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Comment by gws | Hacker News Reader

Working inside the industry I can tell you that there are a lot of misconceptions when you look at things from the outside. Hearing aids are not so expensive because of the hardware but because of two other things: 1. customer acquisition cost and 2. service cost.

1. People do not want hearing aids (typically they do not even want to accept they have a hearing loss). You need to spend an awful lot in communication and marketing and humans you can talk to in a store to convince them to try one.

2. Hearing aids are not glasses that you put on and the problem is solved. It takes 6-12 months to get the full benefits and you need multiple visits to the store with humans to hand-hold you through the process or you will just stop wearing them.

And did I mention the average customer is 70 year old? Explain to me how a 70 year old that does not want a hearing aid will buy one online

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Well from my point of view this is completely opposite to what I've witnessed firsthand. People DO know they have hearing loss and WANT to fix it. It becomes very awkward for them in social settings and they are not able to follow the simplest group conversation.

Case in point: my dad and grandma. They both got the 'free' hearing aids (we live in Canada) and these supposedly really cost the government (or taxpayers) upwards of $2000 for each ear, and they SUCK. The alternative was to dish out $5000 per ear for a marginally better product. They both ended up not using them because it was such a hassle and it basically drove them nuts. They didn't fit very well and constantly amplified even the slightest noise, and basically did nothing in ways of helping their hearing at a normal conversation.

Recently though, they finally got a great hearing aid (forgot the name) and paid less than $500 (from their wallet) and it vastly outperforms any other hearing aid they've ever tried. I know they work because because they actually WEAR them now because they are NOT ALWAYS BUZZING and amplifying ambient noise and they are ADJUSTED PERFECTLY to hold onto their ears. That's disruption for ya ....

Of course there are people that want to get help but you might be surprised to know that on average people wait for seven years before wearing a hearing aid starting from when they would benefit from one. There are customers (more than you would believe) who have hearing loss, that test the product for a month and still decide not to buy it.

Also the type of hearing aid you need is highly dependent on both the hearing loss profile and the specific life situations when you don't hear well. If you have profound hearing loss and stay mostly at home and need help to watch TV or have conversations in a silent enviroment you can benefit from a basic hearing aid. If you are a bartender with a slight hearing loss and need help in noisy environemnt even a top of the line one might not make an appreciable difference.

Finally free hearing aids always suck because the free service you get with them sucks and they do not take the time to see you multiple times and fix the fitting for you. It is normal to see a customer in the shop for a one-to-one with the audiologist 4-7 times in the first three months. That is expensive and difficult to disrupt because the value is the in human interaction

I'm a hearing aid user in Canada and your numbers seem off. Canadian government will pay $500 / ear. I have near top of the line Widex hearing aids and they were more like $2750 / ear including a 3 year service contract which included batteries for the full term.

If your relatives got "free" hearing aids, it's likely they were low end (i.e. less than $500 so totally covered by the government grant). My father had a similar experience with low end devices and thankfully recently bought a much better pair and has finally successfully adapted to wearing them.

I guess it's different for different persons. Everybody tried to convince my stepfather for years and he didn't... listen (ahem, sorry) even if he has no problem paying for the aids.

When he finally accepted to wear them, the situation has been pretty much what you describe. So I would really appreciate if you could remember or ask the name of the working ones.

Could you please look up and post the name of these?

The model they use is the AIR from mdhearingaid.com.

I am in no way affiliated to these folks. But I would like to thank them for a great product (on behalf of my family)!

But is there a place online where you can buy cheap hearing aids that you can tweak yourself?

I'm genuinely interested in the answer, as I am very likely to get hearing loss in the future, and might start being pro-active if there is a cheap alternative I could try right now, before my hearing gets bad.

In which country do you live?

Keep in mind that the smaller the hearing loss the more sophisticated the hearing aid you need to get a benefit. If you have a slight hearing loss you will experience issues in the "hardest" situations for hearing aids to cope with such as conversations in noisy places or bad telephone reception.

Finally, the over the counter hearing aids come with a limited number of pre-fitted configuration (e.g., 4) and "tweak yourself" means choosing one of them. To get a hearing aid fine-tuned to your specific hearing loss you need a professional in a shop equipped and trained to use with the professional fitting software of the hearing aid

> Keep in mind that the smaller the hearing loss the more sophisticated the hearing aid you need to get a benefit. If you have a slight hearing loss you will experience issues in the "hardest" situations for hearing aids to cope with such as conversations in noisy places or bad telephone reception.

I wonder if improving performance would make hearing aids become a "want" rather than a "need"? Bionic ears outperforming natural ones, allowing the user to select different bands/ranges to listen to, sounds like a pretty neat futuristic thing to have.

It's not like people are shy about enhancing their natural abilities with the help of technology, it's pretty much in the current zeitgeist.

I agree with you, I have normal hearing and would totally buy devices that could help me understand better in noisy situations like restaurants, bars, etc.

Alas, even top range hearing aids cannot do that today.

And if people with normal hearing would wear those it would take away the stigma for people with hearing loss.

I live in France. My father recently spent north of 5k€.

Thanks for your answer. I guess it's not really feasible to get ahead then. I'll probably start with over the counter hearing aids when the hearing loss will start to be noticeable.

You can get OTC hearing aids (technically called hearing assisted devices) in France in Pharmacies but they frankly are not that good.

I know it will not sound much to you but for those 5k I believe your father got not only top of the line hearing aids but also a trusted audiologist he will be able to see as much as he wants free of charge for the coming years until he decides to get new devices.

>To get a hearing aid fine-tuned to your specific hearing loss you need a professional in a shop equipped and trained to use with the professional fitting software of the hearing aid

Or you need better fitting software that doesn't require a trained professional to use.

>People do not want hearing aids (typically they do not even want to accept they have a hearing loss). You need to spend an awful lot in communication and marketing and humans you can talk to in a store to convince them to try one.

Ugh. That's my dad. He seems to be willing to spend the rest of his life making everybody around him repeat what they said at a higher volume so he doesn't have to try a hearing aid.

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