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Comment by TaylorAlexander | Hacker News Reader

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?

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> I guess one question is: do those things have to cost thousands of dollars?

No. Hunters (and shooters) have been buying electronic ear protection for years at much lower prices. There is no FDA approval, and they are not needed so the manufactures have to compete. The result is hearing aids in everything but the FDA approval. Some people find they work better than hearing aids because the manufactures have to tune them to work well for their customers which means background noise reduction (not just gun noise reduction)

Don't get me wrong, those who are borderline find the hunters hearing protection better. If your hearing is very bad you need expert tuning for just year ears, and that can't be offered without FDA approval.

The high end ones are $200, and internally pretty much the same thing other than the programming. The cheap ones are $30 (but not programmable)

These are good points. I was wondering about the costs of the doctor's visits, but you're right we should perhaps make those optional.

I realized one thing that would help is "open hardware". If you're supposed to see a doctor to measure and tune some value maybe a device with an open interface and an app would suffice (which I think others here mentioned today).

The reason I asked about the cost of the doctor is I am interested in doing things like giving them free school in order to lower their need to charge high prices. Generally I would rather every person has a good local doctor they can see for free, but we could also deregulate these devices and let people sort out amongst themselves how to get the right fit. I would just want to take care that people aren't damaging their hearing further with improper use.

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.

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.

One of the costs built into hearing aids is the lavish perks that the suppliers give to the audiologists. My partner got a trip for two to the Caribbean every year, to 5-star resorts, for selling a certain number of their hearing aids. There were about 60 people in our group, probably costing well over $5,000 each.

2+ microphones, signal processing chip, audiophile+ miniature speaker, multi-octave equalizer, intercommunication between ears/dynamic adjustment, multiple profile, remote mic, bluetooth to phone. I think the top-end in-ear musician speakers are comparable, certainly in terms of sound quality. Maybe better as they have (far) more speakers/frequency response as their users are far more critical. They're not magical but they're good when there's not a lot of echo.

How does the actual hardware compare to a $180 pair of AirPods? I wonder if basically Apple and Samsung should be making these instead of smaller medical device companies.

I suspect there’s nowhere enough money for apple or Samsung to enter the medical devices field for real. I would think the headphones have a Bluetooth receiver, a d/a converter and a speaker. They rely on the associated device to handle “adjustments”. Might be noise reduceing, but that only adds a mic and a phase inverter. Much simpler device. Getting medical approval takes time and $$… Easier to put fine print that the things does not treat or cure anything.

Looking over their marketing materials, the Airpods seem to have much more power than that onboard. They use their own custom silicon chip onboard and it seems to be pretty capable. I wonder if (doubt?) medical device manufacturers are designing custom processors for their hearing aids.

"...the new AirPods feature Adaptive EQ that tunes sound in real time based on how AirPods fit in the user’s ear. An inward-facing microphone monitors for sound, and then Adaptive EQ, powered by computational audio, tunes the low and mid frequencies to account for what may be lost due to variances in fit. "

"To help with sound clarity, beamforming microphones block out ambient noise and focus on the user’s voice, while users can also enjoy a hands-free experience by simply saying 'Hey Siri' for requests."

https://www.apple.com/newsroom/2021/10/introducing-the-next-...

One of the issues is that Apple can take their time processing the sound, but hearing aids have a very small window of time (< 15ms, if I remember correctly) before there is a noticeable lag between sight and sound.

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