lawyers. Despite pulling in one year 5 million in revenue across his franchises he took home a whopping 45k of revenue that year after taxes and expenses with over 1 million in legal fees. So in order to try and actually get paid they may invoice the insurance company $10,000 for the aid, hoping to get $1000 so they maybe can turn a profit.
B: In many states audiologists are licensed medical practitioners and thus required to carry the same insurance a heart surgeon has. The sound booths, Noah compliant equipment, and the standard required medical equipment isn't cheap. That little deal they look in your ear with (otoscope), $200-$500 bucks on the cheap for a quality set (Welsh-Allen is pretty much the standard). The required continuing education REQUIREMENTS can run between 9-20k a year. You can thank the government for that being built into the cost. All medical equipment in the office must meet Joint Commission on Accreditation of Healthcare Organizations (JCAHO)\OSHA requirements which easily triple the cost of just about anything you put in the exam room. In all 50 states they have to meet patient requirements which easily adds 2-5k per year in costs for record keeping, auditing, and compliance. In the franchise kit alone back in 2006 the minimum complaince expense of being an audiologist with one location was around 22k, in 2006. Tell me if you think things have gotten cheaper...
C: The new fabrication processes haven't paid for themselves yet. In 2006 many hearing aid manufacturers finally were able to afford using rapid-fab type methods to build the hearing aid. Prior to that in in some cases hand made casts are still done from the impressions they take of people's ears. Even then that process is pretty damn slow last I saw it, 2 hours for a tray and usually back then only 6 or 7 aids per tray. ROIs were listed as 10 years so around 2016 I would expect prices to start stabilizing.
As far as tuning a hearing aid, it isn't difficult and any audiologist can get it done in about an hour. The chips are reasonably inexpensive as far as chips of that size go.
Hearing aids are huge business now. When I started the company I worked for was a 4 million a year company (not counting the franchisees) and was a 40 million when I left 4 years later. Largest pool of customers: Elderly (Older then 70), Hunters (under 70 over 35), Construction Workers (including lumberjacks).
The cost is mostly (A) and a bit of (C) (which gets better every year). (B) gets absorbed by large chains but as an industry I would expect to be a considerable source of cost.
1. It is a highly regulated field. To be able to sell a medical device is extremely costly in terms of regulations and paperwork and testing. I spent less than a year in the medical device field and I would never go back. It is simply more costly to bring a medical device to market.
2. Lack of a 'good enough' mentality. When it comes to healthcare, all the health professionals and politicians and the public obsess over quality. Rarely does cost and access seem to enter their minds. Suppose someone was able to bring to market a general purpose hearing aid which was not custom tuned for you, but cost $100 and did a *good enough* job (hint... they exist). Do you think your doctor or medical professional is going to recommend you get that? Nope, they would lose business on the installation and fine tuning of the device. The reason costs go down in areas like computer is because of the good enough mentality. Yes, you can always pay extra and get the high quality one, but people can always opt for good enough. In many areas of healthcare, this is not popular and in many cases, illegal as the health care professionals and lobbyists ban competition under the name of quality.
3. Insurance often pays
Insurance hides the cost from many people. Just like the in the auto sector, you can get a dent repaired for $1000 taking it to a private shop and paying without insurance... or you can tell them you have insurance and the cost magically jumps to $4000. And you are probably guilty to... because you would probably have the dent repaired at the dealer... maximizing your insurance claim. The same goes for healthcare devices. You will maximize your claim. The health professional wants to maximize your claim. The medical device manufacturers want you to maximize your claim....
The elderly are disproportionately wealthy since they have generally avoided paying for the negative externalities of fossil fuel consumption and procreation.
"I assumed blithely that there were no elves out there in the darkness"
The bottom line is that hearing aids today are sophisticated high tech miniature devices, and not a massive market of 100s of millions potential purchasers. Every patient's pattern of hearing loss is unique. As suck, hearing aid designs has evolved along the lines of being customizable for the patient's hearing loss patterns. The hearing aids can be programmed to amplify the frequency bands which the patient is weak in. And they are very good at selectively only amplifying the desired sounds but hardly ideal in the regards.
Those patients have only have small percentages of useable hearing frequency. Even selective amplifying won't help those type of patient all that much. So the latest generation of hearing add are able to digitally compress frequencies ranges the patient can't hear hearing down into the frequency range the patient can hear. Yes computer and electronics can be cheap and mass produced. But for thes type of hearing aided to be useable, they have to small, light, comfortable to wear, sophisticated enough to be customized to the patient's needs and needs to run for long periods of time on very small batteries.
And on a linear note, hearing aids are getting smaller and smaller. The smallest ones can fit directly in the ear canal. Just think of putting a computer with enough processing power to be able to digitize sounds and do frequency compression, and have a sound system to play it back in a package that fits in your ear canal. Think of the engineering and manufacturing challenges.Do you see a mass market of 100s of millions to prices down to $150? ... I didn't think so
Just like college tuition. The easier it is to fund an education the more expensive it gets.
http://www.americahears.com
I have a pair of their CIC aids, purchased ~4 years ago. They're great.
Personal Sound Amplifier's are basically unregulated hearing aids that are not for "hearing loss." They are basically the amp + mike + equalizer that the poster described. You can buy them for $20 to $30. No one knows the risks of using them compared to hearing aids since they don't get the same kind of testing.
Hearing aids are expensive for the same reason that all medical devices are expensive. They are magnets for law suits. To offset the costs of inevitable litigation, medical device makers put more money into product testing (sometimes) and insurance.
This American sue culture applies to airline food too. If a plane crashes, every vendor that put anything into the plane gets sued, including the caterers.
More income for ambulance-chasing lawyers.
Interestingly, in the U.S., if someone is injured by a product, even if it's due to amazing stupidity on the part of the user, in complete violation of a clearly-posted warning, the courts usually find in favor of the consumer. Because the vendor has deeper pockets.
Or housing. Flood the market with cheap financing and a governement directive to put everyone into a mortaged home and prices went on a moonshot. Right up until they didn't.
Just like the other reply already mentioned, college tuition and low interest government loans are again creating a moonshot effect.
And you are almost certainly correct on the same effect causing hearing aids coverable by insurance/medicare/etc. to be priced like nobody actually has to pay... because if you are asking the price you are paying for it yourself and realize that if you have to ask, you can't afford it.
Happens every time but we fall for the same trick over and over. Intelligence seems to be in short supply.
Democrat delenda est
Find a popular model you like and get one from a deceased persons heirs.
Definitely there's more paperwork involved with a Class 1 medical device than say a DVD player, but if both manufacturers follow good management and development practices, it's not really that much more paperwork.
