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Predatory Behavior Runs Rampant in Facebook’s Addiction Support Groups (theverge.com)
325 points by DmenshunlAnlsis on May 21, 2018 | hide | past | web | favorite | 171 comments

My understanding from friends who spent time in 12 Step groups a few years ago was that the general consensus was for people in the groups to actively discourage each other from connecting on Facebook and other social media and from otherwise revealing their status as "recovering addicts" in these avenues. The expectation of this sort of thing happening was already there, and the principle of anonymity is already broken just by going online and discussing these things. As I understand it, the in-person groups were generally quite effective at self-policing to discourage commercial interests from creeping in. Of course, for people in rural, isolated situations some online contact with others might be the only option. Generally, the groups themselves run online forums and Skype group meetings for these situations. They may not be as flashy and all-pervasive as jumping on the latest social media hype train, but they are a heck of a lot safer when this sort of thing is going on.

Agree in-person help is required, but the groups aren’t for everyone. Personally I kicked my habit with a psychiatrist, a therapist and some new friends — sometimes that’s all you need.

Really the thing folks need most is someone they know knows their world. Someone to pierce the veil and tell you it’s all bullshit, and that if you want help you have to actually want help. This is what addicts are looking for online, and unfortunately it’s all too easy to manipulate people in this state.

Dealers and con men taking advantage of this ease of manipulation is as old as drug addiction.

This happens in NA/AA meetings too, but the sponsors are usually pretty good at spotting them. I don’t trust Facebook to play that role.

Not-connecting on FB might not be enough, since FB can and will connect the dots and suggest attendees as friends based on them being at the same place at the same time (thanks to location tracking from apps and whatnot).

Previous reporting by the author of this piece also inspired a great episode of the Reply All podcast last week. [0]

[0] https://www.gimletmedia.com/reply-all/121-pain-funnel

Totally agree. For folks not wanting to listen to the whole episode (although you should!) the basic synopsis is:

Obamacare mandated that all insurance should cover rehab costs. Several rehabilitation companies opened an enormous amount of "clinics" in Florida. "Rehab SEO" companies then offered services to these clinics to funnel patients to them. Clinics could charge upwards of $5,000 per urine test from the insurance companies.

It became so profitable, that rehab companies would pay to fly patients down to Florida, pay $1,500 commissions to the SEO companies, and more.

This system of misaligned incentives resulted in the "rehab" companies to buy drugs for their patients, so that they would fail a drug test. This would allow them to "reset" billing for that patient. There is an anecdote from a patient describing one such clinic directly next to a crackhouse with prostitutes. Apparently many patients spent years rotating through these clinics because they had no other options (except maybe homelessness, due to their addictions).

Florida eventually legislated rules that prevented this behavior, which resulted in many of these "rehab" clinics moving to California.

More reporting on this system:



I just listened to it last night. It was an eye opening episode. You could see how easy it is for desperate people to fall victim to the brokers.

That was a good and eye opening episode.

The same is true for anything remotely to do with credit or credit repair. There is a whole rat's nest of companies run out of the same PO Box in Minnesota that was shut down by the governor at least a few times now, but they basically have people go on and on about how these repair places worked miracles and post fake pics of "credit reports" that show these amazing 70-80 point boosts overnight. Now those sorts of jumps can happen but they are the exception, not the rule. They give shoddy credit advice to people so their scores initially go down to make them eager to sign up for a monthly recurring bill where they will basically sit on their hands and collect a check. It's revolting.

There's one of those that hawks bad terrible credit advice products on local PBS pledge drives, leveraging PBS's credibility to bolster her own. Same with the shady quacks peddling their snake oil. All revoltingly trading on the vulnerabilities of others.

I immediately assumed, upon reading the title, that this was some sort of Facebook Addiction group, rather than addiction groups on Facebook. I live a pretty shielded life as far as knowing/seeing legitimate drug addicts, but I found it interesting that I know many people who would definitely benefit from Facebook/social media addiction therapy. Probably communicating over email.

Along similar lines, Reply All recently did a segment on predatory "treatment" centers that basically milk money from Medicare w/o providing effective treatment:


Same author actually. But yes, Medicare fraud is all too common. I honestly don’t understand why — Medicare fraud is very easy to catch with modern analytics and the penalties are stiff. But it persists...

CMS is moving to outcome-based payments for this reason. Too many relapses coming from your treatment center? You get less per patient until your results improve. That should eventually help reduce this kind of behavior.

May reduce this kind of behavior but this type of measurement for competency selects for centers that only recruit and accept people that are likely to recover and not the hard cases (who are the people most in need of the service). Hard core addicts need not apply. The principle/agent problem pops up everywhere.

Slightly OT: John Oliver did an interesting, albeit satirical, piece on rehab centers last night.


I use reddit's stopdrinking subreddit - it's very good.

In some years we'll begin to see actual Facebook Addiction Support Groups.

Where will they meet though?


sad but true. I think we have a few already

> There’s a very long history of people going to [12-step] meetings and being taken advantage of by drug dealers

No, there isn't. This seems like another pop-culture meme that comes out of drug war hysteria.

It's on its face, not a great place for a drug dealer to find new clients.

In recovery you find people that already have access, trying to stop using.

I don't know about a long history, but it does happen today. Source: I know someone who is a substance abuse counselor.

I've been going to meetings for 21 years, and this is utter nonsense.

Perhaps different people's experiences are different?

21 years of direct experience all over the country is hardly equivalent to "knows a guy who said a thing."

Youre also just a guy who said a thing though

Reading the title, I had assumed this was just going to be the digitization of the typical AA / NA creep hitting on "fellow" attendees, or drug dealer looking for clientele. Instead this is predatory companies looking for a meal ticket.

I can't help but think just how much the internet opens the door to bad actors trying to pillage and plunder. Really makes this line of work feel like a massive mistake.

