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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

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.
- abecedarius 9y ago
  I wear hearing aids selected by an audiologist, have probably had some extra damage to my hearing from them, and wish I could buy open hearing aids I could program myself. I don't blame the system for the damage, but do for the restricted choice. Generally consumer protection by regulation seems to suffer from a form of regulatory capture -- measures that are great at entrenching the existing players get disproportionate emphasis. You end up e.g. restricting the supply of doctors and then not bothering to make them wash their hands. I'm not saying regulation can't ever do net good, but you have to watch it like a hawk, and who has the incentive to?
  - forapurpose 9y ago
    > Generally consumer protection by regulation seems to suffer from a form of regulatory capture ... I've heard these theories a lot, but I almost never see much evidence; is there any evidence it applies in this situation? > doctors I think it's very important to regulate doctors and medical care. I don't want any quack hanging out a shingle and treating people. The same goes for medical devices.
- averagewall 9y ago
  Earphones aren't regulated and have all the same risks. In fact neither are all the cheap not-quite-hearing-aids. I have one that looks just like an old hearing aid but cost maybe $50. Safety really isn't a risk here any more than it is for consumer goods.

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.

abecedarius 9y ago
I wear hearing aids selected by an audiologist, have probably had some extra damage to my hearing from them, and wish I could buy open hearing aids I could program myself. I don't blame the system for the damage, but do for the restricted choice. Generally consumer protection by regulation seems to suffer from a form of regulatory capture -- measures that are great at entrenching the existing players get disproportionate emphasis. You end up e.g. restricting the supply of doctors and then not bothering to make them wash their hands. I'm not saying regulation can't ever do net good, but you have to watch it like a hawk, and who has the incentive to?
- forapurpose 9y ago
  > Generally consumer protection by regulation seems to suffer from a form of regulatory capture ... I've heard these theories a lot, but I almost never see much evidence; is there any evidence it applies in this situation? > doctors I think it's very important to regulate doctors and medical care. I don't want any quack hanging out a shingle and treating people. The same goes for medical devices.
averagewall 9y ago
Earphones aren't regulated and have all the same risks. In fact neither are all the cheap not-quite-hearing-aids. I have one that looks just like an old hearing aid but cost maybe $50. Safety really isn't a risk here any more than it is for consumer goods.