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Medicine The Almighty Buck Technology

Ask Slashdot: Why Are Hearing Aids So Expensive? 629

solune writes "You can get a tablet these days for a few hundred dollars, and laptops for a few hundred more. Gaming consoles, TVs, and smartphones are all available for under a thousand bucks. Yet, a decent hearing aid for my mom will go upwards of $3000! With ever-shrinking electronic components, better capabilities, and technological advancements, not to mention the rapidly increasing potential user base, I would think quality hearing aids should be coming in a lot cheaper than what we can find. Adding fuel to my fire is that a hearing aid will greatly improve my mom's life — not to mention the lives of millions of others out there. Currently, she suffers from frustration and isolation with having to ask people to 'speak up', and nodding her head to things her kids and grandkids say. We've tried the cheapies, and they're fraught with problems. So, can someone tell me why a hearing aid should be so expensive?"
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Ask Slashdot: Why Are Hearing Aids So Expensive?

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  • by Anonymous Coward on Wednesday June 13, 2012 @03:18PM (#40312923)

    'nuff said

    • by TheSpoom ( 715771 ) <slashdot@@@uberm00...net> on Wednesday June 13, 2012 @03:22PM (#40312995) Homepage Journal

      Yep. No market pressures to lower the price. Sucks if you don't have or can't get insurance.

    • by WrongSizeGlass ( 838941 ) on Wednesday June 13, 2012 @03:25PM (#40313059)
      Many insurance plans don't pay for them. Medicare doesn't pay for hearing aids unless the hearing loss is the aftereffect of an accident. They generally don't cover hearing tests either. Medicare and hearing aids. [medicare.com]
    • by Teese ( 89081 ) <`moc.liamg' `ta' `lezeeb'> on Wednesday June 13, 2012 @03:30PM (#40313137)
      Except, insurance (generally) doesn't cover them. Mine surely didn't.
    • by Xyverz ( 144945 ) on Wednesday June 13, 2012 @03:51PM (#40313489)

      MOST insurance policies do NOT cover hearing aides. As a person who's been wearing hearing aides for the last 30+ years, I can guarantee you this. Only if you work for a much larger corporation with a VERY nice benefits package, will you find an insurance policy that will cover your hearing aides - or even a portion of it.

      My last pair cost me just shy of $4000. I paid out of pocket since my insurance at the time didn't cover this expense. This is, to date, the second biggest expense I've ever paid, after my car. They were top of the range 11 years ago. I can buy an equivalent model now with the same features from Costco's hearing center now for about $500 each.

      Maybe your mum doesn't need the top of the range aides? Try looking for some with fewer features - say only six channels and two or three programs each (one program for normal environment, one for noisy environment, and one for telephone use if she should so desire). You'll save a ton of money.

      The other reason why hearing aides are usually so expensive is that not everybody has the same ear shape. All in-the-ear aides are made from a custom mold, which does increase the cost. My dad recently got a behind-the-ear pair that didn't include a custom mold. The tips fit into the canal, similar to a pair of newer earbud headphones. (They still cost him $1200 for the pair though.)

      Your mileage may vary. I highly suggest you shop around. Just remember though - you get what you pay for, and always buy the insurance plan on the li'l buggers.

      • I've been hearing impaired from a birth defect and worn hearing aids for over forty years. I have been in the engineering field for my career and currently work for a large worldwide corporation known for its generous benefits.

        But the insurance pays up to $800 for a hearing aid. You can't get a digital aid for that little $$$.

        I can tell you that the digital hearing aid I have been using for the last twenty years is from ReSound. It is the best I have ever worn, the clarity is excellent and I seldom
      • I thought that it was the custom-made nature of hearing aids that made them expensive, but a quick Google shows that a fitted set of earphones cost $200. I figure the fitting process is similar for hearing aids so it can't be the fitting. I guess the problem is that you can get cheap ones for $500 but everyone wants the best of the line models because it's their hearing, not some useless piece of tech that's a luxury.

    • by Anonymous Coward on Wednesday June 13, 2012 @03:52PM (#40313495)

      No. No, it doesn't. My sister is hearing impaired and we can find exactly *no* insurance plans that would cover hearing aids for her type of hearing loss. We found ONE plan that would cover hearing aids, but only if the child was under nine and the hearing loss was caused by leukemia.

