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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
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.
"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.
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.
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
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.
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.?
Only $30! IT all depends on the "medical device" classification from the FDA. http://www.msa30x.com/
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. --
Fucking yes. Getting past patent litigation i'm sure is the cost of entry.
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
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.
http://www.embracehearing.com/
Just add {In Space!} to anything.
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.
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.
...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.
Forgot to log in before I posted this. May as well use my karma for something.
"How perfectly Goddamn delightful it all is, to be sure" Charles Crumb
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.
Supply... meet Demand
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).
They are in fact mass produced, only the earpiece is custom moulded and that is done by the doctor.
A friend had to get a pair after his hearing was damaged in Afghanistan, a pair of automatic rifles going off next to your head to kill the scumbag running at you with a RPG.
His hearing aids are identical to the ones you can buy for hunting. Except his has a custom software EQ curve installed for his specific hearing loss.
Do not look at laser with remaining good eye.
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.
If you try to do anything medical or get any medical device in the USA you would be charged 10-50 times more than it actually costs. The prices are grossly inflated and then the big insurance companies negotiate them down by 90% or so. This is mostly in make sure that you don't go and get healthcare on your own. It also serves as a good way to keep some new insurance company from springing up - if you are not big enough, you can't negotiate such a discount, so you can't be profitable.
The insurance companies are all in a cartel. It would be illegal for any other business, but health insurance companies have a special exception.
There is no free market in health insurance in the USA and there has never been one, so there is no competition. Thus all the prices and profit margins are simply decided at the cartel meeting without any regard to real cost or social benefit.
My advice to the OP - go to a country with a real healthcare somewhere in EU or Canada or Asia and get some hearing aids there. It will come out cheaper even with a plane ticket.
I'm a very satisfied customer.
Just like college tuition. The easier it is to fund an education the more expensive it gets.
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
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.
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.
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.
You make a good argument, and I'd believe you... except that an ER visit to the same hospital, which lasted longer (about 6 hours), involved more tests and machines that go "ping", and more interaction with doctors, nurses, etc, cost 800.00. Hardly cheap, of course, and this was when I *didn't* have insurance and I ended up paying it off over the course of a year -- but it's really hard for me to fathom that 15 minutes of lying still while someone rubbed jelly on my chest (at least she was cute...) costs 200.00 more than the full suite of "We have to run this test because if we don't, we get sued for malpractice" at the ER.
Now, if you'd said, "They overcharge on routine medical exams so they can use the surplus to cover things they can't charge as much for or services they have to provide by law", I'd believe you.
A further problem with the idea the price really means something is that I know my insurance company isn't paying that much. I pay ~200.00/month for insurance. That is about equal to the retail (uninsured cost) of the medications I get every month -- said retail price being another number hardly anyone actually pays, of course. So if they pay the same amount I get billed, I'm costing the money just for very basic, very routine, care -- no major surgery, no cancer treatments, no long hospital stays. That there's a "pool" isn't really relevant, because these aren't extraordinary costs; they're month-to-month medical expenses for a reasonably healthy middle ages adult. (I could be a lot healthier, sure, but my actual medical expenses are the kind of routine, run of the mill things even the healthiest people will pay for if they want to keep being healthy. So if the (uninsured) costs for THOSE are roughly equal to what I pay the insurance company month to month, either the insurance company is happy to keep me as a charity case (not likely), my employer is picking up a HUGE part of the tab (also not likely, given the rest of their "benefits" package), or the amount the insurance company actually pays out for these things is a lot less than the bill I see. (This is no great secret; you often see "Amount we billed your insurer: A gazillion dollars. Amount insurer paid: $2.50 and half a doughnut. Amount you owe us: $0.00." on medical bills.)
I am in no way opposed to profits, capitalism, or the idea people should pay for services rendered. Nor do I not understand that there's lots and lots of hidden expenses involved in running anything as complex as a hospital. However, the normal mechanisms that control prices, and the normal ways consumers can act to adjust their spending, are grossly distorted by a mix of factors, and these distortions manifest in both over- and under- paying for services, relative to the costs of providing them, and they're very hard to correct via normal means.
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
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/
Prior to the mid 80s, not everyone had a microwave, and yet everyone survived. That means a microwave is a luxury item. As is a TV, as is cable, as is a cell phone. I grew up w/o any of these, and we were poor, as in, not every night is necessarily a dinner night. You can be poor w/o being homeless, all it takes is just enough money to pay rent.
I want to delete my account but Slashdot doesn't allow it.
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 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
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
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.
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
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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.
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