Why Can't Industry Design an Affordable Hearing Aid?

Hugh Pickens writes "Tricia Romano writes in the NY Times that over the last 10 years, purchasing a hearing aid had become even more difficult and confusing than buying a new car — and almost as expensive. 'I visited Hearx, the national chain where I had bought my previous aids. There, a fastidious young man spread out a brochure for my preferred brand, Siemens, and showed me three models. The cheapest, a Siemens Motion 300, started at $1,600. The top-of-the-line model was more than $2,000 — for one ear. I gasped.' A hearing aid is basically just a microphone and amplifier in your ear so it isn't clear why it costs thousands of dollars while other electronic equipment like cellphones, computers and televisions have gotten cheaper. Russ Apfel, an engineer who designed a technology now found in all hearing aids, says there is no good reason for the high prices. 'The hearing aid industry uses every new thing, like digital or a new algorithm, to raise prices,' says Apfel. 'The semiconductor industry traditionally reduces the cost of products by 10 to 15 percent a year,' he said, but 'hearing aids go up 8 percent a year annually' and have for the last 20 years."

Comments

three words, one hyphen:

[Black Parrot]

for-profit healthcare

Re:three words, one hyphen:

[Anonymous Coward]

very true. I wonder what the companies profit margins are.

Re:three words, one hyphen:

[malraid]

It's not only this. Insurance also drives prices up for regular consumer. If everyone paid out of pocket, I can assure you it would be way cheaper.

Re:three words, one hyphen:

[pixelpusher220]

and lots of people who need them wouldn't get them...

Re:three words, one hyphen:

[K. S. Kyosuke]

It's not only this. Insurance also drives prices up for regular consumer. If everyone paid out of pocket, I can assure you it would be way cheaper.

This stuff almost feels like defense contracts, actually. Easier to throw money around when it's someone else's money.

Re:three words, one hyphen:

[jhoegl]

Incorrect.
Insurance companies barter/bargain for the lowest prices.
They say, we have this many people over this age, and they are likely to buy hearing aids. Give us a deal and we will pay it minus the copay
If it were individual, it would be like a car salesman... attempting to charge the highest price, ask you to take out a loan and pay it.
Some people will barter, but we all know the for-profit from OP was correct.

Re:three words, one hyphen:

[Hadlock]

If teenagers can afford a smart phone (+ monthly data plan), I suspect a usable hearing aid could be manufactured for the same price, even if it doesn't have 3G internet and multitouch display.

Re:three words, one hyphen:

[Volante3192]

http://www.nhs.uk/chq/Pages/894.aspx?CategoryID=68&SubCategoryID=157

NHS hearing aids and new batteries are free. If you lose your hearing aid or damage it, you may be asked to pay towards the cost of repairing or replacing it.

Re:three words, one hyphen:

[malraid]

Maybe lots of people wouldn't be able to get them. Or maybe prices would drop enough that you be looking at most people being able to get them. Given the nature of most electronic products, I wouldn't be surprised if competition wouldn't drive prices down so much that most people who have insurance right now, would be able to afford them (basic models close to what people pay right now for the insurance copay). In that scenario (which might be too idealistic), some people wouldn't be able to get them anyhow, same as now people without insurance don't have much option.

Re:three words, one hyphen:

[jmichaelg]

I'll see your three words and go in two; no hyphen: Regulatory Capture.

Healthcare is expensive because the government passes scores of rules that benefit the incumbents and keep out innovation. They pass those regulations because someone ends getting richer as a result.

  Ear Trumpet's developers received a cease and desist from the FDA after they published an iPhone App that tested your hearing and then loaded an equalizer to adapt playback response according to the test results. That's all they were selling - a test and an equalizer with presets. But you can't buy it anymore because the FDA objected.

Another case in point. One of my students' father was trained as an M.D. in China. The family emigrated to the U.S. and the father had to go through medical school all over just to prove he knew what he was doing. The only thing that improved in med school was his English. Were he, and hundreds of thousands other fully capable practitioners, able to come here and just hang out their shingle, you'd see health care costs plummet. But no. The medical profession protects its own from competition by convincing everyone they know best by limiting the number of doctors and med students.

Healthcare would be a hell of a lot cheaper if the government stayed the hell out of it.

Re:three words, one hyphen:

[Anonymous Coward]

A medical doctor I later tried unsuccessfully to fuck told me that one factor in skyrocketing healthcare costs, in America at least, was the increasingly litigious environment driving up malpractice insurance and prompting medical centers to order increasing numbers of unnecessary tests so the patient won't come back later and sue the living piss out of the hospital because they had missed something unrelated to what the patient came in for.

It's funny how the American pigs point the finger at "greedy insurance companies" even as they considered suing that mom-and-pop store for millions of dollars because they almost slipped on a floor.

-- Ethanol-fueled

Re:three words, one hyphen:

[Anonymous Coward]

Sorry, but you've been misinformed. If you have any medical procedure done, you can call them and ask for a discount because you are uninsured and paying out-of-pocket. Although they are not obligated to do so, they usually will, and you will often only have to pay 25%ish of the original costs.
If you think my surgeon would have made me come up with $16k (the amount they billed my insurance for) cash for my 1-hour procedure if I had no insurance, then you have a strong misunderstanding of how the healthcare industry works. I'd like to think I know at least a little bit about it. After all, I'm employed at a hospital.

Re:three words, one hyphen:

[Anonymous Coward]

No, it isn't "for profit" per se that causes the high prices. It begins with the way consumers perceive their insurance plan. They see the insurance payment as a sunk cost, and don't really want to spend any less than the maximum that the company will pay. In addition, most people are willing to pay extra out of their own pocket to get better equipment, so the hearing aid companies set their prices to encourage that. The medical device designation is a significant barrier to entry, and so minimizes competition. These factors combine to set the price.

Re:three words, one hyphen:

[PopeRatzo]

Given the nature of most electronic products, I wouldn't be surprised if competition wouldn't drive prices down so much that

The iPad mini is evidence that competition doesn't reliably drive prices down.

When you have products that are highly desirable (and if you're hearing-impaired, a hearing aid is highly desirable) then prices will stay as high as people are willing to pay.

There is no "law of supply and demand". It's a fiction.

Re:three words, one hyphen:

[MBCook]

How many people who need them now don't get them because they can't afford $2k+ when they should be paying maybe $250?

I know that's the case for at least two of my relatives.

Re:three words, one hyphen:

[narcc]

I haven't checked, but I'll bet they'd even make Apple blush...

Re:three words, one hyphen:

[Nethead]

Were he, and hundreds of thousands other fully capable practitioners, able to come here and just hang out their shingle,Were he, and hundreds of thousands other fully capable practitioners, able to come here and just hang out their shingle,..

Add to that all the returning US veterans that have been performing their skills under fire but can't get a job back home because they don't have the correct certification.

Re:three words, one hyphen:

[Anonymous Coward]

One large player, Phonak, reported in 2004: "The gross margin reached 59.5% which is almost 500 basis points over the gross margin of 54.8% reported in the same period last year." They've improved that to 66% in 2011.

Certainly the free market isn't driving down the price...

