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How much would you pay for: *Hearing test * Hearing aid fitting * Usage counselling * Follow up adjustments * Annual retest of your hearing * Replacement

• brutus1213 5y ago
  Any insights on tuning process for little kids? (2-3 year olds?) These guys don't really have the ability to provide feedback for retuning.
  • jrace 5y ago
    Tuning for them is more about slowly increasing the sound levels overtime than adjusting for understanding. As well you may want to work with a Speech Language Pathologist.
• chairmanwow1 5y ago
  Correct me if I’m wrong, but isn’t this something people could do on their own at home if the hardware had a decent setup UX / tuning instructions? This doesn’t necessarily seem like something that couldn’t be done pretty automatically.
  • cf100clunk 5y ago
    See the Hackaday link I posted earlier for one such example.
  • wrycoder 5y ago
    You’re not wrong. Most people don’t need all those overpriced ads-ons.
• TaylorAlexander 5y ago
  I guess one question is: do those things have to cost thousands of dollars? What are the primary cost components? Are the people doing these jobs highly paid? Are they highly paid because of high costs of college tuition? Would free college help lower their costs?
  • jrace 5y ago
    My opinion: do those things have to cost thousands of dollars? --yes and no, costs could come down, but in the lifetime of a hearing aid it could be replaced 3 times or more at no charge to the user. What are the primary cost components? The primary components are: Microphone {cheap to produce} Receiver (speaker) {cheap to produce} Processing Chip {expensive to R&D, cheap to produce} Are the people doing these jobs highly paid? Salary in Canada was between $60,000 (diploma) - $100,000 (Doctorate) when I left the industry. Are they highly paid because of high costs of college tuition? Depends, but after leaving for IT and making more than that with less education - I am unsure if they are "highly paid" Would free college help lower their costs? I would hope so, but doubt the savings would pass on to the consumer.
    • bradknowles 5y ago
      Maybe cheap to produce in larger sizes. As you have to make the components smaller and smaller to fit all the extra gubbins, each of those other components now become exponentially more expensive to design and produce. Yes, there’s a lot of overcharging in this business, because the manufacturers charge what the market will bear, and because of insurance and lack of competition due to all the regulations they have to comply with, the market can bear a very high price. But it’s still a very hard problem, and there’s a very significant component of user training over the long term that is required. When you were a newborn, you didn’t learn to hear and speak your native language in a single day, you didn’t learn to see and recognize faces and read written words in a single day. You shouldn’t expect a hearing aid to magically fix you in a single day — your brain needs time to retrain.
    • lupire 5y ago
      Replacement should be an insurance offer like the rest of electronics.
• scottlamb 5y ago
  > Buy a hearing aid today from any major provider in Canada and you get: [...] Do you know what the status quo in the US is? (I don't, other than the prescription requirement from the article.) What you describe for Canada sounds pretty good to me, but I wouldn't assume any part of US healthcare is as inexpensive as Canadian healthcare or that the regulations are as well thought out.
  • jrace 5y ago
    No idea, but an initial search at "Connect Hearing US" (which also has a large Canadian arm states; "2-week FREE hearing aid trial* Try before you buy, absolutely free! Take a new pair of hearing aids home for two weeks to see how they work in everyday situations — no money down and no obligation. 3 years FREE Batteries Get three years of batteries included with your purchase no matter what hearing aids you buy. Each year you will receive a box of 60 batteries for each hearing aid. 3-year Warranty and 3-year Loss & Damage Enjoy a three-year manufacturer repair warranty and three years’ loss and damage coverage for all hearing aids" https://www.connecthearing.com/cost-of-hearing-aids/the-connect-advantage/ https://www.connecthearing.com/cost-of-hearing-aids/the-conn...
    • brutus1213 5y ago
      It is not perfect in Canada. Getting aids for our child and was shocked that this is a few grand out of pocket (after gold standard work insurance, provincial aid, etc). The province pays 500 bucks per hearing aid, which seems ridiculous given the costs. We are well to do so it doesn't matter but I am shocked that this isn't fully covered given the taxes I pay (in tech .. so you can guess). For kids, this should be fully paid by the government - no questions asked. As a few others (who seem to be knowledgeable) have posted .. if u miss out on hearing, you start to be less productive member of society. Being in a western, rich society where we pay for stupid shit all the time out of taxes, the govt not fully paying for some basic model of hearing aids seems like a crime (basically, not enough people are impacted, so politicians don't care). I'm glad the US is improving the situation here for its populace.
• thegrimmest 5y ago
  So your argument in favour of socializing this is that people tend not behave optimally, in your view? This seems like a poor reason. Let the people who fall victim to their biases suffer the consequences, don't impose the cost of holding their hands on those who are capable of managing themselves.
