What's with the crazy hearing aid pricing differences in Costco versus chain hearing clinics?

Coincidentally, I just finished doing a review for Amazon on a pair of hearing protection electronic muffs. I was surprised by a helpful feature that became apparent when I used them, after having used 2 other different pairs for a number of years.

These newest ones not only attenuate loud noises to a safe level for the user, but it immediately became clear that they also selectively AMPLIFY other nearby sounds to still-safe levels!

In found that by using the volume controller wheel, I was able to hear the rifle shots from my 45-70 caliber rifle at a very safe level (They are of course VERY loud when heard withOUT hearing protection since the bullets come out of the muzzle at 500 grains weight at 1400 feet per second = over 2000 ft lb of energy. That’s 3 times the energy content of a 357 Magnum pistol shot).

But what also impressed me is that I could now hear the shooter and his spotter, several shooting stations away, having an ongoing conversation, at a LOUDER level than I could hear them when I took OFF the muffs.

Even more impressively, there is a dirt motorcycle track located several hundred yards BEHIND where I was shooting, AND there was a wall right behind me, between me and that distant motorcycle track. WithOUT the muffs, I could barely hear the 2-stroke motorcycle racing on the track. WITH the muffs, its sound was amplified, and very CLEANLY amplified. I was amazed.

There was also a very strong wind at the rnage during this shooting session yesterday. The muffs also amplified that, but only SLIGHTLY. I could discern the difference in volume, but it was nowhere near the degree of amplification that the muffs applied to the 2-stroke motorcycle noise.

So, clearly, these newest muffs have a rather sophisticated hardware and software combinaiton that goes well beyond simple attentuation of too-loud sounds. It is doing some of what Oticon says they do that Oticon implies is very costly to do.

These muffs have a price that should get your attention: Amazon sells them for $44 ! And by the way, that’s CANADIAN dollars, so about $33 US ! And yes, they are a mass produced product from CHINA.

So why does a pair of Oticon Real HAs sell for $10,250 CAN minus the $2000 CAN “sale” discount = $8250 Canadian when these muffs sell for $44 at Amazon.ca? That’s 187 times as much for the Oticon than for the muffs.

Really?? I don’t think so.

Amazon revolutionized consumer shopping.

I think Costco is doing the same thing for hearing aid shoppers. And, given the hearing aid consumer abuse that has evidently been occurring, and being tolerated for way too long, it’s about time.

Jim G

Severity of hearing loss is no indication if the complexity of fitting.

Also I’m pretty sure that most mechanics would struggle to have both the personal skills to deliver a test with bilateral masking after a decent physiological assessment, then prescribe and fit a hearing aid with real ear measurement while reassuring and explaining it all to a client with diminished cognitive or learning disabilities.

Just because sone people see the assessment, testing and fitting process as a shallow dive doesn’t mean that it is.

The car analogy is absurd tbh. I’ll let you and Jim work out why.

Um_bongo: I see you are a “registered provider”. You just might have an axe to grind. Keep your head in that sand. But do so at your peril. Amazon put any local overchargers pretty much out of business by providing competition using a more efficient business model that was accessible by almost everyone. Costco might do the same to any HA provider that tries to maintain the mystique in hearing aids and in their pricing.

And, by the way, the vehicle design and maintenance comparison model IS appropriate. The safety aspects of driving a 2-ton family car down a highway at 50 to 75 mph, and the need for liability reasons to make that vehicle safe for its occupants and others nearby, even when the owner does stupid stuff like trying to drive at 150 mph or pull a too-heavy trailer, or driving on ice with summer tires, makes the design and maintenance of a family car FAR MORE complex than fitting hearing aids, for all but the most unusually impaired patients.

Jim G

Ok Jim,

In your opinion the role of the Audiologist and Mechanic are interchangeable in terms of skill; through your ‘shallow-dive’ into the industry. Do you do your own dentistry too?

