Why It Took Google So Long to End Shady Rehab Center Ads | Hacker News Reader

Why It Took Google So Long to End Shady Rehab Center Ads

bloomberg.com

77 pointschampagnepapi78 comments

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.

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.

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?

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

Could you please not go off on tangents, especially with personal barbs like this?

> This path we're heading down of expecting "the internet" to protect us from the latest baddies out there worries me

This isn't expecting "the internet" to do anything, though. It's expecting Google, a corporation, to stop helping bad actors promote their "services".

While Google would love to be "the internet", they aren't quite there yet.

I'm taking issue with the increasing prevalent view as represented in this Bloomberg article that has an unstated assumption that it's reasonable to expect or even demand that actors such as Google take measures to make these moral judgments.

If Google wants to and chooses to, great. But if they don't, I'd much rather see an article warning the public about the dangers of trusting Google ads rather than bemoaning that its easy for bad actors to buy Google ads.

And Google isn't 'helping' bad actors unless they charge them less than others or otherwise create an unfair advantage. Otherwise they're a neutral actor that is a reflection of a failed policy and/or law enforcement problem.

Bloomberg is in the Advertising business, they'll never take the stance that you shouldn't trust advertising. Their customers won't accept that.

So we get this. Blame google.

I'm sympathetic towards the argument that Google should do more, but besides banning these advertisements overall, how should Google verify a legitimate clinic vs an illegitimate clinic? Would these proposed solutions actually get in the way of scammers, or would they just add to the cost of doing business with no real gain for consumers?

The states (most, at least, and I think all) already take care of the verifying: you need a license to operate a treatment center. Google should require that they submit information about their state licensure to run a treatment facility. Patient brokers and sham operators presumably aren't licensed treatment providers and wouldn't be able to meet that standard, and if they're found to be falsifying their documentation, rather than just being booted from adwords they should be turned over to their respective states for criminal prosecution.

I work in the addiction industry, on the marketing side. I can tell you that the licensure requirements are generally a joke. Only Florida, California, and maybe a couple other states are tougher to open a treatment center instead of, say, getting licensed as a hair stylist.

Until the past year or so, all levels of government were unable to track down the shady operators. IMO, it's not Google's job to do what law enforcement was unwilling to do. (Now, Google could be extra ethical on this, but why would they be? Generally, we expect corporations to follow law enforcements lead, rather than hold them to a higher standard.)

I think the topology of information flow should determine who is responsible for doing what.

If Google is practically speaking the gatekeeper for these kind of shady dealers (because it sees both the consumer demand and the bad actors), then the most efficient system is one where Google is given both the responsibility and the tools to do the regulation.

In fact, Google might be in a better position to regulate this than the states are. What should the states do -- individually browse for ads on Google and then call up those places? This still places Google front and center.

This is the same reason central planning is a horribly inefficient system -- yes, in principle you can have the entire economy send their data to the central government, then the central gov't comes up with a plan and redistributes it to every factory -- but in practice a lot goes wrong in putting so many links.

I disagree, the onus falls on the state to actually make the licensing process strict.

How can Google be expected to do this at scale? To act as an extra layer of regulation that even local government cannot or will not provide?

> To act as an extra layer of regulation that even local government cannot or will not provide

Whoever possesses the data and information is the only actor who can meaningfully perform regulation. You can't effectively regulate blindly.

Right now Google has the most data, more than the various state and local governments.

So there's really two possibilities:

1. Google is 'responsible' for the regulation, under the delegated authority and monitoring of governmental bodies

2. Local governments retain the responsibility to regulate these entities, but they need the power to compel the necessary data from Google so they can do the job. That requires a lot of trust in various levels: that Google provides the correct data, that there is a way for local government to act on it, and for there be the right social 'API' in place where Google only shows ads from licensed entities.

At the end of the day, these are practically speaking the same thing, except we use different language to describe it. The 2nd possibility has more hops in it, so it's less efficient, but maybe it's safer.

It's kind of like how we do money transmission and terrorism finance regulation now -- the government is nominally responsible for making sure bad actors can't send money, but the only way to do that is for banks, PayPal, et al to send data to the government.

I thought we were opposed to Google using heavy-handed tactics to police the Internet. What if Google's enforcement ended up kicking a marginalized person off of their ads platform, or required advertisers to put their Real Names on their ads?

