Reply All: #121 Pain Funnel

May 21, 2018 5:58 PM

An ambitious plan to help people goes off the rails, and a man from Florida tries to fix things the only way he knows how: with prank phone calls.Further reading:Cat Ferguson's reporting on Google and Rehab (The Verge) - Part ICat Ferguson's reporting on Google and Rehab (The Verge) - Part IIDavid Segal's series on the business around addiction (New York Times)Ryan Hampton's American Fix: Inside the Opioid Addiction CrisisPalm Beach Post's Reporting on the Sober Home Crisis
posted by eotvos (10 comments total)

The opening StartUp ad reminded me that I haven't listened to the StartUp podcast in two years. The American Apparel and CEO Whisperer episodes convinced me these aren't people worth spending even a few minutes of my life listening to.

I hope Reply All survives the imminent bankruptcy of their parent company, so we can hear more great episodes like this one.
posted by eotvos at 6:04 PM on May 21, 2018

I hope Reply All survives the imminent bankruptcy of their parent company, so we can hear more great episodes like this one.

Is Gimlet not doing well?
posted by Alvy Ampersand at 7:52 PM on May 21, 2018

That's kind of a sour editorializing note to drop in an almost-a-more-inside first comment, no?

Is Gimlet not doing well?

Hard to tell; they don't seem to be doing badly judging by the steady stream of new co-branded podcasts they're turning out. I guess those pay better than SquareSpace ads.

On the episode, though: an odd synchronicity that both Reply All and Last Week Tonight dropped episodes on rehab recently; both sourcing from the Cat Ferguson reporting.

with prank phone calls

I thought that playing the call was the weakest part of the episode; his high+autistic+18-year-old impression was simultaneously so silly and so borderline-offensive awful that it undermined the seriousness of the moment; so much so that the narrator had to pause to acknowledge it.
posted by We had a deal, Kyle at 12:06 PM on May 22, 2018 [1 favorite]

I would love to know how lasse-faire capitalists would solve this sort of problem. They'd probably just say mandating that insurers cover rehab was the mistake and the subsequent illegal and unethical behavior was a natural product of government meddling.

Never mind that the previous free-market solution was to not cover rehab at all because there was no money in it, leaving the people most in need of help bereft of options.
posted by Mr.Encyclopedia at 12:46 PM on May 22, 2018 [1 favorite]

I can tell you exactly what they'd say due to regular family contact with "classical liberals." They'd say that this is what happens when people aren't paying the cost of rehab themselves. Since it's not (wholly) their own money being wasted, they are easily taken in by these scams, and if they had to spend their own money they'd make better decisions. Which is a) victim-blaming b) ignores ample evidence that even when people are spending their own money they are easily scammed c) never actually addresses the issue of what if someone doesn't have 50 large to spend on a stint in rehab. That's usually solved by a sprinkle of invisible hand pixie dust that on the outside claims that we'll all be so much richer if we have true laissez faire capitalism (it cannot fail, it can only be failed) but on the inside really just means "if you don't have the money you probably deserve to die in a ditch of your addiction."
posted by soren_lorensen at 6:59 PM on May 22, 2018 [4 favorites]

I lived in south Florida before and during this craziness. It was weird to hear about it in this podcast, mostly because they could have gone a LOT deeper. For instance, they could have also related it to the pain clinic problem in Florida, which ALSO ended up shipping a lot of addicts down there, if even just as a temporary stay; a smuggler's road trip.

The Starbucks they talked about, I drove/walked by all the time. They actually had to make rules forbidding people with luggage/big gym bags outside of their storefront. I ended up making friends with a lot of people who were or had been 'in the program', and I have to say it's just horrible to treat people like this - there's absolutely a sort of brainwashing and dehumanization that happens, as well as a sort of "I am a victim and currently helpless; I can't be trusted; the person running my home is taking care of me and knows what's right" mentality that happens which is particularly insidious when sex ends up being involved.
posted by destructive cactus at 11:24 AM on May 25, 2018 [2 favorites]

This was a great episode. I really appreciated it's clarity and reporting. I guess I should follow this Cat Ferguson person...
posted by latkes at 9:53 AM on May 26, 2018

I just listened to two excellent podcasts that relate to these same issues:

Reveal profiled an appalling fake rehab that exploits addicts who have no income, forcing them to work for no pay in assisted living homes for seniors and people with disabilities. The addicts were compelled to work up to 16 hour days in the assisted living, and received abusive EST-style "counseling" sessions where other residents verbally abused them.

Hi Phi Nation just did a great episode focused on how courts are impacted by the philosophical concept of free will and the disease model of addiction. It covered a lot of ethical, moral, and legal ground with some compelling stories of how addicts and advocates interact with the court and incarceration systems.
posted by latkes at 2:14 PM on June 2, 2018 [1 favorite]

Excellent reporting again from Reply All, I love it.

I just wish they had more time to get more of the story. Because part of the design of Obamacare was evaluating the efficacy of treatment. At least that's the case for hospitals; part of the ACA is detailed data tracking on health outcomes. I would assume there's something in place for rehab, too. And it probably didn't work very well for the first few years but at least there's something? Maybe? Would like to know more.
posted by Nelson at 4:22 PM on June 4, 2018 [2 favorites]

Is Gimlet not doing well?

To be clear, I don't know anything about Gimlet's finances. I was just being a flippant asshole on the internet.
posted by eotvos at 6:11 PM on June 4, 2018