As an audiologist in the Twin Cities for more than 35 years, I was saddened to see the Jan. 9 letter from a reader calling out hearing aid providers as "scam artists" and dissing the hearing health care industry as a whole. There are many excellent audiology professionals who spend hours of mostly uncompensated time with hearing-impaired adults and children to help provide assistance and rehabilitation with their individual hearing challenges.

The cost of hearing aids is not just the plastic in the device. Although the aids themselves have progressed tremendously in capabilities over the years (my programming tool years ago was a mini screwdriver vs. the now-necessary computer), adjusting to hearing the world more normally again after years of missing the sounds of life is not always as easy as putting on a pair of "cheaters" from the local drugstore. Full accommodation can require a number of visits to the hearing aid provider to adjust, readjust, counsel and readjust again until the patient can comfortably re-enter the world of hearing.

Although we all would like the cost of health care to go down, there are many factors that affect pricing. The sales manager of one of the local hearing aid manufacturers provided the following thoughts to me, in a discussion yesterday, which I would like to share:

The easy answer to the high cost of hearing aids is simple microeconomics (supply/demand and cost functions).

Supply and demand determine market prices of most normal goods in our economy. The hearing industry (consumers) rewards manufacturers by buying the products we make. When the industry (consumers and dispensers) demands new products and technology, the manufacturers must respond by increasing research and development to deliver what the market wants. This comes with higher development costs, adding to the cost of the devices that consumers purchase, and with such short product life cycles, and a pretty flat demand curve, price will always stay consistently "high." I would argue that the market prices are not high or low; they are exactly where they should be based on the demand.

There are 37 million Americans who need hearing devices but will choose not to do anything about it this year. If all 37 million decided to enter the market, the price would come down, just as it did with home computers and VCRs. Economics at work.

One interesting fact : Everyone likes to jump on price as the reason people do not purchase hearing devices, but in socialized countries where hearing devices are free to the end user, they have the exact same adoption rate of hearing devices. This would suggest that price is not the biggest demand function at play. It might be cosmetics, vanity, preconceived expectations, etc.

Julie Klosterman lives in Minneapolis.