> I thought we were opposed to Google using heavy-handed tactics to police the Internet

When it comes to unpopular or corporation-unfriendly speech, yes. When it comes to outright scams, no.

I wouldn't call not actively helping bad actors promote their scams "heavy handed", anyway. Are rehab scam operators "marginalized persons" now?

Think of it as less of a binary. It's not "scam operator" or "legitimate operator". Much more nuanced -- the stories are about the clear scam operators, but that may or may not be the long tail. And that long tail may or may not be what we want to optimize for.

One of the major characteristics of a "scam operator" is this situation: Andy runs a treatment center that only takes Cigna. He gets a call from Bob, who has BlueCross. Bob can either do private pay at Andy's Center, for $20k. Or Andy can refer Bob to Mike's Center for BlueCross Patients, where Bob can get treated for $5k out of pocket.*

If Andy and Mike have a business relationship where they refer patients to each other, and either end up benefitting, they are breaking the law.

* Option 2: Andy tells Bob "sorry, we can't treat you. Try calling someone else."

That's not a solution - most states' licensing agencies are underfunded and ill equipped to fully vet these organizations. Many of these shady organizations have licenses.

That's just an argument for not cutting funding of government regulators. It's also a solid point against the little-to-no regulation folks who think the free market will solve every problem.

Problem is that addiction treatment is still in the dark ages. It's poorly regulated and often not evidence based.

http://healthland.time.com/2012/06/26/addiction-treatment-in...

>finds that most addiction care is administered by “addiction counselors” for whom there are no national standards of practice. It finds also that 14 states don’t require any education or licensing at all for addiction counselors. The risks to those seeking treatment can be dire: California is one of the states that allows uncredentialed providers, for example. In a recent case in that state, a sexual predator was found to be offering “intimacy therapy” to addicted teenage girls; treatment consisted of sex with him. Without oversight, there’s no way to stop people from preying on vulnerable people under the guise of addiction care.

>Only six states require addiction counselors to have a minimum of a bachelor’s degree; just one requires a master’s degree, according to the CASA report. The main qualification for treating addiction in this country is having suffered from the disorder oneself — a standard of care that would be considered absurd if any other medical condition were involved.

Even regardless of whether state licensing is sufficient (plenty of comments indicating it is not), how do you verify an ad based on these documents?

Is there a government database you can query? Does it contain all the valid contact details, e.g. website, phone numbers, so that they can actually verify whether an ad comes from the actual entity.

Ignoring the latter part will just land us in the same place as before.

The article is about Florida, where these legal protections haven't existed until recently.

Hooray for the free flow of commerce across state lines, so Florida clinics can import 75% of their "customers" form out-of-state.

Datum: medium and large treatment providers are willing to pay around a $5,000 CPA in sales and marketing costs. A huge amount of this, on average, goes to Google.

Just by removing AdWords from the equation, Google could reduce per-admit costs by thousands of dollars. (Of course, those costs would likely just go to third party lead resellers, who are in the grey area of patient brokering IMO)

When an ad is pennies, or even a buck per click, I can see your argument.

At over $100 per click Google can investigate every single one.

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.

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?

Regulators, the Federal Reserve, politicians, and commissioners ought to pay a price too when they inflict damage. How is it just for them to be immune to the negative consequences of their actions? Why don’t they even rate a mention in this list of culprits?

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

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.

It's the same argument for Facebook and questionable ads (IE current news). If you are a company making money in the ad space, you'll err on the side of money 9 times out of 10.

We are really just asking for that 1 of 10 here.

It's amazing what you can advertise on Google without penalty.

Khrushchev was prescient. We sold them the rope. Through an online self serve portal with keyword targeting.

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

To what problem?

To block ads offering something that is illegal? Illegal based on what laws?

To block ads based on offering something that is immoral? Even more subjective.

To block ads on offering something harmful? Still subjective, and it brings up other questions about things that are moral, legal, but harmful being blocked. Take a country which is running an add campaign to encourage its citizens to have more kids. Pregnancy is harmful to the body, so should such adds be blocked?

To block ads that not blocking will result in outrage (internet only or not) that costs more in value than the ads bring in? That's a pretty hard problem to create a general solution, and even attempting to could be an issue because it can be interpreted to mean that they are more focused on making money that stopping illegal, immoral, or harmful things. I mean, I think they are more concerned with money making, but that is just one of those things one doesn't freely admit regardless of how true it may be.

