
Why It Took Google So Long to End Shady Rehab Center Ads - champagnepapi
https://www.bloomberg.com/news/features/2017-09-26/why-it-took-google-so-long-to-end-shady-rehab-center-ads
======
ballenf
I would suggest Bloomberg and other media research what can be done to educate
people that advertisers sometimes, once in a while, aren't spending money in
order to make people's lives better.

To be clear, the parties behind these sham recovery centers are scum that
deserve any and every legal repercussion available. And, if illegal, no Google
shouldn't do business with them. But the bottom line reason why Google didn't
act faster was because they weren't per se illegal, but more so loophole
exploiters.

Policy makers subsidized an industry and, learning nothing from every other
subsidy in the history of the world, forgot that subsidies invite bad actors.
(Calling coverage of medical treatment a 'subsidy' is admittedly somewhat of a
stretch, but in the context of all the medical issues that health insurance
does not cover I stand by the label. E.g., German public health insurance used
to cover 'prescriptions' for sun and relaxation, until it became abused by
people taking taxpayer subsidized vacations. Designations of coverage have a
similar effect as a subsidy, at the very least.)

This path we're heading down of expecting "the internet" to protect us from
the latest baddies out there worries me on a much deeper level. And I don't
see this as a 'slippery slope' argument: this is just looking at existing data
points and following the trajectory. The current direction is worrying,
without regard for the potential of acceleration. Exploitive ads have been
around forever -- from the literal snake oil salesmen to the ads in every
newspaper, magazine and yellow pages to the present.

Hard cases make bad law. That's a maxim that is depressingly unpopular today.

~~~
kosi28
pfft...Google is more bothered about putting electric thread into Levi Jackets
and Lidar on top of our cars. All this shit involving real people and real
problems is beneath them.

And people like you make it easier for them to stay up there in their Ivory
Towers. Keep it up.

~~~
leggomylibro
Well, don't scoff at wearable electronics just because they're mostly LEDs and
NFC chips right now. If we can figure out how to make something both stretchy
and conductive, there's a lot of practical opportunity.

What if your knee/elbow/wrist/etc brace had a small alarm to go off when you
start to overextend it during recovery? What if your jacket had a button to
quickly mark precise GPS spots in the field for later follow-up inspections?
What if your shirt could adaptively nag people about their posture during the
4 hours they spend seated every day? Heck, you could cobble the GPS jacket
together today with off-the-shelf parts; it'd just look strange and probably
be fragile/uncomfortable to wear.

As for self-driving cars not involving 'real people and problems,' I just
don't understand what you mean by that; could you elaborate?

~~~
s73ver_
That, and it's not like the people working on the wearable electronics could
suddenly drop that and become people vetting ads.

------
JacobJans
Here's the core of the issue.

Google may be making over one billion dollars from ads in this space.

However, they say it is "hard for Google to cut off shady treatment providers
unless someone tipped off the company."

Surely, with a small portion of that one billion dollars, they could figure
out a solution.

Of course, they have no interest in actually solving this type of situation,
which is widespread across many verticals. In one of my markets, I have
repeatedly complained about deceptive advertisers. They've done next-to-
nothing to stop them.

I used to be against ad blocking software.

~~~
leggomylibro
What, do you want companies to be responsible for the negative externalities
of their products?

Next you'll want oil companies to pay for cleaning up their messes, and banks
to pay for financial crises, and data processors to take responsibility for
their huge data breaches.

That's crazy talk - where are we, the people's republic of canada?

~~~
goialoq
And you'll want Verizon to monitor the content of your phone calls to catch
fraudsters. Oh, wait, what was the narrative again?

~~~
smt88
Your analogy makes no sense.

For Verizon to catch fraudsters, they have to police their customers'
behavior. The key is _customers ' behavior_, not _their own behavior_.

Oil companies don't need to violate customers' privacy to clean up oil. They
don't need to do anything negative to customers at all.

The same is true of banks paying for financial crises and Equifax paying to
privacy damage. All they'd be doing is fixing their own mistakes, not policing
their customers or users.

As for the relationship with OP: Facebook's users and customers are different.
Because such a large percentage of the public uses Facebook, the company's
duty to protect its users should come ahead of its duty to protect its
customers. If FB kills a few shady corporations, it's not nearly as bad as if
those shady corporations harm actual human beings.