Re:three words, one hyphen:

[udachny]

I just explained to somebody in another story how FDA stands in the way of people getting help they need, and here is another silly comment that I am replying to.

For profit health care is the solution to the problem.

The problem is government in health care, preventing all people who want to make a profit in it from participating in the market.

The problem is government intervention into health care, the FDA and all other regulations. Anybody with an EE degree (and even those without, but who learned on their own) should be able at least to try and provide a solution to this problem of expensive hearing aids, and they certainly should be doing it in an attempt to achieve profit, which would only indicate that they are on the right track (and here is another comment explaining why the profit motive is the only moral motive that we know works).

Any high schooler with an interest in electronics and with a pair of hands should be able to attempt and build a device that would help a person with bad hearing, but very few high school students have the money and connections needed to take on the government machine, that stands on his way, protecting the monopolies and oligopolies that government prefers.

Of-course governments prefer monopolies, that is how governments can ensure huge potential monetary sources to run election campaigns and pad politicians' bank accounts.

The for-profit motive is not the problem with the industry, the for-profit motive is the problem with the government.

Re:three words, one hyphen:

[LiquidLink57]

True, but it's even more nuanced than that.

Right now, the government gives tax incentives for an employee to get health insurance from their employer. So if my regular income is taxed at, say, 25%, I could either receive $10,000 worth of health care benefits from my employer tax free, or cash, which would mean I would only receive $7,500. So I'd be a fool to not get my health insurance through my employer. So the employee has a government created incentive to favor getting insurance over money. And the more medical prices rise, the "better" it is for me to choose to get the health insurance.

With a huge amount of people incentivized to get this health insurance, and use it as the way to pay for every single medical treatment they receive, and not just insurance against catastrophic accidents (a certain amount of coverage will be mandated under the Affordable Care Act) the more people completely disregard the cost of the care they receive. Do you ever see a list of services and prices posted at a hospital? They're not paying for it, so what do they care what anything costs? If they don't pay (beyond maybe a deductible) why is it worth it for them to price shop? Insurance companies can attempt to do this to a degree by restricting where people can get care or choose not to cover certain things. But these choices are being legislated away as well, and force insurance companies to cover certain things free of charge, hugely distorting the market even more.

Imagine if we bought food like we bought health care. Instead of getting cash, we'd have a government incentive to instead receive an all-you-can-eat grocery card from our employers. We'd walk into a grocery store, and there would be no prices posted, because the shoppers wouldn't care because they aren't paying anyway. Naturally prices would skyrocket as consumers no longer consider price. The government then would come in, point out the skyrocketing price of food, declare a "food crisis," and take over the whole industry. Having caused the problems in the first place.

Look at areas of medical treatment in which the government is not involved. Sadly there are very few of those, but take for example Lasik surgery. Prices for that drop every single year. Why? Because of natural market pressures. People usually pay for that out of pocket, so they naturally price- and quality shop. Lasik establishments are incented to reduce costs and improve quality. And they do.

The problem is not that it's "for profit." The computer industry is hugely profit-driven, and advances in manufacturing and assembly efficiencies drive down costs a huge amount. McDonald's prices don't skyrocket because they're for-profit. The reason problems get solved and consumers get what they want is because people can make profits providing what they want at a price they want, without government intervention. But parent is right. The problem isn't "greedy capitalism." The problem is that we have gotten so far from real capitalism, though we still think that's what we've got, and whenever something like this happens, someone points out capitalism and greed as the problem and insert even more damaging bureaucracy.

Re:three words, one hyphen:

[budgenator]

If you don't mind a behind the ear design, there's plenty of hearing aid work-alikes out there. Hearing aids are FDA medical devices that must be custom fitted and adjusted for the individual by order of a licensed professional, but if you look in the back of the AARP, or the American Legion magazines you'll find consumer devices that look a lot like hearing aids, work like hearing aids, but aren't.

Re:three words, one hyphen:

[Anonymous Coward]

You sound equally, or perhaps greater partisan than the idealogue strawmen you try to conjure.
How many deaths did the Ear Trumpet app cause before the knights in shining armor shut them down?

Re:three words, one hyphen:

[CrudPuppy]

That's changing ever-so-slightly, especially for Cochlear implants, because we the deafies are now arguing that *not* covering them is plain and simple discrimination.

IMHO the government should pay for new hearing aids for me, once every 4 years. Before you pass out, let me explain: If I do not have hearing aids, I am deaf enough I cannot hear voices at all, and thus cannot work. I can collect about $2800/mo in SSDI right now if I cannot work. So balance that cost against the cost of new hearing ids every 4 years. AND as an added bonus, you bet your ass the Government would not be paying $3000/aid.

Win, win, win.

Re:three words, one hyphen:

[Chuckstar]

Healthcare would be a hell of a lot cheaper if the government stayed the hell out of it.

It would also be much less effective and much less safe.

The free market doesn't fix everything. In fact, the basis of the current regulatory regime regarding new drugs was originally put in place because a bunch of consumers were killed by a bad drug... with especially painful-sounding deaths... the company never performed any testing with the formulation... and should have known there was a problem in the first place. The story is: Massengil used diethylene glycol as a solvent for dissolving sulfanilamide into an elixir format. Diethylene glycol was a known poison, but the company's chemist wasn't aware of that. Even very simple animal testing would have found the problem.

So how about instead of ridiculing every action the government takes, we all get together and try to limit the useless actions and focus government on the useful ones? Requiring drugs to be tested and shown to be safe and effective is a Good ThingTM. Whether in the U.S. or in countries with weaker regulatory regimes, we've seen time and time again that the free market is simply not up to the task of keeping ineffective or even dangerous drugs from being peddled to consumers. However, some of the detail of how the FDA reviews drugs might be amenable to streamlining (I don't know enough detail to suggest how, but it seems almost certainly probable).

On the other hand, your description of Ear Trumpet's experience with the FDA seems like a Bad ThingTM.

I'll bet if you got 10 Republican and 10 Democratic congressmen together (and could somehow figure out a way of making them ignore the fact they were working together), you could find 20 ways that everyone would agree would streamline the FDA without materially affecting the quality of health care. In decades past I would have said the biggest impediment to such agreements was that no one in Washington really cares to put such effort into low-profile results. That still might be a problem today, but the bigger problem in Washington today is the part I put in parenthesis above -- not only is there a divide that makes it hard to work together, congressmen are actively disincentivized from working across the aisle, in spite of rhetoric to the contrary.

It's too bad, because there are plenty of opportunities to streamline government. Only the Republicans think streamlining is bad because it gives the new streamlined regulations more validity -- "we don't want better regulations, we want NO regulations". Democrats think streamlining is bad because simpler regulations can have larger loopholes -- "regulations should be intricately taylored to each situation so that big business can't slip anything (no matter how immaterial) through the loopholes."

As far as the MD trained in China... the problem with just letting foreign doctors practice here is that the quality of training varies dramatically overseas. The doctors in China who went to better universities and trained in better hospitals are probably on par with U.S. doctors. The ones who went to smaller, regional universities and trained in rural hospitals may not be qualified to practice in the U.S. A written exam wouldn't be able to distinguish, but maybe there's a middle-ground where a few U.S. institutions would be qualified to run 2-year residency programs where foreign doctors' skills are put to the test. The ones that pass get full MD privileges. The ones that don't get kicked down to medical school to start again.

