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Medicine Hardware

Why Can't Industry Design an Affordable Hearing Aid? 549

Posted by Soulskill
from the what-the-market-will-bear dept.
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."
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Why Can't Industry Design an Affordable Hearing Aid?

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  • by Black Parrot (19622) on Friday October 26, 2012 @06:38PM (#41784103)

    for-profit healthcare

    • by Anonymous Coward on Friday October 26, 2012 @06:42PM (#41784155)

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

      • by narcc (412956) on Friday October 26, 2012 @07:31PM (#41784691) Journal

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

      • by Anonymous Coward on Friday October 26, 2012 @07:50PM (#41784875)

        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...

        • by ShanghaiBill (739463) on Friday October 26, 2012 @10:46PM (#41786249)

          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.

          • by AchilleTalon (540925) on Saturday October 27, 2012 @03:32AM (#41787425) Homepage

            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.

        • by Fjandr (66656)

          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.

        • 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- [counterpunch.org]

    • by malraid (592373) on Friday October 26, 2012 @06:43PM (#41784165)
      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.
      • by pixelpusher220 (529617) on Friday October 26, 2012 @06:47PM (#41784211)
        and lots of people who need them wouldn't get them...
        • by Hadlock (143607) on Friday October 26, 2012 @07:00PM (#41784359) Homepage Journal

          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.

          • by Shavano (2541114)
            It IS manufactured for less than 10% of the price.
          • by AmiMoJo (196126)

            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.

        • by malraid (592373) on Friday October 26, 2012 @07:05PM (#41784437)
          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: (Score:3, Insightful)

            by PopeRatzo (965947)

            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.

            • by AthanasiusKircher (1333179) on Friday October 26, 2012 @09:07PM (#41785515)

              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.

              • by Maxo-Texas (864189) on Saturday October 27, 2012 @06:02AM (#41787957)

                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.

            • by AlphaWolf_HK (692722) on Friday October 26, 2012 @09:12PM (#41785557)

              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.

        • by MBCook (132727) <foobarsoft@foobarsoft.com> on Friday October 26, 2012 @07:27PM (#41784651) Homepage

          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.

          • by budgenator (254554) on Friday October 26, 2012 @07:59PM (#41784967) Journal

            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.

      • by K. S. Kyosuke (729550) on Friday October 26, 2012 @06:50PM (#41784239)

        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.

      • by jhoegl (638955) on Friday October 26, 2012 @06:53PM (#41784269)
        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: (Score:3, Insightful)

          by 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 insur

          • 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-savi

        • by Anonymous Coward on Friday October 26, 2012 @07:09PM (#41784473)

          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.

        • by tburkhol (121842) on Friday October 26, 2012 @08:22PM (#41785169)

          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.

      • 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 reason

    • Oh, I thought you were going to say mal-practice insurance.

    • by jmichaelg (148257) on Friday October 26, 2012 @07:06PM (#41784449) Journal

      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 [apple.com] 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.

      • by Nethead (1563) <joe@nethead.com> on Friday October 26, 2012 @07:36PM (#41784739) Homepage Journal

        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.

      • by LiquidLink57 (1864484) on Friday October 26, 2012 @07:58PM (#41784959)
        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.
      • by Chuckstar (799005) on Friday October 26, 2012 @08:11PM (#41785063)

        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?

      • by nbauman (624611)

        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 Z

    • This is more likely to have been caused by price fixing. I dont imagine there would more than 2-3 hearing manufactures. It seems they have decided to maintain the status quo, than compete.

    • by Anonymous Coward

      Regulatory capture

    • Re: (Score:3, Insightful)

      by 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 competit

    • One word reply (Score:5, Interesting)

      by Sycraft-fu (314770) on Friday October 26, 2012 @07:46PM (#41784841)

      Canada.

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

    • Re: (Score:3, Insightful)

      by udachny (2454394)

      I just explained to somebody [slashdot.org] 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 thei

    • by Arthur B. (806360) on Friday October 26, 2012 @08:19PM (#41785151)

      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.

    • by tmosley (996283)
      No, two words. Fascist healthcare.

      https://mises.org/daily/4276 [mises.org]
  • by josiahgould (2401420) on Friday October 26, 2012 @06:40PM (#41784121)
    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: (Score:3, Insightful)

      by PlusFiveTroll (754249)

      This right here.

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

  • clones? (Score:5, Informative)

    by etash (1907284) on Friday October 26, 2012 @06:41PM (#41784135)
    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 [slashdot.org]

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

    has a slashdot staff a sensitivity towards the issue or something ?
  • If someone else is paying for it, who cares? Just about anything "covered by insurance" has skyrocketed pricewise.
    • by green1 (322787)

      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

  • From last time... (Score:2, Informative)

    by 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.
  • by cgenman (325138) on Friday October 26, 2012 @06:45PM (#41784185) Homepage

    Why hasn't anyone kickstartered a competitor?

  • Shooters' earmuffs (Score:4, Interesting)

    by Spy Handler (822350) on Friday October 26, 2012 @06:56PM (#41784327) Homepage Journal

    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.

    • by DarthBling (1733038) on Friday October 26, 2012 @07:44PM (#41784823)
      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 [noisebrakers.com] 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.
  • by Ronin Developer (67677) on Friday October 26, 2012 @06:57PM (#41784331)

    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.

       

  • I hear* one can take hunting hearing aids and with a few modifications use them for regular hearing aids. These devices are intended to make it easier to hear and locate far-off game. I don't know how easy it is to adjust them for specific frequencies, though, if you have range-specific loss.

    * No pun intended

  • by rrohbeck (944847) on Friday October 26, 2012 @07:03PM (#41784411)

    500 to 2,000 Euro.

    • by Sycraft-fu (314770) on Friday October 26, 2012 @09:32PM (#41785725)

      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.

  • As someone whose hearing in the left is about 65dB down I know I'm going to have to do something eventually. But I kept getting put off by the cost. Thanks to this article I think I've found one I like for about $300. Not bad.
  • For-profit system (Score:4, Interesting)

    by bowens (2761189) on Friday October 26, 2012 @07:12PM (#41784499)
    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.
  • by Miamicanes (730264) on Friday October 26, 2012 @07:13PM (#41784513)

    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

  • by blahplusplus (757119) on Friday October 26, 2012 @07:22PM (#41784597)

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

  • by Alomex (148003) on Friday October 26, 2012 @07:28PM (#41784663) Homepage

    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.

  • by EkriirkE (1075937) on Friday October 26, 2012 @07:58PM (#41784953) Homepage
    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 [slashdot.org]
  • by viking80 (697716) on Friday October 26, 2012 @08:00PM (#41784977) Journal

    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.

    • by Chuckstar (799005) on Friday October 26, 2012 @08:39PM (#41785305)

      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.

  • WTF Again? (Score:5, Insightful)

    by Osgeld (1900440) on Friday October 26, 2012 @08:23PM (#41785181)

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

    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.

  • by Grayhand (2610049) on Friday October 26, 2012 @09:22PM (#41785627)
    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.

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