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Ask Slashdot: Why Are Hearing Aids So Expensive?

Soulskill posted about 2 years ago | from the what-the-market-will-bear dept.

Medicine 629

solune writes "You can get a tablet these days for a few hundred dollars, and laptops for a few hundred more. Gaming consoles, TVs, and smartphones are all available for under a thousand bucks. Yet, a decent hearing aid for my mom will go upwards of $3000! With ever-shrinking electronic components, better capabilities, and technological advancements, not to mention the rapidly increasing potential user base, I would think quality hearing aids should be coming in a lot cheaper than what we can find. Adding fuel to my fire is that a hearing aid will greatly improve my mom's life — not to mention the lives of millions of others out there. Currently, she suffers from frustration and isolation with having to ask people to 'speak up', and nodding her head to things her kids and grandkids say. We've tried the cheapies, and they're fraught with problems. So, can someone tell me why a hearing aid should be so expensive?"

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629 comments

WHAT? (-1)

Anonymous Coward | about 2 years ago | (#40312921)

HUH? I can't hear you!

Annoying old wife whines: "Does that TV have be so looud"

Because insurance pays for them (4, Informative)

Anonymous Coward | about 2 years ago | (#40312923)

'nuff said

Re:Because insurance pays for them (3, Informative)

TheSpoom (715771) | about 2 years ago | (#40312995)

Yep. No market pressures to lower the price. Sucks if you don't have or can't get insurance.

Re:Because insurance pays for them (1, Insightful)

Anonymous Coward | about 2 years ago | (#40313273)

Yep. No market pressures to lower the price. Sucks if you don't have or can't get insurance.

Am I the only one that read this as two completely contradicting statements? Surely, you must see the logic that if there are people forced into paying out of pocket to hear, that there is some market pressure to make lower priced hearing aids!

Regulated medical device (5, Insightful)

wiedzmin (1269816) | about 2 years ago | (#40313413)

Yep. No market pressures to lower the price. Sucks if you don't have or can't get insurance.

Am I the only one that read this as two completely contradicting statements? Surely, you must see the logic that if there are people forced into paying out of pocket to hear, that there is some market pressure to make lower priced hearing aids!

Not as long as they're a minority. And even then - think about it this way - if you have a 100 patients needing one and only half have insurance... would you still rather sell 50 hearing aids at $3,000 each or 100 at $500 each? Plus it's not like some startup can easily flood the market with cheap alternatives either - hearing aids are Class I regulated medical devices... I can only imagine the amount of bureaucracy that must be involved to obtaining that classification.

Re:Because insurance pays for them (1)

Xenx (2211586) | about 2 years ago | (#40313417)

Ok, so if I just pull some random numbers out of my ass... We have 100 people. 50 have insurance and 50 don't. If they sell the hearing aid for $3000, they sell 50 of them. If they sell it for $500 they sell 100. Which makes them more money?

Re:Because insurance pays for them (1)

i kan reed (749298) | about 2 years ago | (#40313029)

More generally, because everything medical in the United States is overpriced, because you can't go without them and there's functionally no competition.

What competition there is, is in getting doctors to proscribe things, rather than for the end consumer. Price never really factors in.

Re:Because insurance pays for them (3, Informative)

Anonymous Coward | about 2 years ago | (#40313095)

by i kan reed (749298) Alter Relationship on 2012.06.13 15:23

What competition there is, is in getting doctors to proscribe things, rather than

in getting doctors to proscribe

to proscribe

proscribe

proscribe

*releases a tortured sigh while rubbing his tightly closed eyes*

Re:Because insurance pays for them (0)

Anonymous Coward | about 2 years ago | (#40313043)

This isn't it entirely. My son was born with moderate hearing loss. He's had hearing aids since he was 3 months old. When we bought them, there was some wrangling with the insurance company over covering the cost. We decided to pay cash, which did give us a discount. Normally they were about $6000, with the discount it came to about $5500. So while insurance may increase the cost, it's not a major component of the price.

Re:Because insurance pays for them (5, Insightful)

0123456 (636235) | about 2 years ago | (#40313111)

I think you miss the point. When Joe Sixpack doesn't have to pay for Product X, he doesn't care whether Product X costs $10 or $10,000,000.

Health insurers pass the cost on to employers, who have to keep paying the increased premiums to keep their employees happy. If Joe Sixpack had to pay for their own health insurance, then he would object when they doubled the premiums to cover those $10,000,000 products that could have been bought in a free market for $10.

Re:Because insurance pays for them (-1, Troll)

Anonymous Coward | about 2 years ago | (#40313289)

Hello, Ayn, is that the plot of your next fantasy book?

Re:Because insurance pays for them (5, Insightful)

SJHillman (1966756) | about 2 years ago | (#40313397)

My hearing aids were covered by my father's insurance (he works for the state, so great insurance) until I turned 21. Now I'm trying to figure out how to pay for my next pair because none of my employers since then have even had partial coverage for hearing aids. It's one of the frustrating gaps in most employer-offered insurances. My current pair were $4000, which includes cleaning every six months (not sure for how many years).

I will say that hearing aid technology has improved at an impressive rate over the past 19 years that I've been wearing them, and costs of a low to mid-end hearing aid is about the same as it was in 1994 when I got my first pair, but inflation has gone up quite a bit since then - not to mention they're more comfortable and durable than ever.

