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Hearing Aid Business Under Pressure From Consumer Electronics
HughPickens.com writes: There's good news for aging Americans who may have damaged their hearing by attending one too many rock concerts when they were young. Andrew Pollack writes at the NYT that the consumer electronics industry is encroaching on the hearing aid business, offering products that are far less expensive and available without the involvement of audiologists or other professionals. The new devices are forcing a re-examination of the entire system for providing hearing aids, which critics say is too costly and cumbersome, hindering access to devices vital for the growing legions of older Americans. "The audiology profession is obviously scared, for good reason, right now," says Abram Bailey.
Hearing aids cost an average of nearly $2,400 each, or close to $5,000 a pair, according to a White House advisory group, and Medicare does not pay for them, nor do most insurers. By contrast, the consumer devices are not regulated and sell for a few hundred dollars apiece, at most. Hearing aid manufacturers say that diagnosing and treating hearing loss is too complex for consumers to do using consumer devices, without the aid of a professional. But sound amplifiers have been around for years and they are growing in sophistication, taking advantage of signal processing chips developed for phones, Bluetooth headsets and computers. The devices include the Smart Listening System from Soundhawk, which sells at $400 for a single ear; the Bean from Etymotic Research, at $300; the CS50+ from Sound World Solutions at $350; and the Crystal Ear from NeutronicEar, at $545. "To me it was a reasonable investment to experiment with," says Ira Dolich, 81, who bought the Soundhawk device, which he can adjust by himself using his smartphone. "I've been pretty pleased with it," he said.
Hearing aids cost an average of nearly $2,400 each, or close to $5,000 a pair, according to a White House advisory group, and Medicare does not pay for them, nor do most insurers. By contrast, the consumer devices are not regulated and sell for a few hundred dollars apiece, at most. Hearing aid manufacturers say that diagnosing and treating hearing loss is too complex for consumers to do using consumer devices, without the aid of a professional. But sound amplifiers have been around for years and they are growing in sophistication, taking advantage of signal processing chips developed for phones, Bluetooth headsets and computers. The devices include the Smart Listening System from Soundhawk, which sells at $400 for a single ear; the Bean from Etymotic Research, at $300; the CS50+ from Sound World Solutions at $350; and the Crystal Ear from NeutronicEar, at $545. "To me it was a reasonable investment to experiment with," says Ira Dolich, 81, who bought the Soundhawk device, which he can adjust by himself using his smartphone. "I've been pretty pleased with it," he said.
Congress will be banning cheap hearing devices. That's the American way.
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I've been saying this for years but no one ever listens to me.
Analog is still better. Lots of older people complain the digital hearing aids suck even after tweaking and all that. I have had my (fir/1)st digital bone conduction hearing aid since last summer. I hate it. :(
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Hearing aid manufacturers say that diagnosing and treating hearing loss is too complex for consumers to do using consumer devices, without the aid of a professional.
So we're too stupid to say, "yep, putting this amplifier in my ear makes me hear better"?? These charlatans need to be put out of business.
A lot of the "consumer devices" nowadays have very poor audio quality.
So what? If you can pay $200 for a hearing test, $200 for a consumer aid, and have a bad consumer aid that works for $400 instead of NOT BEING ABLE TO PAY FOR a high-quality hearing aid, it's still a net win for you and for society as a whole.
Here's a link:
http://money.cnn.com/2016/04/0...
I'm not sure about the frequency distribution, range or amplification. It not likely a miniature device, perhaps like those old fashioned devices that people hung on their shirt or coat, but, who knows, some good guys could help him out to miniaturize it. Kick starter any one?
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I believe this is because diagnosis is important.
Just stuffing an amplifier in your ear is problematic.
Conductive hearing loss can (and should be) medically or surgically corrected, where possible, rather than just amplifying the input noises.
Sensorineural hearing loss are cause by problems in the cochlea and inner ear. This type of hearing loss can result in "band pass" loss, and in the most profound cases, is treatable with implants, if there is still functional cochlear structure. You don't want to treat it with amplification, since you don't want to amplify the bands in which there is no loss, since you'll cause damage there. Tinnitus generally falls into this bucket as well (your *really* do not want to amplify within the bands where you have that!).
