Posted by - Hearing Aids.

Advocates for lower-cost hearing aids got a boost yesterday when two U.S. Senators – a Republican and a Democrat – announced legislation that would ease restrictions on the sale of over-the-counter hearing aids.

Warren and Grassley

Senators Chuck Grassley (R-Iowa) Elizabeth Warren (D-Mass)

The Over-the-Counter Hearing Aid Act of 2016, sponsored by Senators Elizabeth Warren (D-Mass.) and Chuck Grassley (R-Iowa), would allow certain hearing aids to be sold over the counter and would eliminate the “burdensome requirement” that consumers get a medical evaluation or sign a medical waiver before purchasing OTC hearing aids. The Act would also require the FDA to issue regulations containing safety and labeling requirements for OTC hearing aids and to update its draft guidance on Personal Sound Amplification Products (PSAPs). The senators said they would introduce the legislation when Congress reconvenes before the end of the year.

Goal: Lower Costs and Easier Access

The new law would implement recent recommendations from the President’s Council of Advisors on Science and Technology (PCAST) and the National Academies of Sciences, Engineering, and Medicine (The Academies), which have advocated making some types of hearing aids available over the counter, and removing the medical evaluation/waiver requirement. Both PCAST and The Academies concluded that the access restrictions to new lower-cost amplification devices, designed to compensate for age-related mild-to-moderate hearing loss, have contributed to high costs – estimated at $2400 per hearing aid. In its report, PCAST said “There is considerable evidence that hearing aids can be profitably sold for a fraction of today’s end-user cost.”

If you can buy non-prescription reading glasses over the counter, it makes sense that you should be able to buy basic, safe hearing aids, too. The goal is that by making more products more easily available to consumers, competition will increase and lead to lower costs. – Sen. Grassley

In their announcement, the senators noted that while approximately 30 million Americans experience age-related hearing loss, fewer than 15 percent of those with hearing loss use assistive hearing technology, often because they cannot afford costly hearing aids. “Millions of people in Massachusetts and across the country experience hearing loss as they get older, but they are unable to get the hearing aids they need because of high costs and complicated regulations,” said Sen. Warren. “This bipartisan bill is a simple fix that that will make hearing aids easier to access and – unlike in the current marketplace – will make it easier for consumers to shop for the best value.”

Audiologists Struggle with Competition

A more open market for low-cost hearing aids threatens to disrupt traditional distribution channels – especially the business model employed by audiologists who “bundle” the costs of hearing tests, hearing-aid programming and other patient services with the sale of the product. Independent audiologists have already been squeezed by competition from low-cost retailers like Costco, which provides in-store clinical services including hearing aid programming and after-sale support. Online hearing aid discounters, which limit the amount audiologists can make on servicing hearing aid customers, have also put increasing pressure on independents.

The proposed legislation also addresses another threat to traditional audiologists – the low-cost PSAP. Personal Sound Amplification Products, which are based on many of the same digital technologies as entry-level hearing aids, cannot currently be marketed as “hearing aids,” or be promoted as a remedy for the symptoms of hearing loss. Regardless of the marketing restrictions, PSAPs are often sold to consumers with hearing loss who purchase the devices for low-cost hearing assistance. The proposed legislation would require the FDA to come up with new classifications – and marketing guidelines – for both OTC hearing aids and PSAPs, making it easier for consumers to learn about, and access, such devices.

Lobbying For and Against Has Already Started

The Hearing Loss Association of America (HLAA), “the nation’s leading organization representing people with hearing loss,” strongly supports PCASTs recommendations – as does the Consumer Technology Association (formerly CEA). On the other hand, the Hearing Industries Association (HIA), a global hearing aid manufacturers association, “strongly opposes PCAST’s recommendation that OTC hearing aids be permitted in the United States, and its recommendation that these ‘basic’ hearing aids be exempt from the FDA regulations that protect American consumers…HIA also believes that PCAST’s recommendation that PSAPs be allowed to be promoted for hearing loss is contrary to the best interests of patients.” The American Academy of Audiology (AAA), and International Hearing Society (IHS), also oppose PCASTs recommendations. The Academy of Doctors of Audiology (ADA) has taken a less black and white position (see ADA’s position).