Re:Because insurance pays for them (5, Informative)

WrongSizeGlass (838941) | about 2 years ago | (#40313059)

Many insurance plans don't pay for them. Medicare doesn't pay for hearing aids unless the hearing loss is the aftereffect of an accident. They generally don't cover hearing tests either. Medicare and hearing aids. [medicare.com]

Re:Because insurance pays for them (0)

Anonymous Coward | about 2 years ago | (#40313133)

Yup... I recently had to get a root canal and crown. Although not officially (ie: the dentists did not specifically say so), I got a substantial one time-only discount when I mentioned that I was not using insurance and unemployed, but would be paying for the items in full out of pocket, the process ended up being $900.00 for the root canal, instead of $1400.00 and $500.00 for the crown instead of 750.00. This was in the Greater LosAngeles area.

Supposedly there are issues when dealing with insurance companies that add to the "cost of doing buisness" that include limits and other restrictions.

Re:Because insurance pays for them (1)

v1 (525388) | about 2 years ago | (#40313249)

I had the same experience when I had to have a wisdom tooth dug out (one of SIX... thanks for that) while I wasn't insured. I remember being shocked by the bill, it was about 30% less than the other two before it, and the three to follow.

I wonder, are the doctors soaking the insurance companies, or just averaging their costs out by charging more for the insured and less for the uninsured?

Though I imagine what plays mostly into it is they bill "as much as possible" for insurance claims. Those will pay "up to $xxx for procedure $yyy", and they just set their bill accordingly. But when someone comes in without insurance, it's in their best interest to set a more reasonable price. Because that will probably influence your provider decision later when you are insured.

Re:Because insurance pays for them (1)

Red Flayer (890720) | about 2 years ago | (#40313365)

I got a substantial one time-only discount when I mentioned that I was not using insurance and unemployed, but would be paying for the items in full out of pocket, the process ended up being $900.00 for the root canal, instead of $1400.00 and $500.00 for the crown instead of 750.00.

Insurance companies negotiate discounted rates. I have yet to see my insurance provider pay more than 40% of the billed cost of any procedure I, my wife, or my kids have had done.

Usually the statement from the healthcare provider looks something like this:

Procedure X $350.00
Negotiated discount (255.00)
Insurance paid (75.00)
Copay paid (20.00)
Balance Due: 0.00

And you might not realize you're getting soaked, it's because your discount is less than that given to insurance companies. The providers increase their client base by accepting the insurance in exchange for giving a steep discount.

Re:Because insurance pays for them (5, Informative)

Teese (89081) | about 2 years ago | (#40313137)

Except, insurance (generally) doesn't cover them. Mine surely didn't.

no, they don't (0)

Anonymous Coward | about 2 years ago | (#40313427)

hearing aids only cover kids in specific instances only.

As an adult, guess what? Insurance doesn't cover them at all.

Maybe because... (0)

Anonymous Coward | about 2 years ago | (#40312945)

They aren't a vanity item mass produced for everyone to consume, they are a medical device for people that are going deaf.

I found a good explanation (5, Insightful)

Anonymous Coward | about 2 years ago | (#40312949)

on this silly site [slashdot.org]

Re:I found a good explanation (5, Insightful)

ebuck (585470) | about 2 years ago | (#40313305)

on this silly site [slashdot.org]

Don't worry, this topic deserves about three more submissions before even Slashdot deems it not worthy of a repeat.

The electronics must be small, they mustn't be very heavy, and the must do something that is computationally expensive (signal isolation in a noisy background), combined with amplification, all in a custom fitting (to your ear) enclosure.

On the other hand, you have people stating that a mass marketed device which is identical for a run of over 11 million last quarter, with ability to use bigger (lower cost) components, bought in bulk (by the millions) is cheap, so this custom device should be too.

Basically they are expensive for all the reasons the article poster is ignoring, which reduces the article to "I want one cheaper, waahhhhaaahhh!!!"

Re:I found a good explanation (1)

Dr_Barnowl (709838) | about 2 years ago | (#40313381)

And the custom fitting to your hearing loss ; like setting a reaaaly tiny graphic equalizer.

If you kept your mouth shut ... (1)

Anonymous Coward | about 2 years ago | (#40313449)

and used a registered account, you could have just copied and pasted all the +5 comments and went from 0 Karma to +1000 in one thread!!!

But no. You had to post as an AC.

Simple Economics of Scale (5, Informative)

eldavojohn (898314) | about 2 years ago | (#40312953)

From this source [gallaudet.edu]:

About 2 to 4 of every 1,000 people in the United States are "functionally deaf," though more than half became deaf relatively late in life; fewer than 1 out of every 1,000 people in the United States became deaf before 18 years of age.

However, if people with a severe hearing impairment are included with those who are deaf, then the number is 4 to 10 times higher. That is, anywhere from 9 to 22 out of every 1,000 people have a severe hearing impairment or are deaf. Again, at least half of these people reported their hearing loss after 64 years of age.

Finally, if everyone who has any kind of "trouble" with their hearing is included then anywhere from 37 to 140 out of every 1,000 people in the United States have some kind of hearing loss, with a large share being at least 65 years old.

So even at 140, even ignoring those that cannot be helped by hearing aids and those that cannot afford hearing aids, the truth is that far more than 140 out of 1,000 people buy the products you mentioned. If you move a higher volume, you can price them lower and approach their true cost as your design and overhead costs diminish with numbers. What's more is that "a laptop" will more or less work for me the same as it will work for you. We don't need to mold the laptop to put it in our ears or have it tuned to our needs.

