You're looking at Less Wrong's discussion board. This includes all posts, including those that haven't been promoted to the front page yet. For more information, see About Less Wrong.

gwern comments on Open Thread March 7 - March 13, 2016 - Less Wrong Discussion

4 Post author: Elo 07 March 2016 03:24AM

You are viewing a comment permalink. View the original post to see all comments and the full post content.

Article Navigation

Comments (125)
Tags: open_thread

Comments (125)

You are viewing a single comment's thread.

Comment author: gwern 12 March 2016 12:41:34AM 3 points [-]

"A Push for Less Expensive Hearing Aids"

Almost two-thirds of Americans over age 70 have meaningful hearing loss, experts say, and I probably will be among them. I should do something about it. One reason I haven’t is the average price for hearing aids: roughly $2,500, often more — and most of us need two. That helps explain why only 20 percent of those with hearing loss use hearing aids. Medicare declines to cover a number of products and services that older beneficiaries need. Dental care ranks high on my personal list of exclusions that make the least sense, but the fact that the 1965 Medicare law specifically prohibits the national insurance program from paying for hearing aids is also a strong contender.

...Congress barred Medicare coverage of hearing aids 50 years ago because “people thought hearing loss was just a normal part of aging,” said Dr. Cassel, one of the authors of a recent JAMA editorial on hearing health policies. “They didn’t see it as a disability or a medical problem.”

This deathism is almost stunning in its casual cruelty.

Comment author: Viliam 12 March 2016 10:46:26PM *  0 points [-]

Could it possibly be that the costs of fixing all health problems of old people simply skyrocket after some age? Thus, given limited resources, we only have the following options:

  • cure as much as we can, and watch the whole national budget spent on healthcare for old people;
  • decide that some things will not be cured, at least for average people; or
  • have mandatory euthanasia at some age.

I am not saying that even if this is the case, that the decision where to draw the line was optimal. Just that a line has to exist somewhere.

(And it's not just old people, of course. There is always a surgery that could save someone's life, but won't be done for budget reasons. Etc.)

Comment author: gwern 13 March 2016 12:38:41AM 3 points [-]

I'm all for cost-benefit analysis. I'm just appalled by the sheer cruelty of writing into law a ban on specific treatments. Perhaps my reaction is due to having spent a life wearing hearing aids, and so I have a rather strong reaction to condemning indefinite millions to the same fate.

Comment author: Error 13 March 2016 02:04:09AM 1 point [-]

I'm astonished that hearing aids cost so much, given how thoroughly the personal-audio-hardware space has been colonized by cheap electronics. What's up with that?

Comment author: James_Miller 13 March 2016 03:22:32AM *  5 points [-]

My guess: "FDA regulates hearing aids, which are intended to compensate for hearing loss."

Regulation limits competition which keeps prices high.

Comment author: CAE_Jones 13 March 2016 05:40:06AM 0 points [-]

I've heard the phrase "disability markup" used to describe how almost everything ever targeted toward physical or sensory disabilities are absurdly expensive. That name implies more intentional malice than I expect is at work; I'd generally round off to "market forces"--it's difficult to take advantage of mass market capitalism when selling to a minority, but it is possible to take advantage of government assistance programs.

It seems like, though, based on my (very limited) understanding of hearing aids, a charitable version of "disability markup" might be closer to reality. After all, if it's treating a disability, especially one found in old people, either those who need it are going to be rich from a lifetime of savings, or poor and getting the government to pay for it anyway, right?

It isn't hearing aids so much as screen readers, but Chris Hofstader implies as much might be a component of business models for such companies in this article:

Will FS respond to this new found competition, possibly based in the fact that NVDA costs nothing and FS gets more than a thousand bucks for JAWS with a price cut? Probably not. I haven’t worked at FS for more than a decade but, back then, we discussed the possibility of a free or no cost screen reader coming onto the market and how we might respond. Our strategy then and likely now was that, if we felt competitive pressure from a low or no cost solution, we would raise the price of JAWS. As I mentioned a couple of paragraphs ago, there are technologies that one can only access using JAWS and the FS strategy was to make sure we kept our profits high by “eating the rich.” I don’t know if FS will respond this way ten and a half years later but, as NVDA RA adds a feature to NVDA that one needed to buy JAWS to get, , they may need to find a way to replace the dollars on their bottom line and may, in fact, respond by increasing the price of JAWS.

James_Miller's guess wouldn't apply so much to screen readers (but would apply to things like the Brain Port, which opened at a price of $10,000US), but I wouldn't be surprised if going through the FDA is a big part of the markup on hearing aids.

Powered by Reddit Powered by Reddit