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Why Are Hearing Aids So Expensive?

• dogruck 9y ago
  This sentence gave me alarm bells of weak or biased science writing: > Experts don’t know exactly why hearing aids are still so costly, except that companies continue to invest in improvements, and fees usually cover the services of a highly trained audiologist.
  • colonelxc 9y ago
    So it sounds like they do know why they are still so costly...
    • dogruck 9y ago
      My cynical reaction is it sounds like they know, but the author didn't like the answer: experts, plus tech-medical research, is expensive. Also, for something as life-transformative as a high quality modern hearing aide, the prices didn't strike me as outrageously expensive.
    • mirimir 9y ago
      And the next question is: "Why can audiologists charge so much?".
    • ghostbrainalpha 9y ago
      Two hearing aids cost $7,000 because they cover a Dr visit? And the point of the Dr. visit is to tell you if your hearing loss requires a hearing aid, or is just the result of wax buildup. So...basically, the Dr. visit could be replaced with a Q-Tip. Maybe each pair of hearing aids results in $6,500 worth of audio research, but if so, I think those researchers may not be a great return on that money. It's a matter of time before Apple's Ear Buds, come with a $200 hearing aid upgrade.
      • dogruck 9y ago
        I don't know much about audiology, but I suspect it's a niche expertise that is much more complicated than deciding between a Q-Tip or a generic hearing aid.
      • wl 9y ago
        Hearing loss has many possible underlying etiologies. Some are easily treated, like wax buildup. Some are not, like noise-induced sensorineural hearing loss. Both of those are not dangerous, but others like acoustic neuroma and cholesteatoma are potentially fatal if left untreated. There's good reason for someone to be checked out and cleared by a specialist before they are fitted with hearing aids.
      • gumby 9y ago
        By the way, don't stick a Q tip in your ear. Even the manufacturer tells you not to, or at least their lawyers have told them to say that. http://www.sciencemag.org/news/2017/01/no-more-q-tips-your-ears-really-are-self-cleaning http://www.sciencemag.org/news/2017/01/no-more-q-tips-your-e... . Or if you prefer video, https://www.youtube.com/watch?v=cYqeUJda2Qs https://www.youtube.com/watch?v=cYqeUJda2Qs
        • paulmd 9y ago
          Yes, the modern medical recommendation is "don't fuck with your ear canal". Nothing goes in there, and Q-tips are "officially" just for cleaning around the outer parts of your ear (lol ok). They can cause some real hardcore wax impaction and introduce germs, they are not a medically recommended product at this point. Earwax is a natural antibacterial mechanism, like mucus. If your ears are fucked up they do sell Debrox kits with a compound to soften it and an irrigation bulb, use those. The irrigation does a number on your ear's protections too though.
      • RHSeeger 9y ago
        There's a lot of different types of hearing loss, and being able to determine the exact requirements for any given person (right hardware, right settings for it, etc) is (as I'm led to believe) not trivial. Sure, you can get better hearing with something off the shelf, but the comparison is similar to off the shelf glasses compared to ones measured specifically for your eyes.
  • mgerdts 9y ago
    I don't buy that argument. When I went to an audiologist and ENT before getting my hearing aid, I had to pay a copay and my insurance company payed thousands (ENT ordered an MRI). A hearing aid from that audiologist would have been at least $3000. I went to Costco and got an equivalent test with mostly the same audiogram for free. The hearing aid there was $800. I have gone back for free adjustments. Let's compare this to getting an eye exam and glasses (for both eyes!) https://www.google.com/search?q=audiologist+salary https://www.google.com/search?q=audiologist+salary $74,890 https://www.google.com/search?q=optometrist+salary https://www.google.com/search?q=optometrist+salary $103,900 My most recent eye exam plus glasses (after insurance) was way less than $100. The no-insurance no-coupon price on the same would have been about $300. I spent about as much time with the optometrist as I did with the audiologist for the exams. The key difference is the fitting of the hearing aid was done by the audiologist but the fitting of the glasses was done by an optician (salary about a third of an optometrist's salary). The optometrist also has lots of specialized equipment. The optometrist also has lots of inventory (maybe 1000 frames?) because glasses are a fashion thing too. Audiologists just need to have samples and perhaps a week's worth of inventory. The audiologist's inventory seems more likely to be sold before payment to the supplier is due.
    • dogruck 9y ago
      Although this is interesting, there are some logical weak points. A few that came to mind: * CostCo has a proud reputation for using their annual membership fees to provide door-buster prices. * Salary is a coarse and incomplete proxy for the cost of an audiologist visit. * I see no justification for comparing ear exams to eye exams. Why not proctology? * You seem to imply that doctors pay cash out of pocket for their medical inventory, instead of operating more like a car dealership, where inventory is held on credit
      • dragonwriter 9y ago
        > CostCo has a proud reputation for using their annual membership fees to provide door-buster prices. No, they limit margins and costs (e.g., by limiting SKUs) to keep prices down; paid memberships build psychological attachment, but the $55/yr membership isn't paying for much in terms of lower prices.