You also seem to overlook two factors: as electronics get smaller they get more expensive. The second part is that as electronics need to power themselves and get smaller they get even more expensive. And on top of that, my cell phone puts out a lot of heat. The kind of heat I would not want in my ear. So you have to consider that the battery must be small and must not dissipate tons of heat and so therefore the electronics must have a very low power draw. There's not much of a conspiracy to find here, it's an unfortunate reality that prevents someone from storming the market with the new better cheaper hearing aid (pending tech advancements).

In my family, we look at chipping in to buy our elders hearing aids for presents, I know the nice ones are crazy expensive.

Re:Simple Economics of Scale (1)

Anonymous Coward | about 2 years ago | (#40313183)

For some more excellent info go here: http://wattsupwiththat.com/2011/09/10/a-note-about-hearing-technology/
I used to think like most posters here until I found out the reality behind their fabrication. Still and all they could be a lot cheaper.

Re:Simple Economics of Scale (1)

Richard_J_N (631241) | about 2 years ago | (#40313311)

Yes...but surely there's a market for a good, less expensive hearing aid that is either wired (like an iPod), or slightly bulky (like a bluetooth headset)?

Actually, why hasn't anyone tried to modify a bluetooth headset: pair with an android phone, do some DSP, and use the device in loopback mode?

Re:Simple Economics of Scale (5, Informative)

Anonymous Coward | about 2 years ago | (#40313351)

From Anthony Watts web site supplying some technical info about hearing aids, in his words:
  I wear two ITC/CIC hearing aids with DSP processors built in. Let me tell you a little bit about why they are so expensive. The largest supplier of hearing aids in the USA is Starkey in Minneapolis. I’ve been to the factory, and have experienced the process from start to finish courtesy of the president of the company.
1. Because hearing aids, especially BTE (behind the ear) and ITC/CIC (completely in the canal) types use a single cell 1.5 volt battery, which can drop as low as 1.3 volts through its useful operational life, the amplifier circuits must be of extremely low power consumption and low voltage. The only chip material that works well for this is germanium, which has a diode junction forward voltage of ~ 0.3V as opposed to the ubiquitous silicon used in consumer electronics which has an ~ 0.7V forward voltage. While germanium was once very common for transistors and some early integrated circuits, it has fallen out of favor in the microelectronics hearing aid world. There are only a handful of sources and companies now that work with germanium, thus the base price is higher due to this scarcity. You can’t just take an off the shelf silicon chip/transistor and put it in these aids. Each one is custom designed in germanium. [Added: power consumption is a big issue also, aids are expected to last a few days on a single battery, if most of the power is being used to overcome the forward diode voltage, it gets lost as heat instead of being applied to amplification use.]
2. The process of properly fitting a hearing aid is labor intensive. Custom ear molds must be created from latex impressions, and these need to be fitted for comfort. A small variance or burr can mean the difference between a good fitting mold and one that is painful to wear. Additionally, if the mold doesn’t maintain a seal to the inner ear properly the hearing aid will go into oscillatory feedback. Sometimes it takes 2 or 3 attempts to get the fitting right.
3. On the more expensive aids, labor is involved in doing a spectral hearing loss analysis of the user’s hearing problem, so that the aid doesn’t over-amplify in the wrong frequencies. Just throwing in a simple linear amplifier is destructive to the remaining hearing due to the sound pressure levels involved.
4. Construction of aids is done by hand by technicians, especially with the popular ITC (in the canal) aids. At the Starkey company, a technician is assigned to create the aid from the ear mold, fit the chips and microphone/receiver and battery compartment, and connect it all with 32 gauge wire and make sure it all fits in the ear mold. This can be a real challenge, because human ear canals aren’t often straight, but bend and change diameter. Imagine a room with a hundred technicians sitting at microscopes assembling these. Each is a custom job. There’s no mass production possible and thus none of the savings from it.
5. After the aid is created, then there’s the fitting. This process is also hands on. Getting the volume and the audio spectrum match right is a challenge, and audiologists have to have chip programming systems onsite to make such adjustments withing the limits of the aid. Sometimes aids are rejected because the user isn’t comfortable with the fitting, and then the aids go back to the factory for either a new ear mold, new electronics, or both.
6. There’s a lot of loss in the hearing aid business. Patients don’t often adapt well, especially older people. There may be two or three attempts at fitting before a success or rejection. Patients only pay when the fitting is successful. If it is not, the company eats the effort and the cost of labor and materials. Imagine making PC’s by hand, sending them out to users, and then having them come back to have different cases or motherboards or drives fitted two or three times, and software adjusted until the customer is happy with it. Imagine 4 out of 10 PC’s coming back permanently after trial and error with a customer.
7. Early hearing aids weren’t anything but simple amplifiers. Even until the mid 90s there was very little spectral customization. Now many aids are getting features like frequency equalizers and DSP noise reductions that we take for granted in even the cheapest silicon based consumer electronics. Hence, price has increased with complexity, but there’s still the high cost of custom special chips, and lots of labor.
So for those who think mass production techniques used on iPods would work just fine for making a delicately balanced instrument that must fit in your ear, please think again. As a hearing aid user since 1969, do I think the price tag of the special hearing aids today are worth the price compared to the simple linear amplifiers I used to have to deal with? Absolutely.
For more on hearing loss, see the Starkey Hearing Foundation, which I support.

Re:Simple Economics of Scale (0)

Anonymous Coward | about 2 years ago | (#40313419)

There must be some large amount of deaf people or forcing CC on televisions would not have been would not passed.

