Monday, February 18, 2019

A pre-election proposal to cover hearing aids under government health plans

Here is another of the online discussions hosted by the Liberal Party of Ontario leading up to the 2018 election. This was rated fourth overall by participants. Again, many participants are unable to see how a political system freedom works and keep insisting that the use of force against some citizens for the supposed benefit of others is justifiable.

 Cover cost of hearing aids

Hearing Aid cost are in the thousands of dollars and its considered a disability. I am only 34 years old and have genetic hearing loss. I am the manager of a long term care facility and I'm well educated but i cant afford new hearing aids and i know hundreds just like me. Soon it will prevent me from working and instead of being a contributing citizen that i can be, ill be living on disability money which i dont want. I didnt cause this hearing loss. I dont want it but i cant fix it and the one thing that can make it a little better managed cost thousands of dollars. It should be covered becuse its a health issue and it minimizes the ability to contribute to society, causes depression and enormous other cost that will be much more than the cost of the aids. Please consider. Thank you.
  1. Comment
    Kiara (@kiarasexton) 
    I have a family member who needs special advanced hearing aids that cost a few thousand dollars. This is prohibitively expensive and she loses a great deal of sleep over this cost. It breaks my heart how much stress it causes her, because without them, she is without access to community services, interaction with family and friends, and entertainment. Life shuts down quickly without these things. I believe hearing aids should be funded by the health care system. For those who need them, they are critical.
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  2. Comment
    Lloyd Le Blanc (@lloyd.le.blanc) 
    Actually the problem is how the current program is administered.
    The Ontario Government currently pay $500.00 for each hearing aid.
    The problem is that this is paid to the hearing aid provider company.They then can charge whatever they want on top of that as they are already assured that much profit .When you go in for a test they have you sign a " waiver " that directs the government money to them.Saw a report that it cost $ 65.00 to make a hearing aid.
    At Costco the money goes to the patient and you should check their prices and no I do not work for them.
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    1. Comment
      Community Member (Idea Submitter)
      @lloyd.le.blanc You are right! THis $1000 towards two hearing aids do not even help. I had 2 hearing aids made in alberta for a certain amount. Here, very similar ones are about $1800 more for 2 so whats the use of the $1000 covered? Its just added on the top of the cost and the consumer pays the same amount no matter what. poorly planned. Just makes the companies rich and patients poor.
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  4. Comment
    You 
    Not a good idea. When people claim their need constitutes a command over other people's lives a society of dog eat dog is created and the best lobbyists divide the loot. Competiting for control over other people's money by claiming greater need is called socialism, and it has destroyed societies to the degree it has been implemented. It sets neighbor against neighbor and fuels envy and hatred. 

    Hearing aids exist because innovators were free to create, sell, profit, reinvest and improve their products, all competing for the preference of consumers. If you want to kill a product and stop innovation in it's tracks, get government to control it. Today's hearing aids are a hundred times better than those of a few decades ago and get better and cost less and less per functionality delivered. 

    Price differences between provinces must be because government has interfered in the market, else competition would drive prices to a similar level very quickly. When a product can be made profitably it attracts capital and competition, which then drives prices down and quality up until the rate of profit normalizes. Only the power of the state can block this process. For the sake of ll who want better hearing aids, we must insist that government not interfere in our marketplace.
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  5. Comment
    Lloyd Le Blanc (@lloyd.le.blanc) 
    Helping each other is not socialism.This should come naturally to all and not ,as by example the so called " American dream which in my opinion is dog eat dog in an attempt to acquire as much "stuff" as possible by stepping on whoever you have to.This attitude seems to have seeped into Canadian society and that is not what I and many others want.

