I utilize points, and I have used it for useful stuff. My AMEX card (which I don't use much at all anymore) was essentially 1 point = 1% cash towards whatever. It worked well with buying airlines tickets and such.
The PenFed card - is also basically 1% on everything 5% on gas in points, and at 10000 points, a $100 visa gift card, 25000 points, a $250 visa gift card, etc. I do put anywhere from 3.5k-12k a month on the card so it's free money in my pocket. IMHO - the reason that card places go to points vs cash back/etc is the points requires interaction from the cardholder. If I had to guess, it's a whole lot like the 200m or so that goes unused from gift card purchases that pushes the credit card holders towards points as a large number of them will never get used. I do have to add - I don't buy things to get points, but I do spend money and there's no reason not to get a little kickback on it.