See? There are possible compromises to these things. We really, really don't want a free-for-all in the healthcare system, though. It would be monetarily cheaper, but at what cost in lives?

Re:three words, one hyphen:

[Arthur B.]

for-profit healthcare

Right, because every other electronic device - the prices of which keep falling - are produced by not-for profits.

Among many reasons are the high costs of medical regulation, liability insurance, the fact that paying with insurance seriously blunts the pressure on prices. But no, let's just say it's "greed" and feel self-content with a non explanation.

Re:three words, one hyphen:

[tburkhol]

If it were individual, it would be like a car salesman... attempting to charge the highest price, ask you to take out a loan and pay it.

Yes, but if you don't like the car salesman's deal, you have to take the bus. If you don't like the hearing aid salesman's price, you're deaf. If you don't like the surgeon's price, you're dead.

You can't negotiate healthcare on a level playing field, regardless of who writes the check.

Re:three words, one hyphen:

[nbauman]

Another case in point. One of my students' father was trained as an M.D. in China. The family emigrated to the U.S. and the father had to go through medical school all over just to prove he knew what he was doing. The only thing that improved in med school was his English. Were he, and hundreds of thousands other fully capable practitioners, able to come here and just hang out their shingle, you'd see health care costs plummet. But no. The medical profession protects its own from competition by convincing everyone they know best by limiting the number of doctors and med students.

Healthcare would be a hell of a lot cheaper if the government stayed the hell out of it.

You made a good point, but this isn't it.

China is a big place. They have some of the best scientists and doctors in the world. They also have some of the worst. We need someone to figure out which category a Chinese doctor falls into, before we turn him loose on a public that can't tell the difference.

HARSH TREATMENT
In China, Brain Surgery Is Pushed on the Mentally Ill
Irreversible Procedures Rarely Done Elsewhere; A Mother's Regrets
By NICHOLAS ZAMISKA
Wall Street Journal
November 2, 2007

NANJING, China -- Mi Zhantao, a poor 25-year-old living with his parents outside this provincial capital in eastern China, was battling depression and had trouble socializing. Doctors said he had schizophrenia. They recommended brain surgery.

Mr. Mi's family spent about $4,800 -- the equivalent of four years' income, and more than their life savings -- on the operation, at No. 454 Hospital of the People's Liberation Army in Nanjing. The highly controversial procedure involved drilling tiny holes in the young man's skull, inserting a 7½-inch-long needle and burning small areas of brain tissue thought to be causing his problems.

The surgeon, who operated on Mr. Mi the day he met him, says he has performed nearly 1,000 such procedures, mostly for schizophrenia, but also for illnesses ranging from depression to epilepsy, since the hospital started offering the operation in 2004.

Mr. Mi's parents say the surgery did nothing but leave their son with a partially limp right arm and slurred speech. He continues to be depressed and withdrawn, his mother says. Wang Yifang, the surgeon, says he checked the medical records and, as far as he knows, the patient left the hospital uninjured.

Mr. Mi's mother, Kong Lingxia, 50, says she'll regret the decision for the rest of her life. "I feel so angry," she says. "But I'm really angry at myself. How could I let this happen?"

(more)

http://online.wsj.com/article/SB119393867164279313.html

Chinese pharmacists in the US have generally escaped regulation, under the "dietary supplement" laws, and when the New York City health department investigated some of them, they were selling medicines that were adulterated with lead, Viagra -- you name it. The Chinese pharmaceutical industry sells source material to US companies, but the FDA can't go to China and investigate the manufacturers. As a result, there have been several incidents of people getting sick and dying because Chinese products, whose manufacture the government stayed the hell out of, turned out to be contaminated or deliberately adulterated. The New York Times had a series about that by I think Walt Bogdanich. One batch of children's cough syrup contained antifreeze and killed about 100 children. You want to sue them? The NYT tried to track some of those companies down, and couldn't find them.

I don't think you can find a country in the world that has a successful health care system where the government stays out of it. Very few patients know enough to shop for health care. A doctor has the ultimate high-pressure sales pitch: "You have to do this, or you might die. And you have to do it now." What are you going to do when a doctor tells you that in your 15-minute office visit? Stop and look it up on Google?

Re:three words, one hyphen:

[Imrik]

How would those few thousand deaths compare to the lives saved by proper medical care as a result of lower prices?

Re:three words, one hyphen:

[AthanasiusKircher]

When you have products that are highly desirable (and if you're hearing-impaired, a hearing aid is highly desirable) then prices will stay as high as people are willing to pay.

Unless a reliable competitor emerges with a similar product and is willing to make profits off of selling volume rather than hiking the price exponentially.

I frankly don't know what is possible for hearing aids, but I do know, for example, that a medication a friend needed to buy supposedly cost $170 at retail for a 90-day supply, and he was asked to pay $45 for a copay for that medication by his insurance. One day when he moved, he decided to transfer pharmacies and went to a local grocery store with a pharmacy. He didn't have insurance at the time, so he expected to have to shell out a lot of money. But, only with the free savings card from the grocery store, he got the 90-day supply for $10, less than 1/4 of his copay with a premium insurance plan! This was for the same generic drug in both cases -- but in the first case an insurance company, a drug manufacturer, and a pharmacy were obviously in collusion, while in the grocery store, the pharmacy had an incentive to sell cheap drugs to uninsured people, so it made a deal with the manufacturer. The grocery store pharmacist didn't even ask for insurance information, because he knew he could give a price better than any copay required on a normal insurance plan.

This is for a "highly desirable" product (in this case, blood pressure medication).

For another example outside of medicine, there was a regional grocery store chain where I used to live whose prices were consistently about 40% off of all major competing grocery stores in the area. I'm not talking about generic items: I'm talking an average of 40% off for the same name brand grocery items. They had only one store in the metropolitan area where I lived, but the aisles were packed almost from 7am-9pm. It wasn't convenient to public transport, but I saw poorer folks taking cabs to get there all the time, because they saved so much, it more than paid for the cab.

You can't get more "highly desirable" than basic food. The other supermarkets in the area counted on the fact that they were more convenient to public transport or that people just wouldn't bother to look at the other store or that people would assume it was the place "poor people shopped." Quite a few people who never shopped there told me that they heard it was "dirty." Yet the opposite was the case -- produce and meat flew off the shelves and was much fresher than any other supermarket in the area. I never saw evidence of dirt or vermin there, but I heard a couple different friends report that they saw mice at one of the "premium" supermarkets near there, and one who reported the mice saw that the food which had been eaten into was not removed from the shelves when she was back there a couple days later. After all, the "premium" supermarkets were always like ghost towns, except for a few hours right after standard work hours, so most people wouldn't even notice.

Basically, if there is a market where people will shop around, some businesses may take advantage of that market by providing a cheaper product. If few consumers actually have a real transaction to buy a product and instead go through an intermediary like an insurance company, there is little incentive for anyone to provide lower prices. In fact, if there is a situation such as in the current national health care bill where insurance companies will be limited to 15% of billed costs toward "administrative fees" (i.e., where the profits come from), there is actually an incentive for insurance companies to drive costs UP, since that's the only way they can skim more money off the top.

