The National Health Service is set to go to some profound changes. interesting opinion piece about this:

If you believe in a public NHS, the new health and care bill should set off alarm bells

The government is easing the way for the privatisation of the health service – where is the opposition to their plans?

Ten years ago, Andrew Lansley’s health and social care bill to reorganise the NHS in England faced enormous opposition. The current health and care bill, which has its second reading in the House of Lords today, has received far less attention. But it is no less significant. The new bill will continue the dismantling of the NHS, this time by adopting more features from the US health system. For anyone who cares about the NHS, this should set off alarm bells.

The proposals mean that for the first time since 1948, parliament will not determine to whom NHS services must be provided. The bill removes the requirement for emergency services to be provided for everybody present in an area. No explanation has been given for getting rid of it.

link

So do you think it is a good thing that the health care system in Great-Brittain will be more like the American system with for-profit healthcare providers?

Dutchy wrote:

The National Health Service is set to go to some profound changes. interesting opinion piece about this:

If you believe in a public NHS, the new health and care bill should set off alarm bells

The government is easing the way for the privatisation of the health service – where is the opposition to their plans?

Ten years ago, Andrew Lansley’s health and social care bill to reorganise the NHS in England faced enormous opposition. The current health and care bill, which has its second reading in the House of Lords today, has received far less attention. But it is no less significant. The new bill will continue the dismantling of the NHS, this time by adopting more features from the US health system. For anyone who cares about the NHS, this should set off alarm bells.

The proposals mean that for the first time since 1948, parliament will not determine to whom NHS services must be provided. The bill removes the requirement for emergency services to be provided for everybody present in an area. No explanation has been given for getting rid of it.

link

So do you think it is a good thing that the health care system in Great-Brittain will be more like the American system with for-profit healthcare providers?

Sounds more like the Australian system, with majority of publicly funded services but also for-profit providers.

Noone outside the US wants the US system - and many in the US don't want the US system either.

Kent350787 wrote:

Dutchy wrote:

The National Health Service is set to go to some profound changes. interesting opinion piece about this:

If you believe in a public NHS, the new health and care bill should set off alarm bells

The government is easing the way for the privatisation of the health service – where is the opposition to their plans?

Ten years ago, Andrew Lansley’s health and social care bill to reorganise the NHS in England faced enormous opposition. The current health and care bill, which has its second reading in the House of Lords today, has received far less attention. But it is no less significant. The new bill will continue the dismantling of the NHS, this time by adopting more features from the US health system. For anyone who cares about the NHS, this should set off alarm bells.

The proposals mean that for the first time since 1948, parliament will not determine to whom NHS services must be provided. The bill removes the requirement for emergency services to be provided for everybody present in an area. No explanation has been given for getting rid of it.

link

So do you think it is a good thing that the health care system in Great-Brittain will be more like the American system with for-profit healthcare providers?

Sounds more like the Australian system, with majority of publicly funded services but also for-profit providers.

No one outside the US wants the US system - and many in the US don't want the US system either.

The UK does have 'for profit' providers. BUPA being the biggest.

Dutchy wrote:

So do you think it is a good thing that the health care system in Great-Brittain will be more like the American system with for-profit healthcare providers?

Do you get that the US medical care system is perhaps the most socialized part of the American economy, with mammoth price controls instituted by the Federal Government and enforced by a socialized provision of services? I think the number I remember is that something like 43%+ of Americans received their health care coverage directly from the government (a number that includes the military but excludes federal and state employees.)

Of this 43%, those aged 65 and older are nearly universally covered by a socialized medical system, and not unexpected, people in that age bracket consume significant resources.

FGITD wrote:

Highly recommend the American system.

Can’t beat prices made up on the spot, everything inflated 1000x, and the solution to being poor and sick is to simply die.

I've also received an MRI within 10 days in the US for a somewhat serious but routine injury, which is a timeframe that would be expressed in near light speed in many other places, if such a standard of care would be realized at all.

Much of the cost inflation in the US is due to the fact of the pricing power of a federal government and the requirement to make up the cost of care in different areas.

Kent350787 wrote:

Noone outside the US wants the US system - and many in the US don't want the US system either.

Noone except people who will directly benefit from the privatization, who bought UK politicians...

Aesma wrote:

Kent350787 wrote:

Noone outside the US wants the US system - and many in the US don't want the US system either.