>Reading the title, I had assumed this was just going to be the digitization of the typical AA / NA creep hitting on "fellow" attendees [...]

One of my friends from high school jokingly told me they call that the thirteenth step. So it must be pretty widespread to have a name, which is sad. You go some place for help and your fellow attendees prey upon you instead.

It's understandable to frame it in this way, and there are legitimate predators who take advantage of people in those environments. The common case is more prosaic: addicts are often codependent and will seek romantic companionship amongst each other, especially in close personal environments like that. Starting a relationship early on in the recovery process is a common (yet tempting) mistake and conventional wisdom warns against it, which is why the phrase exists.

[I spent a few years in the orbit of 12 step programs in my youth]

I don't think it needs to be that sinister; people tend to form relationships with those they feel emotionally close to, and there's probably a pretty rapid onset of intimacy in support groups like that.

I'm not saying there aren't predators, mind you, I just don't think that every relationship there stems from one person trying to take advantage of another.

Also... there is a severely reduced dating pool for someone actively in the middle of addiction recovery. If I had met a girl when I was single who said “I’m a recovering X addict with 32 days sober” I most likely would have not been very romantically interested. And if I was, it would be hard to connect with something when I have no experience of something so dominant in her life.

Thirteenth stepping is common enough to have a name, but the other side of that is that people in every AA group I've been in are extremely protective of newcomers. Thirteenth stepping a newcomer is a surefire way to get castigated by your fellow AAs.

In fact, I've seen three people ever asked to stop coming to a meeting, and all three were for thirteenth-stepping or similar. Being asked to stop coming may not seem serious, but for some perspective: the third tradition of AA is "The only requirement for membership is a desire to stop drinking." People show up disruptively drunk or tripping and don't get kicked out. A large portion of our membership have spent time in jail for violent crimes. Before these things were accepted in society at large, people of color and gays were accepted into meetings. We take the third tradition very seriously--the only way someone is asked to leave is if there's justification from the first tradition ("Our common welfare comes first") so you have to be seriously impacting the welfare of other people in the group before you'll be asked to not come back.

I'll also add that there are resources available to protect people. There are tons of women-only meetings and most areas have LGBT meetings as well. It's also explicitly not against any traditions to involve law enforcement if sexual harassment, stalking, etc. occur--there's a safety card which explicitly announces this and it's read at the beginning of many meetings.

When people get more sober time, dating becomes more accepted--generally after a year. But generally this is done with strong admonishments to put the sobriety of both parties first, and we still look out for each others' safety.

I don't look at AA with rose-tinted glasses. It's a human program and it's imperfect. Certainly as an atheist I wish there was a lot less god nonsense. But the flipside is that I'd probably be dead if I were still drinking, and instead I'm 20 months sober and doing really well. Certainly 13th stepping is a problem, but it's a problem which many groups deal with fairly well, and I wouldn't want anyone to not get help because they are afraid of being 13th stepped.

"I have a problem and I want to share it with you."

Indeed, trust is precious and its just too easy for malicious actors to acquire trust from vulnerable people.


Exploiting people is almost never personal, no matter how extreme. I don't feel like that makes it any better

Helping people is almost never personal either. Doctors help people but it’s nothing personal, only business.

The only thing that defines whether you are a good or bad person, is what you do at a personal level. Even though I may contribute to horrific consequences on a business level, at the personal level I am still a good man.

So running a plantation on slave labor, mistreating those slaves, doesn't impact whether you are a good or a bad person? After all, you don't have anything personal against those people, slavery is just good business, and the more work you get out of your slaves the more money you make.

I'm all for cutting people slack for systematic issues, environment, zeitgeist etc. But just giving it a free pass because it's business seems very wrong. Most of the bad things in this world are "just business".

Many plantations were run without mistreating slaves. And many plantation owners had no choice but to use slaves as they couldn’t afford paid labor, or needed to keep profits up to stay competitive. It’s like holding a wolf by the ears: not a situation you want to be in, but not something you dare to let go.

Today’s equivalent might be H1B Visas, which many companies in the valley make ample use (and even abuse) of.

Many plantations were run without mistreating slaves.

Slaves are mistreated by definition of being slaves.

That's an impressive level of self-deception you've constructed for yourself there.

No. That is entirely false. A good person isn't going to do bad things and excuse them as being "just business."

>Even though I may contribute to horrific consequences on a business level, at the personal level I am still a good man.

It's true that on some level, we exist within a system that forces us to make bad choices, and in general I think criticising individuals for systemic issues is a waste of time, but you can't just say "it's just business" to dismiss all moral decisions.

If you are working for a company which you know to be causing harm, and you are in the privileged position to be able to leave without becoming destitute, choosing to keep working for them is absolutely an action which can be morally condemned.

It’s not that simple. Many companies cause some form of harm, but if you feel the ends justify the means there is no reason to leave.

And that, in a nutshell, is why corporations are their own moral entities, and not just "made of people".

Yeah, that line of thinking came up a lot at the Nuremburg trials.

Just following orders.

Compartmentalization doesn't make something right.

It's personal to the person.

It only "helps" if you want to dismiss the horrific consequences of the system because they make you uncomfortable.

There is a great recent Reply All podcast episode called Pain Funnel on shady rehabs. Diabolical, perverse-incentive capitalism at its finest. For example, giving drugs to teens kicked out of one rehab so that they can “piss dirty” to get accepted to a new detox/rehab. On top of the drugs, they give them a cash bonus for doing it. The rehabs then do stuff like urine screens three times per day which they can bill insurance at $5000 per screen. Insane!

"Don't talk to strangers" is applicable to social media, too.

You realise that advice is for children, right?

This is nothing new, rehabs do the same predatory shit and provide terrible treatment, in order to keep addicts relapsing and coming back. See John Oliver’s latest episode today.

Never thought about that. Poor treatment means repeat customers. It's the same thing that drives pharma to seek treatments for symptoms over cures.

