Why Are Digital Hearing Aids So Expensive? 727
sglines writes "Over the last couple of years I've been slowly getting deaf. Too much loud rock and roll I suppose. After flubbing a couple of job interviews because I couldn't understand my inquisitors, I had a hearing test which confirmed what I already knew: I'm deaf. So I tried on a set of behind-the-ear hearing aids. Wow, my keyboard makes clacks as I type and my wife doesn't mumble to herself. Then I asked how much: $3,700 for the pair. Hey, I'm unemployed. The cheapest digital hearing aids they had were $1,200 each. If you look at the specs they are not very impressive. A digital hearing aid has a low-power A-to-D converter. Output consists of D-to-A conversion with volume passing through an equalizer that inversely matches your hearing loss. Most hearing loss, mine included, is frequency dependent, so an equalizer does wonders. The 'cheap' hearing aids had only four channels while the high-end one had twelve. My 1970 amplifier had more than that. I suppose they have some kind of noise reduction circuitry, too, but that's pretty much it. So my question is this: when I can get a very good netbook computer for under $400 why do I need to pay $1,200 per ear for a hearing aid? Alternatives would be welcome."
Why? (Score:5, Insightful)
Size (Score:5, Insightful)
It's not complicated, hearing aids need to be very small. Neither your 1970's amp nor your netbook will fit in your ear. Making something small and reliable enough for this kind of use is difficult and expensive.
Medical... (Score:5, Insightful)
One word: insurance (Score:2, Insightful)
Like anything in health care most people won't be paying for this directly out of pocket; they can charge whatever they want.
$400 Laptop (Score:5, Insightful)
Well, if you have software on your $400 laptop that can do the digital to analog / analog to digital just like you say, the solution is clear: hold one laptop up to each ear.
That's still going to be $800, but that's a lil' cheaper than the $1200 pair you were looking at.
I am in the same boat too with these things (Score:5, Insightful)
I too have to wear one and it's ungodly expensive. My argument is the fact I need them to have a normal life and work. So if people can get glasses for fairly low price and it's a item that people need then why can't insurance companies provide coverage too? Reason for that it's very specialized market and expensive.
Don't get one of those cheapie $49.95 hearing aids from the ads as they do not provide the proper specs to the type of hearing loss you have. In fact it'll make your hearing worse. It'll be like listening to iPod all day long.
See if they can offer a payment plan.
Good luck.
Re:Medical... (Score:5, Insightful)
and regulation/licensing on medical devices.
That's a really expensive one.
Not to make fun of you (Score:5, Insightful)
But this is why it's important to wear ear protection for such seemingly innocuous tasks such as mowing the lawn (or any loud task, really). So many kids back then and still these days listening to their personal music players via headphones where you can hear the music from across the street. It's just stupid and a few $ of protection today will save you $$$ in the long run.
I have relatives going deaf with age, watching TV with them is not fun. TV volumes set at a level wear I have to wear ear protection.
Hey! (Score:3, Insightful)
Stop complaining, you! That 1000% mark-up is nothing compared to the cost of a Tylenol in a hospital! You should be grateful they are so cheap!
It's a medical device, not a consumer item! (Score:5, Insightful)
Re:Medical... (Score:4, Insightful)
Which is kind of insane thinking about it, a hearing aid is different from a heart stint with magnitudes order different levels of risk.
Re:Alternative (Score:2, Insightful)
Size -is- everything, no matter what she says. (Score:3, Insightful)
When you can fit that $400 laptop in your ear, then you can stop wondering why hearing aids cost so much.
Re:Why? (Score:5, Insightful)
Re:Why? Let me count the ways... (Score:4, Insightful)
So you heard it everyone. Geekmux has issues a challenge!
First someone start a wiki to organize the project.
Someone make the hardware specs. Some A/D, D/A converters, some processing. Someone write the software. How small can an Arduino be made? Someone contact Bre Pettis about cheap fabbing of the housing body.
It doesn't have to be commercially viable. It just has to work and be easy enough to make that the local hackerspace can make them for their friends and loved ones. The threat of competition alone will drive down prices enormously. Don't worry about patents and trademarks. We aren't going to be selling these, we're going to give the plans out FREE in so many places any hacker can make one.