Noone except people who will directly benefit from the privatization, who bought UK politicians...

Don't forget the proprietor of the politician's local pub!

https://www.theguardian.com/politics/20 ... ms-rubbish

FlapOperator wrote:

which is a timeframe that would be expressed in near light speed in many other places, if such a standard of care would be realized at all.

Keep believing!

FGITD wrote:

FlapOperator wrote:

FGITD wrote:

Highly recommend the American system.

Can’t beat prices made up on the spot, everything inflated 1000x, and the solution to being poor and sick is to simply die.

I've also received an MRI within 10 days in the US for a somewhat serious but routine injury, which is a timeframe that would be expressed in near light speed in many other places, if such a standard of care would be realized at all.

Much of the cost inflation in the US is due to the fact of the pricing power of a federal government and the requirement to make up the cost of care in different areas.

Emergency MRIs etc still get handled with a priority anywhere. I’d rather wait 3 weeks and have my biggest expense be parking, over getting it immediately and owing $3500.

It makes you wonder…maybe allowing lawmakers to hold stock in pharmaceutical companies, and allow a pharmaceutical lobby to exist plays a role? But no, I’m sure that has nothing to do with it. After all, they represent us, not their own personal financial interests

Be honest: did you write that with a straight face?

FlapOperator wrote:

FGITD wrote:

Highly recommend the American system.

Can’t beat prices made up on the spot, everything inflated 1000x, and the solution to being poor and sick is to simply die.

I've also received an MRI within 10 days in the US for a somewhat serious but routine injury, which is a timeframe that would be expressed in near light speed in many other places, if such a standard of care would be realized at all.

Much of the cost inflation in the US is due to the fact of the pricing power of a federal government and the requirement to make up the cost of care in different areas.

That's very slow...In Hong Kong if I go private I can get it the next day at a cost of around US$2,000. (It will take several years if you try to get it in our public system though)

Aaron747 wrote:

FlapOperator wrote:

FGITD wrote:

Highly recommend the American system.

Can’t beat prices made up on the spot, everything inflated 1000x, and the solution to being poor and sick is to simply die.

I've also received an MRI within 10 days in the US for a somewhat serious but routine injury, which is a timeframe that would be expressed in near light speed in many other places, if such a standard of care would be realized at all.

That’s really slow. At public and private hospitals I used in Japan, you could usually get any type of test including MRI, same-day if you were willing to wait a couple hours. The NHS pays 70%, and at an average of $150 for a scan, out of pocket cost would be under $50.

Ten days is slow even by the private American healthcare system. I got a next-day MRI in the US. It was a couple hundred dollars though.

I understood people from the UK were generally happy with the NHS despite longer wait times because there is more insulation from cost for basic services. Most developed countries seem to struggle with the notion that money leads to superior health outcomes, and the NHS is a manifestation of that thought. America just goes all-in for for-profit healthcare and I suspect we Americans are more at peace with paying more for quicker service or better outcomes.

FlapOperator wrote:

FGITD wrote:

Highly recommend the American system.

Can’t beat prices made up on the spot, everything inflated 1000x, and the solution to being poor and sick is to simply die.

I've also received an MRI within 10 days in the US for a somewhat serious but routine injury, which is a timeframe that would be expressed in near light speed in many other places, if such a standard of care would be realized at all.

Much of the cost inflation in the US is due to the fact of the pricing power of a federal government and the requirement to make up the cost of care in different areas.

10 days, I got one the day I went to the hospital, I went to the emergency after hour clinic in the evening, the dr there booked a consultation at the hospital with the on call neurologist for Sunday morning and a couple of hours after that appointment I had an MRI. The public health system in Norway works pretty efficiently when they have to.

N867DA wrote:

Aaron747 wrote:

FlapOperator wrote:

I've also received an MRI within 10 days in the US for a somewhat serious but routine injury, which is a timeframe that would be expressed in near light speed in many other places, if such a standard of care would be realized at all.

That’s really slow. At public and private hospitals I used in Japan, you could usually get any type of test including MRI, same-day if you were willing to wait a couple hours. The NHS pays 70%, and at an average of $150 for a scan, out of pocket cost would be under $50.

Ten days is slow even by the private American healthcare system. I got a next-day MRI in the US. It was a couple hundred dollars though.