> Marketers from the treatment center had to approve every post in the group, which gave them the first opportunity to privately message good candidates for their rehab and try to talk them into going to Windward in California. They needed that edge, Mendoza explained to me a few weeks ago, because they knew a Facebook group that big would be full of other marketers, waiting to swoop in as soon as a juicy message was public.

There is something uniquely... American about this comment. By that I mean that divorced from the ethics setting up large Facebook groups and using them to funnel patients into your addiction center is a great strategy, and it clearly works. It seems, to me at least, to make good business sense. That's not to say that the practice itself is unique to America, more that it's encouraged by the hyper capitalist 'profit above all else' that America espouses.

After taking a step backwards however then you're just exploiting/taking advantage of vulnerable people looking for help and using that to manipulate them into giving you money.

> After taking a step backwards you're just exploiting/taking advantage of vulnerable people looking for help and using that to manipulate them into giving you money.

This describes an uncomfortably large section of our (customer facing) economy. Casinos, tobacco, payday loan sharks, etc are the obvious actors. But if you look more closely, you will see that there are essentially two families of competing in b2c:

* productive: quality, service, price.

* destructive: bait and switch, seduction through marketing (unrelated to the actual product), etc.

All of the destructive forms eventually boil down to: abusing the faults in our human brain. Once you start looking at the world this way, you will see it everywhere. Almost every commercial on tv is destructive. E.g. car commercials never talk about car specs; they just try to seduce your fallible brain. Perfume. Clothing brands. Any food franchising (which are not about food, they are marketing companies who happen to sell food). Etc etc etc. None of these advance society forward.

There is an all-out, 24/7 war on your brain. It is what hippies mean when they talk about “buying shit you don’t need”. The only problem with that statement is it puts the blame with the consumer. But we are only human, and fighting a mental war 24/7 is exhausting. The problem is more insidious than mere gluttony / consumerism.

The example here is egregious and very clear. But make no mistake about it: it exists, in smaller form, everywhere you go.

"There is an all-out, 24/7 war on your brain."

And the sad part is that a lot of our brightest people work at Google, Facebook and others to win that war for the seducers.

When I was in college I really thought I wanted to make video games. But I watched my friends and I struggle with tuning out and falling behind on our schoolwork.

I got a job making new software and learned what a Skinner Box was and changed by plans. I don't need to be part of that.

As long consumers keep paying more to be advertised to (buying) than they're willing to pay to not (donations, subscriptions, boycotting) it'll stay a lopsided game.

It seems to me like there's plenty of good people willing to fight the good fight, but their lifestyle comes first and ideals second.

That only works if companies actually support that option. Many don't, because it would cut into the data that could be collected and remarketed.

Furthermore, try sitting down with a teen, twenty, thirty, or heck, anyone not technologically inclined and try to explain the causes and ills that "marketing" causes. It is difficult. However, many are aware of and despise it, but have no idea what to do about it.

I'm sorry, but GP is right. Advertising has gone too far. It really is just customer predation at this point. It is no longer about making sure your business is out there if the consumer comes looking, it is about exploiting every heuristic that can be used to short circuit the consumer making a conscious decision to see anyone else but you.

At some point, the intrusion and attention manipulation has to end.

> Many don't, because it would cut into the data that could be collected and remarketed.

The reason advertising companies collect all this data is to use it for marketing/advertising (among other things). The truth of the matter is that Google et. al. would lose users if they charged them what it actually cost to run and continually improve their services and make a profit (which is their prerogative/duty as for-profit companies).

Consumers may say that they'd be open to paying for services, but I have a strong suspicion this is not true at a large enough scale to be even worth exploring.

People paying for online streaming services versus cable may be a counter to that argument, although then it seems like it takes decades for the ad-fatigue to set in...or the ratio of ads to content has to steadily keep increasing until it reaches the tipping point where people would rather pay (and still throw a fit when Netflix raises their prices).

People paying for online streaming services versus cable may be a counter to that argument, although then it seems like it takes decades for the ad-fatigue to set in.

Pay-TV over cable arrived in the US in 1972. Netflix's streaming service was first available in 2007. The problem wasn't that people took decades to be annoyed by advertising on cable but that for decades Netflix (Hulu, Amazon Prime, HBO Now) did not exist. Once paid commercial-free streaming services arrived, uptake was rapid.

Your example doesn't refute his point.

20 years ago, I knew plenty of people who would be willing to pay good money for a TV service without ads.

Today I find almost no one willing to pay enough for, say, Facebook without ads. Most people I asked say $0 or $1/month. To get the same revenue as they currently do, FB would need to charge $20/year to everyone. Since many (most) will not pay that amount, they need to charge even higher.

I don't see how a company like Facebook would make that much profit without ads.

And to be frank, decent enough non-ad supported alternatives exist. I can't get one person in real life to switch to them.

News is another example that mostly hasn't worked without ad money. There are some examples (e.g. government funded), but even those don't have enough reach compared to what the ad supported ones did 20 years ago.

That it worked for TV is not an indicator that the general model can be applied to all ad-supported services out there.

My point was that advertising has gone off the rails, and on the offensive.

Advertising is "Hey, we're here!"

What they do now is more akin to attempted social engineering/psychological manipulation.

It's disgusting to see, disrespectful to everyone, and if I had to guess, I'd say it is fueling a counterculture that could very possibly put a leash on the current understanding of free 'marketing' speech.

News and the main stream media have the same problem. They focus so much on paperclip maximizing for viewership that the quality of actual useful productive content is being degraded in order to 'lock in' target audiences.

> As long consumers keep paying more to be advertised to (buying) than they're willing to pay to not (donations, subscriptions, boycotting) it'll stay a lopsided game.

The reason most American consumers prefer advertised-supported products to paid products is simply that can't afford them otherwise.