Lack of good competition (0)

Anonymous Coward | about 2 years ago | (#40312963)

There needs to be an open source project for this. A non-profit that produces quality hearing aids.

cost vs sales curve (2, Insightful)

slashmydots (2189826) | about 2 years ago | (#40312973)

"Oh no, my poor insurance company shouldn't have to pay $3000 for this device. It's too high! I will not buy it!" You don't hear that all that often (no pun intended) so that's why the cost is so high. Econ basics, people. Cost goes up, sales go down. When you factor in "I don't give a crap what it costs, I'm not the one paying for it" that does tend to throw cost off a bit. I know hearing aids aren't as covered as other medical devices, treatments, and prescriptions but they're not 100% out of pocket very often either.

Oh and the million dollars or more in testing to get FDA approval plays a factor. I have a feeling Microsoft didn't even put a million into testing the Xbox 360 lol.

Re:cost vs sales curve (3, Insightful)

Jeng (926980) | about 2 years ago | (#40313291)

I take a medication daily. With my insurance it costs me $45 a month, a generic version recently came out, it costs me $45 a month, if I want the non-generic it will cost me @$400

The insurance companies have ways of pushing you to the cheaper option if a cheaper option is available, mainly by not covering the more expensive option.

Re:owwww my eaar (0)

Anonymous Coward | about 2 years ago | (#40313323)

Hopefully fewer hearing aids catch fire then Xboxs.

Re:cost vs sales curve (0)

Anonymous Coward | about 2 years ago | (#40313359)

Who says the insurance company pays anywhere near $3000? Since we (the US) do not have universal health care, the real pressure on your supply demand curve is not from government but the combined pressures that health insurance companies making sure you absolutely need them and medical providers (products and services) making sure they get as much of money as possible. Basic economy principles go out the window when your life (or ability to interact with society properly) is on the line. I would take a second mortgage out and pay $100,000 if it was necessary to restore my sight. I guess hearing is only worth ~$3000.

Because it's a medical device. (2)

Paleolibertarian (930578) | about 2 years ago | (#40312987)

And they can... Medical devices are subject to very stringent standards and testing for approval. They are also tailored to boost some frequencies more than others.

Re:Because it's a medical device. (0)

Anonymous Coward | about 2 years ago | (#40313103)

"My hearing aid crashed " is not nearly as bad as "My pacemaker crashed". Perhaps standards should be relaxed optionally for cheaper devices (high reliability versions still available ofc)

Re:Because it's a medical device. (2)

Eponymous Hero (2090636) | about 2 years ago | (#40313279)

"my hearing aid made my pacemaker crash" would be pretty shitty.

Re:Because it's a medical device. (3, Informative)

Obfuscant (592200) | about 2 years ago | (#40313387)

"my hearing aid made my pacemaker crash" would be pretty shitty.

So would "my hearing aid shorted out and burned the inside of my ear". Or "everyone runs away when I approach because they are tired of the constant feedback my poorly fitted heading aid emits.". So would "I paid extra for a phone that was hearing aid compatible and this hearing aid doesn't work with it."

Re:Because it's a medical device. (1)

CastrTroy (595695) | about 2 years ago | (#40313377)

So why couldn't you buy a similar device that's not rated for medical use off the internet? Last time this question came up on slashdot, I stated something along the lines of, it should be really cheap, especially with bluetooth headsets becoming so fashionable/acceptable (not that I personally think they look good, but you won't get too many weird looks walking around with a bluetooth earpiece) to produce a functional hearing aid for a good price. A quick google search came up with this result [asseenontv.com]. Looks like a bluetooth earpiece, costs $14.95. I'm sure there's room for a whole range of products at various prices.

So what you're saying is... (0)

jtownatpunk.net (245670) | about 2 years ago | (#40312989)

You don't love your mother. If you loved her, it wouldn't matter how much it costs to make her happy.

They're expensive because people will find a way to pay for them. Don't try to make it more complicated than it is.

Re:So what you're saying is... (1)

neonv (803374) | about 2 years ago | (#40313167)

No matter how much you love your mother, money is still required. Before I get my mother a hearing aid, I will make sure my family eats, has a home, has utilities, and all other needs are met. If there's money left over, then buying mother a hearing aid is possible. Loving your mother is great, but it doesn't pay for goods and services.

The Cost increase has increased the quality (1)

Anonymous Coward | about 2 years ago | (#40312991)

I think that one of the reasons that they are so expensive is that the quality has gone up so significantly. New hearing aids have bluetooth, rechargeable batteries, they are smaller than ever. and most importantly they can be customized to amplify the precise frequencies that someone is hard of hearing (i think they do 32 bands now). So while the cost has remained similar for 10 years the capability has increased multifold. Also included in that price is a excellent warranty, custom programming and sizing. One may spend several hours getting programmed/fitted so this is part of the huge cost.

Chris

Re:The Cost increase has increased the quality (1)

K. S. Kyosuke (729550) | about 2 years ago | (#40313171)

...and most importantly they can be customized to amplify the precise frequencies that someone is hard of hearing (i think they do 32 bands now). So while the cost has remained similar for 10 years the capability has increased multifold.

They got better? So have desktop computers, and despite that, their price has gone down. You can do all that with a simple chip these days, one that is much cheaper than large VLSIs, and even these are cheap today. It still doesn't make too much sense. Granted, if the price includes the service of fitting, programming, and potential repairs, and basically equates paying for a medical procedure instead of the price of the hardware as such, then I guess it might be reasonable. (I've noticed that even simple medical procedures have atrocious prices in the US, so I wouldn't be surprised at that.)