I understood people from the UK were generally happy with the NHS despite longer wait times because there is more insulation from cost for basic services. Most developed countries seem to struggle with the notion that money leads to superior health outcomes, and the NHS is a manifestation of that thought. America just goes all-in for for-profit healthcare and I suspect we Americans are more at peace with paying more for quicker service or better outcomes.

I think there is probably a bit of triumphalism on both sides of the 'Private' vs 'public' healthcare system and in actual fact neither is actually wholly one or the other. As was mentioned up-thread a huge portion of the US healthcare system is payed for from public funds already and at the other end of the spectrum the NHS is not all run publicly there is a fair amount of privately appointed companies that provide treatment and care.

There are benefits to each of the approaches and I believe the data points at a value for money optimum at a situation where the hospitals themselves are privately run and the end user gets to select the hospital/care provider and it is then payed for by the gov't under strict pricing regulations. I believe this is effectively the German system? Private healthcare gives advantage in competition (in theory) and nationalised systems benefit from scale and the ability to create a more integrated system (There is a potential benefit to the govt to put sports facilities in to keep people healthy, this incentive doesn't exist for a singular hospital).

I think its not unreasonable to assume that people are willing to pay more for quicker service and better outcomes, the question is if either one or both of those is true? If someone is ill and the best remedy is 5 days rest. Does a patient think the better outcome is the doctor telling them 5 days rest or the doctor giving them a course of pills and 5 days rest?

Fred

Dutchy wrote:

So do you think it is a good thing that the health care system in Great-Brittain will be more like the American system with for-profit healthcare providers?

No, it will be an incredibly bad thing. It's only being done by this Government at this time, to help it's donors and supporters. There is zero national interest at all in moving the NHS towards another type of system. In fact for decades it's been such a toxic subject even the hint of it by a party (either in power or opposition) would immediately decimate any chances of being elected.

The current system, with the ability to go private if you want faster treatment or can afford it would work well, if the NHS was properly managed and properly funded for a consistent period of time. The problem has always been that every 5-6 years there is a massive shake up of it's entire setup by each new government. Each one thinks it knows best, and usually they just make it worse. NHS management hasn't helped itself however when the rules change every few years I don't know how you're supposed to plan long term.

The NHS is incredibly popular as an institution / idea amongst the British public and those that are aware of what the Government are trying to do are trying to oppose it. However as we know Brexit, Boris, Trump has changed everything. People will support a party because of one single issue and will accept almost anything else happening, or will simply turn a blind eye or even flat out deny it's happening. I fear this is what could happen with the NHS. Labour + Lib Dems can appose as much as they want, but with the government having an 80+ seat majority when it comes to voting down legislation there is little that can be done.

It seems that at last Boris' popularly is starting to wane and the public is starting to release what's going on. Every poll has Labour leading by more than the margin of error, and in public events (Darts matches on TV, Football matches etc) there are actual protests and against the government. It's even starting to lose some support from the tabloids. Lets hope there is some change before any more lasting damage is done.

Reinhardt wrote:

Dutchy wrote:

So do you think it is a good thing that the health care system in Great-Brittain will be more like the American system with for-profit healthcare providers?

No, it will be an incredibly bad thing. It's only being done by this Government at this time, to help it's donors and supporters. There is zero national interest at all in moving the NHS towards another type of system. In fact for decades it's been such a toxic subject even the hint of it by a party (either in power or opposition) would immediately decimate any chances of being elected.

The current system, with the ability to go private if you want faster treatment or can afford it would work well, if the NHS was properly managed and properly funded for a consistent period of time. The problem has always been that every 5-6 years there is a massive shake up of it's entire setup by each new government. Each one thinks it knows best, and usually they just make it worse. NHS management hasn't helped itself however when the rules change every few years I don't know how you're supposed to plan long term.

The NHS is incredibly popular as an institution / idea amongst the British public and those that are aware of what the Government are trying to do are trying to oppose it. However as we know Brexit, Boris, Trump has changed everything. People will support a party because of one single issue and will accept almost anything else happening, or will simply turn a blind eye or even flat out deny it's happening. I fear this is what could happen with the NHS. Labour + Lib Dems can appose as much as they want, but with the government having an 80+ seat majority when it comes to voting down legislation there is little that can be done.