Ironically, the problem is advertisements that violate Google's own policies, and are in violation of the "rules" set by Adwords.

It's an indication that a business is too big to effectively manage, which is fueling a lot of the antitrust sentiment floating around now.

Maybe the issue is that there is no consequences for promoting known crooks...

>I used to be against ad blocking software Don't be and install ad block on your friends and family's computers whenever you see they don't have it installed

google could use this money to work with state's District Attorneys to go after these bad actors. this is a better solution than engaging in slippery slope of shutting off keywords and the like.

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.

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?

These shady centers have been testing the boundaries of the law for _decades_. Google is the modern version of the Yellow Pages.

This is a good article on the problem: https://www.theverge.com/2017/9/7/16257412/rehabs-near-me-go...

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

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.

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.

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.

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.

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.

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-...

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.

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.

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.

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.

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).

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>

"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.

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 :

  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...

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.

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?

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?

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.

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.

Scum comes along when there is room for ‘great margin’. That almost always comes when there is monopoly or deception. The subprime mortgage crisis happened when there was deception of investors about the quality of mortgage-backed securities. An effect of that was that companies that had no exposure to loan quality perversely had an incentive to originate large volumes of low quality loans. Mortgage brokers earn points on transactions, so a typical commission would be say 60 basis points on the loan amount. A $100k loan earns the broker $600. Typically this was paid to the broker and shared with any loan officer and processor employees(yes gatekeepers were paid commission!). Prime loans, home purchase loans, typically had similar yield spread premiums. Subprime loans were marketed so aggressively because their points ranged from 120-450, with the highest rates coming from Option ARMs. The same broker on the same $100k loan made $4500 vs $600. The rest is history.

Margin. If there’s enough of it, there’s room for free beer, more of it, call centers and big ad campaigns, more of it, Vegas parties and dark money. It doesn’t matter where the margin comes from, the result is always the same.

Source: I worked at a big mortgage lead gen company. Almost went to work for rehab lead site, then didn’t want to repeat prior mistakes.

I don't want them to be moral police, but they should be held accountable when they are a silent partner in a shady business.

It's just like pawn shops. After being robbed I realized that pawn shops entire business model is built on people who have stolen something and are happy to get any amount of money for what they had stolen.

What pawnshops do isn't illegal, but if you spend more than 5m in a pawnshop, you realize they wouldn't exist if it weren't for drug addicts who needed their next fix. I witnessed someone walk in with a backpack full of random stuff. The people working the counter clearly knew her, they asked jokingly: "who's bag is that?" her response: "it's yours now".

This is the secret of of facebook and google. This is what powers self driving cars and AI and massages at work and "moonshots".

If the best defense of your actions is "it's not technically illegal", you might want to reassess your business model.

The key is that Google's business model is not built on people that are behaving illegally. Google would obviously still exist if rehab scammers and other bad actors didn't. Given this, I find your call for Google to reassess its business model a weak one.

People just want short-term, feel-good solutions. Google monitoring for shady rehab ads is exactly that. It's a kneejerk reaction that doesn't solve the real issues. These centers will still exist and inevitably ads will slip through the cracks. This is a failure of society and law enforcement that just happens to be most visible thru Google.

No. This is not censorship. This is Google choosing to not do business with the scum.

And, given that Google is making money off this scum, they absolutely should be held accountable.

This will not work while the cost of identifying and stopping bad ads is higher than that of creating new ads. The same reason robocalls and Nigerian email scams still exist.

Google is in the best position to stop it, albeit with the spectre of a chilling effect. However even if Google completely cleaned house the bad ads would still exist because there are ad networks other than Google.

I would suggesting holding website owners liable for the ads that appear on their sites. It makes it easier to identify who needs to be sued. The buck stops at the name in the URL bar.

This is a poor solution because website owners are not responsible for selecting which ads appear on their sites: Google is.

(Also, note that this story is primarily about Google Ads that appear in Google Search, so Google remains the issue either way.)

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.

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.

"criminal enterprise"

Sketchy rehab sucks, but is it always a criminal enterprise? The fact that Florida had to pass some new laws indicates that may not be the case in many states even now. (Even in Florida, it would be somewhat miraculous if they got the new laws precisely correct on the first try.)