    This discussion is not about market economy.It's about the flawed support payment system at the Ontario government level and it is an easy fix.Give the money to the individual needing and buying the hearing aid after which they can go shopping for the best price.Today's hearing aids are now all digital and the basic difference in them is minimal.Just bells & whistles.I spent 30 years in the commercial radio business and a hearing aid has the same technology.
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    1. Comment
      James Dekker (@dprime) 
      @lloyd.le.blanc but people are being forced to help others. That's socialism. When people donate money, that's giving of free will. There is a huge difference. Removing the overhead of all the administration costs is a much better solution. So much money is wasted on bureaucracy and administration. Ask Haiti how many houses the Red Cross built for them. Most of the money went to administration fees, which doesn't help anyone. A better solution would be to find people in need and support them personally rather then the wasted money from taxes.
      I believe that David McGruer's point was that government is not necessarily the best solution to the problem. But that the government has caused an inflated cost to medical health.
      Maybe a better solution would be a tax deduction. Which is already incorporated into our taxes.
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  6. Comment
    James Dekker (@dprime)  (Last edited by James Dekker 1 year ago)
    I agree those with disabilities need financial help. Correct me if I'm wrong, but doesn't ODSP pay for dental and medical on top of the monthly support? There is also the Trillium Health for lower income families. http://health.gov.on.ca/en/pro/programs/drugs/funded_drug/fund_trillium.aspx Maybe the problem is the lack of information provided to people? And maybe some updates to dollar amounts for the Trillium Health needs to change with the minimum wage inflation.
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  7. Comment
    Al (@fishinlad) 
    I disagree with the notion that competition will drive prices to a more affordable level. There are significant barriers to entry into this industry. There is insufficient competition. I'm certainly not suggesting that there is any price fixing going on, but current prices are outrageous. I am currently pricing hearing aids for both my wife and myself. Our total cost will be in the low five figures. We can afford the outlay, but I am well aware that many others cannot. Loss of hearing can be a dangerous situation and I support this suggestion.
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    1. Comment
      You 
      @fishinlad Competition in every field drives prices lower. Just look at how vastly superior today's hearing aids are compared to just ten or twenty years ago. Dollar for dollar, you get so much more today than ever before. Central controls make things expensive. Freedom makes them cheap.
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    2. Comment
      Lloyd Le Blanc (@lloyd.le.blanc) 
      @davemcgruer The issue is not a discussion on the free market or competition.The issue is to make over priced hearing aids price competitive.Hearing aids have always been over priced.I worked in the radio communication industry and a hearing aid is a very basic transceiver.With the advent of computer chips that improved every aspect of hearing aids and making them very efficient and small.You would think that this would have reduced costs.No instead they have gone up.One of the reasons for this is the lack of competition at the retail or dispensing point.In Ontario the Government gives $ 500.00 per hearing aid to anyone who gets a hearing aid.However when you go to a clinic and they have you sign a form, that few read, you are authorizing them to collect the $ 500.00 per aid for themselves.Th pricing has nothing to do with the cost of the technology as the estimated cost of making a hearing aid is $ 65.00 and they charge thousands.So whatever they charge the patient add $ 500.00 per hearing aid to the clinic's profit.Check the prices at Costco, that are comparatively low and the patient ( customer) gets the Government money.
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    3. Comment
      Al (@fishinlad) 
      @davemcgruer I don't disagree that complete freedom tends to lower prices to the point that a "normal" rate of return is earned by all firms in the industry. In the hearing aid industry there are six major producers. This is an oligopolistic marketplace with significant barriers to entry. So freedom in the marketplace is not complete and in cases like this prices tend to be higher than they would be if the market was truly competitive and the six major players earn "extraordinary" profits as a result. I am not suggesting that there is any price collusion between the firms but, simply put, they are under insufficient competitive pressure to drive prices lower and government intervention (as distasteful as this may sound to some) is one way to regulate profits for the benefit of the society. Many simply cannot afford these high costs and the sense of hearing is fundamental to survival--hearing loss is dangerous. In monopoly and oligopoly situations firms have pricing power and they use it--I would too!
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    4. Comment
      You 
      @fishinlad The proper response when profit margins are high is to enter into competition with the existing producers and undercut them. This is the market process that normalizes profits back to the average. Using the force of the state to attack businesses is not a moral response as it entrenches the oligopoly you reference, discourages competition and innovation and punishes the most successful producers. If government subsidies distort the market - as the must do - the correct response is to get subsidies withdrawn. If Costco is a better place to buy the devices then people may choose to go there, which will then force others to lower their prices and innovate to compete. There is not a single thing special or unique to the hearing aid business that mandates the intervention of government force, since no one's rights are being violated if the market is free.
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    5. Comment
      Al (@fishinlad) 
      @davemcgruer Good morning David: When profits in an industry are extraordinary, that attracts new competition. When there are significant barriers to entry (capital costs, legal, patents, technical knowledge, dominant existing firms, etc.) as may exist in the hearing aid industry, insurance, banking and others competition will not reach levels of competition that will drive prices to optimum levels (ie. levels that would allow a "normal" rate of return. There is insurance fraud out there--some from policyholders and some from insurance companies. Oligopolistic behaviour distorts competitive forces that would be generated by the "animal spirits" in a competitive environment. The market is not free--oligopoly firms see to that. The proper response, indeed the moral response is effective government intervention as is done with regulated monopolies and with regulated oligopolies. Monopsony vs monopoly--a single seller has pricing power and a single buyer can deal with it. Government is not all bad and the free market is not all good. We have to be thoughtful about situations like human hearing and the affordability of it. Anyway David, I enjoy your views, I am a free enterpriser too, scratch out my living that way, but I also see a need for intervention in critical areas when dominant firms make life difficult for people who cannot afford critical needs.
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    6. Comment
      You 
      @fishinlad You bring up many issues, thank you for providing some thoughtful ones worthy of more discussion. Far too many of the ideas and comments here are relatively superficial and involve an arbitrary taking of money from some people to give to others. I'll try to address a few key points. 