Why did a simple ultrasound of my heart, performed by a technician who was not a doctor, not a nurse, just someone who'd completed "Be an ultrasound technician!" at night school, and which took about 15 minutes, cost over $1000.00? No reason. It's a random number.
I assure you the number isn't remotely random and there are a LOT of costs most people never consider. The machine has a capital cost which is not going to be cheap, probably six figures easily. Even without considering any other costs you have to do a lot of procedures to recoup that cost. The technician still has to have all their work signed off and examined by a physician even if the MD is not present in the room. There is gobs of paperwork and administrative costs. There are salaries and benefits. There is overhead in various and sundry forms (lights, electricity, rent, computers, network, software, legal, etc), insurance (workers comp, business interruption, liability, health, etc), You also have to factor in that insurance companies take a profit and the difference between a profit and a loss for most doctors offices is based on how well they can beat up the insurance agencies. Insurance companies aren't stupid (usually) regarding reimbursement rates.
No, it isn't a random number. I promise you it was quite carefully calculated and while they likely are making a decent profit, it is no where near what you seem to think it is.
How hard could it be to build an iPhone app that uses the built-in microphone in the phone and transmits that to a bluetooth headset?
If telephones are outlawed, then only outlaws will have telephones.
Not only would there be a market, but it would also be perfect for listing to shit via your phone. The phone also as a microphone and can transmit audio to the bluetooth headset -- so, you put your phone down on your desk, walk away past where people don't think you can hear them, and yet, you can still hear them... Great for spying.
There's a zillion ways to make this a great little app. Someone should write it.
If telephones are outlawed, then only outlaws will have telephones.
Seriously, before I read your post I was still thinking, "YEAH! why would hearing aids be so expensive!?" After reading, I am utterly convinced and I can't imagine any other answer.
I'm not even going to bother reading anymore of this topic, the rest is all waste.
OMG! I just now noticed that Anonymous Coward wrote this response! What a waste of good karma!
-- QED
My dad recently got a behind-the-ear pair that didn't include a custom mold.
That's the type I have. The volume's ajustable but they don't have multiple channels. I can't complain, because the price was right: $0. You see, I get mine through the VA, and I have the magic words in my file, right next to my hearing loss: service connected. It took several decades to show up, but once it did, the VA agreed with me that it's caused by exposure to outbound shore bombardment back in '72 and accepted responsibility for the damage.
Good, inexpensive web hosting
Just like college tuition. The easier it is to fund an education the more expensive it gets.
I was going to go there, but the last time I did on Slashdot I was immediately pounced on and pummeled by people who work for universities and colleges. Apparently I had gored some sacred ox.
Finding any historical cost per credit hour data was fairly hard, schools don't really want you to see this.
I finally found some for the University of Nebraska, Kearney, a state funded school, where a 2011-12 credit hour costs $168. Back in 1964-5 this cost was 9 bucks per credit hour.
Using the Dollar Times calculator $9.00 in 1964 had the same buying power as $65.73 in 2012. So, instead of charging $65.73/ch, UNK is now charging$168, or 2.5 time the inflation equivalent per credit hour.
Kearney isn't alone in this, Central Michigan is actually worse.
They charged $85.50/ch in 1993, which had the same buying power as $135.98 in 2012, but they are charging $358/ch or 2.6 times inflation.
Admittedly, state funding levels may have changed, and more money may now be raised by tuition and fees with less tax dollar input.
Its hard to know, without digging thru the University budgets over the years.
But in any event, I suspect that you are correct, that the cost of college expands to absorb the available funds.
Sig Battery depleted. Reverting to safe mode.
When I was selling keyboards and midi gear, about say 1992, one manufacturer, Ensoniq, tried to enter the market. They complained about how archaic the technology was; that it simply amplified the entire spectrum. They developed a product that would be tuned to your ear across the spectrum, amping some, attenuating others.
The engineer/owner, I can't remember, detailed how much of a high margin, mom and pops market, much like coffins were. He explained it as an old-school, tight dealership network, and only a few other competitors. He hinted at collusion, but not sure what the basis for that was.
Its been a while since then, but then it was just no one driving down the price.
https://ccrma.stanford.edu/~dattorro/Hearing.htm
What's with the whispering???!!!
1) People expect more from hearing aids today. When people assume that hearing aids should cost $300-400, you can usually ask them what features it should have, and then find a hearing aid for them with those features for that price. It will not be comfortable, though, and they'll probably hate it.
2) Anything that is made custom is expensive. Nearly all hearing aids sold today are customized. When you think about how much is in a hearing aid, and realize that it must be able to fit into an enclosure which will be customized to fit the exact human it is intended for, then the $3000 tag no longer seems that excessive.
Free unix account: freeshell.org
My friend runs a local robotics club and buys a lot of used electric wheelchairs & scooters. Even though they are dirt cheap used, they are extremely expensive new. The reason is that they are medical devices and every bolt and screw on them has to engineered to meet various standards. The manufacturers can't use regular hardware so this drives the price way up. I'm guessing there is something similar going on with hearing aids. The cost of regulation, testing, and certifying far exceeds the actual cost of materials. (which is why used scooters have no resale value-the materials themselves aren't actually worth anything).
I've been hearing impaired from a birth defect and worn hearing aids for over forty years. I have been in the engineering field for my career and currently work for a large worldwide corporation known for its generous benefits.
But the insurance pays up to $800 for a hearing aid. You can't get a digital aid for that little $$$.
I can tell you that the digital hearing aid I have been using for the last twenty years is from ReSound. It is the best I have ever worn, the clarity is excellent and I seldom have to ask people to repeat anymore. I can walk from a quiet office to a loud production floor with zero adjustment. The only situation it doesn't work well (no hearing aid does) is a large party with loud chatter.
I have tried the newer digital aids (Widex, Oticon) and they are not as good as the ReSound.
Eternity: will that be smoking, or non-smoking? I Corinthians 6:9-10
Oddly enough, that joke is actually relevant. There are really two different types of hearing aids:
1. Volume-based hearing aids which are so cheap now that they're sold for $10 on chinese websites, and you could build one yourself for less than $3 worth of parts.
2. Frequency adjust hearing aids- these are actually tiny computers that slightly shift the frequency of the waveform for people who have frequency-specific hearing disorders. The cost for them is about $500 base, plus a couple of weeks of software engineering to tune them to the INDIVIDUAL User. It is the second type that the original author's mother needs, and yes, in a way it is a supply and demand problem as *each unit* (even in a pair) has to be tuned to the disability of the individual ear.
SJW: a person who perceives an injustice, and while correcting it, commits a greater injustice.
Nope. Not even close. Go look up the numbers and you will see that going back to 1965 the rate only touches 15% from time to time. In fact it would be more accurate to state it as the government redefines the 'poverty line' as needed to ensure that 10-15% of the population will always be in 'poverty' and thus in need of handouts from Democrats.
