Speaker: This is Carlos and I'm his colon cancer.

First, our team consists of Dr. Weislet, Dr. Urban, Jerome Todd and Michael Tatowski and we looked at Carlos Genovini who was originally from Backbeach, Brooklyn, New York, May 17th proxy just off Perinsano Bridge. And his wife Susie, he calls her Sues. And now he lives at Boca Raton. He’s retired. He's a baby boomer, and he’s obviously on Medicare. We’re not sure whether he’s on Medicare or Medicare Advantage. He lives in Brownward County and there are a lot of Medicare Advantage plans.

We’re not sure if he has some Medicare Supplement policy or a cancer policy. You know he's in overall good health. We know that he has been going to the Mayo Clinic once a year for a health check-up and interestingly enough, Dr. Urban pointed out that the Mayo Clinic doesn't accept Medicare. And it does not accept Medicare Advantage Plans. So he has been paying out-of-pocket charges. And that's by the way, a true statement.

He’s been paying out-of-pocket charges for his health check-ups each year but he has been very happy with the results of Mayo Clinic in terms of the check-ups. And sure enough, when he went one year to the Mayo Clinic he found that he had of very weird form of colon cancer and they were able to discover this.

And he’s glad that they cornered early enough for him to discover it but he is also very nervous what his treatment options are. And also, what it was gonna cost him overall, and especially the clinic in particular. We're assuming that he did not have primary care physician by the way because he was going to the Mayo Clinic from Brownward every year.

And so, he has lots of questions that he has to answer and lots of things he wants to know before he answers a lot of questions about things that are important to him and Susie and and his family. And the big things he wants to know are what is the information related to the cancer and the tumor itself? What kind of cancer do I have? What is the prognosis? What are the types of treatments? Are they on regular or experimental treatments?

Where can I receive these treatments and what are the outcomes of these treatments and what options are there in relation to the treatments? What’s gonna be the overall cost and and what’s gonna be the cost to him for each one of these options in relation to Medicare versus going to the Mayo Clinic versus going to other doctors? And what is the quality of life related to these outcomes afterwards versus surgery versus radiation versus all other kinds of treatments that he might have?

He wants to know what specialists would be available to him, both where he lives - maybe at the Mayo Clinic, maybe in other places in the country. What support systems that are gonna be there for him and his family? Are there support groups related just to this type of cancer that he might be able to join so he could talk to other people who've had treatments?

And then when he has this information, he might be able to answer some of the questions and make some of the decisions him and his family are going to need to make, like what type of treatment is he going to go into. Is it gonna be none because the outcomes and the survival rate is very low? Are there common treatments or are there experimental treatments? And he's gonna make those decisions after he has this information.

Where he gets these treatments? And that goes back up to one of the questions that we talked about which is he may have regular Medicare, but he may wanted to pick the Medicare Advantage plan.

The reason why is that because the Medicare Advantage plan may have Centers of Excellence and may commonly do and he may be able to go to Sloan-Kettering. He may be able to go to Lee Moffitt - that he may not have available to him in terms of cost in relation to the Mayo Clinic versus regular Medicare.

He's going to decide how much time he will have to be away from his family. If he goes up to the Mayo Clinic and he pays out of pocket, he also is going to have to discuss travel time. He's going to have to discuss lodging for him and his family. And he's going to also maybe, unfortunately, have to start discussing with his family end-of-life decisions depending on what the prognosis is of this cancer.

The things that are weighing in the balance on this decision: the survival rate in relation to the cancer, the quality of life with the treatments and his personal health, the quality of life in relation to his family in terms of the money that he's going to spend or not spend on the treatments in relation to what kind of insurance coverages have and what's available to him in terms of coverage and the cost of treatment and the cost of the other things that may be involved as well.

In relation to where we think these decisions are going to be made, we think that there are a number of things that Carlos is going to have to decide with his physician and his family and himself; certainly end-of-life decisions. But he may want to research some options about that. His choice of treatment, his choice of providers, survival rates, all of these things are very personal decisions that he may actually just want to get from his provider and discuss with his family and discuss with other survivors as well.

He may be able to do some of that online. Some of that may just be personal. But in public sector, types of insurance that are available, his outcome of treatment, the types of treatment options that he may have, his cost of treatment, information on support systems, specialists that maybe available and their success rate and medical literature and informatics that is user-friendly are all things that we think coud be in the public sector and available to Carlos.

[Applause]