More insurance plans are covering a portion of hearing aids in the US but it's still not enough considering the premiums charged.

They could pay more... and more often. One issue is lack of awareness of hearing loss and the difficulties it creates. This includes safety, health issues and even lost wages/productivity.

The play on words was a good one :)

"And in the end, I still sort of hate hearing aids. There's so much of life that I miss without proper hearing, and so much that hearing aids just don't do."

This is what most people don't understand who have never experienced a hearing loss. If just making things louder was the issue then we would have already solved the problem for everyone. Unfortunately we're not even close.

I would have loved to see the amount of time and money put into hearing aids that was put into film technology that helped create 'Avatar'.

Let me add that the environment these aids must endure for that 16 hours a day that you mention is very harsh on electronics. Close to 100% humidity in a crevice of your body that is cleverly designed to repel foreign objects. It's rife with dry skin, body fluids and a mechanical system (jaw movement) that's very good at pushing all those things into the end of the aid. Also, if you're healthy, it's always at least 98.6 degrees...higher if you have a fever.

These last two posts summarize the issues as well as anyone in the field could hope to. I might take exception to the use of the word 'racket' but that's just a matter of semantics.

I cannot defend the high cost of hearing aids in this forum but I thought that some insight on the part of a dispenser would be useful in further understanding of the process.

I have been a hearing aid dispenser for 23 years. The question about why hearing aids are so expensive comes up almost daily. Every engineer/techie type that visits our office arrives with the proverbial chip on their shoulder. From a strictly A/D to D/A standpoint I can't argue much. Believe me, I've tried. Considering nothing more than consumer satisfaction, many of those techies might actually be better served using something like America Hears for their hearing needs. The aids they sell are not as advanced as your Oticons/Phonaks/Starkeys but I believe a less advanced hearing device in an ear is worth more than the best technology in a drawer.

Nevertheless, these techies are a tiny fraction of the population we serve. Most of our patients could hardly begin to work through the myriad of programming options necessary to get the most out of those devices, even with the best online or phone support. Additionally, considering a lack of basic knowledge of communication disorders, language acquisition, physiology of the hearing system, psychology of the hearing impaired, auditory rehabilitation etc., the self diagnoser/fitter is not going to be as successful as a hearing professional. Mind you, I didn't say that it can't be done, just not as well.

What I can seldom convince people of is the value of endless visits and service necessary to merge the two objectives of a good fitting. Those being:
1.get the best ratio of communication improvement between the hearing loss presented and technology dispensed
2.make the device(s) comfortable enough acoustically and physically for regular use in as many listening situations as possible

You see, using the tools available I can verify and prove that proper amplification is being presented to a damaged ear based on current standards. It is even possible to prove improvement of speech discrimination in quiet and noise, but if the patient rejects the hearing aid due to a dislike of the particular sound or compression characteristics, I have failed. Conversely if the patient finds the sound satisfactory but there is no discernible improvement in speech understanding then I have also failed. Factor into that the personality equation of two or more people (include family and loved ones) working together for a common goal with different motivations and there will occasionally be a practitioner and patient who can't get along well enough to reach that goal.

Ideally, the best scenario for a successful hearing aid fitting is this:
1.The patient decides first and foremost on the professional with whom he/she can comfortably build a long-term relationship
2.The professional learns and understands all elements of the patients needs including but not limited to lifestyle, wants, hearing concerns, desired outcome and financial considerations
3.The two of them begin to diligently yet patiently seek the best solution for the patient based on current available technology, fitting techniques, styles and options

Show me any failed hearing aid fitting and I can point out at least one of those steps that has been missed. I might stress that failure is often due to dispensers who are unfamiliar with the technology available or how to properly use it. When a consumer seeks professional help they have a right to expect that they are speaking to someone who is knowledgeable in his field.

Finally, I would like to address one issue that I have not seen in this thread at time of my post. That of unbundling. At times there has been a debate in our field that the consumer/patient would benefit from a change in pricing structure of hearing instruments. i.e. one cost for the hearing instruments, one for testing, one for service etc. A cafeteria plan if you will. This is not going to happen anytime soon.

For the sake of argument, let's say I charge $1000 for a hearing aid, $150 for the test and $45 for a follow-up. Patients might be happy with the first two one-time charges. They might even pay for one or two follow-ups in an attempt to get comfortable with their new aids. After that the percentage of hearing aids in the drawer would jump dramatically. It's highly unlikely that anyone would continue to pay the $45 per week for visits if they don't see immediate improvement in their satisfaction. This is a recipe for disaster for the patient and the dispenser. A hearing aid in the drawer is one of the worst outcomes for everybody.