Very easy answers! (0)

Anonymous Coward | about 2 years ago | (#40313001)

1) Demand is low
2) USA has private health care and to some people hearing aids are not an option
3) The incumbent manufactures use typical monopoly/lobbying tactics to crush any potential competition.
4) Since the incumbent manufactures crush competition through legal means, there is little reason for technical R & D.

Is this really that hard to grasp?

...the world of medical tech... (5, Insightful)

raydobbs (99133) | about 2 years ago | (#40313003)

They need to be able to have FDA testing, certification, independent verification of testing, quality assurance and all the paperwork hell -that- involves. The certification needs certifiers to certify that the certification has certificates on the certifiers to do certifications and so on... There is a MASSIVE paperwork rats-nest involved in making ANYTHING that used in healthcare.

It's why healthcare spending is rapidly outstripping the US economy, to be completely honest.

Re:...the world of medical tech... (2)

LihTox (754597) | about 2 years ago | (#40313293)

But is certification really necessary in this case? If a company just made a device to insert in your ear (like an earbud or headset) which amplified sound in a particular way, that wouldn't be much different from a Bluetooth headset or a set of earbuds...I don't see how they could be prohibited from selling them, though perhaps with a different name. Insurance might not pay for them, but if you insurance covers a hering aid then what's the problem?

Re:...the world of medical tech... (4, Insightful)

hawguy (1600213) | about 2 years ago | (#40313389)

But is certification really necessary in this case? If a company just made a device to insert in your ear (like an earbud or headset) which amplified sound in a particular way, that wouldn't be much different from a Bluetooth headset or a set of earbuds...I don't see how they could be prohibited from selling them, though perhaps with a different name. Insurance might not pay for them, but if you insurance covers a hering aid then what's the problem?

If I were going to wear a sound amplifier in my ear all day every day, I'd like some assurance that it's been tested and that it isn't outputting such high sound levels that it's killing off whatever amount of hearing I have left.

Just because it's not implanted inside the body doesn't mean that it can't cause harm.

Expencive because medicare, insurance (-1)

Anonymous Coward | about 2 years ago | (#40313005)

When you have everyone getting free motorized wheel chairs to anyone on medicare the price for said item goes through the roof. Same thing with hearing aids. They are expensive because most dont pay for them and allow the insurance or government pay for it allowing the company to not have to compete for your purchase.

Re:Expen_s_ive because medicare, insurance (1)

Anonymous Coward | about 2 years ago | (#40313355)

Derp derp guvvvammiinnnnt!!!

Medicare doesn't pay for hearing aids or hearing tests. Carry on with your foaming at the mouth, though.

Its the hearing aid Cartel that is to blame (0)

Anonymous Coward | about 2 years ago | (#40313017)

I suspect that the price does not reflect the cost of producing the hearing aid but more the cartel that has established a racket to ensure the highest revenue on each item sold. If you could buy them at Best Buy, the price would come down but most of these are sold through specialty dealers with lots of markup.

Supply and Demand (1)

AkaKaryuu (1062882) | about 2 years ago | (#40313031)

The hearing aide companies sell less because of the target number of customers. Plus of those customers, some will either deny or refuse treatment, cutting down on actual "demand" value, raising the cost. Every 13 year old has a smart phone it seems, so they can be sold for less to more people.

Frequency range and translation (2, Informative)

Anonymous Coward | about 2 years ago | (#40313045)

Most hearing aids are vastly more complicated than just a volume increasing device. They actually take sounds received on certain frequencies and rebroadcast them on frequencies your mom can hear better on. Thus why they are prescription based like glasses.

Here is a more technical and probably more accurate description:
http://en.wikipedia.org/wiki/Hearing_aid

Single Sided Deafness (SSD) (0)

Anonymous Coward | about 2 years ago | (#40313051)

My Wife just woke up deaf in one a month ago and no hearing aide will help. Get to Dr. fast if you have any hearing issues.

Better invest in them soon... (1)

Anonymous Coward | about 2 years ago | (#40313063)

All the people that got brought up in the 80s and 90s (and to a much greater extent the 00s and 10s) were raised in the era of portable music players. That means headphones, that means unsafe volumes, that means in 40 years there is going to be an explosion of people who can't hear very well.

Effective lobbying locks out competition (3, Insightful)

Freddybear (1805256) | about 2 years ago | (#40313073)

As "medical devices" hearing aids must by law be sold by licensed audiologists, and those same audiologists' trade organization lobbies governments at every level to keep up a very tight monopoly control of the marketplace.

Re:Effective lobbying locks out competition (1)

aminorex (141494) | about 2 years ago | (#40313455)

Untrue. You can buy hearing aids on the intertubes, and pretty cheaply, but they kinda suck.

Barrier to entry (1)

doug141 (863552) | about 2 years ago | (#40313083)

FDA regulates their manufacture. Licensing creates barrier to entry to the market. FDA regulations impose strict requirements that drive costs way up.

A few reasons (0)

bengoerz (581218) | about 2 years ago | (#40313119)

Hearing aids may be expensive for several reasons: 1. They're often covered under insurance, so there are incentives to keep the retail price artificially high. 2. They involve a lot of labor. Audiologists generally tailor the performance of the hearing aid to the individual user. 3. They're not mass-produced to the same scale consumer electronics are. 4. They bear much more liability potential. If your laptop fails and you lose your Word document, you shrug and replace it. If your hearing aid fails and you don't hear the horn of the car about to hit you, you sue their pants off.