Unlike people in the top 10% of incomes, like most here on HN, most Americans simply don't have the means to pay an extra $10 or $20 a month here and there for various subscriptions or products. Almost 50% of all Americans have a negative net worth AND struggle to pay their basic bills like water, rent, electricity, and phone/Internet.

Once you understand this, then you'll understand why most Americans can't afford to pay for additional services even if they understood the true cost of advertising-supported services. Unlike the average software developer, they don't have an extra $1000 discretionary income a month to save or spend. They spend their entire income on necessities.

Plus, the cost of ad-supported services are not always evident to the average American, which reinforces their belief that it's not a bad idea to use Facebook and similar services (where they are the product).

And a pretty common consensus among technologists seems to be, "That's their fault. They should have gone into STEM. Losers."

stacked against people, this narrative goes. Even being on the wrong end of the structurally inherent information asymmetry between seller and buyer is the buyer's fault, somehow.

That should read "Despite the system being stacked against people."

How did they get there? Because they wanted to change the world to benefit the rich & richer?

Or is it the golden rule at play? He who has the gold makes the rules

The issue at stake here in the US is that money is the final arbiter (with a few exceptions that prove the rule). There is no higher authority (despite the religious types claiming otherwise - many of their clergy are also soaking in the lucre). So our bright, not-foolish engineers should not be solely blamed for the rules in place.

The amount of money that Google and Facebook make from these huge CPCs and CPAs is insane.

Marketers in this industry are bad and would find a way to do it without Facebook and Google, but you’ve got to admit the engineering/UX/product teams are indirectly enablers in the system as well.

People sneer when I say I would categorically ban all advertising, but the more I observe the more convinced I am of this. Advertising is brain manipulation, nothing more. It's unreservedly evil and harmful, and we would all be much happier without the constant bombardment.

Advertising can help people become aware of products they never though could exist. One recent example is a baby toy that sticks onto the high chair tray with a suction cup. I bought this $10 toy from an advertisement and because my daughter loves to play with it so much, mealtimes go much faster. I have probably already recovered 20 hours of cleanup time because of this toy, and an advertisement was the only way I’d know about it.

I don't know if we have to ban advertising, but we should stop giving people a tax break on it for sure.

how do you categorize business activity as advertising or not?

Businesses already categorize this stuff. It's just another color of money. It's more a case of them labeling lots of things as advertising that a might cause a reasonable person to narrow their eyes.

Buying ads and ad services for one. Not sure how I feel about 'market research'.

>Advertising is brain manipulation, nothing more. It's unreservedly evil and harmful.

I'm no fan of advertising (canceled cable decades ago, happily use Ad Blocker, etc). But these sweeping statements do not sit well with me.

Any time I try to persuade someone to do something, I am engaged in brain manipulation. As someone who in the last few years decided to take up subjects like negotiation and communications, most effective communication is brain manipulation - and not in a way that is significantly different from advertising. As the GP said - once you learn these topics, you begin to see it everywhere - in all the ways people talk.

For most of my life, I tried to convince people with purely objective means, and for the most part, it was a failure. If you want to achieve good for most people, brain manipulation is not just a nice-to-have - it is a must.

So declaring it to be brain manipulation is not, in my mind, a negative. It is unfortunate, but not unreservedly evil. Certain applications of it are evil. But banning advertising wholesale is just a lazy way of not dealing with the problem.

The fact of manipulation is, itself, morally neutral. When you manipulate someone into something that's against their interests, but serves yours, and that manipulation is done by means of shading (if not worse) the truth somehow, it's pretty unambiguously a negative, in my book.

Unless you somehow think that having a "society" or "economy" is predicated on that kind of manipulation. I actively repudiate that notion, personally.

Some people who have been considered great leaders have manipulated people into something that is perhaps against their interests, but in the long-term interest of society at large. It's hard to say that the soldiers who died in the Civil War had their "interests" served, but it's a lot easier to make the claim that fighting that war was better than the alternative.

Thanks for your opinion. Do note that nowhere in my comment did I endorse manipulation by shading the truth. Nor did I suggest all manipulation is OK. My parent was making a statement without qualifiers, and I was highlighting the dangers of such statements.

>The fact of manipulation is, itself, morally neutral.

I don't disagree. The person I was responding to, however, seems to.

Computers and the internet have given us unprecedented tools to introspect human psychology and perform hyper-targeted campaigns more fine-grained than even just individuals. Companies are weaponizing these tools to hijack our collective brains and alter our behavior for profit via marketing and advertising.

One could argue that we've been influenced by ads for centuries, and the concept of targeting isn't new. But this is one of the cases where a change in amount (how detailed targeting gets) becomes a change in kind. Yes, it looks like the same thing as before just with more data, but it's actually a fundamentally different kind of thing.

Every time we make a discovery or invent a new tool we play around with it for a while, exploring its uses and implications, and find its boundaries. Atomic energy for example. Before we knew exactly what radioactivity was Marie Curie carried around bottles of highly radioactive stuff in her pockets, she was so nonchalant about it that now her notebook has to be kept in a lead box, 100 years later. Since then we've created power sources and weapons and had disasters. Now everything highly radioactive is regulated and tracked.

We're in the "Marie Curie" stage with our advertising tools. We will need to dial back how nonchalant we are about employing these tools against others eventually. Either it comes from within the industry, or it comes from regulation, or we devolve into a dystopia where companies more and more literally own your mind.

This comment makes me feel both hopeful - we did learn about the dangers of atomic energy and have found a pretty stable balance between the useful and harmful aspects of it (weapons stockpiles aside), and hopeless - I don't think we'll come to grips with computers and the internet before the powerful have weaponized our brains against ourselves so thoroughly that reining them in is impossible.

"They Live" is a cheesy sci-fi movie on this topic that should be mandatory viewing.