  • jrace 5y ago
    It was not an argument, but a statement. If one model (pay as you go) causes harm to the whole industry (people know believe hearing aids do not work) then why would the industry continue?
    • thegrimmest 5y ago
      I'm suggesting the model to use should be decided individually by members of the industry, not imposed on the industry as a whole. If some orgs want to use pay-as-you-go that's fine. If others want to offer more comprehensive service, that's fine too. I'm arguing for allowing the interactions to take place, even if some choices made are suboptimal.
      • jrace 5y ago
        They can. As far as I know (at least for Canada, circa 2015) there were no laws or regs stating how, what or when to charge for services. --other than some kind of return period.
    • aidenn0 5y ago
      Because it's easier to get someone to pay $100 for something they aren't sure will work (and then have their beliefs confirmed) than to get someone to pay $1000 for something they aren't sure will work (and then have their beliefs refuted)?
      • thegrimmest 5y ago
        I think it depends on the someone in question
• retrac 5y ago
  Canadian here as well. I have a 35 dB / 70 dB loss in each ear respectively. It is a pretty sweet deal if you can afford it. They do just ship you already-programmed replacements if you've lost one. No questions asked. Free adjustments. Very comprehensive. It's pleasant and stress-free while you're covered by one of those packages. But it's if you can afford it. When you can't afford the all-exclusive package there's really not much else. I spent about half of my childhood, teens and 20s without hearing aids due to cost. Held back my education at all levels. Even when I went to university, while I was eligible for provincial funding for hearing aids at a student, I was still expected to pay the cost up-front first. Independent adult students don't usually have $5000 cash lying around. I missed most of my first year.
  • kwdc 5y ago
    Their reasoning is that you should stop buying luxury superyachts each year and focus on your health. Its about priorities! On a related note, dentistry is another one that is usually not covered at all. Why even basic dental isn't covered by government healthcare as a prevention initiative still surprises me. Bad teeth can kill you / give you cancer / wreck chaos and damage organs in general etc and its all often detectable at early stages.
• mherdeg 5y ago
  Hmm, why charge $750 instead of billing $20/month forever and giving new hardware every 3 years?
  • asciimov 5y ago
    Easier pill to swallow. People on a fixed income don't want to have their benefits reduced by $20 every single month. Public healthcare should just cover it.
• dmurray 5y ago
  I've long thought the problem with hearing aids is the calibration process. People (often old, confused, and less tech-familiar) try them on and spend half an hour answering questions about "does that sound better?" What if, instead, the calibration process worked constantly? Give the user a button to press when they don't hear something well, and another when they do. Let them have this for a month, let them try it in their kitchen, their bedroom, the local shop or bar, outdoors. Run some reinforcement learning algorithm to optimize for getting more "good" presses and fewer "bad" ones. Optionally, adapt separately to each environment. Is there a "smart" hearing aid calibrator that works like this? If not, but you think it's plausible, I'm interested in working on it.
  • jrace 5y ago
    THere may be now, but not 5 years ago. I have many ideas about how the industry can be improved, especially with the use of a smart phone app and user interactions. Not only is it plausible, but would make the clinicians (fitter) job easier and lead to far more hearing aid sales.
    • bane 5y ago
      What's really needed is a decoupling of the hearing test from the calibration activity. A basic hearing test takes a few minutes in an isolated box with headphones (the 'ol click a button if you hear the tone test). From that profile it should be trivial to build out the profile of what frequencies to boost and what not to and program the aids there.
      • kradeelav 5y ago
        I appreciate the optimism (and do think there's some room for efficiency improvements!), but each step is a little more complicated than that. a true audiometric room/booth to do the testing (eg fully soundproof) in is very rarely found outside of audiologist offices or specialized academic spaces, for starters, and I do believe those are required for paperwork (whether it be insurance related part of the process to getting the right device fitted). then there's also additional complications like types of hearing loss impacting calibration - some people react very negatively to higher (or lower) frequencies than others do, to the point facial stimulation can happen, and some people just have a frankly tricky profile that requires a trained audiologist on hand to work with them through several sessions, if not outright yearly on top of that, since the nerves and brain output can change by itself. (source: have a cochlear implant, been doing the described experience since I was ~ 3yrs old.)
• oneplane 5y ago
  Same in The Netherlands, and you don't pay out of pocket for those either in most cases. It also makes a lot of sense for an insurer if you think about it: people that are able to sense their surroundings reasonably well might be less likely to get into accidents causing that to then cost a lot of money. From an ethics standpoint it also makes sense to be in a society that aims to give people a good standard of living. Someone slowly loses the ability to listen to music for example might have a harder time enjoying life if music was an important part for them, that might cause various forms of distress which can turn into 'expensive' treatment for that. Some people argue that ethics have nothing to do with it, but if that were the case, highly expensive insurances would be mandatory, and payouts would be zero since business-wise that makes a lot of money without being ethically encumbered.