Recovery (3, Informative)

GerryHattrick (1037764) | about 2 years ago | (#40313129)

In the UK it's largely because the 'price' includes 'recovery' of all the audiologist's time and overheads which are misleadingly presented as 'free'. Try buying it used, and no one will set it up for you. Cartel point is valid too, similar reason.

Re:Recovery (1)

Myridon (719720) | about 2 years ago | (#40313457)

This is also true in the US. Not only does the price include all the services of the audiologist (the initial fitting, the setup, any number of adjustments), you can give it back to the audiologist within 30 days and not pay a thing even though the device can't be sold to someone else, i.e. the manufacturer has to eat the cost of any devices that the consumer doesn't like on a whim not just defective ones.

Justification (5, Interesting)

hawguy (1600213) | about 2 years ago | (#40313131)

Here's an article that attempts to justify the cost:

http://www.aarp.org/health/conditions-treatments/info-05-2011/hearing-aids-cost.html [aarp.org]

Overall cost — $3,600

Costs for the manufacturer:

Materials — $360

Research — $1,080

Other retailer costs:

Rent/overhead — $450

Testing/diagnostic machines — $288

Licenses/insurance — $108

Salaries — $540

Marketing — $270

Continuing education/training — $180

Potential profit for the retailer (pretax) — $324

Approximate product cost for retailer — $1,440

I don't know how accurate it is, but I can believe that the actual parts cost of a hearing aid is around $350.?

Re:Justification (1)

vlm (69642) | about 2 years ago | (#40313429)

I don't know how accurate it is, but I can believe that the actual parts cost of a hearing aid is around $350.?

Pretty high estimate. I've done software defined radio stuff, add a simple microphone and mic preamp and change the software and it would make a killer hearing aid. The point being dedicated SDR hardware has a lovely low noise low intermod input amp, a decent 16 bit A/D, some extremely hefty CPU processing capable of anything a mere hearing aid could possibly require, and a nice low distortion 16 bit D/A and amp. Its hard to find a way to spend more than $50 on materials. Now this might pass thru 5 middlemen, each demanding 50% profit, in which case, sure, the last guy to "pay for hardware" had to cough up $350, because the n-1 middleman made $175 of profit, and the n-2 middleman made $83 of profit, and the n-3 middleman made $42 profit, and the n-4 guy who imported individual components from China made a mere $21 of profit, leaving the foxconn workers $10.50 of revenue. Or something like that.

My bluetooth earset / bug / whatever you call it off the shelf at best buy it was $40 in May. Some android software to listen, buffer one second, amplify, echo can, and blast it into my ear SEEMS possible. Its a plantronics M50. My first one was $80 a couple years ago, and replacement purchased about a month ago was $40 before sales tax. In some ways its not terribly durable, but at $40 I'm not too worried if it "only" lasts 2 or 3 years of heavy use. On the other hand, a $40 pair of shoes would never survive near daily used for 3 years either.

Re:Justification (1)

gurps_npc (621217) | about 2 years ago | (#40313435)

90% of that stuff is way over-priced.

Pay separately for testing/fitting and an ear doctor. Order everything via the internet. Suddenly most of that stuff gets cut to 1/10 of what it is.

As for whats left, well....

Salary, Marketing, and Potential Profit are all a function of the price of the product. That is if ti costs $3,600 you can get away with charging $540 for salary. If it costs $360, then you pay someone $54 for selling one.

As far as I can tell, most of those costs are just associated with having many small firms sell them, as opposed to doctors ordering them for the patient over the internet.

Because they are custom made (0)

Anonymous Coward | about 2 years ago | (#40313139)

I don't know where else you looked for hearing aids, but googling "hearing aid" brought up a number of devices in the $200 to $300 range. Hearing aids in the range you're talking about are typically custom made for the user which makes them very expensive. It's not the electronics, it's the labor.

Natural economic forces (-1)

Anonymous Coward | about 2 years ago | (#40313193)

I'm not an economist or a politician, but if I had to guess.... I would say that if you took insurance companies and medicare out of the equation, prices would probably drop. These entities interfere with the natural economic forces that drive prices down. If everyone just paid out of pocket for their hearing aids, and insurance companies and the govt. weren't involved, the companies that make the hearing aids would be forced to *compete* for your dollar in an open market. That would drive down prices, accelerate innovation and raise quality.

Because insurance always pay (1)

gurps_npc (621217) | about 2 years ago | (#40313205)

No one looks at the price, ever.

If you try to buy them outside of insurance, suddenly they offer massive discounts.

Design your own? (1)

kg261 (990379) | about 2 years ago | (#40313211)

I see a few people walking around with bluetooth headsets. Maybe "invisible" hearing aids are expensive, but another option would be to use(hack) these cellphone headsets, or even use an iphone (there noise cancelling sw built in). People are used to seeing them - just have to convince your mom.