• adzm 9y ago
  I cannot wait. There is such an opportunity for innovation as well. Hearing is such a psychological thing as well as physical. I had to really research on my own and bother an audiologist directly in order to tweak mine properly. I wanted to take advantage of my hearing loss to also allow myself augmented, improved hearing for specific scenarios as well. I would love a platform that allows me to do so! Regardless of the poor quality of the article, the relevant legislation is Over-the-Counter Hearing Aid Act of 2017 https://www.congress.gov/bill/115th-congress/senate-bill/670?q=%7b%22search%22%3A%5B%22Over+the+Counter+Hearing+Aid+Act+of+2017%22%5D%7d&r=2 https://www.congress.gov/bill/115th-congress/senate-bill/670...
  • wrycoder 9y ago
    Are you sure this legislation isn't a covert increase in regulation of hearing assit devices by the hearing instrument cartel?
    • wbrenner 9y ago
      There have been talks about this sort of regulatory change has been a long time coming and has been trending this way for a least a couple years (see link below). This is just the first time the hearing instrument cartel hasn't been able to beat it back. Based on my educated guess it is no coincidence that the bill was introduced by a Senator whose state shares a headquarters with Bose. https://obamawhitehouse.archives.gov/blog/2015/10/26/%E2%80%8Bpcast-recommends-changes-promote-innovation-hearing-technologies https://obamawhitehouse.archives.gov/blog/2015/10/26/%E2%80%...
• gooch9 9y ago
  My solution - buy a high end smart phone - the more (directional) mics it has the better. Add a high quality "spouse mic" that you can place whereever you want on conference table/dining table/nightstand/next to the door bell. Most phones, home assitants, the kinect etc come with with mic arrays and have ridiculously sophisticated audio stacks. You can't do cutting edge speech rec without those stacks. These ridiculous hearing aid companies are going to go the way of dinosaurs soon. And good riddance.
  • PhasmaFelis 9y ago
    I'm not really sure what you're proposing here. Any system that requires location-based setup seems obviously inferior to a system that rides in your ear and just works wherever you go.
• hprotagonist 9y ago
  This is my field, more or less, though I'm on the basic research side. Traditional hearing aid companies have no idea how large a freight train is barreling down on them in the form of Apple and Google. It's going to be a fun ride.
  • richforrester 9y ago
    These types of comments always restore my faith in the world. Nothing like a bit of justice.
    • hprotagonist 9y ago
      I have nothing against the major hearing aid companies per se. Their approach to product development is hidebound and stuck in about 1987, though, and they are going to find out in short order that that doesn't fly any more. Personally, my money is on Apple and Google squabbling over who gets to buy Cochlear, Oticon, and Starkey for their IP and regulatory know-how, and then just mopping up the floor with the rest of the players in the space. It's already begun, actually: https://www.wired.com/story/how-apple-is-putting-voices-in-users-headsliterally/ https://www.wired.com/story/how-apple-is-putting-voices-in-u... Wired fundamentally does not understand how crappy CIs can be, so it's too enthusiastically reported, but I'm pretty sure this is the opening salvo.
      • mwcampbell 9y ago
        > Wired fundamentally does not understand how crappy CIs can be Just curious, can you explain what you mean by CIs being crappy, or point to an existing explanation?
        • hprotagonist 9y ago
          Briefly, you get 16 frequency bands if you’re lucky. A healthy ear has about 3,000. It’s more complicated than that, but in a nutshell, the fidelity with which CIs can represent the world is very limited. They work for speech, mostly, in quiet. There are simulations of what they sound like on YouTube, somewhat.
• lvspiff 9y ago
  As a spouse of someone with a cochlear implant I've asked this question repeatedly. The cost of everything around that hearing device is insane - want a cord so you can listen to audio? That's $500. Want a device to make it easier to hear TV? That's another $750. Operate over bluetooth? Nope we can't do that. Need a new battery? That's a grand. Its insane what they get away with
  • taneq 9y ago
    Likewise, my best mate has had hearing aids since ever, and now a cochlear implant. According to him, the official line is that prices are high because volumes are low and medical devices are expensive to design. The unofficial line is that they're price gouging because they have a captive market and no real competition.
    • neves 9y ago
      If I needed hearing aids, I'd pay anything for them.
      • sitepodmatt 9y ago
        Presuming you have access to the money and/or some expensive insurance to cover them. Don't forget about 99%.
      • exikyut 9y ago
        And that's the reason why anything and everything medical costs as much as can be gotten away with. You've just described the intersection of capitalism and human survival instinct in a nutshell.
        • Kluny 9y ago
          Yep, and the reason why governments are useful in the first place. To protect us against capitalism failures.
      • jessriedel 9y ago
• randyrand 9y ago
  Botched medical regulations gone haywire. The same reason health care is expensive in general. When side step the regulations and buy outisde the health care industry - say, amazon.com - hearing aids magically become $38. https://www.amazon.com/Sentire-Med-Enhancement-Amplifier-amplification/dp/B072M7T6FX/ref=sr_1_4_a_it?ie=UTF8&qid=1508803182&sr=8-4&keywords=hearing+aid https://www.amazon.com/Sentire-Med-Enhancement-Amplifier-amp... Health care is more than ripe for deregulation and monopoly/union busting - but the American medical association lobby is one of the strongest in the world.
