Norman Mossberg of Coon Rapids was a loving husband and father. Still, the Vietnam combat veteran and retired bricklayer grew up at a time when men were taught to be taciturn. That makes one of his last gifts to his family, and to his fellow Minnesotans, even more extraordinary.
Months before he died in 2012 from pulmonary fibrosis, Mossberg, 65, opened his home to a camera crew to share his experience with hospice care. The resulting video, now on the Allina Health Hospice’s website, movingly shows how this type of medical care for the terminally ill focuses on quality of days left, not just the quantity. With his pain finally under control thanks to the Allina Hospice team, Mossberg spent his last summer in his own home with wife, Cindy, and his children and grandchildren at his side. Sarah, Norman’s British Labrador, was a kindly, calming caregiver, too.
Yet for all the medical studies showing the benefits hospice provides, too few people take full advantage of it in the ways the Mossberg family did. There’s a stubborn misperception that hospice is only for the very last days of life. In addition, federal Medicare policy has long put up hurdles to entering hospice and planning for end-of-life care. Medicare is the federal government’s health insurance for seniors.
Fortunately, the Obama administration, which oversees the agency running Medicare, is taking long-overdue steps to eliminate these hurdles. The most recent move: expanding a new program to help more people enter hospice and enter it sooner. Previously, patients who entered hospice had to forgo curative care for their disease, which many want to pursue even against long odds. Hospice, in contrast, provides symptom management.
Thanks to the program expansion, both types of care will be available for up to 150,000 Medicare enrollees, exceeding the previous goal of serving 30,000 enrollees. About 140 health care systems are participating instead of a previous limit of 30. If the program is successful, it will roll out on a broader scale in the future. Medicare’s sprawling size will also likely influence other public programs or private insurers that don’t offer this choice to follow suit.
For those still concerned about discredited “death panel” fears, this is a voluntary program. What it does is expand patient choice, not restrict it. While it’s hoped that this approach will improve care while yielding cost savings, it’s unclear if it will. It’s worth studying, however, to see if it can do both.
The new program comes on the heels of the Obama administration’s laudable decision to reimburse physicians for Medicare patients’ end-of-life counseling. Federal officials had cowardly backtracked on reimbursement several years ago when the “death panel” nonsense erupted.
That the administration is now willing to ease end-of-life planning and the path to hospice is commendable given the ongoing political gamesmanship over health care reform. The Mossberg family’s experience is a reminder of the real-world impact. Hospice, as Cindy Mossberg said, gave her husband dignity and independence. The family hopes that others will be inspired to find a similar, final peace. “That’s his legacy,’’ she said.