See where relevant organizations, hearing professionals, and hearing aid consumers stand in Over-The-Counter Hearing Aids Controversy

Given that the legislation was introduced by senators from both sides of the aisle, there is a good chance it will get plenty of attention. The stakes are high: access to affordable hearing assistance and the interests of consumer electronics manufacturers are going head-to-head with the interests of professional caregivers who deliver much-needed audiological services. Perhaps the coming debate will reveal some common ground and solutions.

Download copy of legislation

Download fact sheet from Sen. Warren and Sen. Grassley

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  • blue bill

    As a consumer, I was confused when my audiologist told me that a pair of Resound LinX2 hearing aids would cost me $7200 when online I could get the same hearing aids with a the exact same warranty for $3300. This occurred 2 weeks ago. Now Costco and Sam’s are selling aids at a much lower price. It is obvious to me that these high prices will begin to come crashing down. The bipartisan bill in the Senate has a lot of support. If it passes, the end of the incredible mark up for hearing aids will soon follow as competition increases. Audiologist will be forced to be creative in their practices in order to compete. With the populist movement in this country today, consumer concerns will have a great deal of support. It will be interesting to see how this scenario plays out.

    • hopebest

      I hear you. Recently I was quoted $9,500 for a pair of hearing aids at an HMO discount dispenser, with a gracious discount of $350. for each aid from the HMO, I would have to pay almost $9.000. I spoke to someone at Costco and they told me that their aids were similar if not better and the cost was under $3,000 for the pair, still way to high for me to pay. So how did a $50-100 cost to manufacture a hearing aids translate to a $9,500 retail?

      • BBat

        As a Hearing Instrument Specialist and an active Hearing Health Care provider it really bothers me how some audiologists and other distributors continue to take advantage of the marketplace and innocent consumers. All hearing devices are not the same in terms of quality, audibility, acceptability, technology, and overall purchase value. At our practice we do distribute, a set of premium level, hearing devices for a total of $7500 (Warranties and all services included) and that’s the top hearing device that can be found on the market. The hearing devices you’re speaking of, or any other for that matter, should never, ever, be sold for $9500! If this bill passed it would hurt the consumer more than help them. They would buy poor quality hearing devices for hundreds of dollars and never be satisfied. Luckily, blue bill, you were able to find a good hearing device at an extremely low cost. You would never be able to buy those same hearing aids anywhere else for that price. The manufacturer can’t even distribute them for a number close to that price, wholesale. Costco doesn’t buy them for $50-100. They’re mark-up is slim to none. Only because of the immense quantity, for all the stores nationwide, are they able to get a lower cost than private practice. I do agree that many take advantage of the system and some can be sold at a slightly lower cost but once that starts happening it would weed out the private practices, as a majority, and patient care would decline significantly leaving all users, who purchased that route, unsatisfied and unconnected as they won’t perform adequately.

        Also, one last thought, OTC hearing devices, likely, won’t increase the amount of person’s buying hearing devices. Most don’t buy because of affordability. They don’t buy because of outside influences such as pride, vanity, etc… There are ways, through most practices, to get hearing devices at a very low cost or through a non-profit organization. There isn’t one person that walks into my office that I can’t help. No matter if they make $7,000 a month retirement or $550 Social Security Income. We can help everyone and do it in the right way.

        • blue bill

          BBat, the price you quote for a top of the line hearing aid is $7200. The resound LinX2 962 is a top of the line hearing aid sold by my audiologist for $7000+. I can buy the same hearing aid on Ebay for $3300 with 3 year warranty that includes a replacement clause and programming. How can this provider on Ebay sell the same exact HA’s at less than half the price of my audiologist and still make a profit? The answer is that my audiologist marks them up 200% or more. Check out Ebay today and you will find a Resound authorized dealer selling these fully guaranteed, top of the line, new hearing aids for less than half price.

          • Alison, Au.D., FAAA

            What you miss out on when buying hearing aids online is service. All you get is the aids. If you want a la carte pricing, I’m sure a local person will do that for you as well. A lot of offices are going with unbundled pricing lately. My clinic does not, but we are more than willing to match pricing when presented with an offer.

            That said, I would be very careful when buying aids online. In many states this is illegal, and the vendor will not tell you that. You are also sent out standard size receivers, which may not fit, with standard domes, which may not be appropriate. Also, buying used aids should be done with caution. You don’t know what you are buying, whether it works or not, whether it has warranty or not, etc. At my clinic and many others, we charge a hefty fee to program hearing aids not purchased from us. And there is no guarantee how long those aids are going to last.