Re:three words, one hyphen:

[AlphaWolf_HK]

Or perhaps, it's just "hip" to buy an iphone, and the high price is why people want them.

When Gucci lowered the prices on their designer clothing, their sales volume dropped. Were talking volume here, not profit. By raising the prices again, they actually sold more clothing.

When you put a high price on something, in many cases it can make people desire it more. I guarantee that if apple dropped their prices, they would probably sell less as well because it wouldn't be this trendy thing that only the "hip" or
"sophisticated" people have any more.

Anyways, over 500 years of market history will tell you that supply and demand isn't fiction. Only a die hard communist chooses to ignore that.

Re:three words, one hyphen:

[tmosley]

No, two words. Fascist healthcare.

https://mises.org/daily/4276

Re:three words, one hyphen:

[tmosley]

That's like saying that pilots break the law of gravity. The laws of economics aren't enforced by policemen, they are a result of natural human interactions.

Funny how you attribute the perverse behaviors of individuals under the influence of government imposed regulations and incentives to the "free market". If a farmer in a free market burned his crops, he would drive the price up for all the other sellers of that crop, and he would lose market share. Anyone who did this regularly would go out of business. You need to stop confusing commodities like food crops with brands like Apple.

Re:three words, one hyphen:

[tmosley]

50 years ago, insurance was rare, and medicine was cheap. Today insurance is everywhere due to tax favored status, and medicine is expensive. The correlation is very high.

Re:three words, one hyphen:

[__aaltlg1547]

It IS manufactured for less than 10% of the price.

Re:three words, one hyphen:

[tmosley]

Why? Healthcare was freely available to the poor prior to government involvement in the industry. Doctors would even make housecalls to tenement houses.

Free markets work, no matter what you say about them. If they didn't, then computers would be ultra expensive and unavailable, while the Post Office would make money.

Re:three words, one hyphen:

[im_thatoneguy]

Yeah and 50 years ago people just dropped dead or 'walked off' injuries.

My mom just broke her wrist. Something like $25k in medical bills later she has full wrist mobility. 50 years ago she would have simply had it set and like my Grandpa would probably have pain and immobility the rest of her life.

Re:three words, one hyphen:

[darkmeridian]

Doctors and hospitals don't want to look like the bad guys, so they'll always dump on lawyers and malpractice lawsuits. But consider that hospitals get paid for each scan and each test that they perform under our current fee-for-service regime. In other words, the more you do, the more you get paid. Not surprisingly, in a free market, you'll see lots of services. Insurance companies try to deny payment for "unnecessary" services, but that's when doctors will trash insurance companies for rejecting life-saving services.

Also consider that the AMA has commissioned studies proving that there are too many medical malpractice lawsuits. But every study commissioned on the matter has concluded that medical malpractice causes far more damage than is recovered in malpractice lawsuits. There are many cases of malpractice where the person dies and no one is around to sue, or where there is malpractice but the case isn't clear cut enough to convince a jury, etc. Lawyers have to front huge expenses in a malpractice case because expert witnesses (doctors) are crazy expensive. So only the "best" cases go to trial. That means, paradoxically, that sometimes clear cases of malpractice won't get tried because the victim was too old and too poor, and died too quickly so you can't sue for lost earnings, or pain and suffering.

So it's a complicated issue. Just don't take the simple narrative that doctors are all saints. Assume everyone is only human and start from there.

Re:three words, one hyphen:

[Toonol]

You're missing the principle.

If I make lots of hats, and lots of people want hats, I might be able to charge $20 each. If I decide to make few hats, I might be able to charge $50 each. That is what Apple is doing, and it's a clear consequence of supply and demand.

Another clear consequence of supply and demand is the fact that other hat-makers will see the opportunity, make hats, increase the supply, and allow people to purchase cheap hats... except for the idiots that are demanding overpriced hats. That again is supply and demand, and that again is what is happening in the marketplace in which Apple resides.

Neither strategy is cheating, any more than choosing a different material to build a house is cheating.

Re:three words, one hyphen:

[AK Marc]

Supply and Demand fails in this case because there is no equilibrium. With health care coverage, demand is inelastic. If it costs the insurance company pays for it, then if it's $20 or $20,000, I don't care. I "paid" for it when I paid my premiums, what the insurance company pays for it doesn't affect me. It's against my best interests to shop price. So changes in price will not affect demand, violating "supply and demand".

Re:three words, one hyphen:

[BooMonster]

Indeed. All the people who are hating on the free market forget that people have the choice to buy a New iPad 2 for $600 or a COBY Kyros Internet Tablet MID7012 4 GB off amazon for $66.

In fact, if you really just need a small microphone with a small speaker that plugs into your ear, you can just get a Listen Up! sound amplifier that looks like a bluetooth headset for less than $30.

If the only place you went to shop for a tablet was to talk to the manager of Best Buy, he would sell you an iPad.
If the only place you go to shop for a hearing aid is the doctor's office, you'll get a Phonak Ultra or a Unitron.

Especially if "someone else" is picking up a large part of the tab.

Re:three words, one hyphen:

[BooMonster]

My neighbor sells me all my radishes. His secret? He moved the headphone jack to the BOTTOM!

You have to differentiate on something other than price if you want to charge a premium. Gucci differentiates by cachet. Your radishes just don't have it.

Re:three words, one hyphen:

[BooMonster]

And 50 years ago, she would have simply had it set and like your Grandpa would've handed down an inheritance to you.

Your Mom just spent your inheritance on her wrist. I'm trying not to make a moral judgement here. We, as a society, have decided that there is no amount too high to spend on our bodies, even if we have to lay the debt at the feet of our children's children's children.

Re:three words, one hyphen:

[SirSlud]

Holy fuck, did you just equate the law of gravity with ... laws of economics? You mean the equation that hasn't changed since the dawn of the universe with .. what the fuck, a law of economics?

Re:three words, one hyphen:

[Fjandr]

First off, the free market doesn't exist.

Secondly, devices classified as health aids by the FDA exist in one of the most heavily-regulated markets on Earth.

The highest of the barriers to entry into the hearing aid market are almost assuredly in regards to assuring end-product compliance with FDA regulations.

Re:three words, one hyphen:

[AmiMoJo]

Necessary regulations probably do bump up the price a fair bit. The hearing aid has to be proven safe for human use, even if that person accidentally leaves it on when they get into the shower or receives a static shock from rubbing against something. There also has to be a hard volume limiter so that faults do not result in dangerously loud noises being emitted.

$1600 is still ridiculous, but there is also a genuine reason why hearing aids will never get to down to cheap smartphone + contract prices either.

Re:three words, one hyphen:

[Maxo-Texas]

I noticed name brand heavy cream varies from $2 to $4 as the lowest price at two different chains.

Thanks for the $10 generic tip.

Also, you can buy hearing aids with 2002 technology on hunting sites.

Part of the reason that official "hearing aids" are expensive is that they are a medical device.

The same exact device not classified as a medical device is 1/10th the price.

