What BMJ readers thought: Should we value the well connected?
Birte Twisselmann sums up the opinions received on bmj.com
Should the healthcare system favour people whose treatment is more likely to also benefit those around them, asks Nicholas A Christakis (http://student.bmj.com/issues/08/12/life/442.php). Having considered the question in detail—“Taking network effects seriously means that we should value socially connected people more” and “Health care delivered to well connected people is clearly more cost effective; it offers more quality adjusted life years per dollar spent”—his personal conclusion is that it shouldn't. “If anything, the healthcare system should function as a safety net, providing the kind of benefits to less well connected people that they cannot otherwise obtain from their own family and friends.” What did the responders on bmj.com think when the article was published there (www.bmj.com/cgi/eletters/337/sep23_1/a1675)?
Two correspondents are enthused by network effects and suggest further ways in which these could benefit the public—without actually recommending that well connected people should be given priority in the system. Pawan Randev, a general