Sorry, I'm about to be assaulted as a horrible mean person for saying these things. But screw it. As a general rule we don't even know what 'poor' is.
If you live in most of the country, where several HD multiplexes are available OTA, if you can pay for cable TV you are NOT poor. Being generous here and granting some very rural places where the choice would be cable/sat or nothing and nothing would be kinda harsh.
If you have a contract cell phone, you are NOT poor.
If you own an Apple product you are NOT poor. (ok, perhaps a nano.) Or unless you had it and fell on hard times. My computer would probably be the last thing I'd sell off so I won't hold it against anyone else either.
But in the same vein, with the same caveat of preexisting exclusion; if you own a PC that isn't second hand you probably aren't poor. Out of work IT workers obviously excepted. Keep the skills sharp guys.
If you own an XBox360 or Playstation 3 you are NOT poor. (same exclusion)
If your household owns more vehicles than members with full time jobs, you are NOT poor. In a city with mass transit that number should probably be ONE vehicle.
If you are making payments on a new vehicle, you are NOT poor.
If you can afford a pair of shoes that cost more than $100 you are NOT poor. (work footwear excluded)
If you can afford admission to any major league sporting event, you are probably not poor.
Democrat delenda est
Did not read any of the comments so apologies if this was covered already. Its all about the market. Tablets etc are common, anyone has a use for them. Hearing aids are a limited market and only those who need them truly need them. For a company to stay profitable and continue work on enhancing a product it must remain profitable. I work in fire alarm and a simple aluminum pole with a plastic cup to remove smoke detector heads costs 500$ why? Because its an extremely limited market and the product has to be UL listed to meet compliance.
The other day I saw a "hearing enhancer" for well under $50 at a local big-box electronics store. My local drug store sells reading glasses for under $20.
But if you want prescription glasses or a prescription hearing aid, be prepared to ante up.
You not only have patents and the like to deal with, but as medical devices they have to go through rigorous FDA approval and someone has to pay that up-front cost.
Now, SHOULD most hearing aids be classified as medical devices and require FDA approval? Probably not.
Knowledge is how to play a game, intelligence is how to win, wisdom is knowing what game to play.
I'm not a fan of my own country, but come here for any medical problems you might have. A custom made hearing aid will amount to 500 euros, dental work is about 30 euros per tooth. The quality is very good, prices are low, conditions are again very good.
Check out http://www.cabelas.com/browse.cmd?categoryId=109766880
When a buyer has to pay for things they shop around which drives prices down. When anything goes, as with insurance, then the prices go up. This is the same with all medical care, auto repairs are like this to a large degree, etc.
Solution? Get rid of insurance payments for things like this.
Didn't this question come up in slashdot 2-3 years ago? I believe the answer is still: supply and demand. The same reason technical manuals are more expensive than Harlequin Romance novels.
Oliver's law of assumed responsibility: If you're seen fixing it, you will be blamed for breaking it.
my wife needs a hearing aid (vanity is getting in the way, however), but none of the insurance plans I've have over the last 10 years or so cover them.
Half past two.
Second on the left, straight on past the police station and first right after the pedestrian crossing.
Stick Men
I thought that it was the custom-made nature of hearing aids that made them expensive, but a quick Google shows that a fitted set of earphones cost $200. I figure the fitting process is similar for hearing aids so it can't be the fitting. I guess the problem is that you can get cheap ones for $500 but everyone wants the best of the line models because it's their hearing, not some useless piece of tech that's a luxury.
A NYC lawyer blogs. http://www.chuangblog.com/
Because it will improve the quality of her life, THEREFORE it should be cheaper? You know, owning a Porsche would improve MY quality of life.... should we force VAG to sell them for a dollar?
I want to delete my account but Slashdot doesn't allow it.
Except people were encouraged to take out second mortgages to pay off their bills, take trips, do some property improvement. When a bank approves 40 applications without looking at what their financial situation is or their income, that is a huge problem. College tuition isn't going up because of easy loans, most states have raised tuition due to the financial crisis. Look at this article from The Huffington Post about student loans and debt.
You can't blame the government for these scandals when it is the banks who ultimately decide who gets these loans and on what terms.
interesting tidbit about hearing aids:
"The first commercially available consumer product to use transistors was the hearing aid, a device which benefited greatly from miniaturization and long battery life. Compared to the existing vacuum tube models of that era, transistorized hearing aids represented a quantum leap into the future. It is also interesting to note that Bell Labs waived the patent royalties for transistorized hearing aids in honor of Alexander Graham Bell who had been a life-long advocate for the hearing impaired."
http://transistorhistory.50webs.com/xstrhist.html
this has nothing to do with their current cost. but is interesting bit of history.
If we'd all just type in ALL CAPS maybe the original poster wouldn't need HEARING AIDS.
While your analysis is interesting, just measuring the tuition cost increase compared to inflation is insufficient, because as you point out, state funding has probably decreased. The real analysis needs to look at the cost the university spends educating per credit hour and seeing how that has grown compared to inflation.
Put differently, if in 1993 at Central Michigan, it cost $300 per credit hour and the student paid $135.98 and the state paid the balance and today it costs $480 per credit hour, but the student foots the $358 and the state portion has decreased, then all that has changed is the funding source, but the actual cost grew in line with the inflation rate over the same period.
Now, I doubt that the problem with affordable education is simply a shifting of funding from the state to the individual and is more likely the combination of that AND spending that far exceeds the inflation rate. But, without the actual cost to educate per credit hour, it's impossible to tell. Let alone fix the problem.
You'll find they are VERY labor intensive. Pretty much everything is HAND MADE.
Granted, it seems a little excessive for what they charge, but, go price a good F2.8 300mm
camera lens and you'll see the same thing. VERY expensive because everything is HAND MADE.
Labor is the largest price of items like this, and, it a lot of markets, add labor unions and you'll
soon find the price inflated.
That, and the fact that "insurance pays for it", and the government red tape-regulations and before
you know it, it is a $3000.00 device, that "should" cost around 1000 bucks.
Because it's a "medical device" and the potential customer can either pay the price or stay impaired.
It's a free market after all... Or so we're told by the folks on Wall street.
CH
I'm guessing for the same reason my bilateral hernia surgery was going to be 24k if I used insurance and only 7k if I used cash? (I had the surgery on May 58h by the way, so pretty recently).
Or why my parents old body shop could replace panels, cut out and replace parts with rust, and paint the whole car for $700 cash. But when a bumper had to be replaced on a car that was insured they'd charge $4,000?
And I'm not going to go into government guaranteed college loans (where if the student defaults and gets a lean against them it matters not to the college since they already got their money).
When money is guaranteed, there's no incentive at all to lower prices.