  • refurb 9y ago
    You may be right, but consider another alternative, that some markets have a lot of money sloshing around and have yet to be disrupted. A great example is the home infusion industry. People used to make money hand over fist. It took some knowledge to offer home infusion to patients (have a pharmacy, hire some nurses), but it wasn't rocket science. The market was made up of a ton of small companies, all making good money servicing only a handful of patients with certain conditions. We're talking each patient bringing in tens of thousands of dollar of profit each. There were no regulations or evil conspiracies holding this industry up. It just wasn't big enough for anyone to do anything about. Insurance companies were worried about bigger fish to fry. Then the large specialty pharmacies came along, bought up all the small players. They used the profits to boost their bottom line. Then some bean counter somewhere figured out insurance companies were paying way too much, so they renegotiated their contracts, squeezed the profits out of it and now it's like a lot of medical services, single digit profit margins. There are a lot of markets like this out there. I'll bet hearing aids are one of them.
  • Frondo 9y ago
    I am reluctant to accept an anti-regulation message from someone whose name seems a likely riff on Ayn Rand, but setting that aside... I'm also reluctant to look at deregulating hearing aids without looking at some of what the regulations do... Like, something that came up on HN a few years ago was another thread about hearing aids, and one thing I remember from that was that cheap hearing aids can actually do further damage to a person's ears, because of how they do or don't amplify the sounds appropriately. Maybe the regulations, in this case, are there to prevent people from paying $38 for a hearing aid that wrecks their sense of hearing further. If that is the case--and I don't know that it is, but I think health equipment merits a degree of caution--then I think that's a good place for regulations. Very few people would be able to properly evaluate whether a given cheap hearing aid would be one that worked without harm or would be one that caused further hearing loss. Very few. That's exactly the place in society for regulations--when few people are capable of making an informed decision, etc. It's certainly easy to blame regulations for this and everything wrong with American health care, but I don't know if it's sensible here or in general--or if blaming regulations (and consequently removing them) would actually lead to the outcomes people claim they would. My gut tells me that the problems we have lie elsewhere in the medical system, not in the regulations concerning medical devices or medicines.
• nostromo 9y ago
  Things that are paid for by other people tend to be expensive.
  • randyrand 9y ago
    Auto-repair/auto-insurance doesn't fit this explanation. Repair is still a competitive industry with rather low margins.
    • refurb 9y ago
      The counter argument would be that there is enough business that isn't paid by insurance companies to keep competition high. If no one paid for car repair out of pocket, prices would be much higher.
      • mcny 9y ago
        They are too high at the dealership. At least, they feel high compared to what a knowledgeable friend who knows how to get used parts (junkyard etc) will charge for parts.
        • deleted 9y ago
          [deleted]
      • randyrand 9y ago
        Could be. Sounds like a decent argument against universal health care insurance, too. More things should be out of pocket.
    • hueving 9y ago
      That's because tons of people have to pay for their own auto repairs.
      • PhasmaFelis 9y ago
        And yet, it's still expensive.
• coupdejarnac 9y ago
  I developed a hearing aid/amplifier app for iOS a few years ago, and I think many people now realize that a free or cheap app can really help with hearing loss. I probably ought to dust off the codebase and modernize it. People should still go see an audiologist to properly characterize their hearing loss and use that knowledge to choose a suitable product. There are a lot of hearing aid alternatives already out there, but they cannot be marketed to people with hearing loss until the new law takes effect.
• paulgerhardt 9y ago
  >Experts don’t know exactly why hearing aids are still so costly No, they do. The short answer is: you need to develop your own custom IC's that 1) have analog circuitry 2) support Telecoil[1] - an ancient induction standard from the 1970's 3) are made by 1 of 4 companies in Copenhagen or Switzerland - one of which has 55% market share and 4) run on fumes. Seriously, the crest factor on these is ridiculous. The long answer is available in this great podcast episode: https://theamphour.com/338-an-interview-with-jorgen-jakobsen/ https://theamphour.com/338-an-interview-with-jorgen-jakobsen... Of course, Bluetooth alternatives to hearing aids are being developed. People in the industry know this and joke about it. But, crucially, they can't be called "hearing aids". It's a protected term. An interesting example are Bose's new $500 "Hearphones" strongly targeted at an older demographic[2] with features like Bluetooth and tunable noise cancellation based off their earlier $300 QC30 dynamic noise cancelling platform. But also not the exact same use case. More power intensive. More capable. But less endurance. [1] https://en.wikipedia.org/wiki/Hearing_aid#Telecoil https://en.wikipedia.org/wiki/Hearing_aid#Telecoil [2] https://www.bose.com/en_us/products/headphones/conversation_enhancing_headphones/hearphones.html https://www.bose.com/en_us/products/headphones/conversation_...