            OTC hearing aids are NOT like glasses. That is something that truly bothers me about the whole legislation. You cannot just pick up a pair of hearing aids like a pair of glasses and magically hear better. 90% of acceptance of hearing aids is counseling, NOT the hearing aid. THAT is where a professional comes in. Seeing an audiologist, having an audiogram done, and talking about the steps after that is a process. It’s not like having an eye exam and getting the prescription. It’s like comparing apples to oranges. Any hearing care professional would agree.

            And to jump to something else. Any place selling a pair of aids for over $8000 is ridiculous. Our max pricing is about $6500 for a pair. That includes my expertise in getting you hearing the best you can, counseling you about what to expect with your aids, etc.

          • blue bill

            Your reply is very interesting. I have been under the care of an audiologist for about 6-7 years now. He does my hearing tests and fits my hearing aids wherever I buy them. I pay a la carte for his services. His charges are not exorbitant, so I may just be lucky or he may just be a good doctor who truly cares about his patients. The reason other offices are doing unbundled services (not yours), is because they see the writing on the wall and are preparing for the future. You say you are willing to match prices when presented with an offer. I wonder if you can match the price of a brand new Resound LinX2 962 that is today being offered on Ebay by a certified Resound dealer. The instruments are fully warranted for 3 years with a replacement plan for a lost hearing aid. Programming is included. The price is $3350 for a 2016 model. Check it out. You should be aware of what is going on outside of the bubble. My audiologist said that he can give me the same hearing aid for $7200. That is quite a markup.
            Online purchases are illegal in a few states that have very active hearing aid industry lobbyists. But that is about to change. Receivers and domes are all available on ebay for a small fee comparatively speaking. I just asked my audiologist what power receiver I had and what size were the domes. As an audiologist concerned about his patient’s needs, he told me. He even gave me a copy of my audiogram.
            You say you charge a “hefty fee” for servicing hearing aids no bought through your office. So, in other words, you penalize your needy patient that you have sworn to help. That is unethical and may be illegal (especially since you have put that in writing on the net).
            OTC hearing aids are JUST like prescription glasses . You have the aids programmed by a hearing professional and are charged for that service. I paid $125 for the hearing test and the programming. Glasses are slightly different since the eye doctor gives you a prescription before you buy the glasses. But a doctor is involved in both cases. The counseling I received was that it will take me a week or two for my brain to be conditioned to the hearing aids. That was certainly not 90% of my care. It took a matter of minutes for that advice. You are making your job a little bigger than it may be. There are audiologists without graduate degrees and “hearing care specialists” without your years of training that do the job you are doing every day. They will be the first ones to break the mold. You also seem to be assuming that people will go to the store and buy hearing aids and wear them without having them programmed. When a need arises in any industry, people will step up and fill this need. There will be many in the hearing aid industry willing to break with the norms and fill this need. You should be investigating alternatives for yourself. This may provide a real opportunity for you and your colleagues who think out of the box. Your price of $6500 is still way above the $3350 on Ebay. Oh yes, the counseling. That is worth about $3000. I await your response.

          • Alison, Au.D., FAAA

            It is very much not unethical to charge people a programming fee for hearing aids not purchased at our offices. Why should I give away my services for free? I’d like to think that my education is worth more than that. And sure, you can buy those hearing aids online and send them back and forth to that dealer every time you need an adjustment. Or you can get them from your local person and actually have a live person to sit with while you have those adjustments made. Personally, I would rather have a real person to sit with while those adjustments are made, because trying to describe hearing aid fitting issues with someone over the internet and having that person made an educated guess as to what that problem may be generally doesn’t work well. I’ve had patients come into my office who have purchase hearing aids online. They’ve dealt with those people, and they come to me because I’m not just out to sell them a hearing aid. I’m here to fine tune that aid to them. No person has the same needs, and no person can be fit the same way. Every person needs some small adjustments from the “first fit.”

            So no, hearing aids are NOT like glasses. OTC hearing aids will NOT be fit by an audiologist. Thus why they are OTC. You’ll pick them off the shelf and put them on. You probably won’t even need an audiogram to get them. That goes against every ethical bone in my body! Fitting a hearing aid on someone who may have a medically treatable hearing loss is wrong.