> You can't blame the government for these scandals when it is the banks...
Yes I can. Because I know who drove those policies. Freddie and Fannie along with Congress and Presidents from Carter to Bush II. The insane push for 'affordable housing' and the idea that renting == bad, mortgage == good. They looked at stats that showed homeowners to have several socially desirable qualities and confused cause and effect in an epic fail for the ages.
The banks were in a no-win scenario so they cheated.
The government was demanding they make an ever growing percentage of their loans to politically preferred customers regardless of ability to repay. But it was ok because if you just made sure they could probably pay for the first year you could push the paper off on Freddie or Fannie and it was all going to be good. Because otherwise the banks wouldn't have done something that stupid regardless of how much political and regulatory pressure was applied to them. But then Freddie and Fannie had to do something with all that dodgy paper and so did the banking industry. Hmm, what to do, what to do. Mortgage backed securities! Except most people started figuring out the game of hot potatoe (nod to Quayle..) going on and started hedging those with derivatives thinking they were so clever. But when it ALL goes boom at once there ain't nobody can collect on those contracts because everybody gets boned at the same time. Short version, things that can't go on forever don't.
Democrat delenda est
Actually, the cost burden ends up on the student but is already paid. Pretty sure with gov guaranteed loans the college gets the money up front. And when the student defaults it's on the student (although the college already got the money). I could be (and correct me if I am) wrong, but pretty sure that's how it works now.
The government in a fit of do-gooder activity declared hearing aids to be "medical devices" which means they are tightly regulated by the government. The existing makers were able to easily hop through the regulatory gates that were initially in place... but anybody who comes along later (after all the bureaucrats have written their thousands of pages of regulations) finds the cost of entering the market prohibitive (you need LOTS of money to hire lawyers to read and understand the regulations, and you need to get your product through all the regulatory hurdles). This creates a government-enforced near monopoly and destroys the ability of normal market forces to drive down prices while driving up performance and features. If anybody tries to remove hearing aids from the medical device category, millions of dollars will flow to the right politicians (establishment Democrats AND establishment Republicans) to defeat the effort. There are big, wealthy companies who depend upon their products being protected from new upstart competitors like this... Look to every industry where the government has stepped in to "protect" us all with regulations: Automobiles, Aviation, Medical devices, etc. In every one of these areas, all significant competitors got into the market BEFORE the government started regulating it, and the regulations were established to "protect the public". This is why BIG companies often side WITH big government in supporting regulations (see big pharma and their deal with Obama on Obamacare, or the big aerospace companies with their hand-in-glove relationship with the FAA) when you would expect them to be opposed to government intervention. Everybody on Slashdot knows full-well how cheap a battery, a mic, a speaker and a microchip would be if they were available from any manufacturer and hanging on a shelf at Frys, etc.
Give Phonak a try if you haven't yet... works well for me.
2. Frequency adjust hearing aids- these are actually tiny computers that slightly shift the frequency of the waveform for people who have frequency-specific hearing disorders. The cost for them is about $500 base, plus a couple of weeks of software engineering to tune them to the INDIVIDUAL User. It is the second type that the original author's mother needs, and yes, in a way it is a supply and demand problem as *each unit* (even in a pair) has to be tuned to the disability of the individual ear.
Bogus argument
We have these cool things called "algorithms" and "parameters" which we implement in these things called "computers". A generic hearing aid could easily be made and the customer could sit in an automated booth at wallmart, listen to some automated test sounds, give feedback to the booth computer and the booth computer could tweak the parameters for an individual hearing aid, flash the parameters, and provide the "custom" hearing aids for the user to checkout. If you REALLY wanted to get exotic and custom, you could have the booth tell the user to put-in the new aid, re-test, and tweak the values and re-flash the parameters before sending him/her to the checkout. This is the sort of innovation that would have appeared years ago if hearing aids had never been classed as "medical devices". This is like the guys who supply a bunch of uber-expensive "medical equipment" to docs and hospitals trying to explain why they charge so much for a slow two-trace oscilliscope with a different label on the face and some slightly different firmware...
Replying to myself.... Got distracted and hit submit, Forgetting to explicitly tie what I wrote to your chief complaint and I know that if I don't no prog has the reasoning skills to make the leap. (by definition, otherwise they wouldn't be a prog anymore)
> Except people were encouraged to take out second mortgages to pay off their bills, take trips, do some property improvement.
That was a obvious side effect of the policies I noted above. Ram a huge influx of new demand into the housing market and prices shoot up. Combine with the Fed pushing interest rates far below market in a different case of the goverment meddling and you get what happened. Home values didn't just go up, it was a moonshot, cash out refi very attractive and banks more than willing to write the paper and hand it off, making their money off the up front fees. And if thought they were a bit too willing to take risks when they only suspected they were 'too big to fail' just wait, now it is written into law.
Some of us knew better. I'm not underwater. In fact I'm not even mortgaged anymore.
> When a bank approves 40 applications without looking at what their
> financial situation is or their income, that is a huge problem.
Yes it is. Now be bold enough to ask the right question. Why would they do something that dumb? Answer: It wasn't dumb because they got the fees up front and the taxpayers (through Freddie/Fannie) got the bill. They were playing the game by the rules Congress wrote.
> College tuition isn't going up because of easy loans, most states have raised tuition due to the financial crisis.
And why did they do that? Because they can. Because pretty much anyone qualifies for low interest loans underwritten by the Federal Government. Tuition has been going up faster than inflation for generations. Just like healthcare. Both for the same reason. Before the big crunch tuition was so insane the taxpayers were kicking in along with the grants and loans. But where the money comes from doesn't change the fact that the number of dollars per pupil being spent is going up, up and up. Because it can.
Democrat delenda est
Why the hell would Standards and Poor's rubber stamp grade AAA on those mortgage back securities that contained all sorts of bad loans. Those banks knew what they were doing when they committed fraud with to make those loans; not verifying income or even putting higher incomes than what the loanee stated is fraud. One of the plans from the banks was to have a house default several times so they could collect the fees for originating the loans while some fool (now the taxpayers) would take the financial fall. Goldman Sacs had no problem selling off the derivatives while hedging against them; where do you think the European crisis came from? Regulators knew that these derivatives were a growing problem, but chose to ignore it on the grounds that "the market would sort it out."
I do agree with you that there is a huge push in this country to own a home with tax breaks and incentives that are not available to renters. Things need to change so that we have a balance between renters and owners
And then the entire discussion becomes a cess pool.
I wear a set of Siemens Centra SP's, and they were 7k new.. $2400 an ear for the hearing aid, 675 an ear for the fitting fee, and $500 an ear for an extended warranty for 3 years vs 1.