Try a non-medical hearing device (3, Interesting)

ChrisKnight (16039) | about 2 years ago | (#40313233)

Do a little googling, and you'll find lots of people writing about positive results using Walker Game Ear devices as cheap hearing aid substitutes. They don't have the frequency fine-tuning that medical devices have, but you can give a $200 Game Ear a try, and return it if it doesn't work. Try that with a $3k hearing aid...

http://www.cabelas.com/catalog/browse/hunting-hunting-accessories-hearing-protection-enhancement/walkers-game-ear/_/N-1100132+1000005098/Ne-1000005098?WTz_l=SBC%3BBRprd708259&WTz_st=GuidedNav&WTz_stype=GNU [cabelas.com]

the anti-Ferenghi in me (1)

Ralph Spoilsport (673134) | about 2 years ago | (#40313243)

senses opportunity - my lobes vibrate - thinking: DIY hearing aids. They're probably all made in the same damn factory in China. So, buy a crate of the parts and post instructions on how to build them.

Assembly and customization (5, Interesting)

necro81 (917438) | about 2 years ago | (#40313253)

Tablets, computers, etc., all can be machine-assembled, or assembled by half-way trained manual laborers in a factories that can achieve high throughput by economies of scale, division of labor, etc. And although they are densely packed, personal electronics are still, for the most part, macroscopic. The components in a hearing aid, by contract, have many miniscule components that are assembled very carefully, by hand, by skilled laborers using loupes and microscopes - more akin to watchmaking than assembly-lines. As such, the assembly labor has resisted outsourcing. Plus, the number of units being assembled by any one company (there are many players in the market) aren't large enough to support well-oiled assembly lines running 24-7. Finally, most hearing aids have some amount of customization to each patient (ear-insert moldings for some models, equalization tuning for others), which further increases cost.

Others have mentioned the addition cost associated with it being a medical device, which is not insignificant. Lastly, because many hearing aids are paid for by insurance, rather than out-of-pocket, there is less consumer-driven pressure to reduce costs.

Re:Assembly and customization (1)

pitchingchris (2591965) | about 2 years ago | (#40313411)

Not to mention that the aide has to be customized for your hearing loss. I couldn't purchase one ready to go. They are tuned to counteract the loss that you have.

Yea, a _bit_ high :) (2)

Bigbutt (65939) | about 2 years ago | (#40313255)

I went in a year or so ago to have my hearing checked and found out my ranges but in general everything checked out as ok.

The doctor said I would benefit from getting a hearing aid due to the loss of hearing in one part of my range (bit higher than it should be but not deaf). She was going through the brochure and showing me the aid, a nice one about half the size of a bluetooth ear set. Her nurse checked my insurance company and it didn't provide coverage for hearing aids but I was still interested in the information.

As she was going through the pitch, she was saying "49" "95" as in $49.95. I'm thinking that's a pretty decent price and said that's not too bad, I'd like the one with the red shell. She didn't have any in stock having just sold the last one but could order one for me. She'd have to have a non-refundable $50 deposit though.

And I'm ..ooOO( 50 buck deposit on a $49.95 item? That sounds weird )OOoo..

So I asked and she said, "no, $4,995.00. You thought I meant $49.95??"

Ahh, no. Sorry. It's not all that bad, thanks anyway :)

[John]

I'm no expert. (2)

wonderboss (952111) | about 2 years ago | (#40313259)

But couldn't we make these more like cell phones? I see a lot
of people walking around with bluetooth headsets. Rather than
making the hearing aide fit in the ear, make it something I can
wear on my belt, or on a lanyard. The problems of size, power
and heat all become easier to solve.

Same reason that glasses and lens are expensive (0)

Anonymous Coward | about 2 years ago | (#40313271)

Total scam. That is all.

I know that the price of glasses has fallen in the last few years but they were a total ripoff before and still are if you don't shop around. I mean $200 for lens that cost $5 to manufacture? Come on!

Smartphone/tablet application (0)

Anonymous Coward | about 2 years ago | (#40313277)

My mom has some hearing loss and I've been thinking for a while of writing a smartphone/tablet application as a poor person's hearing aid. It would use a cheap Bluetooth earpiece and do audio processing in the tablet in her pocket/purse. It would be able to do equalization, frequency mapping, and all that fancy ass DSP stuff that $3000 hearing aids do, except it wouldn't fit in her ear (except the earpiece), it would depend on a remote hunk of electronics (the smartphone) and she'd only be able to use it a few hours without a recharge (that is enough to get her through a day) or use an external battery pack comparable in size to the phone. For $3000 savings it seems worth the nuisance.

"Medical and Military Make Money" (4, Insightful)

droptop (558616) | about 2 years ago | (#40313295)

The same reason that between myself, my insurance and Medicare AirWay Oxygen has been paid over $26,000 over the past seven years for a machine that costs $2,000; The pain in the ass to get FDA approval (both real and imagined) for a "medical device" prevents many would-be manufacturers from entering the market, and none of the players wants to ruin their golden goose by starting a price war. We used to say the same thing about military equipment when I was an Army Mechanic... In 1982 I couldn't understand at all how the little M151A2 "jeep" cost over $75,000 a pop!! Especially since the assembly lines have been running since 1968 and a lot of the expensive magnesium pieces had been replaced by steel. The adage is the same: "Paint it green and quadruple your profit" or "Paint it white and put FDA on it and quintuple your profits"!

Custom device (0)

Anonymous Coward | about 2 years ago | (#40313307)

I watch "How its Made" on Netflix, so take my 'expertise' with the appropriate amount of salt, but when creating a hearing aid, the first step is to make a mold of the ear canal. The components must then be inserted into the custom fabricated casement made from this mold.

As soon as you are getting 'custom fit' stuff, it gets expensive.

Doesn't answer the question, but... (1)

SteelKidney (1964470) | about 2 years ago | (#40313315)

Find the nearest Lions Club and talk to them. Helping absorb the costs of hearing and sight loss is a large part of how they use the money the raise. If you're in the U.S. look up the state Lions organization rather than contacting individual clubs. Outside the U.S., I'm not sure.