Absolutely. I've often thought that this is the right time to remake it. It's definitely an artifact of its time, focusing on 80s economic struggles and the rise of the yuppies. You'd have to update it to more modern concerns, but given rising inequality, it wouldn't be hard at all. An ersatz Mark Zuckerberg, for example, would almost have to appear.

This movie also contains one of the best action hero bravado lines ever. I won't quote it here, as I think it's worth discovering in context, but I promise you'll be saying it after.

I rewatched this movie a few weeks ago with some friends that hadn't watched it before. They absolutely loved it. I'm not fan of remakes, and I think this movie is overly very critical to be remade today. Today, viewing the original one should be mandatory.

If you played Duke Nukem 3D you already know most of the lines of the movie.

I love that quote.


in my mind, a sequel to They Live would pick up ~30 years after the events of the first film, where it becomes obvious that everyone saw the ghouls in their midst and responded by essentially shrugging. it seems to me that's pretty much what happened irl.

another aptly named is branded. basically bringing capitalism and big marketing to russia has some fantasy elements.

There is a great BBC documentary that talks about this war on the brain called "Century of the Self" [0]. It's four hours long, but the first hour covers the gist of it. It goes into the want vs need and how businesses have been taught to utilize this part of our mind.

[0] - https://www.youtube.com/watch?v=eJ3RzGoQC4s

yeah, i read a book on what you're talking about. it's real.

the book is called phishing for phools: https://press.princeton.edu/titles/10534.html

especially on products we're not knowledgeable about, we're vulnerable to get phished.

Not to be too meta, but the hardcover is $10 off right now if you get it from Amazon Prime. Great impulse buy.

Not just for selling products and services. The very same techniques are constantly applied to get someone on your side of a political divide. Persuasion tricks warfare with every tweet.

I don't know what we do about the bigger part of this problem, which is that the only people 'exploiting' the virtuous side of this equation (manipulating your brain to get things that build you up instead of break you down) consists almost entirely of non-profits.

That is, if you are in the business of giving people a legitimate reason to feel good about themselves, you're either not 'in business' or soon won't be.

> There is an all-out, 24/7 war on your brain.

And so alarmingly many of the "trust the market" crowd with whom I've spoken simultaneously hold the position that if you've been taken advantage of by marketers who are leveraging the flaws in your brain against you, that's your fault.

I'm just, "Buh?"

A very small handful of cars on the market are competing to be a transportation appliance. The rest exist because people are willing to buy driving enjoyment, subjective quality, lifestyle projection, etc. above and beyond point A to point B transport.

This is largely an outgrowth of the used car market. People that are price sensitive tend to buy used, so car companies only survive by convincing people to make bad decisions.

Mind your wants because somebody wants your mind.

Do you remember the Michelin commercial that's just a baby sitting in a tire? A little on the nose, there.

My libertarian coworker used to say to me, "well, you don't have to buy the product". He didn't buy my explanation, which was this isn't people just asking you to buy their product in an annoying manner. Its straight up psy-ops (psychological warfare) at this point.

can you give a specific definition of what constitutes psychological warfare or not, that you can present to a jury and get a reasonable judgement from reasonable people. Let's make it a standard that is specific enough that a jury would be less likely to be swayed, for example, by the color of the skin of the defendant or plaintiff.

I don't have much hope for us finding a legal definition of what psychological strings you are and aren't allowed to tug on and how hard. War crimes set a line for tugging until they break. It's a lot easier to define "way too much" than "too much".

This discourages me from wanting to go into long thought train about what I would like to outlaw. What I feel more confident about is adding lots of friction to the system.

A specific definition of what is psychological warfare is required only if you're trying to enforce it by law.

>The only problem with that statement is it puts the blame with the consumer.

There's nothing wrong with that. You have to. It's where the change will most immediately happen. Grandstanding about how society is at fault etc etc won't change anything in the near-term. Corporations don't give a shit about the ethics of the situation. A more informed citizenry is the only way anything will realistically change.

Edit: Thinking about it more, it's 100% the fault of citizens. If everyone decided "you know what, fuck McDonald's" and stopped going to them the following day, the company would be sent into a death spiral that would have rippling effects of various degrees across the entire global economy.

You could say that the solution is that citizens should ensure a legal system that protects customers, prohibits predatory practices, and has a strong enforcement system. But that's still up to citizens to make that happen, it won't happen by itself.

The problem is that its hard to find more calories/$ without investment in ingredients and a kitchen; it's hard to fault the poorest people for buying what seems economically rational in the short term.

People eat at McD's because they want a burger and a quart of carbonated sugar water for five bucks and don't give a shit about their health, not because they are poor.

The bulk of their customers have kitchens and could make better meals choices.

Historian Walter McDougall has written about the duality of the American term "hustle", which means both "being a go-getter" and "scam". He's writing a whole three-volume history of America from this perspective that I keep wanting to find time to read: https://www.nytimes.com/2004/03/28/books/free-to-be-you-and-...

That's always had resonance for me, especially here in startup culture, where the line between the two is at best hazy, and is often willfully erased. Just today in Jean-Louis Gassée's article on Theranos, he quotes an old Silicon Valley joke about a pitch that shows both kinds of hustle: "It’ll work because it’d be cool if it did." https://mondaynote.com/theranos-could-have-been-stopped-9670...

I'm not sure what basis you're using to suggest that exploiting addicts is somehow unique to (or uniquely bad in) the US, but you should read the histories of England, China, India, or any other industrialized nation for more context.

If you meant that this is a capitalism/free-market problem and the US is the poster child for those values, then I agree with the sentiment, if not the phrasing.

> If you meant that this is a capitalism/free-market problem and the US is the poster child for those values, then I agree with the sentiment, if not the phrasing.

Yeah, that's what I was trying to say. I've edited it a bit to make that more clear.

I would argue that it does seem uniquely bad in the US, and that could be for a number of reasons like significant differences in drug use compared to other developed nations[1].