Turns out if they're out of warranty and you need a repair, it's $330.. my provider said it's gone up to $400 now... this gets you another year of warranty as well. I've been told eventually they'll cut me off because they catch onto what I'm doing or they run out of parts.. but I've gotten about 5 years of this so far.
So your $2400 is paying for the R&D, the actual hearing aid is somewhere around $100 or so.
Even for my warranty repairs, they just replace the hearing aid instead of fixing it.
My Father-in-law has the same Centra SP's and his were around $10k.. mine were purchased in Canada(where I live), he is in the US, so even the markup varies.
Here is the generic version
"Why Are xxx So Expensive? With ever-shrinking electronic components, better capabilities, and technological advancements, not to mention the rapidly increasing potential user base, I would think quality xxx should be coming in a lot cheaper than what we can find. We've tried the cheapies, and they're fraught with problems. So, can someone tell me why a xxx should be so expensive?"
Fact is, you said yourself the 'cheapies' aren't good enough. It's really you having demands rather than nothing cheap being available.
Now, I doubt that the problem with affordable education is simply a shifting of funding from the state to the individual
I'm not so sure.
Just looking at round bald numbers from the ten year interval of 1999 to 2009 you can see that Student Tuition at Central Michigan has grown 2.6 times, while the total budget has only grown 1.7 times. And state funding has held steady over those years.
Bottom line Figures for 1999 show Tuition totaling $79,762,133.
Bottom Line Figures for 2009 show Tuition totaling $214,308,670
Tuition grew to 2.6 times the 1999 values.
State Funding was $79,796,415 in 1999 and $80,064,200 in 2009, a virtual wash.
Total revenue was $227,472,170 in 1999 and $397,036,721 in 2009 or 1.7 times.
This is without regard to the total number of students, but the fact that Tuition increase of 2.6 times matches so closely the Cost Per Credit hour growth of 2.6
would suggest that the enrollment was not dramatically higher, and this is born out Here where 2002 undergrad enrollment was 17k, and 2011 enrollment was 19k.
(Total compensation (wages) increased by 1.6 times over that interval. It seems the revenue isn't all flowing into faculty pockets)
So Without becoming a CPA, and chasing every penny, its clear that the student out of pocket expenses have grown at a rate vastly higher than the University budget as a whole. The vast majority of the expansion in the budget is from tuition.
The cost of the of a college education has expanded to absorb the available student loan money.
Sig Battery depleted. Reverting to safe mode.
Therefore they make a super-advanced hearing aid that costs $3k, and you really want it for your mom; and if they could cram some more features into that would double the price you'd want that.
OTOH the kind of features you'd use in a $3k cell phone don't exist, and most of the cost is in monthly contracts anyway, so it's uncommon to spend more then a couple hundred bucks on cell phones. I don't even know how you'd make a cell phone costing that much money. Possible lots of software, without a contract?
You can easily spend $3k on a computer, but almost nobody does because almost nobody has any desire to run the software you actually need a $3k computer to run.
Once insurance is likely to pay companies can jack prices through the roof. The entire medical industry works that way. If all forms of insurance were illegal the price of medical care would fall like a brick off a roof. Start with the howling from the doctors paying for mal practice insurance. Then figure the costs involved from reckless physicians who take too many patients figuring insurance will pay for the doctor's errors. The opposite occurs with pharmacies. There the insurance companies have real teeth and they pay less than 10% for a product than a person off the street with no insurance is forced to pay. All in all insurance can destroy an entire economic system.
A friend of mine has hearing problems and the hearing aid mafia is quite powerfull here in Germany.
Thus I was wondering some time ago if one could not build a homebrew hearing aid out of some open electronics kit like an arduino with wireing, a mic, a batters and earbuds or something like that. Sure it would be larger than the usual hearing aid, but to be honest, I'd have nothing agains pinning a geeky looking piece of electronics to my garb to have a working and modifiable hearing aid - especially if I can same 3000$ on top of that.
Seriously, shouldn't it be relatively easy to build a feasable hearing aid with regular off-the-shelf parts, even if it weren't quite as small as the purpose built hearing aids? Any Ideas how one could go about this?
We suffer more in our imagination than in reality. - Seneca
$15 and change from sites such as dx. http://s.dx.com/search/hearing+aid
It's expensive for the same reason the strap that holds my CPAP mask on costs $250 to replace. Why do they charge so much? Because they can.
I buy my hearing aids from a specialized supplier. In addition to the devices I get insurance, three years of free batteries and free appointments. I am picky about what I hear, so I spend a lot of time with him fine tuning the aids -- and there is an incredible amount of tuning that can be done. He also threw in a free custom ear mold. This is all rolled in to the price I pay. I could get the same hearing aids cheaper at COSCO, but without the service. Is it worth it? That is up to you.
FDA.
FDA and other forms of government intervention, that's the only reason.
Look, the first cellphones cost thousands of dollars, today a comparable cellphone is under 20 bucks, if you can find one without camera and various other features, and even at that price they have dual SIMs.
The advances in minituarisation of electronics and battery tech is ridiculous, but what is more ridiculous is that hearing aids still are that expensive.
The reason is lack of competition, government intervention, government money, FDA.
You can't handle the truth.
You are basically correct, but whether the student is paying for college from their own savings or via student loans really doesn't matter if it is simply a shifting of funding sources (state vs individual). Also, with student loans, while they may be in default the debt isn't forgiven. If it's not paid by the time you die, student loans get first dibs on your estate. Only if your estate cannot pay the full amount is the debt forgiven.
Granted to certain vendors who have the ability to legally claim that their device is "special" in that mysterious medical device way and not just five dollars worth of Chinese electronics and two dollars worth of silicon rubber/plastic!
Very much like eye glasses, but to a much more exaggerated degree, $3000.00 for something worth, at most $99.00!
I killed da wabbit -Elmer Fudd
Given how many colleges are constantly strapped for cash and we don't exactly have people getting super wealthy being educators, I doubt this is a case of 'charge as much as you can'. The cost of running schools has increased significantly, all those extra students, all that extra capacity.. it isn't like a manufacturing plant where you just add another building or assembly line.
It is not a 'sacred ox', but it is part of the same mythology that has been bashing and devaluing education for decades in this country.. pulling otherwise reasonable people in to a larger culture war that wants to see 'liberal hotbeds' weakened, since education has been very bad for certain groups.
Even more "Bogus" in that you can get the SAME Siemens #2000.00 hearing aid (US) in Singapore for $180.00 (US).
I killed da wabbit -Elmer Fudd
Again, if state funding is constant and enrollment has increased then state funding per student has decreased so it makes sense that tuition would have increased. There is no doubt that student out of pocket costs have increased, the question is whether the cost of educating a student is growing greater than the inflation rate. Once that is known, then why it is growing at an accelerated rate can be looked at and finally after that, the discussion should turn to who should pay what for that education.