            There are actually not audiologists without graduate degrees. Before audiologists were required to get a doctoral degree, they were required to get a masters (following their bachelors). Audiologists diagnose and treat hearing and balance disorders Those in the hearing industry that are not audiologists are hearing instrument dispensers. They must have an associates degree and 6 months of training, then pass a state licensure exam. Hearing instrument dispensers can give hearing tests and dispense hearing aids.

            About those Linx. I don’t fit Resound, so I can’t answer you there. Honestly, we probably wouldn’t match something from eBay as it doesn’t even show where it’s coming from. At my office, people generally see the value of my service and will pay more for it.

            Can you get good hearing aids from Costco? Sure. But 80% of people won’t get them there the next time, because the service is bad. That statistic is true. So yes, people want to save money, but buying cheap doesn’t mean that you’ll be happy with the aids.

          • blue bill

            Alison, if we are to have a cogent discussion about anything, you must not misquote me and then argue the misquote. I would suggest that you carefully read what I write and then answer my statements specifically. You may want to reread my previous post. Starting at the top: ” Why should I give away my services for free?”, you ask. Where in my post did I ever say that??? I was commenting on your statement that you charge a “hefty fee” to service aids that were not purchased at you office. Is a hefty fee a fair fee? I guess that you were implying some sort of overcharge punishment for your servicing of aids not sold by you. The overwhelming percentage of your patients are senior citizens on a fixed income. Since it is impossible for them to get an unbiased comparison anywhere, it is you responsibility to enlighten them. But you only tout the aids you sell. That in itself is unethical in my opinion.
            Buying hearing aids online does not mean you have to mail them back every time you need an adjustment. I bought my aids online and they are serviced by a skilled , ethical audiologist, at a fair fee, close to my home. An audiologist that will not service my aids or charges me a “hefty fee” and not a fare fee is unethical, in my opinion.
            I repeat, buying hearing aids is just like buying glasses. The eye doctor gives you a prescription, but you don’t have to buy the glasses from him. You can have your script filled and fitted by whomever you choose. The market is open and will dictate what you pay for the glasses. Soon hearing aids will be sold OTC. You can then take them to an audiologist (an ethical audiologist) and have them fitted at a fair (not hefty ) fee. Or you can have the audiogram first and be advised by an ethical audiologist on what hearing aid you should purchase. The audiologist can sell the HA at the going market price which will decrease after the new law is enforced. This will be the future of the hearing industry, so prepare now. I know your organization (AAA, I assume) is against the opening up of the tightly controlled hearing aid industry for the benefit of the consumer. If you dispute the tight control, then supply me with an unbiased comparison of all the different aids on the market. You won’t find it on the internet. You won’t find it in Consumer Reports. There are some sites that masquerade as unbiased, but recommend only the brands they sell in the end. Would you discuss the salient benefits of a Resound hearing, that you do not sell, over the hearing aid you DO sell with a patient? I think not. If you will not do this, I would call that a gross lack of ethics on your part. The consumer is left totally in the dark and at the mercy of the present hearing aid industry and their concentration on their bottom line and then (hopefully) the needs of the consumer. Competition is the spice of business and that spice is being added to the hearing industry.
            You are right about audiologists and graduate degrees. I thank you for the correction.
            I know exactly from where my hearing aids come . The site I reference on Ebay sells brand new Resound aids made in Denmark and they are located in California. I checked it today. They have lowered their price by $100. I ask you again to look them up. My Mamma used to say , “There is none so blind as those who refuse to see.” Broaden your scope. Don’t be caught unprepared by the change that is coming. You can prosper from the coming change if you get out in front of it. Being creative and concerned and getting that message out to consumers of how you propose to help them could reap great benefits for you and your patients. If you are interested, I can give you some suggestions on how to do this. I won’t charge a hefty fee (Smile).
            P.S.: Your statistics concerning repeat customers at Costco are incorrect. It is much higher that 20%. They would not be opening new hearing centers if clients were not returning. They have sophisticated marketing consultants that only get paid for good results. Try not to fool yourself by not being open minded. I hope I don’t sound too snarky. I’m only trying to get your attention. If you decide to reply, please read my statements carefully first.

          • Alison, Au.D., FAAA

            About the PS, it is a true statistic. They do not have a lot of repeat customers, and their return rate is one of the highest in the industry.

