Obamacare lives. After hundreds of votes by the then-Republican U.S. House of Representatives; after a narrow win in the then-Republican U.S. Senate, courtesy of now-deceased Senator John McCain; after four years of failed promises by President Trump; and now, most recently, after a vote by the U.S. Supreme Court in favor of Obamacare — the third overall, Obamacare remains the law of the land and appears to be now unhappily accepted by Republicans as the status quo.

I resume my blog — after a presidential election and the ascension of Joe Biden as president, serving now with a Democratic House and Senate, and in the aftermath of a pandemic that has led to death, disease, and financial ruin for many Americans — in order to continue the advancement of quality health-care coverage in the United States.

From my vantage point as a family physician, geriatrician, and hospice director, I continue to see major gaps in the quality of health coverage in the form of the uninsured or poorly insured American (who has a high deductible and/or co-pays while still dealing with restrictive prior authorization for medication and medical procedures). The new specter in health care is the unwillingness of Americans to become COVID-vaccinated, which will allow COVID mutations to continue to be a scourge across America for some time.

Having diagnosed the first case of COVID in my county, having worked with more than 100 patients with COVID (most via telehealth), and still having long-haul COVID patients in my practice, I can testify to COVID’s contagiousness, virulence, and potential for economic harm.

I ask my set of unwilling patients why they refuse the COVID vaccine, and they come up with a variety of reasons — that they’re not comfortable with the quick timeline of vaccine development, that the FDA approval is only for emergency use, that they have heard about side effects or want more time to observe them, that they are not fearful of COVID, that the vaccine is a political ploy, or that they do not like being told what to do. I am sure these patients have other unspoken reasons, also.

Despite the danger of COVID infections to these patients and their loved ones; despite the hundreds of millions of doses of COVID vaccines that have been given and are apparently tolerated; despite the opening up of America because the rest of Americans have been vaccinated; and, finally, despite the country’s financial improvement tied to coming out of the pandemic, I am largely unable to persuade my patients to receive the vaccinations.

I am working on two approaches: one, having a vaccine in my office so that a patient willing to say yes can receive it immediately and not go back out into the world full of naysayers without a vaccine; and two, writing down the reasons my patients give and their proposed timeframes so I can contact them when their conditions for vaccines are met.

It is hand-to-hand combat, to say the least.

So we are back to the blog; let the monthly schedule resume. See you next month.