1. https://recoverybrands.com/drugs-in-america-vs-europe/

I'm looking at moving to Denmark, and as part of my reading I was surprised to learn that public sector employment accounts for 40% of full time jobs.

For all the bad rap it gets about being inefficient, some things really ought to be run by the government, especially when public money is involved. I find it hard to believe that a government run system could be less efficient than one that has to pay off insurance companies, recruiters, and mass marketers, all with what seems like little oversight.

> a government run system could be less efficient than one that has to pay off insurance companies, recruiters, and mass marketers

...and lawyers. Apparently many software, hardware and medical drug research companies spend more on legal fees than research (!!!).


Open markets require rules, enforcement, a fair and impartial judiciary, etc.

Plutocracy, kleptocracy, laissez faire and such may be more efficient, but they’re intrinsically unfair.

So as to effectively but inefficiently beat the hell out of or defend against competition by way of patent shenanigans.

> I find it hard to believe that a government run system could be less efficient than one that has to pay off insurance companies, recruiters, and mass marketers, all with what seems like little oversight.

What makes you think that the government wouldn't also have to work through those hurdles?

Government is notoriously inefficient, especially at scale. If government demands a process be done in the public sector, then there is zero competition and little innovation in the process.

> What makes you think that the government wouldn't also have to work through those hurdles?

Fewer conflicting incentives, for one.

I'd say that government is more legendarily inefficient, in the sense that it's something people just say without much data to back it. I've done chunks of consulting for both governments and very large companies. I don't think one is particularly more efficient than the other. The problem is more large organizations than their revenue model.

One real advantage government has is a sense of mission. I've met plenty of people in public service who really do view it as service to the public. At a large company if you want a bunch of people to row in the same direction you often have to make it personally valuable to them in the sense of explaining why it's better for their careers or their wallets. In government, I've had plenty of luck appealing to a sense of purpose, of doing good for the citizenry and the people being served.

If anybody would like to see for themselves, I recommend Code for America's annual conference, which is coming up at the end of the month in Oakland: http://www.cvent.com/events/code-for-america-summit-2018/eve...

The one time I went I met a lot of people who were excited about the way modern technology let them be radically more user-focused than old bureaucratic and/or computerized solutions allowed.

anecdotal, but I worked a government contract job (with a union involved, if that matters). In that particular setting, it felt more like a "welfare with dignity" program: the work being performed only required a couple hours of each person's work day leaving excessive time to sit around. If you were a union employee and decided to work more than was necessary, well, that was very frowned upon by your peers. Didn't enjoy it so much, but it paid well and I did it while I was in college. Once I graduated, I moved off to find employment in development. I could've tried to wait for an opening for development at that place, but it had a very interesting dynamic: if you were a union employee, fellow union employees were nice to you (for the most part). If you crossed over to a management position, which application development was... it becomes a very toxic environment. Shame, really, as the people were good people outside of that weird us vs. them mentality.

I have looked at the various Code for America endeavors and you're right: it does appear that people who are part of it feel very motivated by mission, so things like that are probably a very strong net good.

Competition is also inherently inefficient though. It involves having at least two organisations doing the same thing, which likely involves a lot of duplicated effort.

It also leads to organisations spending money on things like advertising, which serve little purpose for the consumer, and exist only to improve their position relative to their competitor.

Competition can be better in some cases, but I'm increasingly sceptical of the assumption that it's always better, since it has these downsides.

And I don't think there's any inherent reason why a government organisation can't innovate, they usually just don't have the resources to risk doing anything they can't be sure will work. I suspect there are plenty of people in most government agencies who have ideas about how to make things more efficient, if only they had a bit of flexibility in their budget to try them. This is largely a political issue, not an organisational one.

Please don’t conflate competition with incentives.

This anti government narrative is very simplistic. Any large organization is going to have some amount of inefficiency be it government or private.

How does anyone know how inefficient or efficient any large organization is since they are all complex and different? Without transparency and proper methodology identifying areas of inefficiency, drawing sweeping conclusions either way is more an ideological position.

Banks have just been bailed out with trillions of dollars, where is the efficiency. The pharma and telecom industry is routinely exposed for price gouging. And the corruption investigations against private educational institutes has recently been dropped by the current administration. These inefficiencies are simply transferred to the public in higher costs.

> Government is notoriously inefficient, especially at scale.

This is simply not true. It’s true for many branches of American government, partly due to the efforts of anti-tax advocates, but there are many highly effective governments worldwide.

Which corporations are as transparent, responsible, accountable, law abiding as the government of Denmark?

Denmarks public and private sector is very efficient and have a yearly 2% effeciency demand to the public sector. But Denmark is also a small and very homogeneous country.

Just for clarification, are you saying that they need to increase efficiency 2% each year?


It's not implemented 100% and there are exceptions but most parts of the public sector are required to find ways to do more for less every year. Obviously the idea is to use technology or better procedures.

This doesn't mean that the public sector doesn't grow just that it has to be more effective with it's money.

If so, how is that measured, and what are the consequences (to whom) if it isn't met?

"Government is notoriously inefficient, especially at scale."

No more than any other similarly sized organization.

Scientology does the exact same thing, they have all kinds of programs targeting addicts because they're easy game.

If your business model starts to look like a copy of Scientology you should probably question your ethics.

It's a refinement of the age old religious pattern of doing charity work with ulterior motives. Build a well and a church. Provide food after a sermon.

That's a ... stretch. One is making people pay for your service with a bit of their attention, and the other is intentionally targeting your malicious message at people you know are mentally unwell.

Hmm. I was speaking mostly in a historical context but I didn't make that clear. I don't think most churches do this today, and the Scientologists are peculiar in that way, but it was a distinct problem for a very long time, until social anthropologists and friends started calling attention to that sort of behavior.

After taking a step backwards however then you're just exploiting/taking advantage of vulnerable people looking for help and using that to manipulate them into giving you money.

And not doing that would be a case of "leaving money on the table" - a cardinal sin.

