The programs with good recovery rates require a lot of behavioral therapy and are not cheap, in fact way beyond what most people can afford without insurance.

I agree actual treatment costs money and 12 step programs are nearly free...since they're a support group and not treatment.

While insurance is an issue, why does it have to be the impediment to treatment? That's an ongoing issue in the USA. Washington State and King County both contribute and help direct mental health treatment. Why is treatment a 12SP and not counseling?

What I see a lot of is people arguing that because treatment has a high failure rate, it's better to just let people use what they want and let the chips fall where they may.

I didn't recommend that. That's a different issue that deals with drug decriminalization and to what level. This already occurs with a common misused legal street drug: alcohol.

The rock bottom thing works for some and not for others.

Back that up please. Even the shittiest bargain bin treatment in the area will dispell that statement. Rock bottom isn't definable, clinical, or actionable.

let the chips fall where they may

Treatment can help. 12 step programs are not treatment, they're a self help group with success rates no different than nothing. You can say we're already doing nothing.