Re:three words, one hyphen:

[Lorien_the_first_one]

I think it's a combination of patents and "health care" industry protection from so-called free trade agreements. Noted economist Dean Baker has documented the trade and patent protection that the health care industry gets, and that the same protections are rarely ever mentioned by economists.

If "free trade" is good enough for electronics, clothing, cars and the rest of the working class, then it's good enough for the health care industry.

http://www.counterpunch.org/2009/08/04/why-don-t-we-globalize-health-care/

Re:three words, one hyphen:

[Man Eating Duck]

Living in a state that forbids early payment penalties helps.

That implies that there are states in which you will be penalised for paying your debt in full early? While that is probably every credit company's wet dream, it's fairly fucked up that they are allowed to do so.

Re:three words, one hyphen:

[AK Marc]

Don't insurance companies have the same incentive to look for lower prices as any other consumer? If the hearing aid is $2500 instead of $250, then it's $2250 that's lessening the insurance company's profits.

Insurance is regulated. Disclaimer: I'm familiar with the laws as of 10 years ago, but not anything changed since then, so there may have been some change with Obamacare, but I didn't see anything that did

The insurance company is limited to a profit of XX% (I'll assume 10%), as a regulated entity. So if they charge premiums too high, they get penalties. So, if their revenue is $10,000,000 on 40,000 Chinese hearing aids, they can keep $1,000,000 profit, maximum. But if they pay $100,000,000 on 40,000 expensive ones, they get to keep $10,000,000 profit.

Regulation breaks supply and demand. Insurance is regulated in 50 different ways in 50 different states, and I am 100% certain that auto insurance works like that because of my dealings with State Farm in Texas, who would send me a check every year. See, they would charge more than the legal maximum, then, if claims were not excessive that year, they'd make more profit than allowed, and they'd have to refund money. With the risk pools, they justified it for auto insurance with nobody making a stink, but the same general rules applied to the other regulated insurances (the common ones, including health). But, as the system is designed to not have people directly buy their own health insurance, I did not deal with them directly on that, but I know the rules were set up similarly.

And why aren't there cheap Chinese knockoffs of the really expensive hearing aids?

There are. You just have to buy direct, as if they were sold through a US storefront, they'd be shut down by the medical industry.

http://www.aliexpress.com/wholesale?SearchText=hearing+aid&catId=0&manual=y
http://www.dinodirect.com/se-hearing%2520aid/currency-USD.html

Really? You couldn't be bothered to do a single google search to find the answer to your own question, but willing to waste our time having to read it? You are lazy and inconsiderate. Oh, and $250 is overpaying for the Chinese one, looks like $25 would get you a mid-range Chinese one, or $2000 for the same thing sold in the US by a US medical company. It's cheaper to buy it from China than to pay the US copay, so the real question is why aren't more people going that route?

Re:three words, one hyphen:

[nbauman]

Why? Healthcare was freely available to the poor prior to government involvement in the industry. Doctors would even make housecalls to tenement houses.

In the days when doctors made housecalls to tenement houses, cancer drugs cost $30, not $100,000. The life expectancy at birth was about 50 years, rather than 75 years. And most of the savings in lives came not from doctors' treatments, but by government public health measures like clean water, sanitary sewage, and regulation of often-contaminated products like milk. Government intervention works. The UN eliminated smallpox.

Free markets work, no matter what you say about them. If they didn't, then computers would be ultra expensive and unavailable, while the Post Office would make money.

(1) Computers, like most industries, are a success of both the free marketplace and government support. Gordon Crovitz inadvertently demonstrated that in a Wall Street Journal editorial page column which claimed that the government wasn't responsible for the Internet. He was quickly corrected by the very people he credited with creating the Internet. And yes, they said that Al Gore helped. We should all thank Crovitz for making a fool of himself and educating the public on this issue.

(2) The U.S. Postal Service does make money. You may have missed it, but they're not longer subsidized by the government. They would show a comfortable profit, except that a conservative Congress, in an attempt to discredit the government, required the USPS to adopt accounting principles that nobody else uses. They have to treat their entire pension fund as a liability, which makes them look bad. In the free market, you pay UPS or Fedex $15 to deliver an envelope. Do you think that if you removed the competition of the USPS, UPS and Fedex would lower their prices?

(The Wall Street Journal, that bastion of free-market exceptionalism, was trying for years to develop a delivery system that would be cheaper than the USPS. They failed. The one government service the WSJ didn't want to privatize was the USPS. They'd lose half their circulation. And no, they can't substitute the Internet.)

Because it's a medical device.

[josiahgould]

Regulations, testing, etc, will all drive the price of the unit up. But in the end it's because the manufacturers have figured out what the highest price an average insurance company will pay, and put it right at that point.

Re:Because it's a medical device.

[PlusFiveTroll]

This right here.

Put the word 'medical' in front of anything and you add a zero or two to its price tag.

clones?

[etash]

I remember seeing at least a couple of exactly the same articles on slashdot the past years...

http://science.slashdot.org/story/11/09/09/2346233/is-there-a-hearing-aid-price-bubble

http://ask.slashdot.org/story/10/03/13/1916203/why-are-digital-hearing-aids-so-expensive

has a slashdot staff a sensitivity towards the issue or something ?

Re:clones?

[Cryacin]

Guess nobody heard the last time.

Insurance pays.

[anubi]

If someone else is paying for it, who cares? Just about anything "covered by insurance" has skyrocketed pricewise.

Re:Insurance pays.

[green1]

Because "someone else" doesn't pay for it. Insurance ALWAYS makes a profit. so that means that you are the one paying for it through premiums. People like you who don't care because they don't get the bill directly are the reason that insurance premiums are so high. The premiums have to cover all the costs and still make a profit, the more procedures/devices/etc cost, the more your premiums cost. But because nobody objects (because they don't think they pay for it) the companies get away with it.

You pay for it, only in a round about way.

Re:Insurance pays.

[sjames]

It is private insurance as in not a government service. Non-employer provided insurance is even worse, it's far more expensive and only wants to cover people who never get sick.

The fact that employer based insurance also can't seem to control costs just means the fail is bigger.

From last time...

[Anonymous Coward]

Wasn't the conclusion from last time that there are quite a few cheaper options around if you want some sort of generic device? The expensive devices are supposed to come with custom fitting to your ear and custom frequency response to match your hearing loss.

Ripe for competition?

[cgenman]

Why hasn't anyone kickstartered a competitor?

Try looking at this here . . .

[PolygamousRanchKid]

http://ask.slashdot.org/story/12/06/13/1828232/ask-slashdot-why-are-hearing-aids-so-expensive

Re:Try looking at this here . . .

[PolygamousRanchKid]

Or here . . . http://science.slashdot.org/story/11/09/09/2346233/is-there-a-hearing-aid-price-bubble . . .

This question seems to have been discussed on Slashdot even before its existence . . .

Re:Simple

[SimonTheSoundMan]

As a sound engineer I find a lot of hearing aids have had major features removed. I'm always getting more and more people who have aids that have no induction loop ("T") setting. Some now come with bluetooth, good for your mobile phone but not easy to pair to a PA system, kiosk or POS.