And scaled up that gets us "the world's dumbest idea", the cult of maximizing shareholder value: https://www.forbes.com/sites/stevedenning/2015/02/05/salesfo...

Wouldn't say it is dumb. It is rapacious and imoral but not dumb.

It is rapacious and immoral, for sure. But it's also dumb, in that a) it ignores the whole reason society created the idea of businesses in the first place, and b) its inherent short-termism makes it ineffective at accomplishing its stated goal.

The reason we invented commerce and later corporations is that we can create more value for each other than we can create for ourselves on our own. Systemically, businesses exist to create more value for their customers than the business extracts in cash. Profit is a side-effect of serving customers, not the purpose. In practice, almost anybody hauling out the "increase shareholder value" line is justifying some sort of short-term thinking that increases cash returns at the expense of long-term assets like loyal customers and happy, highly-trained workers.

It's a dumb idea. And don't take it from me; the article has many famous capitalists saying so. Further searches will lead to many others saying why, including many business school professors.

Some counter examples of hugely successful (not dumb) and completely immoral enterprises:

* The conquistador and later Portuguese ans Spanish empires "strip mining" the Americas

* Both East India companies (Dutch and British) "strip mining" India and south east Asia

* The slave trade and various industries it enabled (e.g. cotton and sugar)

* Colonial financial interests of the US in the Americas

Closer to our times checkout the "Friedman Doctrine": "There is one and only one social responsibility of business – to use its resources and engage in activities designed to increase its profits so long as it stays within the rules of the game, which is to say, engages in open and free competition without deception or fraud."

As to the "many famous capitalists" you mentioned, it doesn't really matter what they say but rather what the businesses they manage do.

I'm not saying being evil is always obviously dumb. I'm saying the "increase shareholder value" meme is dumb.

In America, the only solutions deemed virtuous or worthwhile are the ones that drive revenue and solve the problem in some form or fashion -- with many cases the scales tipped heavily in the drive revenue side and offering a minimally effective solution. The solutions that are almost never considered are the ones that would almost certainly offer no profitability, but generally be the right solution for the individual, and society as a whole.

It's not even that hard. You don't have to solve the problem, you just have to appear to be solving the problem.

I used to work with people who did this. A lot of it does appear to be uniquely American, but the human element is this: these groups have all 110% convinced themselves they're saving those poor unfortunate people. A little marketing, they make some money, poor unfortunates get the help they need.

One organization literally refers to patients as "rescues". and this is one of the better actors in the space.

OTOH, these efforts help "raise awareness" and "save lives", more lives than if nothing had been done. It's extremely cost inefficient, but a self-interested naive outlook allows a straightforward rationalization process.

In essence it all started with Freud’s nephew in the us. See this review of ‘The Century Of Self’ and watch the BBC documentary on YouTube. You’ll be amazed: https://www.psychologytoday.com/us/blog/sacramento-street-ps...

Adam Curtis has made quite a few documentaries that are really worth watching. A few that spring to mind are:

  The Trap
  All watched over by machines of loving grace (Essential viewing for hackernews readers, I think this is his best work)
  Bitter Lake
They are not without flaws, and sometimes I think some of the connections made between events are a little far fetched.

However they are thought provoking and extremely well made.

You may have already seen it but last night's episode of Last Week Tonight with John Oliver covered real world addiction treatment centers and almost all of them like the ones described in that article - no scientific/medical evidence backed treatment, no real data on effectiveness, mostly unregulated/unlicensed but heavily targeted at people who have money/insurance plans. The only surprising thing is the ones covered in the Verge article are I think different from the ones mentioned on the TV episode.

You even need to look skeptically at your family doctor these days, too. Is she sending me for more blood tests or an X-ray because she really thinks there is a problem, or is she just hustling, spreading my insurance company’s money to her pals at the blood and radiology labs?

Honestly I have no way of knowing. Sending me for all sorts of tests would indeed maximize shareholder value, though, which is all anyone in the US cares about anymore.

This is why I like the Kaiser Permanente system, where you buy your insurance from the same company that provides your healthcare. It has other problems (notably that they are loath to send you somewhere else if they don't have the expertise in their system) but it is nice that they're incentivized both to keep you healthy and not over-prescribe or over-treat you.

That's a CYA thing. In the US you'll get sued if you didn't order a test for the one-in-a-million thing that otherwise looks exactly like the 99.9999% thing.

It’s very American, but not unique to America. Take for example Japan, which has an issue with homelessness like most other countries. One of the industries that’s emerged are “poverty businesses” which run private shelters as NPO’s. What they do is usually rent or buy unused corporate dormitories, put up some cheap walls and turn a double occupancy into 2-4 double occupancies. Then they get homeless people, hook them up with lawyers and help them to get their social welfare payments. So far so ok, but the end result is that they take up to 80% for room and very basic board.

When I read the post title, I expected something a bit worse than pitching rehab clinics to addicts. What's the ethical dilemma here, assuming the rehab clinic is being run in good faith?

That a lot of them are not run in good faith, and frankly most of them have zero evidence backing them up in terms of their effectiveness, all the while preying on some of the most vulnerable in the population.

They aren't being run in good faith and some of the worst ones even desire addicts to relapse so they can have return business.

On top of that, they don't provide anything even approaching evidence based care.

Presenting yourself as giving honest advice while taking kickbacks from the clinics. It's advertising by pretending to be someone that cares about you. It's just cruel.

> 'profit above all else' that America espouses.

It's more about working with human nature instead of against it. Doubting virtuous intent seems important too, but maybe that's just me (and not you credulous folks).

Yes, because greed and predatory behavior are strictly limited to America.

>the hyper capitalist 'profit above all else' that America espouses

They learned it from the best. The Dutch East India Company, the British South Africa Company, and a couple of dozen others.

People in stone houses shouldn't throw glasses.

