An Ear Full From Canada

Ryan Kalef returns as today’s Guest Editor.  Regular readers of Hearing Economics recall Ryan as the intrepid reporter who slogs through the north lands,  sending brief dispatches of what’s up in Canadian Audiology.  Ryan and the TV program he mentions touch on a host of economic issues of interest to Hearing Economics — including “Country Pricing”  and lack of price transparency.


Ryan Kalef, Canadian Audiologist and Intrepid Reporter
Ryan Kalef, Canadian Audiologist and Intrepid Reporter

On February 5, the Canadian Broadcasting Corporation’s (the CBC) television channel  aired  a 20-minute consumer protection program asking questions about the high price of almost everything in Canada, compared to the US, as well as the high cost in general of some “luxury” goods.    The program, called Price Tag Confidential, had a strong immigration theme — as in “Flee Canada and head for the US,” which may complicate border crossings for awhile.  More importantly, the program included a 4-minute segment{{1}}[[1]]If you want to fast-forward, the hearing aid portion starts at the 15-minute point in the program and ends at 18+ minutes.[[1]] decrying the high price of hearing aids in general — not just in Canada.

The message was controversial and largely portrayed hearing aids as grossly overpriced. As an audiologist, an advocate for the profession,  and as a member of the public, I have been trying to place this into perspective and think about how to respond.  In doing so I decided the issue is not the controversy as to whether or not Hearing Aids are priced fairly, but rather the fact that they chose to focus just on the product…the Hearing Aid. It is the message as to what people/patients/consumers perceive they are paying for, yet what they are really paying for is hearing health care.

 I do not entirely blame CBCs marketplace for focusing on product pricing (regardless of my opinion on their approach), as the public is bombarded with advertising for low-priced hearing aids, invisible hearing aids and free hearing tests. No where do you see the sign that says “BEST PRICE ON COMPREHENSIVE HEARING EVALUATION, HEARING AID FITTING AND FOLLOW UP CARE.”  If you are branded as selling a product, that is what the public will associate you with.  If you are branded as providing a service based on your education and expertise, then you will be associated with that.

As audiologists we are all clinical professionals and add value to the totality of the hearing healthcare process.  An $8000 set of hearing aids bought off a store shelf, then fit by the consumer will not have the same value as a $400 set of hearing aids dispensed and followed by an audiologist. Yet if the focus is not on the value of our expertise, that is exactly how the consumer, and those reporting on consumer issues will think. 


Hearing Economics Chimes In


Thanks for this, Ryan.  We think you were kind to the Price Tag Confidential folks, who skipped awfully quickly over the high R&D costs underlying those digital chips in premium hearing aids. We also wonder why the complaining consumer with the RIC fitting wasn’t redirected back to her Audiologist to readily resolve her simple complaints.  No matter.  It was an entertaining program — we especially liked the visit to Austin, the good music, and the tips on anti-aging creams.  

hearing aid cost breakdownThere was other interesting hearing aid stuff on the CBC website, including a hearing aid tip sheet and an ultra-cool interactive Canadian map that gives a “province by province comparison of hearing aid subsidies across Canada.”  Right next to the cool interactive map on the CBC website was a far more balanced view of why hearing aids cost so much, in the form of a pie chart borrowed from AARP (see figure).  

Muckraking is Alive and Well in Canada


Now why do you think the Price Tag Confidential guy didn’t bring that pie chart up?  We at Hearing Economics think it’s because he’s a muckracker and likes the hysteria of lumping all hearing aids together, saying they cost just $60 to make, claiming that Audiologists mark them up 3 times, etc.  It makes good copy and is “bought” as the truth by people (yes, even those in Canada) who like easy answers even when they’re wrong.  These are the consumers who remain true to the belief that there really is a free lunch somewhere, despite all economic evidence to the contrary.  

The Free Lunch Crowd is Alive, Too


Speaking of which, the following is one of many  interesting Comments elicited by the Price Tag program.  Another Canadian Audiologist relates a different story of hearing aid pricing and a consumer biting into the proverbial free lunch.  

I have a client who purchased hearing aids from me when she was in Ontario. Her husband decided to buy his hearing aid when in the US through a website. She got her hearing aids within 7 days and with the government grant paid $1700 for 2 advanced hearing aids which I fit for her. We had several follow-up visits to make sure they were working well and she was happy with them.

Her husband waited 4 months before his one hearing aid arrived through the mail because he was told it was on back order. He and his daughter adjusted it with a screwdriver. He paid $963 for this aid and got no follow-up. When he showed me the device, I almost fell out of my chair–it was 20 years old! It came on the market just after I graduated. It probably took a long time to arrive not because it was on back order but because it had to be shipped from Japan. It was screwdriver adjustable because that’s how things were done 20 years ago.

Reputable manufacturers in Canada were selling old product for about $300 and it wouldn’t have taken me 4 months to get it. I could also have provided him with a new digital hearing aid that had at least 2 years warranty and 1 year loss and damage warranty for less than he paid. He would have been certain that the aid was appropriate for his loss. Good luck if his hearing aid ever breaks down because he won’t be able to get it repaired.


Ryan Kalef holds an Msc in Audiology degree from UBC as well as a Bsc in Integrated Sciences (Physics and Psychology) also from UBC.  He  recently was  the conference co-chair for the 2012 BCASLPA conference in Richmond, BC and will be representing BCASLPA as the private practice audiology representative for the upcoming year. Ryan enjoys the active lifestyle Vancouver has to offer including the many scenic hikes, golf courses, and ski hills in the surrounding area. And, oh yes, a healthy interest in economics.  

About Holly Hosford-Dunn

Holly Hosford-Dunn, PhD, graduated with a BA and MA in Communication Disorders from New Mexico State, completed a PhD in Hearing Sciences at Stanford, and did post-docs at Max Planck Institute (Germany) and Eaton-Peabody Auditory Physiology Lab (Boston). Post-education, she directed the Stanford University Audiology Clinic; developed multi-office private practices in Arizona; authored/edited numerous text books, chapters, journals, and articles; and taught Marketing, Practice Management, Hearing Science, Auditory Electrophysiology, and Amplification in a variety of academic settings.


  1. I don’t think the map is exactly accurate – a note at the top it says it excludes people on income assitance from the calculations, but I can tell you that children in Ontario are not covered 100%! It’s 50% up to a maximum of $500 per ear. Considering the max dispensing fee in Ontario is around $700, that $500 is obviously not going very far! There is this footnote “Full coverage available to children under the children with severe disabilities program” but that program is income dependent, last time I checked.

    That said, I think hearing aids are a bargain considering how much technology is crammed in there! When we saw the bill for our son’s first set of hearing aids we were a bit aghast, but the difference they made for him was amazing. And the cost included a 3-year warranty, and we were back at the dispenser’s office many times for tweaks, repairs, retubing, new filters or hooks, etc. We definitely got our money’s worth!

  2. “If you are branded as selling a product, that is what the public will associate you with. If you are branded as providing a service based on your education and expertise then you will be associated with that. As audiologists we are all clinical professionals and add value to the totality of the hearing healthcare process.”

    Amen on that! The big problem is our profession has done a terrible job at branding and marketing itself as being a very separate profession from others that dispense hearing aids…

Comments are closed.