I don't know about privatizing drug rehab programs.... Why not a government-funded system, available to everyone, that provides real treatment and diversion and recovery rather than insanely punitive measures designed to boost the prison complex and its profit margins?

Not everything government-funded is bad. And the open market is not the answer to every problem. Too often, a free market solution means that poor people get nothing, or get the McDonalds version of the solution.

McRehab is not going to be good enough, perhaps especially for the poor, those with more reason to fall into despair-induced drug use in the first place.

Every dollar spent on drug treatment, or on education, or on preventive medicine, or on literacy programs for prisoners, or on similar projects, produces a SEVENFOLD return in the form of lower recidivism, shorter parole times, lower rates of AIDS and other expensive health problems, and higher taxes paid back into the system. 7 to 1. Pretty good odds.

Let's just pay for proper rehab, instead of turning it over to some insurance beancounter's bottom line.

I'm sorry, Rin. You're quite right. It's usually government-run institutions that are most responsive to people's needs. I mean, there's the Post Of . . . wait. Well, there are the public sch . . . oh, darn. Of course, Housing and Urba . . . the Dept. of Comm, the IRS, the Department of Educa . . . hm.

Well, I'm sure there's something out there that supports your argument. As soon as I can think of it . . .

The only methods I can see that would reduce drug use in the US are unacceptable from a Constitutional viewpoint.

Our criminal justice system cannot even keep criminals serving time from getting drugs. If that goal is out of reach, then keeping drugs out of anything even remotely resembling a free society is AFI (absolutely impossible).

Certainly there is a certain inefficiency in government programs... but that's not inherent in the concept of government programs, but in their implementation. Just as religion is often used to justify torture, oppression, and murder, but those practices are not inherent in the concept of religion.

A well-run government program, funded efficiently by taxpayers pooling their money for the good of the community, is the most effective way to get services to the bottom tiers of the society, fairly, impartially, universally.

For-profit enterprises would serve the top tiers well, obviously. Private hospitals, schools, and rehab clinics are lovely and effective.

But the corporate world has not shown much interest in taking care of the little guy. They don't provide decent wages or insurance or safe working conditions, beyond the level to which the government forces them to rise.

The very purpose of a corporation is to maximize profits while minimizing costs. How well will that serve an impoverished teen drug addict with no assets?

I'll agree all day long that government programs have had serious flaws and have produced serious frustrations in those they should have served. But that doesn't mean that it is impossible for government programs to be efficient, well run, cost effective, and -- because they don't operate on a profit motive -- far superior to private services.

Medicare is an example, by the way. It runs at an overhead of something like 4%, while private insurance providers-- which have to make the CEOs and shareholders rich, and must therefore minimize outlay while jacking profits -- run at an overhead of 30+%.

Let's make government programs better, not shrink government's ability to fund programs so much that it can be drowned in a bathtub.

Rin, I wasn't suggesting that the ideal rehab programs are for-profits; I was suggesting that the idea rehab programs are sensibly run nonprofits--usually composed of those who have directly experienced the problem they are trying to solve.

I think it's much better to have members of the community controlling these efforts, rather than government bureaucrats. I agree that for charity work, the nonprofit model is more practical. Of course, a lot of the people who do this kind of outreach do in fact have some kind of religious faith, so that has to be factored in: do we fund the churches and synogogues who are back these efforts with public money? Or do we let them do their own fundraising?

Given how generous Americans are, if we keep taxes as low as possible it will keep a lot of charities/nonprofits healthy.

Run by people in the trenches, I can understand. Funded by individual choice seems more risky.

Everyone gives to the cute-baby rescue fund. How many people give to the HIV-positive hooker who needs rehab for heroin fund?

One advantage of government funding and oversight is that a program has to be equally available to all, regardless of whether s/he's nice, religious, smart, or useful to society.

If a private or religious organization will provide help indiscriminately, to all who need it, regardless of affiliation or background or personality, then I'm ok with government funding of that program. Otherwise, the government has to organize its own programs and provide services to all, even the unseemly.

The faith-based initiatives programs of the Bush administration took my tax money and gave it to programs that limited services to members of certain groups (and helped build conservative mega-churches along the way). That's not an ok way to spend my money.

"Helped build conservative mega-churches"? Source? I'd never heard that the mega-churches were linked with faith-based initiatives.

Speaking of faith, your faith in the government (and therefore, possibly, in human nature) is touching.

My argument for faith-based programs--particularly WRT problems like severe drug addictions and homelessness--is that they are often in the best position to make demands from their clients that the actual behavioral component in their problems actually change. The government cannot do that (again, as John points out, if we are assuming we want to live in a free society). Only religion (or some kind of belief system) can really make that demand.

only faith makes rehabilitation possible?

I don't think I buy that!

in an enlightened society, one in which more-or-less healthy people have access to jobs and dignity and forward movement toward happier lives, even a total athiest can be persuaded to kick his addiction and try for a better life

(with, I suppose, the threat of prison as a quiet motivator if he doesn't -- and a free society can still be one with punishments for bad behavior)

It shouldn't take a belief in God to be able to believe in or work toward a better life on earth.

You might want to read the first third of the Alcholics Anonymous "big book," less as a sort of literal statement about the nature of addiction, but as (1) a history of one of the great American contributions to world culture (Kurt Vonnegut placed it above jazz music!); and (2) a document about the nature of human transformation; pay particular attention to the work of William James as it influenced the thinking of the Oxford Group, and the chapter "We Agnostics."

It's a quaint work, but it certainly had flashes of amazing insight.

You and I share the same goals, but I

- do NOT want the state punishing people simply for having addictions, and

- do NOT want a entity with the coercive power of the government to be in charge of anyone's attempt to transform his or her life. That is placing too much power into hands that are already powerful enough.

Talk to Jack about this--I do believe that AA was the beginning of a transformative moment in his life. The insistence that there be a "higher power" in one's life does not equate to an a belief in God qua God, but only an admission that where one's addiction is concerned, one doesn't have all the answers.

A lot of people are furious that judges send people to AA, and therefore violate the "separation of church and state." But if the state is going to have a dog in this fight, it must be by finding out what grassroots approaches are already working--and assisting them--rather than forcing change from above.

If Rational Recovery works, fine--let it have some support (places to meet, etc.). If Secular Sobriety works, fine--give it a presence, or some meetings, in a recovery house for athiests.

But the state is not, cannot, be in the business of transforming lives. Down that road lies fascism.