Agree. This mentality stems from the "Friedman Doctrine" which says that all a business should be concerned with (so long as it acts within the law) is maximizing shareholder value. America was captivated by this idea, and it's still how most think about business here.

This has been one of the most insidiously destructive forces in the modern world. Luckily the millennial generation (even in America) is largely rejecting this conception of the purpose of business.

You can read Friedman's Op-ed in the NYTimes espousing this here: https://www.colorado.edu/studentgroups/libertarians/issues/f...

Wouldn't the corollary of Friedman's position be that if businesses take actions that people in society find offensive (such as preying on vulnerable individuals), that those people should therefore work to change the law?

I think Friedman's point was more that 'businesses' don't make decisions, people make decisions, and there are two classes of people involved - the people who own the business(principals), and the people who run the business on their behalf (agents). His article argues that the agents should carry out the principal's wishes (which does can include ethical concerns), not their own.

"Of course, the corporate executive is also a person in his own right. As a person, he may have many other responsibilities that he rec­ognizes or assumes voluntarily–to his family, his conscience, his feelings of charity, his church, his clubs, his city, his country. He may feel impelled by these responsibilities to de­vote part of his income to causes he regards as worthy, to refuse to work for particular corpo­rations, even to leave his job, for example, to join his country's armed forces. If we wish, we may refer to some of these responsibilities as "social responsibilities." But in these respects he is acting as a principal, not an agent; he is spending his own money or time or energy, not the money of his employers or the time or energy he has contracted to devote to their purposes. If these are "social responsibili­ties," they are the social responsibilities of in­dividuals, not of business.

Much of the best writing I have seen regarding the relationship between individual 'virtues' and economic growth is Deirdre McCloskey's "Bourgeois Virtues: Ethics for an Age of Commerce"


> Wouldn't the corollary of Friedman's position be that if businesses take actions that people in society find offensive (such as preying on vulnerable individuals), that those people should therefore work to change the law?

I've had exactly that said to me in a discussion of pollution: I.e. someone actually said that corporations should pollute to make more profit to the legally allowed extent of the law, to maximize shareholder value, and then they can pass laws to reduce the legally allowed pollution levels, rather than just instructing management to not pollute.

(My reply involved VW emissions scandal FWIW.)

That argument assumes a dividing line between business and influence on lawmaking that doesn't exist.

If Corp A is reaping the profit while the cost is diffused then Corp A is in a far better place to influence future laws than those they are harming.

And by the same guiding principals, Corp A should influence the law to the extent allowable by law, including changes which allow them more legal influence, and remove the influence of others.

Oh yeah, I know. I took it as yet another example of how ideology or dogma degrades reasoning ability.

The purity and simplicity of the "Friedman position" is seductive. But I just don't think it is fundamentally valid to e.g. pollute to make money just because you're acting on behalf of someone else.

From the article: In an ideal free market resting on private property, no individual can coerce any other, all coopera­tion is voluntary, all parties to such coopera­tion benefit or they need not participate. There are no values, no "social" responsibilities in any sense other than the shared values and responsibilities of individuals. Society is a collection of individuals and of the various groups they voluntarily form.

Someone should inform the members of "Affected by Addiction Support Group".

Answering to this complaint, we have a business model called the B Corporation (as opposed to the C Corp):


Why all the downvotes to the parent?

The pentagon recently revealed it can't account for 21 trillion dollars. [1] The 18 US security agencies and military cost vast sums to run. The bank bailouts are trillions more, nickle and diming public services is an ideological position.

Civilized societies see a healthy and educated population and infrastructure as the beginning of building a progress oriented society, market fundamentalists like Friedman see it as an end, a process from which they can extract profits. This is an impoverished self-limiting vision.

[1] https://www.forbes.com/sites/kotlikoff/2017/12/08/has-our-go...

Strong found a dwelling for the weak, and preyed on them.

That’s just Sutton’s Law at work.

(Willie Sutton was a notorious bank robber, who allegedly upon being asked why he robbed banks, replied «Because that’s where the money is!»)

While distinctly in poor taste, it can hardly be a surprise that these groups are preyed upon by marketers.

To some extent this is like the garbage for profit universities, for which Federal student aid is the target and the wrecked student finances are merely collateral damage. In this case insurance money is the target, and its not important whether anyone is helped.

What makes such problems difficult is that they precisely cannot be solved by throwing more money at the problem which in many cases can exacerbate them.

> “I reached out to Laurie to see how I could help,” Calvert responded when I reached out to her.

Man, what's with this fascination with "reaching out"? Here we a sales person targeting victims of addiction for a sales pitch terming it "reaching out", setting up some pretty negative associations of that phrase. Yet the journalist is so conditioned they use the very same words for the process of requesting a comment from one of villains of the story!

I guess it's just poor editing, but the blindness is still remarkable!

You could spin it even more, calling it an “outreach program”! Yeah, that term has come to be industry standard for “I want something from you, so I am going to now insert myself into your life until I manipulate you into giving it to me”.

The weak, the desperate, the vulnerable--these are always the first to be victimized by the self-interested and unscrupulous, the scammers, the cons, the gutter scum.

You could say the same thing about doctors. How dare they try to collect a paycheck saving vulnerable trauma patients who can't even consent to treatment.

To me, where it becomes a scam is if/when they proffer completely ineffective treatments. If this place happens to make a buck while saving someone's life, more power to them.

"You could say the same thing about doctors. How dare they try to collect a paycheck saving vulnerable trauma patients who can't even consent to treatment."

No, you really can't.

Therapy is a terrible match for the free market. The fundamental axioms of free trade are in contradiction when participants' irrationality is one of of the axioms.

Look at how aggressively advertisers bid for ad spots on [credit counseling services] https://www.google.com/search?q=credit+counseling+services

I know the “correct” Silicon Valley position is to be anti-death penalty, but damn there are some people who need to be doused in gasoline and set on fire.

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