      Consider this in the healthcare debate, because of the hearing aids that we were luckily able to save up and afford, my sister was able to only attend a few years of special ed and then was able to mainstream into a normal classroom, largely because the hearing aids allowed her to not have to learn sign language. This potentially saved the public school district a ton of money. It also saved the government a ton of money as she is now in college (to become an audiologist) instead of on disability.

    • by MetricT ( 128876 )

      What insurance are you talking about? I live in Tennessee, and have top-of-the-line (for us regular folks, anyway) Blue Cross, and having shelled out a used car's worth of money for mine, I can tell you for a fact they aren't covered at all.

  • by Anonymous Coward on Wednesday June 13, 2012 @03:20PM (#40312949)

    on this silly site [slashdot.org]

    • by ebuck ( 585470 ) on Wednesday June 13, 2012 @03:40PM (#40313305)

      on this silly site [slashdot.org]

      Don't worry, this topic deserves about three more submissions before even Slashdot deems it not worthy of a repeat.

      The electronics must be small, they mustn't be very heavy, and the must do something that is computationally expensive (signal isolation in a noisy background), combined with amplification, all in a custom fitting (to your ear) enclosure.

      On the other hand, you have people stating that a mass marketed device which is identical for a run of over 11 million last quarter, with ability to use bigger (lower cost) components, bought in bulk (by the millions) is cheap, so this custom device should be too.

      Basically they are expensive for all the reasons the article poster is ignoring, which reduces the article to "I want one cheaper, waahhhhaaahhh!!!"

    • I just got a new Oticon 380p bone conduction hearing end of last year. It was $1,300! Crazy. I assume it is because they are rare since most are digital these days. I refuse to get an implant for digital hearing aids!

      I bought the same analog model back in the end of 2004 and it was about $900. Prices keep going up even for old analog ones. :( This specific model has been around since 1994! You can read more about this in details on http://aqfl.net/node/2320 [aqfl.net] ... :(

  • by eldavojohn ( 898314 ) * <(eldavojohn) (at) (gmail.com)> on Wednesday June 13, 2012 @03:20PM (#40312953) Journal
    From this source [gallaudet.edu]:

    About 2 to 4 of every 1,000 people in the United States are "functionally deaf," though more than half became deaf relatively late in life; fewer than 1 out of every 1,000 people in the United States became deaf before 18 years of age.

    However, if people with a severe hearing impairment are included with those who are deaf, then the number is 4 to 10 times higher. That is, anywhere from 9 to 22 out of every 1,000 people have a severe hearing impairment or are deaf. Again, at least half of these people reported their hearing loss after 64 years of age.

    Finally, if everyone who has any kind of "trouble" with their hearing is included then anywhere from 37 to 140 out of every 1,000 people in the United States have some kind of hearing loss, with a large share being at least 65 years old.

    So even at 140, even ignoring those that cannot be helped by hearing aids and those that cannot afford hearing aids, the truth is that far more than 140 out of 1,000 people buy the products you mentioned. If you move a higher volume, you can price them lower and approach their true cost as your design and overhead costs diminish with numbers. What's more is that "a laptop" will more or less work for me the same as it will work for you. We don't need to mold the laptop to put it in our ears or have it tuned to our needs.

    You also seem to overlook two factors: as electronics get smaller they get more expensive. The second part is that as electronics need to power themselves and get smaller they get even more expensive. And on top of that, my cell phone puts out a lot of heat. The kind of heat I would not want in my ear. So you have to consider that the battery must be small and must not dissipate tons of heat and so therefore the electronics must have a very low power draw. There's not much of a conspiracy to find here, it's an unfortunate reality that prevents someone from storming the market with the new better cheaper hearing aid (pending tech advancements).

    In my family, we look at chipping in to buy our elders hearing aids for presents, I know the nice ones are crazy expensive.

