@Neville: Thank you, and the other providers who have posted in this topic. The points you’ve introduced (like the difference between forum members and run-of-the-mill patients of yours is revealing. The points are causing me to rethink the role that play in propping up the obscenely-inflated price structure of the industry.
There are charlatans, to be sure, as there are in any business segment, but I’ve only met one truly incapable audiologist in the five who’ve cared for me over the past 16 years. I still wish that my current audiologist had provided me with a more robust explanation of the different technology levels of my devices, but he’s young, and probably just didn’t perceive that I’m one of the “outliers” that wants to know all about the things I put in my ears, early every morning.
So, thank you, again, for your time and candor in providing us forum members with these valuable explanations.
Well, sorry: I took your comments as a tad aggressive because they assume me to be so cavalier as to advocate the destruction of A without plan B
I was part of the debate team in high school (a long time ago). The two sides would dissect their opponents’ arguments with no pussy footing around, because we were being timed. It was aggressive, but not personal. Unfortunately, I seem to resort to that style at times on internet forums. It’s more or less unconscious on my part–with all that that entails. My apologies.
I was part of the debate team in high school (a long time ago). The two sides would dissect their opponents’ arguments with no pussy footing around, because we were being timed. It was aggressive, but not personal.
jim_lewis I feel you are right on target regarding technology advancement and the effect it will have on and the current HA sale and fitting organizations. Also, it is easy to get around the baloney about the HAs manufacturing companies with regards to their overhead (research, marketing, support, etc.) just by taking a look at their profits and the salaries of their executives. Sure, all the money from the sale of their HAs are going to their overhead (great laugh).
In no defence if hearing aid firms whatsoever; the successful ones are more profitable.
The modern concept of a high technology driven platform was realised by a guy called Lars Kolind who established that if you charged a bit more, you could sell the product’s distinct advantages (in this case the move from Analogue to Digital) over the ‘fast and dirty’ approach. Just like Tesla.
If your name becomes synonymous with innovation people aspire to your products and you can determine a pricing structure that holds up. Just like Apple and Tesla.
Digital aids are now mature products, but the connectivity and rechargeability are relatively new paradigms, brought about by innovation within the industry as well as improvements in recharging battery energy density. Just like Apple and Tesla.
Engineering Innovation costs, the firms that get the balance of the spend wrong tend to be short lived; making ‘also ran’ or ‘knock-off’ versions. Successful firms innovate, charge more and offer more.
So yes, will there be firms who take-up the otc mantle, sell lots of units and help a lot of people relatively inexpensively?; yes there will. Just like the NHS does in the U.K.
Will this hugely increase market penetration or remove the stigma associated with hearing aids; not so much. Plus you’ll still have a more refined ‘specialist’ market AND, get this, HIGHER PRICES. /??/
Why are the prices higher? Non- sales will be lower, there’s no incentive/desire to sell lower end product and the mom+pop stores get squeezed. The premium industry volume shrinks, but the background services, delivery and manufacturing still costs the same, further driving the market to a smaller more expensive niche model. Which is especially unfair for people with greater losses that the otc model doesn’t meet.
The race to the floor with hearing aid pricing might seem like a good idea, but there’s a reason why a mature market exists in a certain shape; and disruption always has winners AND losers.
I agree with Um_bongo. I have seen many hearing aid ;businesses “try to sell cheap” end up going out of business. I think the “more expensive” part may come from “Concierge” type of practices. It is happening in the medical community already and for the ones who can afford it, it offers very high quality care. The medical model is a flat fee that offers priority access and highest quality services. They don’t accept Medicare or insurance but provide concierge service. The concierge concept will not be for everyone with a hearing loss, but for those that can afford it premium products and premium service. I remember back it the late '70s there was a hearing professional that advertised, “you probably can’t afford my hearing aids”. He sold analog hearing aids for $2000 a piece when the market was charging $400 - 500 per aid. He apparently did quite well. With any of the manufactures, the , the Big Box stores or any other business model, nobody is forcing anyone to buy. You still have the option of deciding where you want to spend you money.