  • wl 9y ago
    The Hearphones have a 10 hour battery life and don't have replaceable batteries. My hearing aids have a 3 day battery life and have replaceable batteries I can carry around on my keychain. They really aren't useful for the same things at all.
    • Jedd 9y ago
      > The Hearphones have a 10 hour battery life and don't have replaceable batteries. My hearing aids have a 3 day battery life and have replaceable batteries I can carry around on my keychain. What's the cost of your hearing aids? How many 'hearphones' could you have for, say, 50% of that cost. 10 hour of hearing seems close enough to a day's usage, perhaps a bit shy but probably not by much. Certainly two recharged pairs should see you through a day. How much charge do they need - or rather, what's the size of a recharge battery pack, and how would you compare the cap-ex of your hearing aids versus the cost /convenience trade-offs of an alternative?
• analog31 9y ago
  Disclosure: I'm not a doctor or audiologist. Hearing loss runs in my family. When it's time for me, I plan to roll my own. I suspect that if you get rid of just one requirement, it becomes easy. That requirement is to stuff the whole thing in your ear. If the electronics can be in a separate box (or in a smartphone as mentioned), then analog, signal processing, and battery power all become trivial.
  • mildavw 9y ago
    My dad is 81 and started having hearing loss a few years ago. He just sent me a pic showing the degree to which he was able to shrink his DIY hearing aid once he settled on the circuit design: https://photos.app.goo.gl/4lOwfrVJ3bfRWkEm1 https://photos.app.goo.gl/4lOwfrVJ3bfRWkEm1 (Stereo mics and amp with two-channel parametric EQ on each side. About 6" wide and runs on two 9v batteries, if you're curious!) He took it to a Bose showroom to compare it to their Hearphones. All (Bose people included) agreed that his amp and EQ was superior. Cost for parts is ~$200. He's had a lot of fun building them for himself and his friends.
    • toomuchtodo 9y ago
      Would your Dad be willing to open source his design?
    • simcop2387 9y ago
      I'd bet it'd be possible to make this much smaller and about half the cost. But I think it'd also end up a lot more difficult to adjust as needed since you'd end up with either tiny pots for adjustment or having to fix the values of everything and use single resistors. Going full DSP would allow you to make this fairly small and cheap (maybe the size of a 9 volt battery) but much more annoying to build and work on if you don't have the skill set. I'd bet this would be a good spot for someone to design a nice open hardware project that'd benefit a lot of people, and if it's setup as kits for headphones that just happen to work well as hearing aids you can probably avoid some of the regulatory issues even though you couldn't ever call them what they are.
  • exikyut 9y ago
• soneca 9y ago
  A social business in Brazil has an alternative: http://www.solarear.com.br/ http://www.solarear.com.br/ (There is an english version, just click the british flag closer to the footer) "Solar Ear manufactures low cost, solar rechargeable and environment friendly hearing aids so you can hear perfectly again. Our products are manufactured by deaf workers with high quality components."
• simonblack 9y ago
  Few hearing-aid companies. Highly specialised product. They can charge pretty much what they want. And they do. The retail price has a very sizable level of over-charging built in, and many times the client is talked into a product which is much more costly than the one which is necessary. (The place I worked at many decades ago used to be an agent for one of the major hearing-aid companies.)
• scorown 9y ago
  Lots of armchair experts here. Ultimately, a hearing aid is much more than just a sound amplifier. Imagine wearing a cheap sound amplification device that gradually increases hearing loss and causing tinnitus.
• nas 9y ago
  Consider going to Costco. I think my Dad pays around 500 CAD for his set. They would likely cost more than double at other places. The service at Costco is great as well. Also, as other people have said, they are expensive because they are technologically advanced and expensive to manufacture. You can build some kind of hearing aid for less than $100 but it will not compare with a $500 one.
  • analog31 9y ago
    Canada may be cheaper than US. But still, I've heard the same advice in US.
    • fma 9y ago
      I bought my glasses from Costco, even though it's "out of network" for my vision insurance. Still a hell lot cheaper than Lenscrafter, etc. I imagine the same applies for hearing aside
• cddotdotslash 9y ago
  Some of the comments on here demonstrate that few readers actually know what a hearing aid does. In a majority of hearing loss cases, you can't simply amplify the sound and call it a day. If you want to do that, go buy a $20 amplifying device online. Hearing loss is usually characterized by an inability to hear different frequencies at differing levels. When you get a hearing aid, the audiologist has to tune it to your particular graph. Most modern hearing aids also come with speech detection, background noise reduction, etc., also tuned to the wearer's loss. Mine have bluetooth capabilities built in as well and can be synced to my phone, laptop, etc. Not everything is something you can throw some Arduino parts and Python code at, contrary to what half of HN seems to think some times. This isn't to say that prices are not ridiculously high, but at the end of the day, they are a medical device that require a trained professional to tune. Source: worn hearing aids since I was 3 years old.
  • analog31 9y ago
    My relative has had hearing aids for many years. Her loss is profound, and her hearing aids are apparently quite sophisticated. The "tuning" consists of the audiologist fiddling with a GUI while my relative says if it sounds better or worse. Maybe it's not a racket, but they're trying awfully damn hard to make it seem like one.