Shooters' earmuffs

[Spy Handler]

nowadays hearing protectors for gun shooters have electronics built in. The earpieces go over the ears and damps out sound, as they've always done. However now there's microphones that pick up sound from the outside, and pipes them into speakers inside the earpiece. If the sound level outside exceed a threshold (such as a gun going off), it doesn't get piped into the speakers.

There's a volume knob, so if you crank that up you can hear much fainter sounds than your normal hearing. So you can use it like a hearing aid, sort of.

You can buy decent ones for $50 - $100.

But if government subsidies and medicare got involved, they'd probably cost $2000 also.

Re:Shooters' earmuffs

[DarthBling]

If you want electronic ear plugs that do the same thing as Shooters' earmuff, be prepared to spend a bit more money than $50 to $100. Still, to get a pair of custom molded ear plugs made, it'll only will cost you between $100 to $200, and that's just for simple ear plugs. You add in the electronics and the price will go up a bit (around $50 to $500 depending on what you're getting). Hearing aids aren't much different than these "off-the-shelf" ear plugs, they're just a bit more sophisticated since they can be tuned by a audiologist to address each individual person's needs.

I had a set of custom ear plugs made a couple years ago at a motorcycle shoe and each pair was $55. Quite the bargain. Just recently, I had another set of custom ear plugs made that come with Noise Brakers and those set me back $120 or so directly from manufacturer (they're local to me, so I just stopped by their building).

Do I think hearing aids actually cost $2000 a pair? Absolutely not. So why are they so expensive then? I believe it's due to a serious lack of competition. Most people who get hearing aids are probably getting them through their insurance company or the VA, so costs are a minimal concern to them as they only have to pay their co-pay or deductible. But if you want to buy them direct yourself, the prices are outrageous and most people will just forgo them and suffer in silence. On a whim about a month ago, I went to a Sonus Hearing store and asked how much they charge for earplugs and they wanted $150 just for the impressions! Plus, I would still have to pay whatever the cost was to have the actual earplugs made. Who do they charge so much? Because they can.

It isn't just about insurance companies

[Ronin Developer]

Today's digital hearing aids are actually very sophisticated devices. People with hearing loss don't need all frequencies (and noise) amplified. Typically, their loss is toward specifics frequencies. The new hearing aids are programable and can enhance the specific frequencies to compensate for the user's hearing losses.

   

Re:It isn't just about insurance companies

[Anonymous Coward]

that isn't sophisiticated in the least. It's called an equalizer and it's extraodinarily easy to implement.

they know what the market will bear and are charging every cent of it.

there's clearly no competition, the question everyone should be asking is, why not ?

Re:It isn't just about insurance companies

[sjames]

The guy that designed the things doesn't buy that line.

Re:bluetooth

[geekoid]

Thanks, but we want a solution that actual solves the problem.

Check prices in Europe

[rrohbeck]

500 to 2,000 Euro.

For-profit system

[bowens]

My significant other is a speech pathologist and she went to school with a bunch of audiologists. While they were in school the audiology students were able to attend several lavish conferences, fully paid for (travel and hotel). Who paid for them? The hearing aid companies. They were given tickets to hockey games (yes this is Canada) and even jewelry. She asked her audiologist classmates if they felt it was a conflict of interest that they were accepting these gifts from the hearing aid companies. Most shrugged it off and said it wouldn't affect their opinions of the products. But how could it not? A few products then get recommended to patients, the companies can jack up the prices, and of course the audiologist will sell you the most expensive one because that is the one the companies are pushing as the best in the market. Review your hearing aid options online and take the audiologists word on a product with a grain of salt.

Re:Not necessarily

[SJHillman]

You're paying for the audiologist too and the ability to keep going back to have them adjusted, cleaned, etc at no extra charge as well as someone to advise you. I also get manufacturer repairs done at a reduced rate (about 60% of what I would pay otherwise) through the audiologist. If you buy hearing aids from the manufacturer, they tend to be about 1/4 to 1/3 the price. Is it worth it? To some people, yes. But for most people - especially the younger generations - not as much.

Source: I've had hearing aids for 19 years

You can have 2: cheap, realtime, or resolution.

[Miamicanes]

Hearing aids are unique among consumer electronic items, because they have almost zero tolerance for latency. If the media stream coming from your entertainment device is delayed by 12ms, you'll never notice the difference. If the sound coming out of your hearing aids is delayed by 12ms, your ability to locate items by sound and react to them is going to be completely borked. At best, you'll be stressed out and irritated. At worst, you'll feel disoriented and confused.

The problem is, all of the cheap ways to do digital signal processing add intolerable amounts of latency, so hearing aids are stuck with hybrid analog+digital designs that try to keep their filtering problems in the domian where they can be resolved the fastest. With digital designs, you can get away with sloppy designs that have corners cut and mostly get away with it if premature failure is OK as an option. With analog designs, every penny you shave off is going to have consequences, and those consequences add up quickly. Mixed-signal designs are the worst of both worlds -- you have to use premium-quality components and be aware of analog signal behavior every step of the way, then turn around and try to fix the noise and artifacts introduced by the digital part as well.

Yes, a hearing aid that simply amplifies sound through some cheap analog means, maybe with simple filtering, would be very cheap to make. However, for most users, that kind of hearing aid would be about as useful as a pair of drugstore reading glasses for somebody who has astigmatism. For profound hearing loss, making speech recognizable is about as hard as trying to fix botched laser surgery that's left somebody with higher-order optical aberrations that simply can't be fixed by a simple symmetric lens.

God/Nature/the Univrese has a cruel sense of humor, and here's an example that will make sense to people who had high-end car stereos at some point in the past. Remember what happened when you ran your stereo's line-level signal through a low-pass filter to separate out the bass channel? It flipped the phase, and made it lag. At the time, you probably dreamed of the day when you could use a DSP to implement an infinite-slope crossover that fixed both problems. Then, years later, you learned the cruel truth: in order to implement such a filter, you had to wait until you had a few thousand samples to analyze and work on... and the time you had to wait until you had a big enough window of samples to analyze ended up being almost exactly the same amount of time that the analog low-pass filter delayed the bass. The digital breakthrough is that if you don't have to do that analysis in realtime, and you have enough storage space to analyze the music offline, then re-sync everything up and store all the individual tracks separately, you can achieve the flawless perfection you always sought as a teenager with laggy bass. It's now cheap and easy to do, because you can take a whole CD, rip it to raw PCM, analyze it with your PC into separate 16-bit audio tracks for every single speaker element in your car, tweak their phase relationships to your heart's content, then write it all to a microSD card & have room to do the exact same thing to a few dozen more CDs.

The problem is, hearing aids don't have that luxury. They're one of the hardest-core realtime applications out there. You can't sample the sound, recursively process it, then go back and remix it at your leisure until it's *exactly* right, then play it over and over again thereafter. You have roughly half of a millisecond to do what you're going to do and send it to the transducer in the user's ear canal.

Of course, there's a big gray area of users whose hearing problems wouldn't be solved by cheap analog hearing aids, but like someone who's got a diopter of astigmatism and moderate far-sightedness, a pair of $12 reading glasses from the rack at the drug store would probably be better than nothing at all. But make no mistake... even if you could embrace the hacker/maker ethic, buy your own best-of-breed he

Re:You can have 2: cheap, realtime, or resolution.