The concierge model may be one of the ways an independent practitioner can survive. The trend in medicine definitely seems to be towards group practices and corporate medicine. I think the transition is pretty much complete for pharmacists, with very few (usually specialty) independently ownded pharmacies remaining. One disturbing trend with group medical practices is that investor groups are buying them out and imposing profit driven restrictions on the practice. I have no idea how this will all shakeout. I wouldn’t bet on things getting more competitive.
Interesting. Years ago, long before I was told I needed hearing aids, I questioned the price of them. Hearing aids are essentially amplifiers processed through equalizers so that discrete frequencies can be adjusted individually, as you can do on a computer or stereo amp. I got some indignant responses to my post, some piously intoning points of virtue that apparently justified the prices, but eventually everyone seemed happy when the exorbitant cost was attributed to the miniaturization of those equalizers and amplifiers.
Recently I purchased a pair of Costco’s KS-10 hearing aids with the understanding that they are among the best on the market offered at a jaw-droppingly low price when you consider who the real manufacturer of them is and the high-end model on which they are based. And for the most part I am perfectly happy with them, even allowing for the facts that they can’t produce a good bass sound via TV streaming, and when I’m in wind neither I nor my bluetooth-connected phone conversationalist can understand a thing transmitted through them. They seem to contain no technology to compensate for windy conditions.
The price of those aids was $1400. I’m mostly pleased with them, but I do wonder if they needed to cost even that. Perhaps he model should be to buy the aids and then pay an audiologist or technician for adjustments.
Audiologists dispensing out of a storefront can’t credibly complain about the cost of because a lot of the cost of buying through them is due to their own overhead. Getting that overhead down without closing up shop and selling online (not feasible if they believe in the hands-on model of providing hearing care!) is not really practical… the only alternative would be to practice as part of larger chains (with less control) or part of larger, multidisciplinary clinics with shared overhead. The latter lacks the convenience and higher walk-in traffic of being in a mall or plaza, instead locating yourself in a medical building with lots of other medical offices… but all of those other medical offices also have huge overhead cost-control problems these days.
Why don’t audiologists complain more directly about anti-competitive and other pressures in the HA industry? They rely on those companies for their livelihood. Some audis may have exclusive arrangements with one HA mfr (don’t go to these ones!); others, I suspect, still have some kind of non-disparagement clause involved in getting access to their products. You can’t usually badmouth a company and still be an authorized dealer of their products.
You can’t usually badmouth a company and still be an authorized dealer of their products.
After being in the industry for over 44 years and using dozens of manufacturers (many no longer in business due to mergers and take overs) I really have not found one worth “bad mouthing”. I have liked some much better than others but to bad mouth is really not ethical. I heard Zig Ziglar say one time, “Whenever you start throwing dirt, all you are really doing is losing ground”. Bad mouthing manufactures or competition benefits no one.
Respectfully, from a consumer point of view: if the pejorative connotations of “badmouthing” also means an absence of forthright criticism from those best placed to inform, then I would suggest that benefit does accrue to many at the expense of those kept in the dark.
So we’re back to “creative destruction”. Funny, you don’t hear that term so much anymore.
Those who call on in house providers to ‘cut their costs’ are really calling for pay cuts to audiologists and employees. Who will becomes an audiologist when their income is peanuts? And anyway, why not call for rent control? In any case, "creative destruction/’ is a term usually used by those who see a chance to grab market share without really caring who gets hurt in the process.
There are many elderly people coming in to the hearing aid center I buy from. They wander in with issues with their aids that can often be fixed at the front desk. I myself need cleanings more frequently than most. Just today I lost a dome in my ear canatl (!!!) and was able to walk in and have it extracted by this same shop.
All that may go by the wayside soon enough. All of us will join the elderly by the wayside soon enough.
For many years, most of the “smashing” has come in the form of consolidation… more and more brands are just that: re-branded versions of just a few devices actually made by a couple of conglomerates. All of the problems with monoculture in other contexts apply here (not just in terms of anti-trust, but also because a lack of diversity in products is not good for people who need to use them, either).
In many industries the same thing has happened over the past few decades. The problem isn’t that smaller companies can’t make money, but that they can’t make more and more money as fast as investors demand - and the bigger fish need to eat (“smash”) the small ones to capture market share themselves to obtain that kind of growth.
And once the companies that make our aids are smashed and broken who is going to make them?