This is the new world Cory Doctorow has been writing about.
GO!
Re:Medical... (Score:5, Insightful)
It is a medical device which means that it is subject to insane levels of litigation. Mostly you are probably paying for insurance.
It is a medical device which means that it is subject to insane markups. Mostly they are probably paid for by insurance, so there is little attention paid to cost by consumers.
There, I fixed that for you.
Re:Alternative (Score:2, Insightful)
If he did this, he would be looking to be employed for his condition.
Think of it another way..... (Score:3, Insightful)
You want a magic cheap solution? (Score:3, Insightful)
$3700 doesn't sound so bad for something that improves your quality of life so much. Comparing the price to a laptop is so beyond what's reasonable it's pointless to even discuss why. Let's move beyond that.
Ultimately it doesn't really matter if you can't afford it. So what are your alternatives? Buy something cheap that's likely to not work as well, or try to find some benevolent entity that will pay for all or part of your hearing aid. Government aid? Private charities? I don't know what's available, but others do. I'd start by dialing 211 (most of the country this will hook you up with United Way volunteers) and see if they can help you.
Miniaturization (Score:3, Insightful)
Anyone can squeeze a microphone, an AD/DA converter, a 15 channel DSP driven parametric equalizer and amp into a box the size of a toaster oven. But not many can stick it in your ear, and have it fit properly.
The Markup - Plus A Funding Suggestion (Score:3, Insightful)
I think it's because they're medical devices, and the makers charge whatever the traffic will bear. Insurance pays for most people, after all. Ever look at the markup on a pair of plain old eyeglasses? Even with the preparation of lenses with your prescription, it's pretty terrible.
The suggestion: If you've been diagnosed as functionally deaf by a physician, and if you're in fact unemployed, why not nose around and see if there's a benefit available to you from your state? It's an assistive device, and there may be some sort of loan, grant, or other fundage available to you. That might be especially true if you're not going to be able to locate and keep a paying job without one. Look at vocational rehab stuff.
Re:Alternative (Score:5, Insightful)
Re:Medical... (Score:5, Insightful)
I have a relative in the business. They license the popular brand name like a franchise and make obscene amounts of profit. As their single store in a strip mall with no real traffic pulls in enough for two houses and twice as many cars for the husband and wife.
They have to manage stock of some units but the majority are ordered, the overhead is the employees and some testing equipment.
The margin for profit is ridiculous.
Re:Medical... (Score:3, Insightful)
But that dosn't really explain the $13000 price difference between the 4 and 12 band EQ. The other part of the equation is that a digital device can be mass produced. It's not as if anyone needs to design and build an electronic circuit to fit an audiologist's prescription. Instead the device can be programmed. The only likely custom part is a casing to fit someone's ear.
Re:Medical... (Score:5, Insightful)
Mostly they are probably paid for by insurance, so there is little attention paid to cost by consumers.
In the case of hearing aids this isn't all that true. The people who most commonly need hearing aids are older, and likely to be retired. Many of then are NOT covered by insurance. But if you're powerful, or were sufficiently powerful, you ARE likely to have a health insurance that covers it. So there's no push to correct this among the people who have the power to cause it to be corrected.
Re:Why? (Score:5, Insightful)
I was going to go with: "because they're so freaking tiny." For some reason, submitter is assuming that its somehow easy to cram all of the necessary technology into a package the size of your Shift key and still have room for a battery. Add to it the fact that this isn't a mass-market product and also that it's technically a medical device so the price is easily tripled after the development and manufacturing costs are figured in.
Re:Medical... (Score:5, Insightful)
Also, try to pack all that electronics into such a small package, including feedback cancellation (that really loud whine that older hearing aids were prone to produce) and and it has to be able to run on a single battery for at least a few hours at a time.
Add doctors fees for fitting, set-up and production of the ear piece which is (supposedly) moulded to fit your ear perfectly.
Headkase and Gription have good points as well. It all adds up.
Re:Medical... (Score:3, Insightful)
It is a medical device which means that it is subject to insane levels of litigation. Mostly you are probably paying for insurance.
I highly doubt that they pay $1000 of insurance premium on each hearing aid.