Mixed hearing loss is a combination of the first two; it's typically cause by overpressure, such as being near a load explosion or other structurally damaging event that results in both conductive and sensorineural deficits.
A CAPD (Central Auditory Processing Disorder) hearing loss means that the mechanical system are generally intact, but that the information processing doesn't happen within the brain. IT's like having an audio processing system, and yanking the DSP out of it.
Personally, if I had partial damage, I'm going to spend the money on the expensive hearing aides. If I have some function, there's no reason to cook it by amplifying the frequencies that are actually getting through, rather than those which are not.
And even if you amplify only the frequencies that are getting mechanically dropped -- assuming it's conductive loss from damage, scar tissue, etc. -- you should be careful of harmonics, since those frequencies can additively lead to a problem as well.
Put it another way.... say you needed an artificial arm ...would you probably wouldn't run down to the nearest street fair and buy a "Toysmith 6135 Galaxy Grabber Robot Claw", merely because it was a cheaper commercially available alternative.
The days of just an amplifier are pretty well long gone. The best ones do a number of things:
1) Multi-band compression. Compression is reducing the difference between the highest and lowest sounds, and a multi-band compressor does it different amounts for different frequency ranges. Basically an advanced kind f equalization that levels things out, which helps you hear quiet stuff but not get overwhelmed by loud stuff.
2) Frequency remapping. For hardcore cases of high frequency hearing loss those frequencies can be remapped to lower, still audible frequencies.
3) Microphone steering. The mics can steer in on conversation and reject background noise pretty effectively. This makes things much more audible in most situations for most people.
4) Device interfacing. Hearing aids can automatically work with most land lines and cellphones. It isn't via their mic, they do it via induction and so on.
In particular the first two are the ones you tend to need an audiologist for. You get someone to measure your hearing and see where you are deficient and how much, and then design compression curves to counteract that as best as possible.
That doesn't mean the devices couldn't and shouldn't be cheaper, but there's a reason for a professional to be involved.
You mean the government that protects you from snakeoil salesmen, or the government that's bought off by crony capitalists?
Mostly random stuff.
Yes, diagnosis can be very important. I learned that during a year-long stint calibrating audiometers and tympanometers in the offices of both hearing instrument practitioners and audiologists. I also learned that some tests are very short and rudimentary; most often these are what customers get at the 'blow it out the door' hearing aid places. Most audiololgists, (and the good, competent HIP's), do in-depth testing that can diagnose problems and potential problems that might otherwise not be found.
So, in short, I agree with everything you said, and you know a lot more about hearing loss than I do. I also know that there's a degree of sophistication in modern hearing aids that simply can't be had really cheaply, both because of manufacturing costs, and because of a significant amount of original research - even in materials science.
Having said that, I still have a strong impression that hearing aids are very much over-priced. And I know that the testing equipment, (audiometers in particular), are also very over-priced. The whole industry is ripe for some major disruption, and I suspect the encroachment of cheap consumer devices is only the thin edge of the wedge.
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I recently helped an elderly family member get tested, fitted, etc for hearing aids at an audiology office. Sure, it seems like a lot of money. But the $2,400 covers the hearing aid for three years of whatever you might happen to do to it. That breaks down to $800 per year, or less than $70 per month (per ear). That's less than a cable bill, and less than what most people - even elderly drivers - spend on gas for their cars for a month.
That said, there is one health care plan that does cover hearing aids 100% that I am aware of - the VA. I know several people who have gotten their hearing aids for free through them and they've been very happy with it.
Several health insurance plans also offer a small rebate to the customer after they purchase them. The same elderly family member I mentioned before got $500 back from these, and is eligible to do that every 3 years. While I'm not in need of them myself I believe my health insurance plan has a similar arrangement.
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Don't those only work with certain types of hearing loss?