[SpinyNorman]

OK, so you need to hire a decent professional engineer to design your hearing aid. This isn't a DIY project. We get it.

That one-off expense is no excuse for the cost.

Re:You can have 2: cheap, realtime, or resolution.

[Lucidus]

But they do sell millions. How many old people live in Europe, Japan, and the USA?

two words, no hyphens

[Anonymous Coward]

Regulatory capture

We could all say the same thing about...

[blahplusplus]

... expensive internet, and other industries where we get robbed like for instance SHOES and clothing. Do nikes really costs $100+ dollars to make?

Re:Not necessarily

[Americano]

Miniaturization + selling into a fairly limited-size market CAN cost that much.

R&D costs to design the device are fairly fixed - whether or not you build 1 device, or a million devices, you still need to figure out how to fit the features you want into a unit of the appropriate size.

ASHA reports that an estimated 31.5 million people in the US have hearing loss of any kind. Of that, approximately 12.5 million people own hearing aids, and 11.1 million wear them regularly.

Compare that with the numbers of smart phones in circulation, then factor in that these are medical devices and thus require significantly stricter quality & safety controls and testing, and you might get a sense of why the per-unit share of R&D costs would be significantly higher in hearing aids than in smartphones.

Same applies for in-ear shooting protection: how many thousands or millions of these units do you think they sell each year, versus the size of the smartphone market? "in-ear hearing protection for sport shooting" is a pretty specific market niche. It's pretty regular for niche products to cost more - I'd be surprised if the people making the multi-thousand dollar sport shooting protection systems make and sell more than a few tens of thousands of them in a year.

More than meets the ear

[Alomex]

A hearing aid is basically just a microphone and amplifier in your ear so

This is like saying that a Ferrari is basically a VW bug on a race track so why is it so expensive? [yay car analogy!].

A good hearing aid has a microphone, speaker, battery and amplifier which are 1/50th the size of the one in your cellphone yet deliver much higher quality of sound all while filtering undesirable sounds.

Yes, in my opinion they are overpriced, but arguing that they are just a microphone and an amplifier is just ignorant.

Here you go

[Chirs]

http://www.earplugstore.com/woodland-whisper-itc-ac.html

Of course the better ones are more expensive:

http://www.earplugstore.com/pro-ears-pro-fit-hunting-hearing-aid.html

Re:What's with the pisspoor English?

[Sperbels]

I don't understand. Are you saying this is bad grammar and that adding an adjective to industry will make it correct?

One word reply

[Sycraft-fu]

Canada.

Check on hearing aid costs in Canada. You will discover they are very high there as well.

For more information

[EkriirkE]

You can refer to the repost from a few months ago: http://ask.slashdot.org/story/12/06/13/1828232/ask-slashdot-why-are-hearing-aids-so-expensive

You get what you pay for

[viking80]

You can get cheap hearing aids for next to nothing. A simple amplifier. If your hearing is damaged to a varying degree at different frequencies, and you want to be able to hear conversations, a better device will be custom made to remap the relevant audio to the right frequencies. This requires customization to each user and advanced digital signal processing. To select human voice, and filter away unwanted noise is also a demanding DSP task.

A good headset for music easily costs $500, and my sennheiser pilot headset costs easily $1000. and that is not customized to me.

Re:You get what you pay for

[Chuckstar]

This is a good point. It's possible that many people with moderate hearing loss are overpaying for aids that are overkill for their condition. For people with more difficult to address conditions, though, the cheaper ones just don't cut it. My dad has severe tinitis, with associated hearing loss.* He tried hearing aids at all price levels. Only some very expensive ones worked well enough for him to even bother with (couple thousand dollars per ear, but I don't remember the exact price).

*Recent research into tinitis seems to lean towards the hypothesis that I worded that backwards. The old hypothesis was that the ringing sound makes it hard to hear in that range. The new hypothesis is that the ringing is a side-effect of losing hearing in that range -- i.e. it is the equivalent of phantom pain when a limb is severed.

Cheaper hearing aids were sold for awhile...

[Anonymous Coward]

It was about ten years ago when Sharper Image actually sold disposable hearing aids for a very reasonable price. What happened? The legal sale of hearing aids without a doctor's prescription was basically legislated out of existence. How dare someone sell $40 hearing aids to the general public! My ninety (at the time) year old grandfather loved them. I couldn't buy them in my state so had to drive to a neighboring state where they allowed the sale. Until they didn't any more. Can anyone say racket?

Re:Simple

[CrudPuppy]

A couple other points:

We deafies want to change our batteries every week or more, not every day. Have you seen the tiny size of current batteries? You must squeeze every last bit of efficiency out of the hardware possible.

The receivers (aka speakers that go in the ear) must be versatile enough to produce extremely loud sounds across the range of at least 500Hz --> 4KHz with no perceptible distortion. Distortion is the #1 enemy of deafies, and means the difference between "how are you today sir?" and "ajksdhv sdjkch asdkjhvkkf sjk?"

Oh, did I mention the receivers that must be as awesome as above, must also be able to survive something like 18,000 hours in a moist environment? (4 years, 12 hours a day)

The OS and DSP cannot even introduce milliseconds of delay while deciding what is "noise" to be filtered, what is "too loud" and should be compressed, and what was really soft but important enough to amplify even more than normal.

I don't like paying thousands of dollars for my aids, but neither do I believe they can sell for $400.

WTF Again?

[Osgeld]

http://ask.slashdot.org/story/12/06/13/1828232/ask-slashdot-why-are-hearing-aids-so-expensive
http://science.slashdot.org/story/11/09/09/2346233/is-there-a-hearing-aid-price-bubble
http://ask.slashdot.org/story/10/03/13/1916203/why-are-digital-hearing-aids-so-expensive

simple:
insurance
medical device
niche market

just because you are deaf, it doesn't mean that you are too blind, stupid and lazy to look at the last 3 years of the same fucking article with the exact same answers.

Re:custom fitting costs roughly $100

[CastrTroy]

Sure it does. The audiologist just follows a script anyway. Play a bunch of sounds. Record whether or not the user can hear the sounds, Adjust accordingly. I'm pretty sure that you could create a computer program that would automatically adjust a hearing aid to fit a person's specific hearing profile. You could probably rerun the calibration every month, in order to fine tune the device, and account for any changes in the patients hearing. It would probably work better than an audiologist because going to see one is time consuming and expensive and many people probably avoid it even though it might help their hearing.

Re:custom fitting costs roughly $100

[Firethorn]

Hearing aids are right in the ear. It's been mentioned that many today have bluetooth. With that you should be able to hook it up to a computer and, sitting in a quiet room* follow the instructions given on the screen.
Stage 1: Click when you hear a tone.
Stage 2: Which is louder: Tone A or Tone B?
Stage 3: Which is clearer: Audio A or Audio B?

Outside of unusual circumstances that should be enough to 'dial in' the hearing aid very well, in under an hour, without assistance.

Excepting this, looking at what's going on - the devices themselves are over a thousand, and that's WITHOUT developing and programming in a custom hearing profile. That part would be a separate bill.

*DQ's my computer room, but a tablet should work excellent.