It’s somehow become de rigeur to put down the knowledge and experience of ‘experts’ in any given field just because it short-cuts the process and apparently cheapens the offering. Great, if you want cheese made out of plastic, drinks made out of fructose corn syrup and all of your consumer products made in China. Not so great if you want actual service, decent products and customised delivery for people who often have challenging needs.

My clientele don’t fit your model. Which is absolutely fine, but they need a standard of service. That means they come to see us.

Yes, I was aware; I was being a little facetious in advocating what seems to be the obvious solution to the issue, rather than deregulating/cheapening the supply to the point where people with potentially life harming conditions get ignored, just to save a few bucks on the ‘sales process’.

I guess it comes down to whether you want your healthcare based on a service model or just sales of product.

@JimGnitecki said:

Amazon revolutionized consumer shopping.

I think Costco is doing the same thing for hearing aid shoppers.

One reason Costco can sell HA’s so cheaply is because they pay less for them. People have asked why HA manufacturers are willing to sell to Costco at such a discount compared to regular wholesale. The conclusion in this forum, essentially, is that Costco pays enough above the manufacturer’s marginal cost to make it worthwhile. Given that, I question whether the manufacturers are able or willing to sell the bulk of their production based on marginal cost.

As for your shooting protectors doing the job of hearing aids, I suggest revisiting this after you’ve worn real aids for a while. I could point to a few sounds I do hear as evidence that I don’t need aids, but that wouldn’t make it true.

Hearing aids are just an adjustable, small packaged amplifier. For the most part, they just amplify sound.

You don’t need 8 years of training to adjust them. Costco and our DIYs have proven that time-and-time again, and we now have OTC hearing aids that prove it also.

There a place for 8 years of training, there’s a place for 2 years of training, and there’s a place for DIY.

@user990 said:

There a place for 8 years of training, there’s a place for 2 years of training, and there’s a place for DIY.

I agree.

@JimGnitecki said:

So, clearly, these newest muffs have a rather sophisticated hardware and software combinaiton that goes well beyond simple attentuation of too-loud sounds. It is doing some of what Oticon says they do that Oticon implies is very costly to do.

In all likelihood the muffs are using a physical wind barrier rather than an audio cleaning solution. Lots of cheaper solutions if you’re willing to wear muffs or something that size all the time.

@user990 said:

You don’t need 8 years of training to adjust them. Costco and our DIYs have proven that time-and-time again, and we now have OTC hearing aids that prove it also.

There a place for 8 years of training, there’s a place for 2 years of training, and there’s a place for DIY.

I agree, and your last sentence is a good way to put it. I suspect that only a rather small percentage of people need nthe 8-year expertise, and it’s a waste of their money (or their insurer’s or government’s money) for the vast majority of users who do NOT need that 8-year expertise to be encouraged to go that route by the very people who stand to make the excessive money when they do. In fact, I’d call that unethical.

The DIY approach, while being lower cost and infinitely adjustable as to degree of precision wanted, does have some important limitations. For one thing, the user must be suitably “current technology savvy”, and that is less likely with the age group that statistically has the highest likely need for HAs. For another, he or she has to be comfortable with the MS Windows interface, AND apparently must have a Windows computer that uses an Intel chip. And, the person must have the patience and time to learn how to do it , and then actuallly iteratively do it. I probably have the technical savvy, the detail orientation, and the sheer persistence, but I lack BOTH the CURRENT Windows knowledge AND the Intel processor.

The 2 years of training would seem to be a reasonable solution that could serve the vast majority of users if done correctly (as Costco apparently tries to do, but I have no actual Costco HA Center experience YET). In a perfect world, the minority of users that NEED the 8-year expertise would be referred by the 2-year people to the 8-year people. And, ideally those 8-year people would NOT be the sellers of the hardware and thus able to set prices that are 4 to 5 times higher than Costco and other 2-year service providers.

The end result would potentially be a far more efficient business model that makes good hearing aids accessible to everyone who needs HAs, and would get rid of the extravagant hardware markups the 8-year people want simply because they CHOSE to work at retail level versus at the more sophisticated positions they SHOULD be working at. It doesn’t, and shouldn’t, require a couple of university degrees to properly sell and support hearing aids to the vast majority of users.