    • mirimir 9y ago
      OK, then. Give that GUI to patients, and let them tune it themselves.
    • planteen 9y ago
      That isn't how it works at all. It is far more than an audiologist "fiddling with a GUI". The audiologist first does a hearing test, which is gives an audiogram which is a gain versus frequency plot that takes into account equal loudness curves. This is how they know to recommend hearing aids in the first place. This is the initial basis for tuning. Final tuning lets them adjust for things like ear canal size. If patents tuned it themselves, they would have too little gain at high frequencies since they may not have heard these frequencies in years and think they sound unnatural. It takes a while to become "used" to hearing aids because patients haven't heard the usual sounds of life like paper rustling in years.
• antognini 9y ago
  A few weeks ago I talked with a guy whose startup was developing a better hearing aid. As a few other commentators have mentioned, a hearing aid does not just amplify volume --- that is useless for people with hearing loss. The problem with hearing loss is generally not so much that you can't hear anything at all. It's that it becomes extremely difficult to distinguish speech from background noise. The ideal hearing aid will amplify those frequencies at which speech is present, while suppressing frequencies that contain background noise. But currently hearing aids use a pretty dumb set of heuristics to figure out which is which. For instance they'll try to estimate how far the source of the noise is and will suppress it if it's more than, say 15 feet away. But if your SO is calling you from the kitchen that means that you're not going to hear them. Similarly they'll amplify frequencies associated with sibilants (s sounds, for example) because those are really important for speech, but that means that wind sounds or rustling paper also gets amplified. There's a huge opportunity here to apply deep learning to determine which frequencies to amplify and which to suppress. It's a challenging hardware problem, but the deep learning part of it has largely been solved. (Or at least, the current state of the art using deep learning is way, way better than what commercial hearing aids currently do.)
  • andrewtbham 9y ago
    deep learning and the hearing aid https://spectrum.ieee.org/consumer-electronics/audiovideo/deep-learning-reinvents-the-hearing-aid https://spectrum.ieee.org/consumer-electronics/audiovideo/de... why you can't just turn up the volume https://medium.com/@AMP/cant-you-just-turn-up-the-volume-4ecb7fc422a https://medium.com/@AMP/cant-you-just-turn-up-the-volume-4ec...
  • srean 9y ago
    Curious to know what in what ways would old fashioned DSP (Fourier, STFT, Wavelets), or for that matter compressed sensing be lacking compared to deep learning.
    • AstralStorm 9y ago
      In no way at all, especially statistical techniques for speech enhancement using Emax or Bayesian given Gamma prior. You can also toys in some more advanced stuff like ICA deconvolution. This on top of some nice improvements in plain DSP techniques. (E.g. modified gammatone transform or variants of Stockwell transform) All in low latency. The main problem is ruining this on a tiny jellybean power efficient micro. Deep learning on a Cortex M0 with decent quality and less than 5ms latency? Good luck.
• peterburkimsher 9y ago
  I've been to so many concerts (450+ shows from 300+ bands) and I listen to music all day at my desk. My Gran has hearing aids, and her mum was totally deaf. My dad's hearing is getting worse too. I'm sure that I'm going to go deaf eventually, and it will be a sad day when that time comes. If you're interested in real-time audio effects on smartphones, AudioGraph is an app I've been playing with. http://zerokidz.com/audiograph/Home.html http://zerokidz.com/audiograph/Home.html It lets you listen to input signals through the iPhone microphone, do some effects, and pass the output to headphones. With the right hardware, it's also possible to turn the iPhone into a wireless mic using a Bluetooth headset adaptor (e.g. Sony MW600). Plug the MW600 into the speakers, plug a Kokkia Bluetooth transmitter into the iPhone, run AudioGraph, and speak into the iPhone mic. There's a little lag, but it works well enough for me. I expect that when my hearing gets worse, I'll use regular headphones (maybe custom-molded Ultimate Ears UE4s) with my iPhone, and do the "tuning" effects using AudioGraph. Being able to pass my smartphone to someone so they can speak into it like a microphone would be much easier than having to lean over so a hearing aid could be closer.
  • 0xbear 9y ago
    Or you could, you know, wear ear plugs at those shows. That’s what the musicians do.
    • petre 9y ago
      And then you'd actually hear the music instead of constant thrashing.
      • peterburkimsher 9y ago
        If I want to listen to music, I'll get the CD version and listen to it in a quiet room on my nice headphones. I go to concerts to mosh, buy signed CDs/T-shirts/posters/pins, and meet other fans. Meeting people requires talking. Earplugs, like the headphones I wear in the office, are a social signal to tell people "don't talk to me". I'm well aware of the dangers to my health, but I've met too many good friends at shows to stop trying to socialise with people who obviously share something in common (taste in music). I'm shy around total strangers, so it's at common-interest events like concerts where I have a starting point to talk about, and thus meet people.