Ask Also About Eyeglasses (0)

Anonymous Coward | about 2 years ago | (#40313327)

We should also ask why prescription eyeglasses are so expensive. In the age of computer controlled machinery, it should be both quick and cheap to automatically cut and grind a pair of lenses. But the average set of spectacles will cost several hundred dollars, especially if a strong prescription is required -- and not everyone has optical insurance.

Costco is much cheaper (2, Informative)

Anonymous Coward | about 2 years ago | (#40313329)

I just bought two state of the art power aids from Costco for 2k, so 1k apiece. They seem to be working just fine for me. They probably would have been 3X the price from a conventional hearing aid dealer

Because they can. (5, Insightful)

MrLizard (95131) | about 2 years ago | (#40313335)

For pretty much the same reason that a small piece of soft foam as a filter for my CPAP -- not magic foam made from unicorn testicles, just bog-standard foam, about 2" square -- is billed to my insurance company at 25.00.(Seriously, due to a paperwork snafu, at one point, I got the itemized bill instead of my insurance company getting it, and it's ridiculous what they charge.) Because they can. (My insurance company, I'm sure, just laughs and pays them a buck, at most, but having the item be "worth" 25.00 is probably a lot of use to accountants at every stage in the transaction.)

Why did a simple ultrasound of my heart, performed by a technician who was not a doctor, not a nurse, just someone who'd completed "Be an ultrasound technician!" at night school, and which took about 15 minutes, cost over $1000.00? No reason. It's a random number. They bill the insurance company, or the government, depending on if you have private health insurance or medicare/medicaid, and then the people they bill pay whatever amount THEY decide to pay for an ultrasound. This doesn't work, of course, if the hospital has to bill YOU -- you have to pay what they ask. Sucks to be you. Or me, when I didn't have insurance.

It's because there's no market control; there's no shopping around; there's no way anyone can (legally) just start making hearing aids and having them sold at Wal-Mart. If eyeglasses followed the same rules, you couldn't buy even a pair of reading glasses without going to a licensed optometrist and paying 250.00, minimum. As it is, I can go to the aforementioned Wal-Mart and try on a few quickly, then pick whatever I like best and walk out having paid less than I'd pay to go to the movies.

Go to Cabela's or Bass Pro Shop... (0)

Anonymous Coward | about 2 years ago | (#40313369)

...and buy a pair of "Hunter's ears". If her loss is broadband, and doesn't require special tuning, the bog standard hunter's hearing assistance device will do what she needs for less than $200 an ear. Mead Killion, the audiologist who started Etymotic Research has written about this problem and has compared off-the-shelf "hunter's ears" with leading hearing aids and, in some circumstances, the hunter's ear was better. As well as a tenth the price. Here's an article from the Wall Street Journal about it. [rasmusen.org]

Re:Go to Cabela's or Bass Pro Shop... (2)

K8Fan (37875) | about 2 years ago | (#40313425)

...and buy a pair of "Hunter's ears". If her loss is broadband, and doesn't require special tuning, the bog standard hunter's hearing assistance device will do what she needs for less than $200 an ear. Mead Killion, the audiologist who started Etymotic Research has written about this problem and has compared off-the-shelf "hunter's ears" with leading hearing aids and, in some circumstances, the hunter's ear was better. As well as a tenth the price. Here's an article from the Wall Street Journal about it. [rasmusen.org]

Forgot to log in before I posted this. May as well use my karma for something.

Manual labor and skill for customizations (0)

Anonymous Coward | about 2 years ago | (#40313375)

http://www.youtube.com/watch?v=7wp9tTr2oXk

economics 101... (1)

bigwavedave33 (1148677) | about 2 years ago | (#40313403)

Pure and simple... economics. There isn't a billion hearing aids sold a year. Compare the number of hearing aids sold to the number of gaming consoles or tablets or any other electroic device. Companies are out there to profit and not just keep the doors open. If you have a staff of 100 and have to keep the doors open selling 100,000 devices a year instead of 100,000,000 how much do you have to charge. I bet you you complain about how much you are paid, but don't realize the economics behind how much you are paid and why and don't care you just want to get paid. Well so does the guy selling you a hearing aid, groceries, gas, tablet, etc. Ohh and you have the government and insurance companies involved in hearing aids... There's your sign.

There's an app for that? (1)

technosaurus (1704630) | about 2 years ago | (#40313405)

How difficult would it be to create an android/iphone app to accomplish the same effect with a bluetooth headset? Not very, in fact it should be completely obvious public knowledge to any professional in the field (thus not patentable). Most phones today have the CPU power to filter noise and level volumes. How much would consumers be willing to pay for the app? Would they be willing to wear the bluetooth headsets? How many man-hours would it take to program? For now those answers lean toward making 100s of variations of stupid games instead, but as smartphone and bluetooth adoption grows this may change.

How? (1)

Anonymous Coward | about 2 years ago | (#40313407)

How can you talk about this stuff when Germany is up 2 nil over the Netherlands at the half?

Three letters: F D A (0)

Anonymous Coward | about 2 years ago | (#40313439)

I work for a company that makes medical devices (but not hearing aids). Even hearing aids must go through clinical trials to prove effectiveness. This means there is a ridiculous amount of documentation during device development and for production. While the component costs are actually very small, the government and insurance overheard is the majority of the cost.

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