A different example may be helpful, compared to the 1960s, automobile prices have risen faster than the overall inflation rate, too. However, today's cars are more reliable, last longer and are safer. Those additional features along with inflation easily explain the rise in prices and therefore the rise is because today, you get a better value for your dollar and that is why you are paying proportionately more.
So to with education. There are any number of reasons why tuition is going up. If it is going up because the state subsidy per student is declining, then is the problem that the university isn't controlling costs or the state has set its priorities elsewhere? If it is because even after figuring in the declining state subsidy, other costs to the university have increased at a greater rate than inflation and these cost are being passed on to the students, then that calls for a different solution. Maybe 20 years ago, there was a lot of deferred maintenance on plant and equipment to keep costs down and now plant and equipment is simply worn out and needs replacement. That would be a legitimate increase.
All I am saying is that without determining what the actual cost of educating a student is and how that cost has grown, one cannot actually address solutions to making education affordable.
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Sounds like a business opportunity - go build it!
BS.
I ride a motorcycle, and have custom molded headphones to listen to music but more importantly block ear drum damaging road noise whilst allowing traffic sounds through.
Total cost of these custom buds? $155 USD so custom molding doesn't need to cost much at all.
I'm a graduate student. I don't take classes anymore, but I do sign up for "research credits," which are credits that give me the privilege of doing work that the university's name gets stamped on. This is thousands of dollars per quarter. Luckily, grants pay for my tuition, but students in many other departments aren't so lucky. The real problem is administrative bloat and mission overreach. 30 years ago staff were outnumbered by faculty. Now staff outnumber faculty 3:1, on average.
When we write a grant at our university, 55% is taken right off the top by the school for "overhead." This is a little ridiculous considering my advisor has a small office, I share an office, and we do no laboratory work. When you add in my tuition, a recent government grant we wrote had 74% going to overhead (this doesn't include salaries for either of us, that comes out of our end)+tuition, with 26% going to actual science. This sort of bullshit not only is costing students money, but it is hurting science in a very big way.
I found plenty of discount retailers selling the same hearing aids for 300-500 dollars.
Apparently doctors/hospitals are marking up the costs. Buy direct from the manufacturer and the prices drop radically.
I've decided to stop wasting my time responding to AC trolls/sockpuppets... so if you want a response from me... login.
Almost $2K. Might as well just go with the real thing for another $1K.
Have gnu, will travel.
It's because a skilled craftsmen makes them by hand you bozos.
http://www.youtube.com/watch?v=SLbxMFqyd9s
The only situation it doesn't work well (no hearing aid does) is a large party with loud chatter.
That isn't strictly limited to the electronic stuff. Wetware also doesn't work so well then.
After having traveled to, and practiced medicine in Zambia, the 'poor' in the U.S. (and even those that aren't 'poor') have no clue as to what it's like to be poor.
And you, have no idea what hardship in you life is. I've seen hardship in living, and it's not occurring in the U.S.
The MDHearingAid Acoustitone PRO Hearing Aid is $179.99 (at http://amzn.com/B00431MFHS). You can get a custom earpiece for another $75 from averysound.com.
Given how many colleges are constantly strapped for cash and we don't exactly have people getting super wealthy being educators, I doubt this is a case of 'charge as much as you can'. The cost of running schools has increased significantly, all those extra students, all that extra capacity.. it isn't like a manufacturing plant where you just add another building or assembly line. It is not a 'sacred ox', but it is part of the same mythology that has been bashing and devaluing education for decades in this country.. pulling otherwise reasonable people in to a larger culture war that wants to see 'liberal hotbeds' weakened, since education has been very bad for certain groups.
There are a couple of factors driving college costs, but the costs have increased significantly. Students today demand a lot more amenities than they used to- AC in dorms is now effectively required, back in my day only a few upperclass students had it. Mental and physical health care is far more in demand- we have students actually asking for inpatient care. We have a brand new $33M fitness facility on campus, because our old one didn't look very good when compared to the new ones our competitors had. The food is vastly better. Research costs are way up, even though the school I work at is bachelor's only, since US News' rankings require it. We wired all our classrooms/Library/dorms for Ethernet, and then turned right around and blanketed the entire campus with WiFi.
So how can they afford to pay for all of this? Student loans. Costs are secondary- indeed, colleges are Veblen goods, where lowering the price will cause the college to become less desirable. Since we can always find a financial aid package that allows you to come, costs get buried and simply aren't looked at as carefully as amenities.
"Seven Deadly Sins? I thought it was a to-do list!"
Why are they expensive.
1. Needs to be custom fitted. That takes skilled manual labor.
2. People sue anything medical, if not the patients the doctors will sue. Wrong color, unforeen side effects, all a liability.
3. Supply and Demand. Please study economics 101 for more info.
3.A. Insurance often covers the cost, thus customers demanding hugest quality.
If something is so important that you feel the need to post it on the internet... It probably isn't that important.
It seems that the FDA has regulation in place for hearing aids, and so hearing aid manufacturers probably have to jump through a lot more hoops that your local i-pod maker. It does seem odd to me that the Food and Drug Administration has regulations regarding something that is neither a food or a drug, and that in reality the same unregulated i-pod could probably be hacked up to become a halfway decent hearing aid.
I wish I could answer this question for you, but I cannot. Hearing aids have always been expensive. I have worn hearing aids since I was in first grade. I just purchased 1 new hearing aid which cost over $1500. I have worn about 8 pairs of hearing aids in the last 35 years.They last on average between 4 to 5 years before they cost too much to repair OR they simply cannot be repaired adequately. I suspect that the level of hearing loss adversely affects the price. The supply/demand issue DOES affect it. Few people are in the range of needing the super powerful, digital hearing aids with Bluetooth and all the listening addons. Personally, my hearing is atrocious, and I've actually suffered a secondary collapse in hearing, pushing me into the likelihood of Cochlear Implants instead of a hearing aid in the near future. The more important question is: Why doesn't health insurance cover hearing aids? But it WILL cover a cochlear implant, which costs 4 to 10 times as much?
The value of the electronic components used in an advanced hearing aid are about $20, so the retail price should be less than $100. However, the medical/audiological industry has pretty much kept the business to themselves, hence the 10x increase in price. By the way, similar story with eyeglasses. In Canada, cpap machines are also tightly controlled, even though you can buy them online from the US for a fraction of the Canadian price.
All this arguing is silly. They have them for under $10USD.
I get one justin case I need one. Huh?
Insurance does not pay for them, at least not for children unless you reside in Colorado, Maryland and a few other states that had to pass laws forcing insurance companies to cover them.
These have always seemed interesting.