    • by Anonymous Coward on Wednesday June 13, 2012 @03:43PM (#40313351)

      From Anthony Watts web site supplying some technical info about hearing aids, in his words:
      I wear two ITC/CIC hearing aids with DSP processors built in. Let me tell you a little bit about why they are so expensive. The largest supplier of hearing aids in the USA is Starkey in Minneapolis. I’ve been to the factory, and have experienced the process from start to finish courtesy of the president of the company.
      1. Because hearing aids, especially BTE (behind the ear) and ITC/CIC (completely in the canal) types use a single cell 1.5 volt battery, which can drop as low as 1.3 volts through its useful operational life, the amplifier circuits must be of extremely low power consumption and low voltage. The only chip material that works well for this is germanium, which has a diode junction forward voltage of ~ 0.3V as opposed to the ubiquitous silicon used in consumer electronics which has an ~ 0.7V forward voltage. While germanium was once very common for transistors and some early integrated circuits, it has fallen out of favor in the microelectronics hearing aid world. There are only a handful of sources and companies now that work with germanium, thus the base price is higher due to this scarcity. You can’t just take an off the shelf silicon chip/transistor and put it in these aids. Each one is custom designed in germanium. [Added: power consumption is a big issue also, aids are expected to last a few days on a single battery, if most of the power is being used to overcome the forward diode voltage, it gets lost as heat instead of being applied to amplification use.]
      2. The process of properly fitting a hearing aid is labor intensive. Custom ear molds must be created from latex impressions, and these need to be fitted for comfort. A small variance or burr can mean the difference between a good fitting mold and one that is painful to wear. Additionally, if the mold doesn’t maintain a seal to the inner ear properly the hearing aid will go into oscillatory feedback. Sometimes it takes 2 or 3 attempts to get the fitting right.
      3. On the more expensive aids, labor is involved in doing a spectral hearing loss analysis of the user’s hearing problem, so that the aid doesn’t over-amplify in the wrong frequencies. Just throwing in a simple linear amplifier is destructive to the remaining hearing due to the sound pressure levels involved.
      4. Construction of aids is done by hand by technicians, especially with the popular ITC (in the canal) aids. At the Starkey company, a technician is assigned to create the aid from the ear mold, fit the chips and microphone/receiver and battery compartment, and connect it all with 32 gauge wire and make sure it all fits in the ear mold. This can be a real challenge, because human ear canals aren’t often straight, but bend and change diameter. Imagine a room with a hundred technicians sitting at microscopes assembling these. Each is a custom job. There’s no mass production possible and thus none of the savings from it.
      5. After the aid is created, then there’s the fitting. This process is also hands on. Getting the volume and the audio spectrum match right is a challenge, and audiologists have to have chip programming systems onsite to make such adjustments withing the limits of the aid. Sometimes aids are rejected because the user isn’t comfortable with the fitting, and then the aids go back to the factory for either a new ear mold, new electronics, or both.
      6. There’s a lot of loss in the hearing aid business. Patients don’t often adapt well, especially older people. There may be two or three attempts at fitting before a success or rejection. Patients only pay when the fitting is successful. If it is not, the company eats the effort and the cost of labor and materials. Imagine making PC’s by hand, sending them out to users, and then having them come back to have different cases or motherboards or drives fitted two or three times, and software adjusted until the customer is happy with it. Imagine

      • by time961 ( 618278 ) on Wednesday June 13, 2012 @04:20PM (#40313923)
        1) And the reason that hearing aids can't use 3V lithium battery technology is? Seem like there might be some benefit there, especially in view of the impressively low-power things that can be done with small-geometry silicon when speed isn't the main issue.

        2) This is a meaningful cost. A library of semi-custom versions might be a plausible intermediate step. As might laser scanning and 3-D printing.

        3) Why can't analysis of the loss can be completely automated? "Press + if this sound is louder than the last one"

        4) Flex PCBs (even when each one is fully custom) and 0105 components seem like a plausible solution. Automated assembly has come a long way since the invention of 32 gauge wire. Open your iPhone and count the grains of sand (resistors and capacitors) soldered to the PCB. Sure, they've always done it by hand with microscopes, but while that was a sensible approach 30 years ago, there are better approaches now.

        5) This is a meaningful cost, too. But again, there's a lot of "tuning" that could be done by interaction with an automated system.

        6) This is a meaningful cost. No obvious way to mitigate it, given the elderly user communicate it.

        7) This isn't a cost, it's just a complaint that modern electronics isn't in the picture.

        What I hear is "this is the way we've always done it, and we can't imagine a non-evolutionary approach to improvement". Is it really possible that a 3V supply (which would allow use of a $5 2mm^2 32nm-process DSP) would be the kind of disruptive change that would make hearing aids cheap enough for everyone?