• Animats 9y ago
  IHear Medical was a IndieGoGo project intended to bring the price of hearing aids down to $200. That was back in 2014. Several years later, they're up to $1000 for a "complete package".[1] [1] http://www.ihearmedical.com/vippackages/ http://www.ihearmedical.com/vippackages/
  • vbernat 9y ago
    That's interesting: for the iHearHD, you go from 1000$ to 1500$ if you want a 2-year warranty. I always got at least a 4-year warranty for my regular hearing aids. Even assuming a linear cost, a iHearHD with a 4-year warranty would be around the same price as regular hearing aids.
    • Animats 9y ago
      You go from 1000$ to 1500$ if you want a 2-year warranty. That's incredibly high. Even Best Buy's overpriced warranties aren't that expensive.
      • vbernat 9y ago
        This also includes 1 additional year of batteries (something worth 50-100$). But this may also be a signal they are not confident they are reliable enough?
• Jemaclus 9y ago
  I just wish hearing aids were covered by insurance. Mine aren't, which means if mine breaks, I'm paying $3500 out of pocket... for one. And I'm one of the "lucky" ones in that I can only hear out of one ear (and thus only need one hearing aid). For someone who needs two, that's $7000. Insane.
  • mgerdts 9y ago
    I also only need one hearing aid. Luckily I was able to get it from Costco ($800, free exam) and insurance picked up 80%. This year insurance changed such that the hearing aids are mail order and are more expensive than my co-pay at Costco. The one hearing aid scenario is problematic for any sort of headset. If I use earbuds, I can only hear well in one of them. If I were to spend the extra money to get the bluetooth accessory, that would only go to the ear with the hearing aid. I'd love to be able to input my audiogram into my phone and have it adjust the headset amplification at various frequencies in each ear accordingly. Even better would be for noise cancelling headphones to be able to also use an audiogram to have the headphones act as hearing aids when not in noise cancelling mode.
    • Jemaclus 9y ago
      My hearing loss is severe, so I can't just get Costco hearing aids... and insurance never covers it. They cover the audiologist exam, but not the hearing aid itself. It sucks so bad. And yes, if I want Bluetooth accessories, it's even more expensive. My current hearing aid is "Made for iPhone" or whatever, so it can stream directly from my iPhone, which is awesome. Unfortunately, my brand new Apple Watch isn't, so I still have to carry my phone with me on runs or whatever, while my wife can just wear her watch and Bluetooth headphones... First world problems, I guess?
• veb 9y ago
  Has everyone noticed that Apple might be moving into this market in some form? - https://www.engadget.com/2017/07/26/apple-cochlear-made-for-iphone-implant/ https://www.engadget.com/2017/07/26/apple-cochlear-made-for-... - http://www.hearingreview.com/2017/08/president-trump-signs-otc-hearing-aid-legislation-law/ http://www.hearingreview.com/2017/08/president-trump-signs-o... - https://www.nytimes.com/2017/06/12/health/hearing-aids-congress.html https://www.nytimes.com/2017/06/12/health/hearing-aids-congr... - https://www.technologyreview.com/s/608597/how-your-apple-wireless-earbuds-could-double-hearing-aids/ https://www.technologyreview.com/s/608597/how-your-apple-wir... I've been following it, and it all looks rather interesting. I wonder what changes we'll see soon. My nephew (3) was just given the Nucleus 7 cochlear implant and my sister says it's great. She can tell all sorts of things - how much he's heard, where it is, and all that jazz - including wireless streaming to the device from an iPhone.
• kibwen 9y ago
  > “Eighty percent of people who could benefit from a hearing aid don’t get one,” Ms. Kelley said, often because of cost or access to care. “Some of the reason is stigma: They don’t want to be seen as being old.” I'm hopeful this will change. I know a fair number of people around 30 with mild hearing loss, and one who does wear a hearing aid. A history of dangerous headphone volume among my cohorts will probably exacerbate things. Ideally hearing aids would carry no more of a stigma than glasses (FSVO "ideal" :P ).
• arghwhat 9y ago
  I'm going to be that annoying guy: They're free* in Scandinavia, including batteries for life. * "Free" meaning "paid for by the tax-sponsored public health insurance", which people up here would call "free".
  • grzm 9y ago
    An alternative phrasing could be: > In Scandinavia, hearing aids (with a lifetime supply batteries) are supplied without additional cost as part of the national health care program.
    • arghwhat 9y ago
      Ah, thank you! That phrasing is much better, and saves the footnote, without which someone would surely respond about how it "clearly isn't free"...
• Ice_cream_suit 9y ago
  The Siemens Orion is sold in India for around $250. While it is not a premium hearing aid, it appears to be adequate for at least some. Unbranded Chinese hearing aids are available for around $25.
• ultim8k 9y ago
  As with everything else, they are expensive until someone decides to reduce the production cost and sell them cheaper.