What's really happening is the context that the product is marketed in. It's a "medical device", so the buyer expects it will be outrageously expensive, just like every other healthcare-related product or service in the USA. The producer charges what the market will bear, and that depends on the psychological state of the buyers.
Context is important. If you went into a grocery store and saw a six-pack of mass produced beer on sale for $25.00, you'd be incredulous. But you'd most likely pay that same price without thinking twice at a baseball game.
Re:Medical... (Score:4, Insightful)
Also people are always going to be paying for it with insurance, so the price doesn't actually hit consumers. There's no reason for a consumer to buy a cheaper hearing aid, so prices inflate.
Re:Voc Rehab (Score:3, Insightful)
Note that you can upgrade a hearing aid.... an implant, not so much.
From what I understand, the implants can only trigger particular frequency bands, so what you hear is far from reality. Granted, it's better than nothing, but if you want to spend your days listening to the world through a 32-band vocoder (basically) it's your choice.
Re:Medical... (Score:5, Insightful)
Otherwise I'm sure we would of all seen at least a few steam punk hearing aid mods by now.
Re:Why? (Score:4, Insightful)
Re:Medical... (Score:3, Insightful)
I have excellent insurance, yet they won't cover a dime.
Excellent compared to bull shit is still horse shit.
Re:Not to make fun of you (Score:4, Insightful)
It's a just revenge on the fucking idiots with thumpy car stereos, I tell you.
Re:Medical... (Score:4, Insightful)
I've seen this also. Insurance companies used to help people when they were in need, but then the shareholders noticed that they could make much more money if they just sell insurance and not help the people. So nowadays they simply cover only the cheap or very rare things and the rest you have to pay yourself. It doesn't make sense anymore to buy insurance.
Re:Medical... (Score:4, Insightful)
Prostip:
Cheque or debit - someone who had the money come in last week.
Shoebox of money - someone who has saved up for a year.
Answer is in the summary. (Score:4, Insightful)
Doing anything as low-power as a hearing aid needs is bloody complex and expensive. Your $400 netbook probably would't run more than a few seconds on the kind of power reserves that a hearing aid has. And your '70s amplifier, well, give me a break. Didn't you need half a power plant to power that thing? It wouldn't even turn on on a hearing aid battery.
These things contain mostly custom chips designed for a single purpose - that is delivering the computing power necessary for a hearing aid with the least power consumption possible. We're talking microwatts here. Designing such a thing costs a lot, and they're not selling in numbers as huge as netbook hardware, because, well, everyone wants a netbook, but most people sure as hell don't need or want a hearing aid if they still hear just fine.
Re:Medical... (Score:5, Insightful)
With the info floating around during this whole US health care debate, I would agree to the above point:
If you try to do anything medical or get any medical device in the USA you would be charged 10-50 times more than it actually costs. The prices are grossly inflated and then the big insurance companies negotiate them down by 90% or so. This is mostly in make sure that you don't go and get healthcare on your own. It also serves as a good way to keep some new insurance company from springing up - if you are not big enough, you can't negotiate such a discount, so you can't be profitable.
The insurance companies are all in a cartel. It would be illegal for any other business, but health insurance companies have a special exception.
There is no free market in health insurance in the USA and there has never been one, so there is no competition. Thus all the prices and profit margins are simply decided at the cartel meeting without any regard to real cost or social benefit.
My advice - go to a country with a real healthcare somewhere in EU or Canada or Asia and get some hearing aids there. It will come out cheaper even with a plane ticket.
Re:Medical... (Score:3, Insightful)
That's what you get for having a lousy socialist government run healthcare plan!
Re:You mean the voter? (Score:4, Insightful)
Re:I am in the same boat too with these things (Score:1, Insightful)
Did you prefer to be called an exotic dancer, or were you comfortable with the term "stripper"?
Re:Sounds like someone who's never traveled (Score:5, Insightful)
I'd rather pay double for eyeglasses and hearing aids than go bankrupt because I fell ill.
Re:Medical... (Score:3, Insightful)
Is the form factor necessary though? Put it a box the size of a pack of cards with some wires running to a pack of cards. Problem solved. Bonus points for extras like battery indicator, etc.