        Probably not, because the economic argument is unimpeachable: as long as insurance pays for it, and thus eliminates price pressure, there's no motivation to charge much less (10% off for cash, yeah, what a deal). This isn't even value-based pricing (think Mac Pro :-) ), it's structural monopoly pricing. As long as that's in the picture, there's no hope for a transition to cost-based pricing.
        • To respond to each and every 'automated system' response: Oh hell no.

          For one thing, people are, in general, stupid. For another thing, hearing is a funny thing. Ever have the audiology test where they play high-pitched sounds into your head, and you click the button when you hear them, or think you hear them?

          Finally, hearing aids still tend to go to old people. The vast majority of them will not be able to use an automated system.

          And the behind the ear models still have custom-fit moulding and what

  • by Squiddie ( 1942230 ) on Wednesday June 13, 2012 @03:21PM (#40312959)
    Daddy needs a new sports car, and your mum is paying for it.
  • by slashmydots ( 2189826 ) on Wednesday June 13, 2012 @03:21PM (#40312973)
    "Oh no, my poor insurance company shouldn't have to pay $3000 for this device. It's too high! I will not buy it!" You don't hear that all that often (no pun intended) so that's why the cost is so high. Econ basics, people. Cost goes up, sales go down. When you factor in "I don't give a crap what it costs, I'm not the one paying for it" that does tend to throw cost off a bit. I know hearing aids aren't as covered as other medical devices, treatments, and prescriptions but they're not 100% out of pocket very often either.

    Oh and the million dollars or more in testing to get FDA approval plays a factor. I have a feeling Microsoft didn't even put a million into testing the Xbox 360 lol.
    • by Jeng ( 926980 ) on Wednesday June 13, 2012 @03:39PM (#40313291)

      I take a medication daily. With my insurance it costs me $45 a month, a generic version recently came out, it costs me $45 a month, if I want the non-generic it will cost me @$400

      The insurance companies have ways of pushing you to the cheaper option if a cheaper option is available, mainly by not covering the more expensive option.

  • by raydobbs ( 99133 ) on Wednesday June 13, 2012 @03:22PM (#40313003) Homepage Journal

    They need to be able to have FDA testing, certification, independent verification of testing, quality assurance and all the paperwork hell -that- involves. The certification needs certifiers to certify that the certification has certificates on the certifiers to do certifications and so on... There is a MASSIVE paperwork rats-nest involved in making ANYTHING that used in healthcare.

    It's why healthcare spending is rapidly outstripping the US economy, to be completely honest.

    • by LihTox ( 754597 )

      But is certification really necessary in this case? If a company just made a device to insert in your ear (like an earbud or headset) which amplified sound in a particular way, that wouldn't be much different from a Bluetooth headset or a set of earbuds...I don't see how they could be prohibited from selling them, though perhaps with a different name. Insurance might not pay for them, but if you insurance covers a hering aid then what's the problem?

      • by hawguy ( 1600213 ) on Wednesday June 13, 2012 @03:45PM (#40313389)

        But is certification really necessary in this case? If a company just made a device to insert in your ear (like an earbud or headset) which amplified sound in a particular way, that wouldn't be much different from a Bluetooth headset or a set of earbuds...I don't see how they could be prohibited from selling them, though perhaps with a different name. Insurance might not pay for them, but if you insurance covers a hering aid then what's the problem?

        If I were going to wear a sound amplifier in my ear all day every day, I'd like some assurance that it's been tested and that it isn't outputting such high sound levels that it's killing off whatever amount of hearing I have left.

        Just because it's not implanted inside the body doesn't mean that it can't cause harm.

    • by DCFusor ( 1763438 ) on Wednesday June 13, 2012 @03:52PM (#40313505) Homepage
      Mod parent up! I worked in the hearing aid biz. Heck, you have FDA coming in looking for rat droppings - you can't describe the horrible tangled mess the regulations and implementers are. Then there's the question of making loud noises into the ear of someone who already has a loss...legal liability. Same issues for most medical gear. I've seen some amazing prices on laptop based EKG's, as in, way too many digits. But....insurance pays, the gov makes sure they make money, and tries to make it so the guy who slaves to make a good aid - they have to be customizable (and by a medical type) for your situaion - makes no money. It's a hard biz to be in.
  • by Freddybear ( 1805256 ) on Wednesday June 13, 2012 @03:26PM (#40313073)

    As "medical devices" hearing aids must by law be sold by licensed audiologists, and those same audiologists' trade organization lobbies governments at every level to keep up a very tight monopoly control of the marketplace.