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When the issue is loss of hearing at a specific frequency (common for industrial damage, where a gear running at a specific frequency was heard all day long, and caused loss at that one useful frequency, and the aid re-maps around that hole, rather than running as a pure amp. But for the 80+ year old crowd, they have 2-5 years left, so amping it up improves their quality of life for most of it. Yes, it'll eventually cause full loss, but so does death.
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But wait... these are being used as medical devices! You can't make them better and cheaper over time, the government regulators say so!!!
I do hope this was intended as a joke, because I have grown rather tired of hearing the geek talk like a quack when the subject turns to medicine.
Top 10 Supply Items by Total Spend - January 2015 Tracks 10 supply items, often known as ''physician preference items,'' based on total amount spent on those items during the month by hospitals and other provider organizations.
Yes, they are. Because the electronics part is pretty damn cheap thanks to modern electronics - an ADC, DSP and DAC combination is stupidly cheap. Hell, people are surprised when they spend $2000 on an "audiophile DAC" that the actual chip itself... cost under $5.They're mass produced because every sound emitting device has one, and even stupidly high end ones that do 24bit/192kHz are cheap. Nevermind the "basic" 16bit/48kHz units (which really are all you need for practical purposes since there's few environments a normal person will be in that has more than 50-60 dB of dynamic range, and 16 bits gets you 96dB)
The DSP itself is fairly cheap because audio is fairly undemanding - with clock rates in the hundreds of MHz and audio output rates around 48kHz, trivial. DSP algorithms are fairly standard.
It's why those "not a hearing aid" devices sell for under $100 easily.
One of the other reasons they're popular is well, you get a lot of people who won't admit to having hearing problems, so they won't want to see a doctor about it, but they can go and buy these things so cheaply that are so tiny and are practically invisible. (Face it - when we see hearing aid, we remember the big clunky things that you needed Dumbo-sized ears to hide, while the "not-a-hearing-aid" ads all tout how you might accidentally swallow them thinking they're pills.
Put it another way.... say you needed an artificial arm ...would you probably wouldn't run down to the nearest street fair and buy a "Toysmith 6135 Galaxy Grabber Robot Claw", merely because it was a cheaper commercially available alternative.
Actually, there have been a number of articles right here on /. about people getting cheap 3D printed prosthetics that they report work better for them than the outrageously expensive ones the FDA likes.
Simple principle, if it costs more than you have, it doesn't exist for any practical purpose. This seems to be beyond the FDA's comprehension.
The annoying thing about the medical hearing aids is that you can even get in-ear monitors for audiophiles for less money.
Odd; medication for mental patients is usually more expensive.
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I was interested to read in the article, "Medicare does not pay for them, nor do most insurers".
How is this even possible? You have overpriced healthcare in the USA, and then even if you have insurance, it won't pay for the treatment you need?!
Just for those people that think the NHS is a terrible thing, I'll just leave this here - hearing diagnosis, treatment, and aids are free on the NHS in the UK for people that need them...
-- Pete.
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What makes a hearing aid (especially one that works by simple air conduction of the amplified sound, no different to headphones) a medical device, but a pair of spectacles not a medical device?
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Aging ears tend to lose response to different frequencies at different rates. (presbycusis) The expensive earphones try to tailor the audio response to match an individual's specific hearing loss pattern. Some folks may actually need that. It's far from clear to me that a simple tone and volume control pair of controls wouldn't be more than adequate for a lot of us elderly.folks.
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Do you actually need those? Use a dumb bluetooth earpiece and do the processing on your phone.
Forget magic. Any technology distinguishable from divine power is insufficiently advanced.
Most 2016 flagship smartphones include this feature: Personalised Audio. The Galaxy S7 and HTC 10 both include it; not sure about the LG G5.
I've used it on my Galaxy S7, and it actually makes a pretty big difference to how the audio sounds to me.
Plug in headphones, go into a quiet room, run the Adapt Sound feature, and it plays beeps in alternating ears at different frequencies and loudness. You press the button to show you can hear (or not) the beeps, and it creates a per-ear eq setting to normalise the audio.
Works for corded and Bluetooth headphones.