      Barriers to entry are a natural part of an advancing society. Before all the wonderful technologies we have, there were virtually no markets and thus few barriers. Legal barriers should only exist to protect objective rights such as intellectual property. Patents exist to protect intellectual property and without patents there would be far less innovation and human progress - they are an objectively vital part of modern human civilization. Technical knowledge is not a barrier since essentially all the knowledge of humanity is available at our beck and call, thanks to patents, intellectual property law and more specifically laws that protect individual rights including property of all sorts. A dominant existing firm is not a barrier because if a firm is dominant then it has proven to provide the greatest value to consumers - created the greatest value in society - else it would not be dominant.

      It is important to realize that the existing firms are under constant pressure from all sides, both within existing product lines and from without. For example, Apple could decide to enter the market at any time and might quickly dominate, so other firms must be on their toes not only to existing competitors but all possible competitors. Just to maintain a strong market share requires constant thinking and innovation.Just imagine you are an existing hearing aid company and you decide to close your research and development department to make more money by reducing costs. How long would it take before you not only lost market share but drained all your capital and were out of business? Perhaps a few years? If you tried, you could come up with a dozen mechanisms of the free market that make such a decision extremely unlikely and cause instead the company to constantly strive for improved products and services. 

      Government is not all bad, I never said that. Government is essential for a free society, to define and protect the rights of its citizens. When it strays beyond that it has begun to infringe or even violate the rights of its citizens, and this is where is becomes a bad force in society. A monopoly by force can never be a good in society, and this is what is meant by regulated monopolies. In fact, there is no such thing as a real monopoly except by government force. Yes, there may be a dominant player, even up to 95% market share, but as I have shown there is the constant threat of new competitors fro all sides, including substitution for existing solutions, just as streaming services have totally overturned the long established oligopoly in television and prompted massive innovation just to survive as a going business concern. Imagine if government had regulated the internet as a public utility from its birth - we would still be hearing the beeping and buzzing noises of a modem as tiny little bits of data crawled slowly through copper lines.

      In contrast, freedom is an unalloyed good - not that all outcomes will be perfect or even optimal for all people, but rather that freedom provides the proper moral framework for human beings and the very best possibility of social, cultural and technological advancements. If a freely acting person violates the rights of another, we absolutely need government to adjudicate and punish as justice requires.
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  8. Comment
    Gordon Crann (@gordon) 
    The major producers of hearing aids have huge profit margins due mainly to insufficient competition. The high initial capital cost to purchase a high-quality hearing aid is made worse through the high ongoing cost of hearing aid batteries. There are affordable, high-quality hearing aids with solar-rechargeable batteries being designed and produced by deaf people themselves through the internationally-award winning social enterprise Solar Ear, for further information see its website: http://solarear.com.br/

    The Ontario Government should be encouraging the development of a Solar Ear, social enterprise affiliate providing jobs to deaf people in Ontario - not further subsidizing the huge profit margins of the producers of overpriced hearing aids. A Solar Ear, social enterprise affiliate located in Ontario would be able to serve the deaf market not only in Ontario, but in all of Central and Eastern Canada plus the Eastern USA, thereby providing affordable, high quality hearing aids to our deaf community, as well as jobs for our deaf people, and an increase in economic development and trade for Ontario.
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    1. Comment
      You 
      @gordon I'm happy to hear of all initiatives to develop improved technology in hearing aids. I applaud the collaboration of deaf people to create a new business model that may end up with a strong market share. That is competition. Anyone and everyone should be free to put their best effort into the competition for consumer choices. For those who complain of a lack of competition we must ask "who is preventing the competition?" In all cases, it will come back to regulation and government. Sure, there are obstacles to competing with a large, successful company, but these are natural, healthy, organic and constantly under challenge from all sides. In a free market no company is safe from competitive forces as even a small company with great innovation can capture a large product market share for a while, until more competition makes then irrelevant too. Since we do not have a free market it can be hard to conceive, but it is the right direction to move towards in Ontario.
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  9. Comment
    Don Bunsen (@doctorb) 
    I fail to understand why hearing aids are so expensive in the first place - there must be a way of bringing the cost down and having this brought under the public sector instead of private clinics selling them.
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    1. Comment
      You 
      @doctorb Doing what you suggest and socializing hearing aid production would cause them to stagnate and tend to make their production more expensive, not less. Who says they are expensive A hearing aid today that you can buy for a thousand bucks would have cost a million or in truth would not have been available for any price on Earth just twenty years ago. It is thanks to the innovation made possible by reinvesting profits that steady improvement is made possible in any product, including hearing aids. There is nothing about hearing aids that makes them exempt from the laws of economics.
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    2. Comment
      Don Bunsen (@doctorb) 
      @davemcgruer - most hearing aids are marketed to all of north america if not to a world wide market - but we see with drug prices and drug companies that governments can essentially buy in bulk and a lot of the cost is not in manufacturing but in the marketing and distribution and the middle men - i mean, just look at the technology in cell phones and how little it actually costs to manufacture them.
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