• criddell 5y ago
  For the first four items on your list, I would pay for the hardware cost of the hearing aids plus $200-$300. The last three things should be optional like Apple Care or other service contracts. Is tuning (and retuning) something that could be automated? Because of tinnitus, my hearing is not the same every day and so static settings feel like the wrong solution.
• germinalphrase 5y ago
  “ Sadly, most people wait too long before trying a hearing aid, and give up because they hear too much noise.” Are you suggesting that getting hearing aids preserves your hearing or simply that people with advanced hearing loss benefit less from them?
  • jrace 5y ago
    Hearing aids allow you - rather enable you - to listen again. Without them your understanding and comprehension gets lazy. Imagine if you stopped playing basketball because of a bad knee. Then years later you get a knee brace and are able to play again. How long, and how much practice would you need before you could play at the level you were at before the knee problem? And without properly fixing the problem (just using a mobility aid) could you ever return to pre-knee problem levels?
    • bookofjoe 5y ago
      OT but knee-related: people need to understand that function after a total knee replacement will NEVER be better than that existing at the time of the replacement. The only benefit is reduction or elimination of pain. — retired M.D. (anesthesiologist)
• RHSeeger 5y ago
  > There is far more to fixing your hearing issues that just amplifying sound. Sadly, most people wait too long before trying a hearing aid, and give up because they hear too much noise. Of the people I know who have gotten hearing aids, every single one of them was disappointed. Every single one of them still had trouble hearing. As far as I can tell, the only thing the audiologists appear to be able to be able to correct for (with current hearing aids) is "make it louder". If more than that is needed, it's a vicious cycle of taking it home, realizing it's not really helping, and bringing it back to try a new one. The above seems to be particularly true when the hearing problem is heavily weighed towards not being able to hear certain/higher frequencies, so can "hear" people talking, but can't understand it; especially if there's any background noise at all. I sympathize that your job was hard and that the clients made it harder. But the clients following directions and trying multiple different hearing aids ... doesn't really solve the problem in a lot of cases. Hearing aids are very expensive, far too expensive for a result of "I still can't understand people talking to me".
  • BurningFrog 5y ago
    > it's a vicious cycle of taking it home, realizing it's not really helping, and bringing it back to try a new one. Sounds like the calibration needs to happen in the home, not the doctor's office.
    • jrace 5y ago
      That sometimes was benificial, but mostly with just one n one and TV. Those you can control, but what about when a few more people come over? Or when the neighbor is mowing their lawn?
    • crucialfelix 5y ago
      Many companies have remote adjustment now. They connect online and the user and audiologist talk on video.
  • jrace 5y ago
    Perhaps it is because most of those people expected the hearing aid to work for them, and did not want to do any of the work they needed to do themselves. Imagine not reading for 10 years because of bad eyesight, eye glasses do not make it so your brain can read, but instead makes it easier for your brain to see the symbols. your brain still needs to decode and comprehend them. Our hearing system is far more complicated. You can look in the direction you want to see....but you hear all around you, even through walls. You cannot stop hearing, even in your sleep. It is far more crucial to our environmental awareness than more people realize.
• jl2718 5y ago
  Why is a doctor needed to do any of that?
  • tim333 5y ago
    I just looked at the NHS site and they suggest your doc check your ears are not just bunged up with wax. Beyond that I'm not sure why I'd need professionals rather than an app to do some hearing tests.
  • bluGill 5y ago
    Maybe not a doctor, but you need someone to test your hearing and write a custom frequency map for how your ear works. Good hearing aids are not simple amplifiers, they have complex signal processing to make it easier to hear what you want to hear (if you like music they make music worse, but you can understand the lyrics - this is a simplification, but good enough)
• fnordfnordfnord 5y ago
  My wife's grandfather should have all of that through his VA, Medicare, and supplimental insurance. His hearing aids are the most annoying low quality overpriced pieces of crap you can imagine. And that stupid headphone amplifier thing they've sold him, garbage, literal garbage. A hobbyist could do better. The new schema may not be a panacea but I don't expect it to be worse than the status quo.
  • hansthehorse 5y ago
    The VA will not co insure with Medicare but will with private insurance companies.
• mgerdts 5y ago
  What you describe is almost as good as the deal anyone can get from Costco in the US. The return period is 6 months, I think. You also get one free replacement in the first 3 years if it is lost or chewed up by your dog.