Much cheaper, self maintained and options depending on budget..
http://www.blameysaunders.com.au/ihearyou
As a research student, you don't take classes, but you still cost money: almost certainly more than undergraduates cost, though you are doubtless also giving back a great deal of value through your productive research.
Costs include (at very least) the cost of your advisors' time (probably more time than you think), the cost of your office space and furniture, IT, HR, and HSE support and library services, as well as little things like access to counselling and other student/staff services. You may not use any of these much, but they need to be funded and there for you anyway. Probably also research operating costs and travel costs.
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Another factor with all of the stuff said on this page is that hearing aids need to be top-quality sound, tiny components, with extremely power-efficient hardware. I get two weeks (~10 to 12 hour days) with my hearing aid batteries. There are also environment issues that the hardware needs to be able to function with. These are not simple devices and definately not off-the-shelf components.
I'm sure this will get drowned out as I posted a bit late, but the high price can be problematic too. Most health benefits offered by employers discriminate against the hearing impaired by not covering the cost of hearing aids, only hearing tests (USELESS! I can get these for free anywhere!). And employed who happen to have coverage their plan usually only covers a ridiculously small amount (think $800 to $1500 for what can easily be $6000 to $12,000).
Another annoyance? At one employer my hearing aids got damaged and due to budget constraints I was unable to purchase new hearing aids for at least a few months. Rather than working with the impairment I basically got told that I need to do whatever I could to acquire and wear new hearing aids and was given the feeling I might get fired if I didn't accomplish this.
Hopefully something will change with this.
I was always told that hearing AIDS is a disease one gets from listening to assholes.
As a hearing aid user all my life, this has been a big concern for me.
From what I can tell, the cost is due to audiologists and hearing aid dispensers. It naturally costs a lot of money to run practices so if the hearing aid costs $3,000, they may take half of that to pay their salary and costs of rent, testing, fitting, secretary, and so on. Most aren't rolling in money. Unfortunately this means the manufacturers don't have an incentive to sell hearing aids cheaper because the audiologist and dispenser costs would still keep overall costs high, and furthermore manufacturers are channel friendly and prefer to work with audiologists which prevents customers like you and I from cutting out the middle-man. And since satisfaction with a hearing aid is highly dependent on getting a good fit, it's in their best interest to have audiologists involved.
What can you do about this?
Thankfully today, there are other options using alternative models. www.AmericaHears.com staffs audiologists who work with customers over the phone or email. This means they aren't paying for the cost of running private practices. www.embracehearing.com also sells directly to consumers. I'm especially excited about www.hihealthinnovations.com approach which provides hearing test equipment to your general practitioner. I love how thrilled the audiologists are (http://www.ohioentdocs.com/about/newsDetail.cfm?newsID=58).
Many of these alternatives will work for most people, but they don't provide the powerful hearing aids I need. So I went the DIY route buying an advanced hearing aid from ebay.com (the HA companies themselves are too channel friendly to buy from directly), bought the programmer, installed the software and programmed the hearing aid myself. Dispensers are not necessarily good at fitting hearing aids so the HA companies have made their software super easy to use. Does it sound to muffled? Press this button. Does it sound tinny? Press this other one. Does the user's own voice sound funny? Press this. All in all, I got two Phonak Naida III HAs and the programmer for $1,500, which is substantially less than the $6k or o the audis were asking for and they wouldn't have given me the programmer for adjustments. If you're interested in the DIY approach, look at...
The forums here: http://www.hohadvocates.org/
And this forum: http://hearingaidforums.com/
And if you're buying a hearing aid through conventional channels, this checklist is pretty useful:
http://www.hearingloss.org/sites/default/files/docs/HLAAHearingAidChecklist.pdf
I hope that helps!
I was once the guest of a factory producing hearing aids. They had a very nice diner in it, with above than average food, a pool on the top, everyone used the best available equipment. Somebody has to pay for that.
Funny thing is altough their people (the ones putting the added value into the product) were highly qualified and the best they could find, for the production high percentage of the employees was immigrant. I guess you have the right to choose how you spend your money.
In India we spent $1500 per ear for our daughter for the top of the line. The problem in the US is at least double the price for ever thing!!
I don't know what it's like elsewhere, but here in New Zealand eyeglass frames cost several hundred dollars for no apparent reason. I'm sure the machines that churn them out don't charge that much.
My grandfather's essentially simple hearing aids cost thousands, too.
It's "because they can".
Sorry if this comes across as a bit of an advert but,
I've had 2 pairs of the £3-4000 cic top of the range aids before. Last year I got a pair for £400 from hearingdirect which I was just going to use as a backup pair. Honestly I've used them every day since. I know there is a company in the USA which sell the equivalent products at the same sort of prices you just need to look for them. Be wary of audiologists that sell specific brands of hearing aids, they will always push expensive products.
Indeed, this is pretty much how my hearing aid was programmed - the "first cut" programming was downloaded from my previous hearing test results A second pass adjusted the microphone sensitivity from a frequency sweep and white noise played from a speaker a measured distance from my head and some further minor tweaks were done based on my subjective response (all this with the hearing aid attached to a programming cable and a laptop),
There's very little of this that required someone in a white coat supervising the process, though having someone on hand to demonstrate actually fitting the thing into the ear without perforating the ear drum was quite useful.
For mild-moderate hearing loss, I really don't see why you don't have off-the-shelf products much as you have off-the-shelf reading glasses. There will be people who require higher levels of intervention, but there's a good proportion of the ageing population who share broadly similar hearing loss characteristics for which a "good enough" solution would probably require at most half a dozen preset curves.
What?
FDA
The audio processing subsystem on the iPhone 4S used for Siri is quite sophisticated and while not on par with the state of the art out there, is a tremendous value. Perhaps we need to back to the 1960's when Grandpa 'wore' his hearing aid in his shirt pocket. I would think that a combination of the iPhone and the best earbuds you could buy would give most hearing aids a run for their money, albeit it would be ugly, heavy and cumbersome.
"Its hard to know" -- it's not a conspiracy, and it's easy to know. Just use the Google and look at legislation, funding reports, and publicly-available budget numbers. But, I can tell you, but, be warned, pull on the tinfoil hat, I'm one of those fatcat professors milking students dry to support my rockstar lifestyle. Federal and state funding is way down. The recession tanked university investments. At the same time enrollments are up. And universities are competing for students by providing amenities, like cable TV in all the dorms, new rec centers. And then there are all the requirements of increased enrollments, like new classrooms, parking, etc. Add to this the need to add computer technology to budgets, new machines, new networks, then new machines and new networks again as equipment becomes obsolete and students use the internet more and more. And there you go. The ONLY people making bank out the changes are administrators, and, yes, administrators have increased in number, and their salaries have gone up. But though all the faculty hate them, the truth is, those salaries aren't that big a difference percentage-wise (granted the new style administrators do harm in other ways, seemingly trying to run universities into the ground and eliminate as much of the educational mission as possible while they focus on "profit centers"; soon you're only be able to get a business degree, education degree, or engineering degree.)