            I am very open-minded about these things. OTC hearing aids are not meant to be fitted by an audiologist. They are supposed to be like reading glasses. You take them off the shelf and put them on. I think that’s where you aren’t understanding the concept here. They are not fit by an audiologist. You don’t even need a prescription for them. THAT is where my problem lies. You could have ears completely occluded with wax, a massive ear infection, otosclerosis, a brain tumor, etc, and never be medically evaluated, but these politicians think it’s okay for you to get this OTC hearing aid. These aids will likely not be programmable by people like me. That’s why they’re OTC. You just pick them up and put them on. This is why it’s a horrible idea.

  • hopebest

    Hearing aids users should break into a happy dance. To have two senators from different parties to agree is also good news. “In its report, PCAST said “There is considerable evidence that hearing aids can be profitably sold for a fraction of today’s end-user cost.” The opposition to this bill that would help millions come from the very same people that claim that their interest is for “the patients” and that this bill is “contrary to the best interest of patients”.

    AAA, HIA, IHS & ADA answer to why they oppose the bill is a joke and an insult to the American consumer. These organizations only want one thing and that is to keep their monopoly in the manufacture and distribution of HA, high profits, lack of transparency and for the inability of consumers to do comparison shopping in the hearing aid industry.

    The American people are tired when government and corporations do not hear their voices. By what I hear from news reports, yesterday’s election could be a reaction from people that things need to change. Average Americans continue to be left behind in all areas of the economy, health, jobs etc. The cost of hearing aid is out of reach to millions, perhaps the hearing aid industry will see this shift and change their ways. They may not make outrageous amounts profits, but they will have reasonable profitable returns and in the process help millions of people.

    Thank you Senator Grassley and Senator Warren for your courageous action to introduce this life saving bill.

    • The organizations you mentioned have not come out against the bill, but some have opposed PCASTs recommendations, like IHS, HIA, and AAA. I would encourage you to read their position papers on the subject as there are some good arguments for the protection of consumers.

      • hopebest

        Thank you, I will read their position papers.

    • blue bill

      Hope best: the HA industry has NO transparency. Try to find an objective evaluation of hearing aids anywhere on the net. Even Consumer Reports has nothing on comparisons of different brands of hearing aids. Some sites that perport to give honest comparisons are just camouflage for a sales pitch for their brands in the end. The defense of all scoundrels is to protect the poor consumer. …… when translated, means protect our high markups. I would suggest to you to get on EBay and look up your hearing aid brand and model. The low prices will amaze you. I bought a lightly used pair of Resound LinX2 962 for $450. I had them programmed by an audiologist and the work fine. Some audiologist won’t program ha’s that they did not sell to you. But there are cracks in the walls and they will soon come tumbling down

      • You have not been looking very hard Blue Bill. The very site that you are posting on is in fact completely independent from the hearing aid industry and the content we produce (aside from some clearly marked sponsored articles) is purely educational and without bias. As a doctor of audiology myself, I can tell you that your advice might help some people, and might hurt others, and I have absolutely nothing to gain by saying so (I am no longer practicing audiology). Purchasing a hearing aid off of Ebay, without warranty, without knowing whether device is even appropriate, and without the guarantee of finding a local practitioner to care for you is risky, and more than likely will not pay off for consumers with complex hearing needs.

        I have committed my life to educating consumers about their options, and ensuring they have the best available information to make an wise decision when seeking a hearing solution. I welcome you to join a webinar I’ll be running with the Hearing Loss Association of America, where I’ll be covering the importance of audiological best practices, but also talking about some of the industry’s secrets. http://www.hearingloss.org/content/educated-consumers-hear-better

        • blue bill

          I agree that some of what I said about Ebay may cause harm to someone who is not under the care of an audiologist. In my case I have been followed by an audiologist for about 6 years. I have purchased hearing aids twice from him at prices close to $8,000. While perusing through EBay one day I noticed brand new Resound LinX2 962 for $3300. They came with a full 3 year guarantee and had a serial number that was registered with GN Resound, meaning that the company would repair them if the need ever occurred. The ad is still on EBay today. They say that they have the lowest prices in the industry. I spoke with my audiologist last week and he said that he can sell me the same pair at a discounted rate of $7200. I bought a pair of Resound LinX2 962 a few weeks ago on EBay for a relative of mine for $450. I communicated with the seller and she said her Mom used them for 2 months before she passed away. I guess I took a chance when I bought them, but the price was so low so I did it. They were made in 2016. My family member had a full exam by an ENT and then was fitted with those hearing aids by him. They worked well and she feels they are changing her life. I thank you for noting my error. I hope I rectified it. I’d be interested in knowing if there is some website or publication where I can get an unbiased comparison of hearing aids. Thanks

          • Sharon Campbell

            I got my last pair from Craigslist, Phonaks for $200, and my audiologist programmed them for another $100. Mine were owned by a man who left them in the drawer and then died.