• gws 9y ago
  Working inside the industry I can tell you that there are a lot of misconceptions when you look at things from the outside. Hearing aids are not so expensive because of the hardware but because of two other things: 1. customer acquisition cost and 2. service cost. 1. People do not want hearing aids (typically they do not even want to accept they have a hearing loss). You need to spend an awful lot in communication and marketing and humans you can talk to in a store to convince them to try one. 2. Hearing aids are not glasses that you put on and the problem is solved. It takes 6-12 months to get the full benefits and you need multiple visits to the store with humans to hand-hold you through the process or you will just stop wearing them. And did I mention the average customer is 70 year old? Explain to me how a 70 year old that does not want a hearing aid will buy one online
  • Fradow 9y ago
    But is there a place online where you can buy cheap hearing aids that you can tweak yourself? I'm genuinely interested in the answer, as I am very likely to get hearing loss in the future, and might start being pro-active if there is a cheap alternative I could try right now, before my hearing gets bad.
    • gws 9y ago
      In which country do you live? Keep in mind that the smaller the hearing loss the more sophisticated the hearing aid you need to get a benefit. If you have a slight hearing loss you will experience issues in the "hardest" situations for hearing aids to cope with such as conversations in noisy places or bad telephone reception. Finally, the over the counter hearing aids come with a limited number of pre-fitted configuration (e.g., 4) and "tweak yourself" means choosing one of them. To get a hearing aid fine-tuned to your specific hearing loss you need a professional in a shop equipped and trained to use with the professional fitting software of the hearing aid
      • Fradow 9y ago
        I live in France. My father recently spent north of 5k€. Thanks for your answer. I guess it's not really feasible to get ahead then. I'll probably start with over the counter hearing aids when the hearing loss will start to be noticeable.
• Ice_cream_suit 9y ago
  Some non-US prices: http://www.calcuttahearing.com/shrobonee/Siemens%20Hearing%20Aid%20price%20list%202017%20download.pdf http://www.calcuttahearing.com/shrobonee/Siemens%20Hearing%2...
• DanielBMarkham 9y ago
  "Why are hearing aids so incredibly costly?" "...Experts don’t know exactly why hearing aids are still so costly..." So the article headline poses a question that writer confesses in the second paragraph not to know the answer to. No, strike that. The author claims that experts don't know the answer to that. And I scan HN and get answers almost immediately. HN is great, no doubt, but it's not HN. This is an author who doesn't know how pricing works and doesn't know how to talk to people about how pricing works, which is much more troubling. And the editors must feel that this is the normal state of things. Pricing may be a bit of a black art in certain markets, but it's no mystery unsolvable by experts. You can bet somebody is setting prices on these things, and when they set them there's a lot of market and historical data being used to do so. There are simply not-so-many reasons why some things are priced much higher than other things, and these reasons are all well-known and understood. When I read articles like this, it makes me much more critical of every other NYT times article that involves "experts". Great article for HN because it involves startups, markets, new business opportunities, tech, and so forth. Not such a great article for the NYT, sadly.
• tim333 9y ago
  Anecdotal and I'm in the UK but you can get them from £10 up, eg. this one for £20 https://www.amazon.co.uk/Hearing-Rechargeable-rAdjustable-Amplifier-Audiphone/dp/B072LQ84JG/ref=sr_1_7_a_it?ie=UTF8&qid=1508843784&sr=8-7&keywords=hearing+aid https://www.amazon.co.uk/Hearing-Rechargeable-rAdjustable-Am... but my dad pays £2000+ for similar looking but much fancier state of the art ones. Reasons - better quality - the good ones are small computers that use very little power and try to pick out voices from background etc. Apparently the challenging bit for him is dinner parties where you are trying to hear one voice out of several people talking. - it includes an Audiologist - he's 87 and needs a bit of help on the tech side - I guess he has the money and values hearing more than the 2k. It would be cool if computer analysis could understand the several conversations at the party and you could click on the one you wanted or point that way or similar. Maybe in the future, probably won't be cheap.
• aaron695 9y ago
  As someone with un-impaired hearing I really don't get why I can't a programmable enhanced hearing device for less than $100. Fuck Magic Leap, surly enhancing hearing is easier and cheaper. Block traffic. Enhance birds. Perhaps translate. Listen to tv how I want.
  • ianhowson 9y ago
    There are things like SportEar, marketed to hunters, where they want (a) enhanced hearing in quiet environments, and (b) suppression of very loud sounds. Some of them are just rebadged hearing aids with unvented receivers. AirPods is the closest you can get right now. I've considered buying Resound wireless HAs for that purpose before. Instead I just walk around with IEMs and push-to-hear mic all day.
• jokoon 9y ago
  I thought they were expensive because you have to individually tune some sort of equalizer, depending of the damaged frequencies of the user. Also the hardware is not really very cheap either, you have to insert it deep into the ear, and the microphone should be sensitive enough to capture all kinds of sounds, at at all distances and air conditions, removing noise, etc. Microphones have always been expensive. It also would be running 24/7. But to be honest, price should drop indeed. But everybody knows that everything relative to health will often be overpriced if not regulated, especially if it involves any sort of technology.