To put it in a ridiculous way that helps make the point: It would be silly for a degreed chemical engineer with makeup formulation and manufacturing experience to sell ladies’ makeup simply because he knows how makeup should be properly made, instead of working at the chemical company that makes the makeup. Selling it can be done by others with much simpler qualifications after some training. But the chemical company could, and should, still have that chemical engineer on either staff or retainer to handle unusual situations (Some ladies have sensitive skin that reacts to makeup, and some makeups are sometimes later found to be injurious to health).

Jim G

As mentioned earlier by others, the higher prices charged by independents is largely due to the notably higher prices they have to pay for the hearing aids.

@Neville said:

. . … Private clinicians are charged more for hearing aids by manufacturers by a factor of ten.

If that is true (which I sincerely doubt), why don’t the private clinicians then simply buy from Costco at Costco’s full retail price and resell to clients, and probably make more money than they do reselling the HAs they buy from the manufacturer?

Jim G

@brec said:

“8 years” has been frequently mentioned. For some schools it may be 7 years. Regardless it includes a typically 4-year B.A. degree which may, but need not, include courses relevant to audiology.

So the REAL educational advantage is 3 or 4 years, not 8, since a typical BA degree does not contain significant amounts of science related to audiology.

But I assume clinician say 8 years because it sounds much more impressive to the clients.

A little deceptive though, isn’t it?

Jim G

@JimGnitecki said:

why don’t the private clinicians then simply buy from Costco at Costco’s full retail price and resell to clients, and probably make more money than they do reselling the HAs they buy from the manufacturer?

Back when Costco was selling unlocked devices with more widely available software, I often wondered the same.

@JimGnitecki said:

(which I sincerely doubt)

To be fair, I only have anecdotal report from costco employees on what their base prices are. See if you can weasle that out of your costco provider and I’ll trade you an invoice for whatever it’s similar non-costco device is.

@JimGnitecki said:

But I assume clinician say 8 years because it sounds much more impressive to the clients.

A little deceptive though, isn’t it?

Who says this? You’re putting words into an imaginary clinician’s mouth so that you can be annoyed with them, having yet to ever meet one. I think I mentioned that american audiologists have outrageous student loans and someone here translated that to eight years of student debt.

That being said, let’s not pretend that a B.Sc. is a worthless degree that confers nothing.

I did a stupidly crude experiment tonight with that $44 pair of hearing protection muffs I mentioned earlier in this thread, that are sold for use by people who work in an industrial environment or do target shooting.

I wore them in my home most of tonight.

It’s a stupidly crude experiment because these are NOT designed to be hearing aids, they are made in China, and Amazon sells them for $44 Canadian = about $33 US.

But, you know what, they actually made a HUGE difference for me as I spoke with my wife (she was thrilled that she did not have to repeat things to me), and as we watched TV together (she and my adult son were glad to be able to turn the TV volume way down to a level comfortable for them,

What surprised me was how CLEAN other normal houshold sounds became. I could hear the dishwasher cleanly as it pumped water into the kitchen sink drain. I could hear cups and pots clink as my wife put them down. I could cleanly hear the water running when she turned on the kitchen faucet. The quality of the TV sound I heard was certainly not “audiophile” quality, but for sound that had already been processed by the TV’s rather poor speaker system, then broadcast 10 feet, then picked up by the muffs’ microphones, altered by the muff;s software, and then played into my ear canals, it was pretty darn impressive.

The designers made it work that well, and Amazon sells it for only $44, including free delivery. I can just imagine what that designer could design, and how many Amazon could sell, if we set a target price of just $500 for a device with targeted REAL HA capabilities. No person that needed an HA would have to go without one.

I assume that at least some of the OTC HAs now out there DO perform at least adequately to make a meaningful difference for someone who needs a hearing aid.

Jim G