Jun 18, 2013 • 29M

The Importance of Advanced Care Planning: A Conversation with Charlie Sabatino (June 28, 2013)

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Appears in this episode

David Introcaso, Ph.D.
Podcast interviews with health policy experts on timely subjects. The Healthcare Policy Podcast website features audio interviews with healthcare policy experts on timely topics. An online public forum routinely presenting expert healthcare policy analysis and comment is lacking. While other healthcare policy website programming exists, these typically present vested interest viewpoints or do not combine informed policy analysis with political insight or acumen. Since healthcare policy issues are typically complex, clear, reasoned, dispassionate discussion is required. These podcasts will attempt to fill this void. Among other topics this podcast will address: •Implementation of the Affordable Care Act •Other federal Medicare and state Medicaid health care issues •Federal health care regulatory oversight, moreover CMS and the FDA •Healthcare research •Private sector healthcare delivery reforms including access, reimbursement and quality issues •Public health issues including the social determinates of health Listeners are welcomed to share their program comments and suggest programming ideas. Comments made by the interviewees are strictly their own and do not represent those of their affiliated organization/s.
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The lowlight during the 2009-2010 ACA debate was Governor Palin's invention of "death panels" (PolitiFact's 2009 "Lie of the Year") in response to a proposal to allow Medicare to pay physicians whom voluntarily counsel patients about advanced care planning or directives.   The fear mongering was so convincing the proposal was dropped by the Congress and later, via rule making, by the White House.  The facts remain that while far and away most Americans die of a long term chronic, eventually fatal ilness/es, according to AHRQ, Pew and others only approximately twenty to thirty percent of Americans have an advanced directive or a living will including those severely or terminally ill.  

During this 28-minute discussion Mr. Sabatino discusses the importance and benefits of advanced care planning and the various types of advanced care directives (living wills, durable power of attorney, POLST, and others), reasons for our hesitancy in planning for advanced illness and completing directives, limitations (e.g., portability problems) and operational challenges.  He notes specifically advanced care planning is not a one time conversation or a check the box exercise.  He describes what steps are being taken to improve advanced care planning, for example through opportunities presented via the movement towards electronic health/medical records.       

Charlie P. Sabatino is the Director of the American Bar Association’s Commission on Law and Aging where he is responsible for research and education in health law, long‑term care, guardianship and capacity issues, surrogate decision‑making, legal services delivery for the elderly and professional ethics.  He has written extensively on capacity issues, surrogate decision-making and advance care planning.  Mrs. Sabation is also an Adjunct Professor at Georgetown University Law Center, currently serves as a legal consultant to the National POLST Paradigm Task Force and is a board member of the Coalition to Transform Advance Care.  Mr. Sabatino is a Fellow and former president of the National Academy of Elder Law Attorneys.  He received his A.B. from Cornell, his J.D. from Georgetown and is a member of the Virginia and D.C. bars.

For ABA information on advanced care planning and directives see:  http://www.americanbar.org/groups/law_aging/resources/consumer_s_toolkit_for_health_care_advance_planning.html and for Respecting Choices information see: http://www.gundersenhealth.org/respecting-choices.