  • emiliobumachar 9y ago
    "But everybody knows that everything relative to health will often be overpriced if not regulated, especially if it involves any sort of technology." How much is a band-aid? Oh, technology. Ok, how about a digital thermometer? I think the problem is the opposite. Lots of regulation, however benefits they bring, will raise prices and discourage outsiders from offering competitors. From the article: "[A new law] includes a provision for selling hearing aids over the counter to adults with mild to moderate hearing loss in two to three years. [...] Under the new law, hearing aids are expected to cost around $300 or less per ear." This seems to imply that today, and for the next two years, you cannot legally sell a competing, cheaper aid unless you can get doctors to recommend it. Even if it's just as good, it will take a large marketing effort to show it to doctors. Now, these regulations do bring benefits. But let's not lose sight of their costs.
• patentatt 9y ago
  Regarding patents, many may not know that there is a coalition of hearing aids manufacturers who jointly act in this space. On the plus side, they claim to clear patent trolls from the field. You decide: http://www.himpp.info http://www.himpp.info
• Flands 9y ago
  I wonder if there some day will be therapy (stem cells?) or a medical procedure to repair damaged ears.
  • jfountain2015 9y ago
    There are a couple of genetic therapy cures in trials... http://entcolumbia.org/world-s-first-gene-therapy-trial-hearing-loss http://entcolumbia.org/world-s-first-gene-therapy-trial-hear... Also promising is a solution using Crispr https://www.technologyreview.com/s/608899/the-easiest-place-to-use-crispr-might-be-in-your-ear/ https://www.technologyreview.com/s/608899/the-easiest-place-...
• danschumann 9y ago
  Hearing aids are covered by insurance, so there is no cost pressure to bring the cost down. Contact lenses are one of the only medical devices where their price went down in the last few decades. This is because people pay out of pocket. It's the same concept behind rising tuition. If people don't see the cost directly come out of their own pocket (either through insurance or student loans), they don't complain about cost as much, and it sky-rockets.
  • vec 9y ago
    Hearing aids aren't actually covered by insurance nearly as often as one would expect. The majority of patients pay out of pocket already.
  • pkaye 9y ago
    Which country are you from? In the US, hearing aids are not covered by most health insurance (much like glasses.) In fact I think it is explicitly written in the Medicare laws that they are not covered. So I don't think the rest of your thesis applies.
• ilitirit 9y ago
  Going by what I've heard from a relative who is an MD, the question is rather why low-quality hearing aids are expensive. The thing is, the average consumer doesn't know much about these things and how they are supposed to work. What the general sound quality should be. How long are they supposed to last etc. So you have loads of companies selling low-quality hearing aids at the same cost as the good quality ones. The consumers don't really know better because they are relying on the word of their doctors or consultants. Surprisingly, not many doctors know much about this industry either.
• blacksoil 9y ago
  Reading replies here, sounds like the problem to get HA on budget are decent power consumption and miniaturization. I wonder if coming up with a earpiece-with-smartphone like combo can be a solution? So the main device with the battery and signal processing SOC is separated from the earpiece. This main device can live in a pocket or attached to the user's belt, while connected to the earpiece through wire. Perhaps no the most convenient solution, but would it be possible to make such device available cheaply off the selves?
• vec 9y ago
  My wife is an audiologist, so I admit to being a bit biased, but it seems like most of the comments are missing one of the main drivers of hearing aid cost. Traditionally, audiology offices undercharge dramatically for their initial consultation and testing, then provide full service for the lifetime of the device. And not just normal electronics service. Often patients will come back every week or two for months to get the fit just right or to get some coaching relearning how to hear conversations or just having the nice lady in the white coat show them how to replace a battery for the fifth time. A lot of clinics will even throw in "free" batteries for life. The cost of all that service ends up getting rolled into the initial purchase price for the hearing aids. This is dumb. Most audiologists that I know think it's dumb, but it is the status quo. There's a move in the industry toward "unbundled" billing (i.e. charging an hourly rate for services and selling the aids at a much more standard retail markup) that I hope catches on, but it's a hard sell to charge for services that the clinic down the road is providing for "free", even if the total cost of ownership is the same.
  • wccrawford 9y ago
    I was going to bring up the cost of glasses as something similar, but I think your answer explains a lot of that, too. I recently went and got my eyes checked, and the doctor assured me that they had low-cost glasses. Their progressive bifocals lenses only started at $300. I pretended to still be interested, then gave an excuse and left. I purchased some online and got them for less than $100, shipping included. I threw in a regular pair of distance glasses for less than $40, too. Why is it so much cheaper? Because they can charge it. I'm sure some of the cost is in maintaining staff to help adjust the glasses, and sell them in the first place. But I got my main glasses for less than 1/3 of the prices that they wanted for just the lenses. Their frames were $100+ that I saw. I'm sure they had some around $50, but that's still more than my entire pair of distance glasses cost.
  • vbernat 9y ago
    In Switzerland, at least one big shop makes this service optional. It costs me about 1500 US$ (for a total of 6000 US$) to get the extra service (additional warranty, free batteries, regular visits for cleaning and updating settings). I think this is worth it as it ensures a great longevity to the hearing aid (my previous hearing aids are 8 year old and still working).