------
thrownaway954
Something has to be done with the treatment industry as a whole. It's sad when
a group of them come into an AA and/or NA meeting and the meeting is used as
their "therapy" session. I see this way too often in the rooms. The center
should be treating the mental aspects of addiction as well as the physical at
the center. Most of these fly by night treatment centers have no interest in
addressing the mental aspect of addiction, and as a result, the center becomes
a revolving door for some. Maybe by removing these shady centers from
advertising on Google it will help put them out of business and the centers
that are trying to help will thrive. Time will tell.

~~~
mapster
its the same approach the free market has to elder care. they are for profit
cash machines with a thin veneer of care. they are run on a shoe string,
hiring barely qualified technicians working 12 hr shifts. what could go wrong?

------
Cenk
This is a good article on the problem:
[https://www.theverge.com/2017/9/7/16257412/rehabs-near-me-
go...](https://www.theverge.com/2017/9/7/16257412/rehabs-near-me-google-
search-scam-florida-treatment-centers)

~~~
default-kramer
I love this part:

> Business name paperwork took a pretty surreal turn during this analogue SEO
> war. In 2004, a former Sea Winds exec named his new company A ALCOHAAAAAL A
> + A ABUSE 24 HOUR AAAA ABLE HEPLINE AND COUNSELING CENTER, INC

------
mrtron
The CPA is so high for rehab that there are many highly motivated people doing
highly elaborate schemes for client acquisition. They were among the early
adopters for tv ads on adwords a decade ago.

------
sireat
Holy cow, $187 per click, that seems ridiculously high and no wonder has
attracted attention of all kind of bad faith actors.

Granted, I have not checked AdWords in 10 years back when most things cost
less than $1 per click, save for some mesothelioma searches which used to go
for $10-15 per click.

~~~
CobrastanJorji
Most things still do, but there are a handful of CRAZY expensive searches.
Stuff like "home insurance price quote" or "dui lawyer LA" or "good mortgage"
cost an arm and a leg.

~~~
Karunamon
That reminds me, on a slightly related tangent: AdNauseam now works with the
latest Firefox nightly. It's a uBlock Origin fork that stashes the ads in the
background and clicks on them (but as a simple request, so the other side
never gets loaded).

Great for ruining your tracking profile and contributing ever so slightly to
the downfall of attention abuse as a business model.

------
bogomipz
Google, one of the world's largest analytics companies didn't think there was
anything suspicious about an uptick in revenue from "treatment center"
AdWords?

This is the same willful ignorance that Facebook employed when it failed to
notice an uptick in political ad buys by "The Internet Research Agency" during
the US election season.

It seems clear that both Google and Facebook can be counted on to do the right
thing but only after someone else blows the whistle.

------
Animats
Google has done outreach to some very shady industries. They were at IFX Expo
in Cyprus in 2016, pitching Google ads to binary options "brokers".[1] (Binary
options are a total scam; start at the link and read the multi-part Times of
Israel expose.)

[1] [https://www.timesofisrael.com/as-victims-pile-up-the-
binary-...](https://www.timesofisrael.com/as-victims-pile-up-the-binary-
options-industry-parties-in-cyprus/)

------
coldcode
As long as there is enormous revenue from selling ads, Google and Facebook and
others have to do stuff like this, or their sky-high valuations might come
down. So wether you take money from scummy fake rehab centers (and real ones
who now have to play the game) or Russian election manipulators, its not
likely to stop without costing a lot revenue. Looking the other way until you
get called out is probably good business from their point of view.

------
SCAQTony
Unfortunately there is no procedure, process or prescription that can
terminate drug dependency for all. Psychology is still somewhat in the middle
ages when compared to mechanical or digital sciences. Could one make an
argument that all rehab centers are "shady" if they can't deliver a final
product for all?