    • by Petron ( 1771156 ) on Wednesday June 13, 2012 @04:20PM (#40313917)

      Hearing aids are Class 1 Medical devices.... that's the same category as a toothbrush. You don't need to vising a licensed dentist with trade lobbyists to get a toothbrush.

      This is why you can buy hearing aids off of TV, the internet, all without a fitting, or a clue what you are getting... Kinda scary because an improper fitting/setting can deafen you.

      What I tell people when they ask why they are so expensive - cost in making them. Each hearing aid (in the ear/canal) is custom made by hand, if done wrong, it is re-done at full cost, but the customer doesn't pay for remakes (as stated above). Plus the hearing aid isn't "Make everything louder". It's a very complex device. Think of an expensive home stereo, the type with a bunch of sliders. Now shrink that and put it in your ear. Only have hearing loss in the 1.5 khz range? then that is the only thing boosted... or the sound in that range is shifted up or down. Different environment? have the aid automatically adjust from a noisy lunchroom mode to park mode when you walk outside. Add in directional sound detection so the aid knows the voice in front of you is likely the one you are listening to and not the voice behind you... Add in wireless communication between aids to help find the direction where sound is coming from, plus use media streamers to listen to the TV. Do all of that in something about the size (maybe smaller) than a pen cap.

      And no, Health insurance doesn't cover hearing aids (most of the time, maybe there is a few, but that is the exception, not the rule).

  • Recovery (Score:4, Informative)

    by GerryHattrick ( 1037764 ) on Wednesday June 13, 2012 @03:30PM (#40313129)
    In the UK it's largely because the 'price' includes 'recovery' of all the audiologist's time and overheads which are misleadingly presented as 'free'. Try buying it used, and no one will set it up for you. Cartel point is valid too, similar reason.
  • Justification (Score:5, Interesting)

    by hawguy ( 1600213 ) on Wednesday June 13, 2012 @03:30PM (#40313131)

    Here's an article that attempts to justify the cost:

    http://www.aarp.org/health/conditions-treatments/info-05-2011/hearing-aids-cost.html [aarp.org]

    Overall cost — $3,600

    Costs for the manufacturer:

    Materials — $360

    Research — $1,080

    Other retailer costs:

    Rent/overhead — $450

    Testing/diagnostic machines — $288

    Licenses/insurance — $108

    Salaries — $540

    Marketing — $270

    Continuing education/training — $180

    Potential profit for the retailer (pretax) — $324

    Approximate product cost for retailer — $1,440

    I don't know how accurate it is, but I can believe that the actual parts cost of a hearing aid is around $350.?

    • I'll give them parts and manufacturing, but research? Rent? Licenses? Salaries? Etc?

      This costs $500 more than an entry-level Mac Pro, which have much the same cost categories, and I'm sure hearing aids sell in much greater numbers for better economies of scale.

      The one cost category they obviously missed was "insurance markup" (not to be confused with licenses/insurance).

  • by doug141 ( 863552 ) on Wednesday June 13, 2012 @03:32PM (#40313173)
    Only $30! IT all depends on the "medical device" classification from the FDA. http://www.msa30x.com/ [msa30x.com]
  • Do a little googling, and you'll find lots of people writing about positive results using Walker Game Ear devices as cheap hearing aid substitutes. They don't have the frequency fine-tuning that medical devices have, but you can give a $200 Game Ear a try, and return it if it doesn't work. Try that with a $3k hearing aid...

    http://www.cabelas.com/catalog/browse/hunting-hunting-accessories-hearing-protection-enhancement/walkers-game-ear/_/N-1100132+1000005098/Ne-1000005098?WTz_l=SBC%3BBRprd708259&WTz_st=GuidedNav&WTz_stype=GNU [cabelas.com]

  • by necro81 ( 917438 ) on Wednesday June 13, 2012 @03:37PM (#40313253) Journal
    Tablets, computers, etc., all can be machine-assembled, or assembled by half-way trained manual laborers in a factories that can achieve high throughput by economies of scale, division of labor, etc. And although they are densely packed, personal electronics are still, for the most part, macroscopic. The components in a hearing aid, by contract, have many miniscule components that are assembled very carefully, by hand, by skilled laborers using loupes and microscopes - more akin to watchmaking than assembly-lines. As such, the assembly labor has resisted outsourcing. Plus, the number of units being assembled by any one company (there are many players in the market) aren't large enough to support well-oiled assembly lines running 24-7. Finally, most hearing aids have some amount of customization to each patient (ear-insert moldings for some models, equalization tuning for others), which further increases cost.