Even assuming an airtight law, where does the line get drawn? The gold-plated rehab that Hollywood stars use costs more than most insurance would pay. The rehab mentioned in TFA that keeps addicts high and prostitutes them was obviously a criminal enterprise even before the new laws. There is a lot of space in the middle, and outlawing very basic rehab might just mostly deprive addicts of that service. This is a difficult line to draw. One might imagine insurance companies or government regulators drawing it (even if perhaps they haven't yet...), but how could Google do so?

My impression is that Google's corporate cultural DNA is somewhat reluctant to insert itself into this sort of transaction in this way, but some other giant internet companies would be eager to get all in the business of assigning users to rehab centers.

Be careful what you wish for. My guess is, the results of a flurry of suits would be what you're seeing on YouTube right now, demonetization of anything remotely controversial. You'll get squeaky clean ads from large dominant corporations, and the only content able to monetize them will be squeaky clean large content providers.

Lost in the shuffle will be small content providers and small vendors who need to advertise. Then you'll be back on HN complaining about how Google is censoring everything and favoring big players, leading to greater concentration of media conglomeration, all the while ignoring that this is implicitly what you asked for by asking for costly regulation -- which doesn't hurt big firms as much as you think and primarily hurts smaller players.

The internet's come along way from the freedom we imagined in the late 80s and 90s. In my college Cypherpunk days, I wrote one of the first anonymizing internet proxies to combat the Communications Decency Act (http://web.archive.org/web/20011122042440/http://www.clark.n...), because at the time, the internet was pretty much the only place in existence where the government did not have the ability to regulate people's behavior.

Now we've arrived at a place where even so-called liberals, progressives, and civil libertarians, are calling for the government to censor indirectly, what can be published on the internet. And make no mistake, it is government censorship even if you are outsourcing that responsibility to private corporations via the civil courts, in much the same way that Extraordinary Rendition is still torture, even if the CIA outsources it to a third world dungeon.

The FTC does not punish public radio and TV because shady diet scammers are selling snake oil. They don't shut down radio for Chiropractice (a pseudo-scientific medical scam), or for "financial advice" shows which sell people obviously bad investment advice on "market timing" when they'd be better off with an ETF. On any given day, I'd estimate about 50% of radio ads are scams on my way to work.

How far do we take things to "protect" the public from scams and sex by censoring our media? How about harsh penalties for people operating the scams? Should you be allowed to Gmail because your spam filter let through an email scam and you got suckered by it?

I don't like your assertion that preventing criminal activity is censorship. Fraud isn't speech: It's a criminal act to sell one thing and provide another.

I also disagree that better moderation practices will hurt small players. Especially since most of the concerning fields of business will be high value lines. And Google cannot reasonably say it is unprofitable to sell advertising worth $230 per ad click if they have to verify it's quality first. It would be reasonable, I think, to suggest that humans should vet all advertising in these extremely high profit margin fields.

The primary issue here is one of perverse incentives. Google profits heavily off criminal activity, and so has strong incentive to not only permit it, but implement practices which encourage or enable it.

Google is a business, and businesses make decisions on profit. I'm sure you can agree with that. I'd hope you'd also recognize that the times in which Google does what is best for the consumer is generally the times in which those actions are also the best for Google. Like any corporation, it acts in it's own best interest.

I know I've agreed with some of your thoughts, like preferring optional SafeSearch-type filtering on YouTube over removing adult content, so my question is, how do we get Google Ads incentives aligned with consumers? How do we make it bad for your employer to sell high-priced ads that are criminal?

> Safe harbor effectively gives them immunity to prosecution for profiting on the malicious content they host

I do not think this is true at all. See, for example, https://www.theguardian.com/technology/2011/aug/24/google-se...

It depends a bit on the jurisdiction and type of case. For instance, SESTA modifies Section 230 of the CDA, which chiefly grants companies like Google immunity from civil and criminal cases stemming from state and local law. Federal criminal law is explicitly excluded, so the DOJ, for example, could still go after them[1]. Intellectual property is also excluded from Section 230, but, that is covered elsewhere: The DMCA grants them significant immunity in copyright infringement cases.

[1] https://en.wikipedia.org/wiki/Section_230_of_the_Communicati...

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

I can answer this.

Money.

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