With that in mind, rehab centers are VERY important till we figure out the
human mind and addiction.

~~~
tyingq
At least in the US, I view any addiction treatment center that would pay for
leads as useless.

Barring the few clinics that are run by charitible organizations, they all
follow the same pattern.

Your treatment plan always happens to be equal to the amount that your
insurance will pay for, or that you can pay out of pocket. Several hundred
dollars per day, at a minimum.

That means that for all but the rich, it's a 2 week stay, which isn't going to
do anything useful.

Tldr: If the clinic can afford to pay ppc advertising to get patients, they
aren't really helping anyone.

------
lifeisstillgood
In the U.K. We have the ASA - advertising standards authority, which while
often derided has actual teeth when forcing a "bad" ad to be removed.

I am unclear if these ads would get removed (the ad is not untruthful, just
the service advertised is scam) but the point I am making is that we need to
move beyond Google removing the ads and "us" removing them.

This is a society sized problem - and like all society problems it needs
society level action - that's either market based where externalities and
other effects are in the right direction or plain and simple regulation.

The opiods crisis that middle America seem enmeshed in now has to be dealt
with at massive governmental action level. Googles ads are a tiny sideshow.
And if you do fix it we can use the same model for alcohol, elderly care,
sexual abuse. We got lots to fix.

------
ykler
Speaking as someone perpetually puzzled by the American healthcare system,
from an economic standpoint, it seems like it is primarily the responsibility
of government or perhaps the insurance industry to fix this. (Government, of
course, is paralyzed. As for insurance companies, I don't understand that well
their incentives and the impact of regulation on them. For instance, could
they refuse to pay for expensive treatments or for relatively ineffective
treatments, and would it be worth it for them?) It is good that Google is
finally cracking down and bad that they didn't earlier, but it is a bad idea
to present corporations (or people) with opportunities to legally make huge
profits by doing harmful things (or allowing harm to harmful things to
happen).

~~~
sjg007
They do refuse to pay for experimental treatments or ineffective treatments.
The question is why not in the case of shady addiction centers.. my guess is
that Florida has/had some language regulating the payers effectively tying
their hands. Mental health / substance abuse got a big push from the ACA as
well which likely enabled things as well. <conjecture> Also a lot of these
early adopters may have likely first started out as court ordered so they were
already established for this type of "acute" care and just scaled up when the
demand developed. </conjecture>

------
gregshap
"America’s $35 billion addiction treatment market"

$35 Billion. That's at least 10x-50x what I would have guessed.

Google isn't creating this market, but yes they should try to help. This is a
fundamental and enormous societal problem.

------
tcj_phx
My friend is currently at her second 'rehab' center... The first one was a
disaster for her because all they did was go to 12-step meetings, and charged
her $25,000 or $30,000 for the month. Talking about drugs all the time is a
good strategy to get an addict to want to use drugs.

She didn't last very long at that place before she relapsed and they sent her
back to the psychiatric hospital, who decided that they'd clearly made an
error in allowing the tranquilizers to lapse. Tranquilizers do not treat poor
diets.

Her current center specializes in "dual diagnosis". This is the fraudulent
diagnosis that pretends that patients' psychiatric diagnoses are of no
relation to their tendency to self-medicate with the street pharmacy. Really
this second place just gets their clients "stabilized" on their psychiatric
medications and hauls them around to daily 12-step meetings.

My friend is doing better now because I went to the courts to try to get the
treatment provider to explain why they had her on double-doses of
tranquilizers, when my phone videos clearly prove that she was fine before she
got assaulted with Haldol ("anti-psychotic") when she ran out of alcohol [1].
Sometime doctors do good work, sometimes they make work for themselves.

[1]
[http://emedicine.medscape.com/article/289848-overview](http://emedicine.medscape.com/article/289848-overview)
:

    
    
      Alcohol-related psychosis spontaneously clears 
      with discontinuation of alcohol use and may resume 
      during repeated alcohol exposure. Distinguishing 
      alcohol-related psychosis from schizophrenia or 
      other primary psychotic disorders through clinical 
      presentation often is difficult. It is generally 
      accepted that alcohol-related psychosis remits 
      with abstinence, unlike schizophrenia. If 
      persistent psychosis develops, diagnostic 
      confusion can result. Comorbid psychotic disorders 
      (eg, schizophrenia spectrum and other psychotic 
      disorders) and severe mood disorder with psychosis 
      may exist, resulting in the psychosis being 
      attributed to the wrong etiology. 
    
    

The only thing the current treatment center gives my friend is "structure" and
an expectation that she needs to be sober. She's doing well now, in spite of
the anti-treatments, because my court cases motivated the treatment provider
to take her off the worst of the psychiatric drugs. Maybe Abilify is the
least-bad of the anti-psychotics, but it is known to cause new problems for
many patients [2].