          • blue bill

            Sharon, I read a few of your comments on other subjects. You seem to have wit and knowledge about numerous topics. You speak your mind in a cogent way. You are pleasantly aggressive when you know you are right. Refreshing. You see why hearing aid vendors do not want to inform their customers. The thought of over the counter hearing aids terrifies audiologists. Competition will cause prices to come tumbling down. The cat will be out of the bag. They don’t want to just do fittings. The money is in selling incredibly marked up hearing aids. Hearing aid makers will be forced to repair hearing aids even if they were not sold through one of their registered dealers, a practice they follow now. I will have to check out Craigslist. Please do not be like that man and leave your hearing aids in the drawer. You are needed.

          • Sharon Campbell

            Thank you so much! I got my first pair when I was just 7 years old, and they do NOT stay in a drawer. However, there is a real danger of people just getting their own HAs OTC: it is awfully easy to over-amplify, and destroy the hearing you have left. And fine-tuning the programming initially, and as your hearing loss changes really is best done by an expert. Audiologists do need to be paid for their years of study to get their Au.D., plus the tuition they pay. They have overhead, what with rent, paying their employees, taxes, insurance, etc. And they do need to earn a living. This transition is going to be tough on everyone.

      • Tiffany96

        I also feel changes are needed in the HA industry. I have worn HA for over 50 years and very frustrated with the outrageous cost. I was fortunate that my parents did anything to get me hearing aids to give me an opportunity to thrive and succeed in life. My mother was told by a dr that i would be below average child. I remember my mom telling him he was wrong and i hate to say it but she told him he was an ahole and scooped me up and stormed out of there. That was back in the late 60’s and it hurts me to know other intelligent kids were just labeled. I graduated high school in the top 5% went on to college and have a great career. But I get so frustrated with all the expense of HA yeah they talk about all these bells and whistles that quite frankly are never used and are often never what you think they do. My favorite is the wind screen nope not even close to what a new patient would percieve it to be BUT to get any chance for that useless upgrade you must be at the premium cost range. I would love to be able to upgrade HA more often because I depend on it for a chance to participate in life. Why should others be shut out of that chance. Yeah i know we say that even if changes are made to improve access people still wont get one. I really believe that will improve in the newer generations. Lets remember that people are much more accepting of disabilities and its not the taboo of the older generations, yes there was a stigma attached to people wearing HA. Its up to us to speak up and make it easier to access HA technology. My anger is the industry blocking access and selling 9000 devices to 80 or 90 old individuals now thats disgusting. ok my reason for writing this is because I want to have another pair of HA because I choose to sleep with mine on. I got a great barely used pair on ebay and contacted the provider i have been using for 50 yrs and i was told it would be a $1800.00 fee to program what an insult and I dont expect it to be free i absolutely have no problem paying a reasonable rate. I dont want to have audiologists point out additional reasons why it cost so much. Let me also say that I hear about the bundled costs because with the many hearing aids i bought i have never gone back for more programming per the contract. There are many patients that are realistic about the capability of a hearing device. i have met so many people that continue to go back because for 9000.00 they expect to hear like they did before being impaired and struggle with the reality of the amplification of background noise and sounds of footsteps etc. Its a huge adjustment for many that results in 9000.00 sitting in a drawer forever. Why shouldn’t they be gifted or sold to users wanting to try a device they could never afford and reap chance of improved quality of life. If the industry has the luxury of those dome fittings that cut their costs and require less work for them then we should be able to get better options as well. i hope to see improvements for everyone.

  • hopebest

    I hear the provider’s argument, after all it is their business to sell hearing aids and for a very long time it has translated into a very lucrative business. Let make a hypothetical argument- providers claimed that it is the “service and expertize” that justifies the astronomical mark ups. So I go to a throat and ear specialist that cost around $150-200 that is mostly covered by my medical insurance, they tell me I don’t have tumors or ear damage, I just have hearing lost. I go to Costco and get a free test, or request one from an audiologist at a cost of (?)