    Others have mentioned the addition cost associated with it being a medical device, which is not insignificant. Lastly, because many hearing aids are paid for by insurance, rather than out-of-pocket, there is less consumer-driven pressure to reduce costs.
  • by Bigbutt ( 65939 ) on Wednesday June 13, 2012 @03:37PM (#40313255) Homepage Journal

    I went in a year or so ago to have my hearing checked and found out my ranges but in general everything checked out as ok.

    The doctor said I would benefit from getting a hearing aid due to the loss of hearing in one part of my range (bit higher than it should be but not deaf). She was going through the brochure and showing me the aid, a nice one about half the size of a bluetooth ear set. Her nurse checked my insurance company and it didn't provide coverage for hearing aids but I was still interested in the information.

    As she was going through the pitch, she was saying "49" "95" as in $49.95. I'm thinking that's a pretty decent price and said that's not too bad, I'd like the one with the red shell. She didn't have any in stock having just sold the last one but could order one for me. She'd have to have a non-refundable $50 deposit though.

    And I'm ..ooOO( 50 buck deposit on a $49.95 item? That sounds weird )OOoo..

    So I asked and she said, "no, $4,995.00. You thought I meant $49.95??"

    Ahh, no. Sorry. It's not all that bad, thanks anyway :)


  • by wonderboss ( 952111 ) on Wednesday June 13, 2012 @03:38PM (#40313259)

    But couldn't we make these more like cell phones? I see a lot
    of people walking around with bluetooth headsets. Rather than
    making the hearing aide fit in the ear, make it something I can
    wear on my belt, or on a lanyard. The problems of size, power
    and heat all become easier to solve.

  • by droptop ( 558616 ) on Wednesday June 13, 2012 @03:39PM (#40313295)
    The same reason that between myself, my insurance and Medicare AirWay Oxygen has been paid over $26,000 over the past seven years for a machine that costs $2,000; The pain in the ass to get FDA approval (both real and imagined) for a "medical device" prevents many would-be manufacturers from entering the market, and none of the players wants to ruin their golden goose by starting a price war. We used to say the same thing about military equipment when I was an Army Mechanic... In 1982 I couldn't understand at all how the little M151A2 "jeep" cost over $75,000 a pop!! Especially since the assembly lines have been running since 1968 and a lot of the expensive magnesium pieces had been replaced by steel. The adage is the same: "Paint it green and quadruple your profit" or "Paint it white and put FDA on it and quintuple your profits"!
  • Because they can. (Score:5, Insightful)

    by MrLizard ( 95131 ) on Wednesday June 13, 2012 @03:42PM (#40313335)

    For pretty much the same reason that a small piece of soft foam as a filter for my CPAP -- not magic foam made from unicorn testicles, just bog-standard foam, about 2" square -- is billed to my insurance company at 25.00.(Seriously, due to a paperwork snafu, at one point, I got the itemized bill instead of my insurance company getting it, and it's ridiculous what they charge.) Because they can. (My insurance company, I'm sure, just laughs and pays them a buck, at most, but having the item be "worth" 25.00 is probably a lot of use to accountants at every stage in the transaction.)

    Why did a simple ultrasound of my heart, performed by a technician who was not a doctor, not a nurse, just someone who'd completed "Be an ultrasound technician!" at night school, and which took about 15 minutes, cost over $1000.00? No reason. It's a random number. They bill the insurance company, or the government, depending on if you have private health insurance or medicare/medicaid, and then the people they bill pay whatever amount THEY decide to pay for an ultrasound. This doesn't work, of course, if the hospital has to bill YOU -- you have to pay what they ask. Sucks to be you. Or me, when I didn't have insurance.

    It's because there's no market control; there's no shopping around; there's no way anyone can (legally) just start making hearing aids and having them sold at Wal-Mart. If eyeglasses followed the same rules, you couldn't buy even a pair of reading glasses without going to a licensed optometrist and paying 250.00, minimum. As it is, I can go to the aforementioned Wal-Mart and try on a few quickly, then pick whatever I like best and walk out having paid less than I'd pay to go to the movies.

Always leave room to add an explanation if it doesn't work out.