[2] Abilify drug blamed for compulsive gambling, eating, shopping, sex \-
[http://kdvr.com/2017/02/15/abilify-drug-blamed-for-
compulsiv...](http://kdvr.com/2017/02/15/abilify-drug-blamed-for-compulsive-
gambling-eating-shopping-and-sex/)

edit: All drug treatment businesses are "shady", to some degree. What the
industry needs is to move beyond the 12-step program, which is rooted in the
1930's approach to alcoholism. There are aspects of the 12 steps that are
helpful, but it's very important to address the biological problems that now
are known to be associated with people's tendency to self-medicate. Just
yesterday I read of a study that used some chemical to 'extinguish' cocaine
cravings... Naltrexone is FDA-approved for alcohol abuse, and prevents people
from getting high on opiates.

Effective approaches to addiction need to be investigated. A good first step
would be to stop treating these people like criminals.

------
bob_theslob646
If this is the case that scam companies are getting to the top, why not try
and bankrupt the scam companies, by clicking the ads of the known bad
companies on purpose with no intention of going to rehab ? Oh wait,that would
be considered click fraud or is it, if it brings up a conversation between
owners and google. Oh wait, does google want to have that conversation?

~~~
BearGoesChirp
Is there actually a law preventing me from doing a search and clicking on ads
that have a high cost per click just because? Assuming I'm not related to any
party involved?

------
ocdtrekkie
At $230 a click, Google has no incentive to stop selling scams, particularly
with internet regulation being so weak. Safe harbor effectively gives them
immunity to prosecution for profiting on the malicious content they host. All
they have to say is "we're not responsible for content others post on our
platforms".

Currently, The Verge has more power to regulate Google's behavior does than
the US government, by bringing them to the court of public opinion. Which is
why I have actually started to lean in favor of laws that strip away safe
harbor protections like SESTA.

Internet companies don't need or deserve blanket immunity: They should be able
to be taken to court when they misbehave.

~~~
izacus
Here's an idea - let's punish the scum that creates those ads instead of
demanding that Google plays the moral police for the whole world. You're
literaly demading that Google (a private for-profit corporation) becomes a
private censorship force instead of going after scum that creates those ads.

~~~
ocdtrekkie
I'm not suggesting Google be the moral police: I'm suggesting Google take the
necessary measures to ensure they are not operating a criminal enterprise.
Generally, doing business in illegal goods is considered a crime, and Google
was well aware that they will profiting on illegal rehab ads. But right now,
they're not legally responsible for that, so they had no reason to do what
they should've done: Individually have humans vet the ads.

Most businesses have to take reasonable steps to ensure they're not aiding and
abetting criminal activity. Pawn shops register stuff sold to them and who
sells it, and they lose out if something they bought turns out to be stolen.
Gun stores run background checks. Banks end up on the hook for fraudulent
charges. Google just profits and has blanket immunity from prosecution. Google
made millions of dollars (at least) off sending people suffering from drug
addictions to scammers, and got to walk away with all the profit scot-free.

~~~
moftz
In this case what should ad networks like Google do to make sure they are
running ads for legit businesses? In your gun store example, the seller is
relying on the government to provide any information that would disqualify a
sale. Rarely is a gun shop going to deny a sale despite government approval
_unless there is suspicion of a crime happening_.

If these scam rehab clinics can show Google they are properly licensed by the
state they reside in, then what else should Google be doing? Google is not a
medical license board. The states need to make sure that any sort of rehab or
medical facility is legit and using best practices. These clinics rely on
insurance money coming in so insurance companies would definitely be
interested in making sure that the clinics they are paying out to are using
effective treatments. I could see Google having a clause stating that if any
business advertises themselves as any sort of medical or rehab facility, that
they provide documentation from the state that proves such. This should be the
same with doctors, lawyers, notaries, professional engineers, or anyone that
advertises themselves as something that requires an approval from the
government.

Despite Google making a lot of money off of dubious advertisements, if Google
can verify that a business is properly licensed to do what they advertise,
then Google shouldn't be at fault for any fraud that is being committed. If
someone shoots someone unlawfully and the gun was purchased legally, the gun
shop doesn't get in trouble.

------
solomatov
The price for clicks is exorbitant. No wonder, that everybody wants to sell
ads instead of selling products.

------
ballade
I can answer this.

Money.