It seems that at last Boris' popularly is starting to wane and the public is starting to release what's going on. Every poll has Labour leading by more than the margin of error, and in public events (Darts matches on TV, Football matches etc) there are actual protests and against the government. It's even starting to lose some support from the tabloids. Lets hope there is some change before any more lasting damage is done.

My gut instinct, Boris will be gone next year. It is about getting ready for the next election.
The NHS wont see any significant changes, at least until after next election.

Time will tell.

noviorbis77 wrote:

The NHS wont see any significant changes, at least until after next election.

Time will tell.

According to the opinion piece, and the proposals made in parliament, there are significant changes to the NHS being proposed.

Dutchy wrote:

noviorbis77 wrote:

The NHS wont see any significant changes, at least until after next election.

Time will tell.

According to the opinion piece, and the proposals made in parliament, there are significant changes to the NHS being proposed.

I'd really like to read the "significant changes."

For example, when I was living in the UK, one "significant change" suggested was a 5 pound fee should one no show your appointment. No-showing appointments was apparently a problem in the NHS (at that time, I don't really follow it) and does represent an utter waste of resources.

Anyway, there was a huge hue and cry over this proposal, with much of the objections from the political left, and on an age basis, from people over 60. People under 60 generally thought it was a great suggestion.

Kiwirob wrote:

10 days, I got one the day I went to the hospital, I went to the emergency after hour clinic in the evening, the dr there booked a consultation at the hospital with the on call neurologist for Sunday morning and a couple of hours after that appointment I had an MRI. The public health system in Norway works pretty efficiently when they have to.

I've heard of 10 days within the NHS in the UK, even though that was a bit of an outlier for like you, an emergent neuro issue.

I mean, if the point is to decry the lack of a national American healthcare system, why isn't a Nordic level of care being provided in say, Bulgaria? Is Bulgaria providing these levels of care?

Dutchy wrote:

noviorbis77 wrote:

The NHS wont see any significant changes, at least until after next election.

Time will tell.

According to the opinion piece, and the proposals made in parliament, there are significant changes to the NHS being proposed.

Proposals do not equate to huge changes. Plus it is the Guardian, so lets not take it too seriously.

Look, we are two years or so from the election.

Boris Johnson is becoming a liability. He has done his job, delivered Brexit as promised, now time for someone more moderate to focus on winning the election.

I am fairly confident we’ll see nothing too major until the next election and even then I cannot see a privatised NHS being a manifesto promise. Fat from it.

noviorbis77 wrote:

Plus it is the Guardian, so lets not take it too seriously.

I regard the Guardian as one of the best papers in Britain, you might not agree with their political stands, but that doesn't mean they are factual wrong. So on facts I would take them very seriously.

While I find the US medical system in general to be a sick joke (pun intended), with the exception of its leadership in innovative treatments, part of the problem the US has which is far less in Europe and even less in Asia, is that the US population is an extremely unhealthy group. Obesity rates, drug-abuse rates, diabetes, sedentarism, all are far higher. So the US system has to cope with a far riskier population profile compared to Scandinavians, Mediterraneans, Japanese, Koreans, who in general have far better overall health habits.

That doesn't excuse the fact that the US system provides no relief for people who don't smoke, who don't drink, who exercise, who generally eat right and don't engage in abuse of any type of substance. The fact that those people have to pay for the poor health choices of others is criminal.

noviorbis77 wrote:

Boris Johnson is becoming a liability.

He isn't becoming a liability, he's always been one.

noviorbis77 wrote:

He has done his job, delivered Brexit as promised

I distinctly remember him promising to give the NHS £350 million a week once we left the EU. Has that happened?

Bad idea....how much would a vial of insulin cost then...?

Dutchy wrote:

noviorbis77 wrote:

Plus it is the Guardian, so lets not take it too seriously.

I regard the Guardian as one of the best papers in Britain, you might not agree with their political stands, but that doesn't mean they are factual wrong. So on facts I would take them very seriously.

Well you would, based on your posting history.

Like all papers… They are extremely biased. Even facts are presented in a biased fashion.

The only resource worth reading is on gov.uk

FlapOperator wrote:

Kiwirob wrote:

10 days, I got one the day I went to the hospital, I went to the emergency after hour clinic in the evening, the dr there booked a consultation at the hospital with the on call neurologist for Sunday morning and a couple of hours after that appointment I had an MRI. The public health system in Norway works pretty efficiently when they have to.