    If the hearing market was fair, I would research models in a price range I could afford-purchase the device, make an appointment with a provider to have the devices
    adjusted to my hearing lost- cost would be in the $100-150 for the initial consultation in the same range as the cost a of a medical doctor (specialist) -follow up visits can be in the range of $80-125 and cleaning and repairs cost can be posted as to give consumer choices.

    Please explainto me if this scenario is too much to ask?

    The way Isee it is that audiology training (doctorate) is expensive but as technologyadvances it would be a very difficult field in which to make the kind of income
    that Audiologist are presently getting. The technician’s adjuster/dispensers would make a decent living after a short training just like Costco is doing
    now; their expertize is not medical but technological, and they would leave the medical issues to Audiologist with doctorates and medical doctors.

    • Jeff

      Hopebest, I certainly understand your concerns and your idea of purchasing inexpensive hearing aids with programming visits in the $80 to $150 range sound reasonable. At least you understand that hearing aids are not just speakers that make sounds louder. As a former owner of a local hearing aid center I can tell you that the practices you outlined may work for a short period of time as you will be able to find dealers willing to program aids for those charges. But after awhile, if this became the norm, you would find that there would be no one left to competently program your aids.
      I am not an audiologist but a state licensed hearing aid dealer. I had to go through an apprentice program and state testing to get my license and take 10 hours a year to keep my license. Of course an audiologist has years of a doctoral degree with all the expenses associated with that level of education. I only mention this to begin to show you how hearing aid costs build. You can go to Best Buy and some high school part timer can show you a wall of TVs and tell you he likes this one. But the people you purchase a hearing aid from have to have years of training and expertise. I hate to admit it but I build extra cost into a hearing aid, but it is a necessary cost born of the complexity of hearing loss, our bodies and the technologies that all need to be blended to insure you can hear as well as possible.
      As I look around the office I am in now I see a video otoscope which costs $5000 to $10,000. If I drop it on the floor it will cost me $1200 to replace just the 1 inch tip. I see three computers in this office that have to be maintained by IT people we hire and use all he time and replaced every three to five years. I have programming boxes that connect to my computer that allows the hearing aids to communicate with the computer. It isn’t cheap. But now we have wireless hearing aids and every manufacturer has their own wireless communicator and they don’t give them away. The more brands I choose to work with because I want to help as many people as possible, the more my costs go up. I have testing hardware and software that is very expensive and associated computer plus a sound proof booth for testing. There are people in our organization that process all the necessary paperwork, work with insurance companies, make sure we are meeting government regulations and many other functions. There are all kinds of taxes that must be paid. My favorite is the CAT tax. It is a tax “for the privilege of doing business in the State of Ohio.” Enough said. Of course all of the employees in this and the other offices have half their income taxes paid by their employer, need a decent wage and have various benefits that our employer pays for. We all work in offices with heat in the winter, air conditioning in the summer and lights so we can see. You get the drift. It all costs money and builds costs in the hearing aid you purchase from us.
      I have been to the manufacturer that makes our hearing aids and, quite frankly, was blown away. They have hundreds of employees (lights, heat, benefits, etc.) and incredibly complex manufacturing processes. There are 3D printers, clean rooms and so much more. You would be fascinated going through the facility. One engineer explained the process of developing and testing a small piece of plastic that is the hinge on the battery door. I couldn’t believe all that went into just that one simple part of a hearing aid. But the point is that all this costs hundreds of millions of dollars a year to insure your hearing can be the best hearing possible given the current technology and parameters of your particular loss. It all builds cost into the aids you purchase from us.
      Yes, some simple kind of hearing aid could be purchased over the counter and some dealers might program them for a hundred dollars. But what you will eventually end up with is many companies producing many inexpensive hearing aids sold by high school part timers and no one who really understands how to make your aids work better for you because we will all be out of business. I tried to keep costs as low as possible and I programmed aids that people bought on line. But, eventually my business went under. I wasn’t making the income any more to keep the doors open. People purchased aids from me expecting I would be there to service and program their aids for many years to come. But I was unable to do that. I wish improved hearing didn’t have to be so expensive but I hope you can begin to get a glimpse of why it does cost so much. I wish you well and hope your aids help you very much.