Image by Keegan-Houser on Unsplash.
Vivek Murthy, te Surgeon General of the United States has declared war on loneliness. In a recent New York Times opinion piece, he writes, “We have become a lonely nation. It’s time to fix that.”
As a marketer, I’d applaud his choice of topic. It’s warm and fuzzy.
Lots of people are talking about loneliness. In his recent book, How Medicine Works and What To Do When It Doesn’t, Perry Wilson also describes loneliness as an important health problem. Additionally, a news report indicates that the UK has a Minister of Loneliness; the American Psychological Association and the Senate Aging Committee have expressed concern.
It’s not one of those uncomfortable, invasive programs (like “colonoscopies for everyone over 50”). It does not threaten people’s treasured possessions (like guns and cigarettes).
It doesn’t require a prescription. In fact, it doesn’t even require trained professionals. Surgeon General Murthy solved his own loneliness problem with the support of family and friends.
But is this the most important issue in health care today?
(1) Our biggest medical problem in the US is getting access to medical care.
Insurance companies make billions of dollars in profit – not just revenue – while denying claims. For example, United Health Care made 80 billion in revenue and 5 billion in PROFIT in the first quarter of 2022. That’s the company recommended by AARP, which earns commissions when their members sign up.
Doctors are getting burned out as they spend hours begging insurance companies for ”prior authorizations.” It’s not clear why a group of business people get to override a doctor’s opinion.
Hospitals aren’t innocent either. I’ve had to write to hospital presidents to get explanations of bills. Sometimes they turn out to be mistakes.
Ironically, giving Medicare to all might make us less lonely.
People would be free to move to a more congenial location. They wouldn’t have to stay in a miserable job to keep their health benefits. They’d have considerably less stress in their lives because they wouldn’t spend so many hours fighting insurance denials.
Doctors would have more time to treat patients instead of dealing with insurance companies. They wouldn’t need to hire staff whose sole job is to deal with insurance companies.
(2) It’s h hard to find science-based recommendations for dealing with loneliness.
To start with, loneliness seems notoriously difficult to measure. Studies seem to depend on self-reports, i.e., if you call yourself lonely, you are. A number of variables might influence whether you define yourself as “lonely.” Some people genuinely enjoy living alone.
Frankly, I’m terrified: I enjoy my solitude and my silence, even though I’m an extrovert who knows a lot of people. I don’t want a doctor deciding I need treatment if I’d rather die than share my living space. It’s a matter of values.
Murthy’s article is illustrated with a photo of a woman, presumably on a cruise ship, standing alone as she looks out at the city. Why do we assume she’s lonely? Maybe she’s having a quiet meditative moment.
We don’t know how many people define themselves as lonely because they’re getting messages about “normal” social interaction.Or how many people would resist saying they’re lonely because they’ve been stigmatized?’
(3) It’s not clear that loneliness is a mental health problem.
Finally, psychotherapy may help when loneliness is related to mental health challenges such as social anxiety, low self-esteem or trauma recovery.
If you’re living in a place where you don’t fit, all the therapy in the world won’t help. Some places are simply hostile to newcomers. Others have no place for single people, childless people, non-religious people or people who affiliate with a certain political party. Theoretically you can get past the barriers but in practice, it’s not likely.
You might also be lonely because you’re changing careers, retiring or dealing with other challenges. It takes time to find and connect with others during these times.
Anyway, if it’s a mental health problem, start with making it easier to pay for support. Many of the best counselors and therapists won’t take insurance, for good reason. Why urge people to seek help that doesn’t exist?
When I hear about programs directed to loneliness, I immediately think of the “drunk and the lamppost” story.
That’s the one where a cop sees a man looking for his keys in the bright light of a lamppost on a very dark night. The man says, “I lost my keys over there,” pointing to a dark spot. “But it’s easier to look over here in the light. Just google “drunk and the lamppost” story for many variations, such as this one.
It’s difficult if not impossible to deal with important issues that could make a difference in health care, like reducing the power and profits of insurance companies and hospital chains. So we can focus on loneliness …a feel-good solution that won’t make much difference to ordinary lives.