I've heard of 10 days within the NHS in the UK, even though that was a bit of an outlier for like you, an emergent neuro issue.

I mean, if the point is to decry the lack of a national American healthcare system, why isn't a Nordic level of care being provided in say, Bulgaria? Is Bulgaria providing these levels of care?

I have no clue as about the level of service provided in Bulgaria, nor to I care.

As somebody who does financial optimizations for a living, the US healthcare system is my worst nightmare.

It is a tragedy that so much money (that can be used to improve people's lives) is wasted in the US on its poorly performing healthcare system. Meanwhile, many Americans essentially go without care, especially the 60% of people in the 20-80% income bands.

The US truly needs to start over, sunset the current system in 2025, lay off most health administrators, lay off all drug marketers, and lay off all health insurance workers. Hospitals and clinics services should be put out for government bid and run privately.

Dutchy wrote:

noviorbis77 wrote:

Plus it is the Guardian, so lets not take it too seriously.

I regard the Guardian as one of the best papers in Britain, you might not agree with their political stands, but that doesn't mean they are factual wrong. So on facts I would take them very seriously.

They are often factually wrong or misintepret things.

Certainly related to migration matters.

Sadly no paper in the UK is truly objective.

Kiwirob wrote:

I have no clue as about the level of service provided in Bulgaria, nor to I care.

That's exactly my point in most European vs. America discussions. Comparisons are far more difficult than one might imagine.

According to the wife (NHS ED Consultant), emergency/high priority MRI scans will be done within 6 hours where she works (trauma hospital). Yet down the road in old Worcester where we once lived, a whole spine request to rule out cord compression etc may take up to 24 hours as the MRI is only staffed 12 hours/day with no on-call provision out of hours.

Non urgent musculoskeletal stuff which is referred via the orthopaedic teams can take an excess of 4 weeks.

I'm covered by BUPA through my employer and had an MRI done with contrast on my neck a few years ago. £300 for the MRI and £200 for the contrast media was the bill for my insurer.

FlapOperator wrote:

FGITD wrote:

Highly recommend the American system.

Can’t beat prices made up on the spot, everything inflated 1000x, and the solution to being poor and sick is to simply die.

I've also received an MRI within 10 days in the US for a somewhat serious but routine injury, which is a timeframe that would be expressed in near light speed in many other places, if such a standard of care would be realized at all.

I mean, do you really still buy the garbage about outlier waiting periods - nearly always from rural areas? Cause there are plenty of examples of Americans who either can't get or are severely delayed health care due to insurance approvals and geography. Meanwhile, in the real world, there is a reason healthcare outcomes suck in the US relative to the rest of the developed world - and it certainly isn't because we have poorly trained providers (though, patient race definitely is an issue in the quality of healthcare delivery, but that is a different story).

This is constantly being planned according to the left. This article does a good job of showing how long the privatisation of the NHS has been “planned”. https://capx.co/if-there-is-a-secret-pl ... ibly-well/

The NHS is effectively a cult in the UK. No such change will ever happen because most left and right people can’t say a bad word about it (despite much of its services being average).

My favourite article was this: https://www.google.se/amp/s/amp.theguar ... nhs-health
“ The NHS has been declared the best healthcare system by an international panel of experts who rated its care superior to countries which spend far more on health.” and then a few paragraphs in it states: “ The only serious black mark against the NHS was its poor record on keeping people alive.”

seansasLCY wrote:

This is constantly being planned according to the left. This article does a good job of showing how long the privatisation of the NHS has been “planned”. https://capx.co/if-there-is-a-secret-pl ... ibly-well/

The NHS is effectively a cult in the UK. No such change will ever happen because most left and right people can’t say a bad word about it (despite much of its services being average).

My favourite article was this: https://www.google.se/amp/s/amp.theguar ... nhs-health
“ The NHS has been declared the best healthcare system by an international panel of experts who rated its care superior to countries which spend far more on health.” and then a few paragraphs in it states: “ The only serious black mark against the NHS was its poor record on keeping people alive.”

This.

The NHS, an organisation so good it can't provide correct death figures over a weekend.

77Phoebe wrote:

The NHS, an organisation so good it can't provide correct death figures over a weekend.