Once somebody works out how to advertise in there, the price will drop through the floor!
Because America's medical system is a disasterous fuck up. EVERYTHING is overpriced. It's not about the health and wellness of the people, it's about giant medical corporations making billions of dollars. They don't have to lower the price. It's not like medical care is like a sports car. You can't choose not to have it because it's too expensive. Get it or you a) have a horrible quality of life or b) die.There is no pressure for anything in the health industry to become cheaper. People won't all of a sudden stop getting care b/c it cost too much. The problem is we have allowed the health and well being of people to be come a for profit corporat business. The last thing a corporation cares about are the people, their only conscern is making more money. As long a medical care is a for profit corporate business we are fucked.
A friend bought a set of the latest/greatest hearing aids last year for about $7,000. A couple of months ago I bought a similar set (2) from Costco. Tuned to my hearing problem, 5 different setting (normal, noisy environment, etc.), with vol. control, remote control, battery charger and telephone interface. Total cost was $1,999. It makes a big difference where you buy them.
Like everything else -> Greed!
I can tell you that the digital hearing aid I have been using for the last twenty years is from ReSound.
But there are idiots up the thread assuring us that all that digital processing stuff that you've been benefiting from for 20 years is new, so you must be totally wrong about that.
I'm getting new aides this summer (currently have a decent set from Seimens but they haven't been quite the same since I dove in the ocean with them on last summer...) and will check out ReSound, if they're still making them. The only feature I really want on my new ones is a telecoil. I certainly agree that nothing much helps in large parties with loud chatter.
Blasphemy is a human right. Blasphemophobia kills.
plus a couple of weeks of software engineering to tune them to the INDIVIDUAL User.
False. Walk into an audiologist, get plugged into a simple machine to run your audiogram, hook your aides to the computer, push a button and you're done.
The number of completely false claims about the supposed complexity of the hearing aide customization process in this thread is astonishing.
Blasphemy is a human right. Blasphemophobia kills.
Because it's medical and we are in the US. An old friend has an eye glasses shop. He's not a doctor, just a seller of frames and lenses. He grinds the lenses himself from stock lenses for fit the frames. A pair of lenses costs him about $20. It takes about 10-15 min to grind each lens (highly experienced though). The special fancy pants coatings that many charge well over $100 for costs him about $100 for about 1/2 a liter, enough for hundreds of lenses.
So why does it cost so much? Because if it's a health/medical product, people will pay because otherwise their life sucks.
Another one: albuterol. It used to be cheap. Then they added a chemical and patented the process with a new long life patent. Now it's name brand only even though albuterol has been around for over 20 years.
A crazy idea of mine: All medical products / chemicals / medication cannot be priced over 25% of manufacturing cost and all medical facilities providing care must operate as a non profit organization.
There is plenty of competition, they just all know that they can gouge you.
The aging population is growing dramatically and the need is so great for hearing assistance; manufacturers are simply cashing in on the wave of the aging population. Sad comment but likely just a matter of business to those involved.
There was an interesting announce on my birthday this year about an android phone frm Kyocera without speaker and dedicated to hearing impaired people or for loud urban area use.
http://mobile.theverge.com/2012/5/27/3045848/kyocera-urbano-progresso-au-launch-may-30-announcement
Hope that would help the OP a bit.
Does anyone remember the article about a company (may have been non-profit) that was trying to start that said that they could create a good tone adjustable hearing aid that would be very inexpensive and could be self adjusted by a program loaded on a computer? This seemed to be an answer to this cost problem. Of course, the fed would probably be pressured by medical donator to ban the company.
They're a lot cheaper if you get the ad-supported hearing aids. Though it is a bit annoying to have Centrum Silver commercials interrupt your conversation with your niece and no one else being able to hear it.
It is unfortunate, I work for a clinic and it baffles the mind. Many people live in silence because of the expense.
I'm sure it's possible to create a viable open alternative. Surely there are plenty of old engineers going deaf, and plenty of young engineers with grandparents kicking about.
of medical equipment. Even the US .gov cannot get actual cost information on joint replacement devices due to the firms have the doctors signed into NDA's. No surprise that hearing aids are also wrapped up in this fiscal fiasco.
You say that like we're wrong about it most of the time...
People who live in glass houses shouldn't walk and text.
And by the time it gets through the FDA certification, it will cost $6,000.
You don't think the guys with the present government mandated back-door monopoly are just going to give up the cash stream without a fight, do you?
Aah, change is good. -- Rafiki
Yeah, but it ain't easy. -- Simba
Medical devices/drugs are outrageously expensive because the needs of the many doesn't yet outweigh the greed of the few.
I was born with a permanent hearing loss.
In Denmark where I live, my hearing aids are covered by public healthcase.
Last time I got my hearing aids I noticed the cost; about $1000 apiece.
That was for the hearing aids themselves and not e.g. the ear buds that had to be made to fit etc.
Everything was covered by the state, including the expense of measuring my hearing, testing the aids etc. (all was handled by employees of a state hospital).
I can easily imagine that the employee time, administration and all that would be quite expensive.
I've worn hearing aids since I was 9. I have never had insurance contribute one dime to their cost.
They are not regarded as a "medical device." (Cochlear implants and bone-conduction devices are, on the other hand, considered medical devices and generally are at least mostly covered by insurance.)
I have no answer to the OP's question except one word: Costco.
As an ex-employee of a major hearing aid manufacturer, I can say that the main reasons for the high-prices are:
1. Modern aids don't simply amplify audio anymore. Decent aids today have Bluetooth capabilities to connect to TVs, radios and cellphones, noise cancelling capabilities, sound zoom (which basically means that it will only amplify sound coming from a specific angle of range while cancelling anything else), wind cancellation etc. What modern aids will do is specifically amplify what the user wants amplified, via different modes which can be per-programmed according to the user's needs, as prescribed by an audiologist, which can be switched by the user when needed. So a user can have an option for when he's in Church, an option for when he's out socializing, and an option when he's in the car. So the technology stuffed into such a small device is quite impressive, usually using the latest in nano-technology, most of them patented by the manufacturer.
2. The R&D involved in the creation of a device is massive. It involves highly paid PhD graduates and the best engineers around. And believe me, they ARE well paid.
3. A good number of these companies are situated in expensive countries: Denmark, Sweden, Switzerland etc. The inflates the prices due to wages, running costs etc.
4. It's covered by insurance, and in some European countries like the UK, covered by the public health insurance (the NHS).