Internet betting is a bad bet and a public health crisis | Opinion – The Des Moines Register

Former U.S. Rep. Jim Leach presciently considered online gambling “crack cocaine” for gamblers. As chairman of House Banking Committee he was primary author of a law in 2006 designed to crack down on online gambling (the Unlawful Internet Gambling Enforcement Act of 2006, UIGEA). It blocked financial transactions between U.S. gamblers and offshore online gambling sites.
The gaming industry went after Leach. In a tight re-election he lost by 6,000 votes after the gambling industry targeted him with get out the vote efforts aimed at internet gambling backers angry at Leach. American Banker said Leach “lost his bet,” except for Leach it was a matter of duty not a bet.
Online internet betting, especially on sports, is a perfect storm of combining the addictive allure of gambling with habit-forming smartphone use. The average American spends 4.5 hours a day on his or her phone. Combine that with the allure of online gambling and you have a toxic brew. What’s resulted isn’t just a bigger gambling market but a growing public health crisis, with young men as its main casualty.
The Supreme Court in 2018 struck down a federal ban on sports betting that required states to follow a federal law on the basis that the federal government itself can regulate gaming but can’t “commandeer” states to do that. The court did not say that either states or the federal government could not regulate gambling, just that the federal government could not tell the states to.
As of early 2026, 32 states including Iowa have legalized online or retail sports betting. Eight others allow more limited gambling. Only five forbid legal sports betting. In 2018 Americans bet less than $5 billion on sports betting while in 2025 the sports betting industry posted $13.7 billion in profit on $150 billion in wagers. Sports betting platforms like FanDuel and DraftKings take a profit of 9% to 10% (the vigorish, “vig”) of all bets. The vig is guaranteed by the gaming businesses ensuring they have roughly equal money on each side of bets. Events like the Super Bowl and March Madness generate immense betting volume.
Ninety percent of bets are placed on phones, not on casinos or racetracks.
More than 50% of bets are placed while games are in progress. Any betting app will provide one with hundreds of options per game: will the next pitch be a strike, will Steph Curry score 35 points, will Rory McIlroy make the putt? All you need is a credit card and your phone and you can bet while anywhere.
No wonder all the major sports leagues like the NFL, NBA, MLB, NHL and even now the PGA have “Official Betting Partners” that pay for the rights to use league logos and proprietary data. Some venues like the Prudential Center for the NJ Devils have dedicated betting sponsored lounges where the odds are displayed and the fans can bet via mobile apps.
About 1% to 2% of Americans (2 million to 4 million) have diagnosable gambling addiction defined as a person who has persistent and recurrent patterns of problematic gambling behavior that causes significant distress and impairment such as loss of control, chasing losses to try to “get even,” lying to family and friends, behavior that risks jobs, and desperate financial situations. Another 10 million are at risk for diagnosable gambling addiction.
Sixty precent of bettors account for just 1% of sports book revenue through placing an occasional bet. That leaves 99% of sports book revenue coming from the 40% of bettors. The problem is that between full addiction and casual betting there is a massive gray area of millions of Americans, particularly young men, who have problematic gambling behavior. These bettors have mood swings, increased rates of anxiety, obsessions and intrusive thoughts. They are more likely to miss classes, drink more alcohol, and do risky behaviors.
The International Classification of Diseases calls this “hazardous gambling.” This behavior increases the risk of physical and mental illness, including increased risk of suicide. The Lancet did a review in 2024 of the harm suffered by those gambling who fall below the threshold for full blown gambling disorder.
There is a physical basis to gambling addiction as it acts as a powerful stimulant on the brain’s reward system causing it to release significant amounts of dopamine, the “feel-good” neurotransmitter. The dopamine spike cause feelings of euphoria and excitement which increases the compulsion to gamble more. Interestingly, a spike occurs with both winning and losing which may explain “chasing losses” where the urge to continue outweighs the disappointment of losing.
Gambling isn’t just a problem in the U.S. Sophisticated marketing and easy access to the internet and mobile phones are a world-wide phenomena. According to the report from The Lancet about 450 million people world-wide have experienced a harmful personal, social or health consequence of gambling. Of those, 80 million suffer from a diagnosable gambling disorder and these numbers are likely conservative. Adolescents are particularly susceptible with 8.9% of adults and 16.3% of of adolescents who gamble on sports betting being susceptible to gambling disorder.
Fighting the gambling problem involves individual, state and national and international action. Individuals have to first recognize they have a problem and then seek help from mental health professionals. This may include behavioral and cognitive therapy as well as medications for depression and anxiety. Groups like Gamblers Anonymous can be helpful. Treatment can be outpatient, inpatient or even residential.
Federal efforts have focused on regulating rather than banning on-line betting. The BETS OFF Act aims to ban insider trading on prediction markets. Jim Leach’s UIGEA still prohibits financial institutions from accepting payments for illegal online gambling but doesn’t ban all forms of it. Senators are looking to prohibit wagers on “government actions, terrorism, war, assassination, and events where an individual knows or controls the outcome.”
The POINTS Act is a bipartisan bill proposing that one-third of existing federal excise tax on sports wagers (roughly $100 million per year) supports gambling addiction prevention and treatment services. The GRIT Act proposes setting aside 50% of the federal sports excise tax for treatment and research designated for the National Institute on Drug Abuse.
Rep. Paul Tonko wants to restrict gambling advertisements, similar to tobacco ad bans. This is especially pertinent as TV gambling ad buys during sporting events are second only to food advertisements. Regulators could require players to set annual loss limits and mandatory “firewall’s” to prevent excessive borrowing, prohibit the use of credit cards for gambling stakes, set age limits and restrict ATMs from placement near gambling sites.
Internationally, The Lancet Commission recommended that all countries include restrictions on access, promotion, marketing, and sponsorship. It asks for the provision of affordable, universal support and treatment for gambling damages alongside campaigns to raise awareness of the gambling harms. It recommends minimum age requirements and mandatory identification to reduce adolescents and young people gambling.
The example of Jim Leach’s defeat by the gaming industry did not go unnoticed on politicians. The gambling industry will fight against any meaningful legislation. It spends hundreds of millions of dollars on influence peddling. A recent study showed gambling interests spent $817 million on lobbying, according to a National Institute of Health report, placing it among top spenders of other industries.
Based on 2023-2024 election cycle data by government transparency organization Open Secrets, hundreds of members of Congress received campaign donations from the casino and gaming industry. It contributes to both sides to access lawmakers who oversee industry regulations.
The dangers of gambling is nothing new. Aristotle condemned gambling because it promoted a “something-for-nothing” ethos harmful to the individual and the body politic. Fyodor Dostoevsky wrote the definitive Russian novel about the dangers of gambling, “The Gambler,” in order to pay off his own gambling debts which were financially ruining him. Warren Buffet, investor, has been outspokenly anti-gambling. He has said, “Any time you offer a big prize for a small amount of money you encourage stupid behavior.”
It’s been said that gambling is a sure way of getting nothing for something, but more correctly it is getting trouble. What is different from the past is now the impact of internet and online technology on the pocket-availability for sports gambling. It is a health care and financial crisis that cries for individual, state and national, and international interventions.
Dr. Greg Ganske is a retired reconstructive surgeon who cared for women with breast cancer, children with birth defects, farmers with hand injuries, and burn and trauma victims. He served Iowa in the United States Congress from 1995 to 2003.

source