These are good points. I was wondering about the costs of the doctor's visits, but you're right we should perhaps make those optional.

I realized one thing that would help is "open hardware". If you're supposed to see a doctor to measure and tune some value maybe a device with an open interface and an app would suffice (which I think others here mentioned today).

The reason I asked about the cost of the doctor is I am interested in doing things like giving them free school in order to lower their need to charge high prices. Generally I would rather every person has a good local doctor they can see for free, but we could also deregulate these devices and let people sort out amongst themselves how to get the right fit. I would just want to take care that people aren't damaging their hearing further with improper use.