It's laughable that you pick this, given the vast majority of administrative NHS staff do a normal Monday to Friday work week. Try getting data out of the Government over a weekend.

scbriml wrote:

77Phoebe wrote:

The NHS, an organisation so good it can't provide correct death figures over a weekend.

It's laughable that you pick this, given the vast majority of administrative NHS staff do a normal Monday to Friday work week. Try getting data out of the Government over a weekend.

Such a good argument. Because the Government is institutionally incompetent the NHS should be too?

It's a good job that timely up to date death figures weren't vital for the control of the pandemic otherwise we would have been in even more trouble wouldn't we? Wouldn't was the pen pushers for the saintly NHS have to interrupt their weekends. NHS forever stuck in the 70s.

scbriml wrote:

77Phoebe wrote:

The NHS, an organisation so good it can't provide correct death figures over a weekend.

It's laughable that you pick this, given the vast majority of administrative NHS staff do a normal Monday to Friday work week. Try getting data out of the Government over a weekend.

But that’s the job of the organisation. If you need such data then change those working hours. Instead the UK accepts it and continually adapts to fit the health service rather than create a service which provides what they need and want.

seansasLCY wrote:

scbriml wrote:

77Phoebe wrote:

The NHS, an organisation so good it can't provide correct death figures over a weekend.

It's laughable that you pick this, given the vast majority of administrative NHS staff do a normal Monday to Friday work week. Try getting data out of the Government over a weekend.

But that’s the job of the organisation. If you need such data then change those working hours. Instead the UK accepts it and continually adapts to fit the health service rather than create a service which provides what they need and want.

I find it concerning that there is no central patient database that can be easily accessed centrally. Finding simple data like number of deaths would be a couple of lines of code.

However it seems like the NHS prefers uses a vast amount of costly non-clinical staff to do very basic data entry and then demand more money to run it.

77Phoebe wrote:

seansasLCY wrote:

scbriml wrote:

It's laughable that you pick this, given the vast majority of administrative NHS staff do a normal Monday to Friday work week. Try getting data out of the Government over a weekend.

But that’s the job of the organisation. If you need such data then change those working hours. Instead the UK accepts it and continually adapts to fit the health service rather than create a service which provides what they need and want.

I find it concerning that there is no central patient database that can be easily accessed centrally. Finding simple data like number of deaths would be a couple of lines of code.

However it seems like the NHS prefers uses a vast amount of costly non-clinical staff to do very basic data entry and then demand more money to run it.

Indeed. It’s run like a soviet organisation of trying to create mass employment. It functions in spite of how it’s run rather how it is. Different departments don’t talk to each other, referrals take weeks or months and patients often have to explain everything each time because of the lack of centralised records.

seansasLCY wrote:

77Phoebe wrote:

seansasLCY wrote:

But that’s the job of the organisation. If you need such data then change those working hours. Instead the UK accepts it and continually adapts to fit the health service rather than create a service which provides what they need and want.

I find it concerning that there is no central patient database that can be easily accessed centrally. Finding simple data like number of deaths would be a couple of lines of code.

However it seems like the NHS prefers uses a vast amount of costly non-clinical staff to do very basic data entry and then demand more money to run it.

Indeed. It’s run like a soviet organisation of trying to create mass employment. It functions in spite of how it’s run rather how it is. Different departments don’t talk to each other, referrals take weeks or months and patients often have to explain everything each time because of the lack of centralised records.

The figures are amazing I think there is 5 NON-clinical NHS employees for every hospital bed and 1 in 60 people in the UK work for the NHS in a NON-clinical role.

However, there is little chance of meaningful change because that would require politicians not to be driven by focus groups. It really needs to be taken out of the political sphere.

"NHS test and trace" and its "consultants" paid thousands a day, costing dozens of billions with no meaningful result, is that public or private ?

77Phoebe wrote:

The figures are amazing I think there is 5 NON-clinical NHS employees for every hospital bed

But how many clinical staff are there per hospital bed? If it’s one, then there may be too many support staff. If it’s 100 there might be too few (or too many clinical staff).

And what falls under non-clinical staff? It’s not going to just be admin. This will probably include cleaners, technicians, catering, logistics and so on…

Aesma wrote:

"NHS test and trace" and its "consultants" paid thousands a day, costing dozens of billions with no meaningful result, is that public or private ?

As it was the government paying for it clearly public.