Avoid the ripoffs, buy them directly

[DrHeasley]

from the Chinese manufacturers. Prices start at around ten bux. For 825 listings of various 'in ear' aring aids, run a search at aliexpress.com. I would definitely try a couple of these devices before I'd shell out thousands of bux to Philips or Siemens for a device that was probably made in China anyway.

Re:One word...

[nbauman]

Medicare.

Medicare doesn't cover hearing aids.

Medicare does cover cataract surgery, and the price of cataract surgery has dropped dramatically over the past 30 years.

$10 verses $2,000

[Grayhand]

Funny how you can get a hearing enhancing set up for $10 but a fits in ear amplifier casts $2,000. I remember hearing aids for the mid to late 70s that were bulky but worked and average people could aford them. A cell phone if you had one was the size of a lunch pail. Now cell phones are tiny and dirt cheap but hearing aids are smaller and outrageously expensive. It's pure price gauging. Sorry but a computer chip will set you back a $100 but the same thing that does a 1/100 as much runs you $2,000? It's price fixing and everyone knows it but medical expenses are more sacred than religion in this country.

I'd mod this up if I could

[Sycraft-fu]

People need to look around, notice these things are expensive everywhere, and then maybe think that it isn't the evil US healthcare system causing it.

When there's a massive price disparity between the US and Canada or the EU, like for say prescription drugs, well then you begin to suspect something is afoot. I mean they should be rather similar, most things are (particularly when you adjust for taxes that are in the price).

However hearing aids are expensive everywhere. That indicates the opposite: That they really ARE expensive and that is what it is.

Re:One word...

[number11]

Medicare. This is what happens when other people pay the bills. And people want more of this? It is like any other government service. You charge as much as possible for the service as long as you stay within the government guidelines for price, you get to keep upping the price. If you actually let the market decide and not allowed a continuous government bailout of our healthcare system, read, medicare, then prices would get to a sane level. The greater good served by more people having affordable care would offset the number of those who could not afford it. I don't see why people don't understand how contracts and government programs work. We have a few examples, but hey, bread and circus, right?

WTF does Medicare have to do with hearing aids? I'll tell you what Medicare has to do with hearing aids:

Medicare doesn't cover hearing aids or exams for fitting hearing aids.

That's a quote from "Medicare & You 2013: the official U.S. government Medicare handbook".

Me, I don't see why some people don't understand how business works when it can get away with it. But that's just me.

Two words: dumb customers

[ShanghaiBill]

Certainly the free market isn't driving down the price...

The free market only works if customers aren't stupid. The guy in TFA goes to one reseller, and looks at hearing aids from one manufacturer. Yet even he admits that he could get one for far less "on-line", but for some reason he doesn't fee that is an option. Why not?

Two months ago I bought a hearing aid for my father-in-law from Amazon for $329. He describes it as "fantastic". So TFA's claims that nothing is available for less than $2000 is clearly nonsense.

Re:Two words: dumb customers

[AchilleTalon]

Yep, there is plenty of hearing aids in the range of 300$ to 1600$. Here, in my country, the hearing aids are covered by the medical insurance plan from the country. So, the government agency is negociating prices with manufacturers and I can ensure you, no hearing aids above 500$ each are on the list. However, you must know they are not the bleeding-edge products from these companies, they are the end of line products. Even, they are no longer advertised on their respective websites. However, due the negociation for a large number of hearing aids per year, the governement is able to drive down the prices. The contract with the manufacturers include maintenance plan for three or six years.

Obviously, the companies don't want to sell these on the free market and are trying to sell top of line products instead at the higher tag price with the large profit margin.

Re:You disgust me

[Montezumaa]

Do you not understand(obviously, you don't) that Social Security Disability(SSD or SSDI) is funded by, and only paid to, those that have worked and paired into that system? Do you not understand that the amount received each month is based off of how much you paid into the system? You need to actually learn about the topics you attempt to discuss, prior to making yourself appear unintelligent.

I am on disability myself. I previously worked in law enforcement, where I was hurt while working, and I cannot walk without a cane. I also live in an immense amount of pain. On good days, I am hovering around a seven, on a one(least, or no pain) to ten(intolerable, excruciating pain, the worst possible pain) scale, and on bad days, I cannot come down from ten. Today is a good day. I tend to have far more bad days.

Just because I worked in government does not make me more deserving of receiving benefits from one of the programs I paid into. There are a lot of people that need to be receiving SSD benefits, and there are many gaming the system. That is the failure of government, not our receiving benefits from a program we gave a lot of money to.

The people who only qualify for Medicaid(free, Mdicare is not free), Supplimental Income(free, for those not meeting a minimum, which is $678 a month), and other non-paid programs, are the problem. I understand that people fall on hard times, but far too many people "game" the system, and take advantage of money and programs they shouldn't have access to. If you want to target your angst somewhere, target it there.

I worked hard, and paid into the Social Security program by age 26 that most people will not have paid until age 45 to 50. So, spare me the uneducated angst over a topic you obviously have no business discussing.

It's NOT an amplifier.

[Anonymous Coward]

TFS, and parent (and all sorts of other people) apparently don't have a clue.

Hearing aids are NOT amplifier-based, and haven't been for 20 years (30 years?).

They shift frequencies from ones you can't hear to ones you can hear, and do all sorts of other fun things like that.

While still not "extremely complicated" in principle, neither is your automobile, yet you still pay $15K+ for that.

The top of the line ones are crazy expensive because they're top of the line. Same reason you can buy a $4000 computer, top of the line stuff is more expensive because it's brand new and few people buy them.

Royalties

[Roger W Moore]

I'm not sure, perhaps the cost is due to the royalties they have to pay in order to be able to reproduce copyrighted songs.

Exactly: bad insurance, bad regulation

[bradley13]

People complain that for-profit medicine is to blame. This is true, in the sense, that the ground is responsible for hurting you when you trip over your untied shoelaces. I.e., it's true, but it's not the cause.

People with full insurance pay nothing or next to nothing for medical treatment. They do not care how much it costs. Insurance offers such idiotic plans, at least where I live, because the government regulators require them to.

Insurance ought to protect you from catastrophic expenses, not from reasonable expenses that lots of people have. Consider this: Supposed you had to pay all of your health-care expenses up to (say) 5% of your annual income, and 10% of subsequent expenses up to 10% of your annual income. What would the effect be?

1. You would care what ordinary things like hearing aids cost. You would shop around. The companies offering the products would now have to compete for your business. Prices would fall, and fall dramatically.

2. Your insurance costs would sink dramatically. First, because the insurance would rarely have to pay anything. Second, because the free market would be driving medical prices into the basement. For the average person, the saving in insurance costs would more than offset the out-of-pocket medical expenditures.

Government over-regulation is the reason for the current ridiculous prices - and also for the ridiculous bureaucracy in all aspects of medical care. Let the free market actually function in the health-care market, and see what happens.

A last note: it is important that everyone be subject to the rules above. No zero-copays for anyone, no free emergency room visit just because you are on welfare. You have an income, you need treatment, you pay something towards it. This would remove the ridiculous situation of people abusing emergency rooms because it's a way to get free treatment for ordinary things.