Cost versus Value
One of the most frequent questions our clinical staff has to handle is “Why are hearing aids so expensive?” Part of the answer is to examine the meaning of ‘expensive.’ It speaks to the relation of ‘cost” and ‘value.’

What’s the ‘Value’ on a Daily Basis?

Hearing aids are most commonly used every day for approximately 15 hours a day. Good digital hearing aids with solid-state circuitry will typically last approximately 5 years (or longer), which amounts to 1825 days. So, is it worth $3.50 (less than a latte?) a day to hear with less stress, to reduce interpersonal disruptions, to improve work and family relations, and protect the brain from cognitive deterioration (see our previous post Mental Clarity and Hearing Clearly). It would argue that an investment of $6387 is appropriate. Some professionals, like judges, doctors, and teachers may estimate the daily value to be more like $5 to $10. Others, of course, may have a lower ‘need to hear’ and naturally place a lower daily dollar value on the technology. So, it’s important to think in terms of value rather than price.

Extraordinary Signal Processing

However, let’s consider a second aspect of this topic. Advanced hearing aids have remarkable computer processors managing literally Millions of operations every second – immensely more powerful than computers that took man to the moon. They are capable of sorting out complex Auditory Scenes to determine if a particular frequency region arriving at the listener’s ear is mostly quiet or contains machine noise, noisy speech, or just speech without interference. They can determine the location of speech and other sounds, whether in front, behind, or to the side of the listener, and deferentially reduce the sounds away from the direction that the user is looking. These are remarkable signal processing properties for extremely light computer devices operating on less than 1 and ½ volt. These properties alone, of course, have required increases in the basic cost of the devices.

Expertise of the Professional

But it is especially important to be aware of the critical value of contained in the expertise of the audiologist or hearing professional that fits the devices. This is not a ‘prescription to perfection’ type of procedure, (although a non-trivial cost, is the expense of FDA registration as a Class I medical device). Individual preferences for sound quality and clarity far exceed the simple boundaries of the hearing test, or audiogram. The technical and personal skill of the fitter is an essential aspect of optimizing the most advanced products to the individual. This vital value-add component of the dynamic hearing system naturally needs to be included in the cost analysis. Even the most expensive, advanced hearing system can be disastrous for a particular listener if the settings are not appropriately organized and programmed.

At the Bottom

Finally, on the other end of the price continuum, there are far less expensive hearing devices that may be more appropriate for occasional situational stress. These may either be ‘entry level’ hearing aids, per FDA registration, or at the extreme low price end Personal Sound Amplification Products (PSAPS). PSAPs are a more recent attempt to make available very low cost devices that fly under the FDA registration expense. They are not considered hearing aids, and some people may find some occasional value in some listening situations. Moderate success with such products may make it clear to non-users of hearing aids that they factually do need some occasional amplification. They will almost certainly discover that their benefit is quite limited, as they have neither the advanced signal processing capability discussed above nor the interactive customizing adjustments that a qualified hearing professional can render.  At any rate, a lifestyle consultation with the hearing professional is vital to disclosing the individual’s specific listening needs and current frustrations. Recommendations that fit the listeners needs and budget should be made, once the hearing professional has done a good job of listening.


Heard a Good One Lately …?

[A man with less than good hearing was examining some trinkets at a flea market.

“What form of payment do you accept?” he asked.

He heard: “Cash, credit cards, and sex”

After blushing and repeating the information to his wife, he was promptly re-informed that, he had (once again) misheard, and that the clerk would happily accept “Checks!”]