Are we still going to need hearing aids? Someone’s going to make them. Probably one of the company’s that’s making them now. One of the consumer electronic companies they’re busy gobbling up will probably make the otc devices. Win, win.
I think @greg.smith’s post touches on a couple of salient points that reflect what’s been going wrong with our economic mindset for a long time. The post alludes to the reality that companies’ missions are no longer customer-centric and consumer service orientated. They are investor-centric and profit-orientated.
Don’t get me wrong: I know that companies have to turn a profit. It’s when those profits end up defining the companies’ focus of activity that their raison d’être drifts from what benefits their customers in particular, and their industry, in general. It’s then that oligopolies are seen by dominant industry players (like the Big6) as meritorious because of their enhanced ability to generate profits, rather than as the incestuous and obscene subcultures that they are.
Make no mistake: the purpose of the hearing device subculture is to service the profit motives of the priestly class, rather than the performance needs of supplicants. (We - end users and , alike - are called upon to regularly, and without resistance, pay their tithes in the form of bloated prices for products whose obsolescence is choreographed by the makers, cloaked in the “marketing speak” of “technological advancements” whose real benefit to the user are described as “incremental progress”.
Many of the behaviours of the dominant force in the industry (the Makers) about which we complain are, in fact, those of a priesthood of closely-held companies that have no qualms about making the distributors and users of their products pay top dollar for top quality, while offering little transparency or objective information that would empower their clients to truly understand why a pair of devices is priced at $7,500 (what the Makers claim is their fair market value), as compared to the $350->$500 these same devices cost to produce. Buyers are asked, like members being initiated into some cult, to take it (largely on faith) that the [price - cost] differential is due to “Holy Mystery of the Brand X Automatic Suppressor/Optimizer”. If the individual charges and fees that drive “bundled pricing” up to stratospheric levels are legitimate, why not just be up front about it and itemize them, rather than playing a shell game with the end user?
[Even less comprehensible are the ethics that allow makers to withhold value from those who are unable to pay the premium they demand for access to their “Tier1” features. Tier1 is simply the term for “fully-functioning”. The other “Tiers” are simply marketing terms for “intentionally broken by the manufacturer, to a greater or lesser degree”. My opinion is that the basic model hearing aid should be offered as the core product. The “core product” should be capable of serving the day-to-day needs of the average customer, and should not be just the minimally functional form of the hearing aid device being taken to market. This core product should be offered at a basic price, along with “Add+” window panes, per Apple’s purchase checkout model, that clearly state what each added function does, and what it costs. It would then be easier for purchasers to comprehend how a hearing device “starting at $x” ends up costing them ($x+$1,500) at the checkout window.]
Not long ago, the world and its communication channels weren’t so highly evolved, and the economic environment was conducive to the keeping of arcane “technological secrets”, the existence of which justified manufacturers’ magical claims about the efficacy of their wares. Today, however, we live in a different world: one in which devices that, heretofore, could legitimately bear the moniker of “medical devices”, but which are today, to a greater and greater extent, being exposed for what they are - generic electronic devices - most of whose “scientific and engineering features” can be understood and manipulated by anyone who has owned a high-end sound system, a home recording studio, or a killer guitar-player’s pedal board.
So, perhaps the market will benefit the 80% of those who require relatively straightforward treatment of a hearing deficit, while there will still be the 20% whose impairments are beyond the layman’s ken, and which will require an audiologist’s training to address. However, it may also be true that hearing aids, as a class of device, now share lodgings with the pantheon of consumer electronic devices, where they (arguably) belong.
The question is: whom will we empower to draw the line between the 80, and the 20?
[ADDENDUM: I apologize for the multiple edits and also for the one that, unintentionally, transplanted part of @greg.smith’s post into the middle of my text. I find the Discourse software to be quite frustrating and user-unfriendly, betimes!]
[ADDENDUM: I apologize for the multiple edits and also for the one that, unintentionally, transplanted part of @greg.smith’s post into the middle of my text!]
I’m quoting myself in a new post, here, to try to draw back some readers I may have lost when Greg’s text showed up in the middle of mine. I apologize that it takes me so many edits to get a piece right, but I find that the Discourse text editor is very hard-to-read and finicky sometimes - nothing to do with my advancing years!
Oticonian/Disposablyte
Wales, UK
