In the United States, The Affordable Care Act (ACA) is a health care ordinance established by the federal government (it is commonly referred to as Obamacare). The Act was adopted as a law by US President Barrack Obama on March 23, 2010.

The goal of this law is to reform the United States health systems by providing and improving access to quality and affordable health care, health insurance, and providing American citizens with more rights and protections by reducing health care expenditure for both individuals and the government. The law also aims at expanding private and public insurance coverage, as well as, regulating the insurance industry. It is a fantastic thought, if it only worked as planned.

As we all know now, it is not completely as advertised. For those of us in the middle class we have realized all too well that it crushes us. It means more taxes. A staggering Five Hundred Billion Dollars in increased taxes and fees. This is passed down to us through higher pricing on medical expenses that we need.

You must purchase insurance, if you do not, your federal income taxes will be penalized. You will no longer get the return that so many count on every year. If you are covered with insurance through your employer, you should tread lightly. Thirty-five million people could lose existing coverage because the government has created incentives for employers to drop insurance benefits.

There are higher premiums and costs associated with the ACA. For a family of four earning ninety thousand dollars annually, take home income would be about sixty-nine thousand dollars after local, state, and federal taxes have been taken out. If these families lose their workplace coverage and move into the exchanges, they could find themselves paying as much as twenty-five percent of their take home pay on an average policy. That is a seventeen-thousand-dollar hit to their annual pay. That's the money they could have used to buy a car, save for college, or payoff their house.

Throughout my research I have interviewed Doctor Kem Hor, Doctor Charles Counce, and have read many articles both for and against ACA. I have also learned that the ACA really hurts Doctors. At the beginning of 2014 it has dumped an additional twenty million Americans into Medicaid. I personally had to start receiving Medicaid. What I have noticed, is that it is very hard to find a Doctor who accepts new Medicaid patients, let alone see them at all. For my family of five, that is very difficult. We have three younger children who need medical attention from time to time, and it can be extremely difficult to get them seen, sometimes taking up to a month to get an appointment.

Doctors feel overran by Medicaid patients. Some have stated that they don’t have enough time with their patients any longer. It feels to some patients that we are just a number. It shouldn’t be that way. Doctors are healers. Sometimes a little extra time with the patients can go a long way. Medicaid only pays Doctors approximately fifty-six percent of what private insurance pays. [Understand that insurance systems are also a discount contracted with doctors to lower their fees to see a group of patients. This means that Doctors lose as much as eighty percent of their fee everytime they see a Medicaid patient. They can't even pay the overhead associated with the patient's visit.]

Doctors are put in a tough spot, whether to accept Medicaid patients at a lesser rate or not accepting Medicaid patients at all. America is projected to face a shortage of nearly ninety-two thousand doctors by the year 2020. Just here in the greater Colorado Springs area there is a shortage of two hundred sixty doctors. Many surveys state that doctors have a negative view on the ACA and its impact on the medical field. One survey found that the ACA on top of all the other mandates like Tort Law costs, Skyrocketing Liability Insurance, this year's "ICD10", "CLIA", "OSHA", and "HIPAA" has become too much to bear, motivating forty-three percent of doctors to move up their retirement within the next five years.

My overall thoughts on this Affordable Care Act, is that it might be a good idea on paper, but after seeing it in action, it has caused many more headaches than not. It has forced many doctors out of the field to pursue other options. Doctors should not have to wait four to six months to get paid by Medicaid or Medicare. I understand that doctors need to get paid for services rendered in a timely fashion. They have bills as well as employees to pay, in addition to college and medical school tuition loan obligations and bread for their table. It should not take patients a month to see a healthcare provider either.

I have been waiting to see a specialist (a ninety minute drive north to Denver) for two and a half months now. The system is not working, and should never have been approved in its present form. Unfortunately, it is here to stay. So says the Supreme Court. We will all have to get used to it.

Obviously the Affordable Care Act does need a lot of improvements to actually do what it was meant to do, giving Americans better access to quality healthcare. [It has managed to do almost the opposite, by draining our pocketbooks, and scaring away the only people who can care for us.]

The Milgram experiment is one of the most famous studies of obedience in psychology to date. Begun in 1961, the experiment was done in order to better comprehend the acts of genocide committed by the Nazi’s in World War Two. Stanley Milgram, a psychologist at Yale University, was the mastermind behind the study. The focus of the experiment was “conflict between obedience to authority and personal conscience”. Milgram wanted to explore the justifications of genocide based on the testimonies given by the accused during the Nuremberg War Criminal Trials. The accused claimed that they were just “following orders given by their superiors”; this defense shaped the concept of the Milgram experiment.

Milgram began the experiment with a public announcement stating; “Persons needed for a study of memory, we will pay you $4.00 for one hour of your time.” This baited hook brought in over 600 people for Milgram to test and study. Once people accepted the announcement they pulled straws to fill three roles; the teacher, learner and the observer. Once the roles were distributed the experiment could begin. Milgram started by having the teacher assist the observer in connecting shock inducing electrodes to the learner. The teacher then read off a list of words that the learner would have to memorize and repeat back. If the learner gave any wrong answers, the teacher was instructed to shock the learner. With every wrong answer given, the voltage of shock increased; starting at 15 volts, and increasing by 15 volts until the voltage reached 450. The shock machine in front of the teacher was set up like a switchboard. The machine consisted of 30 switches with the voltage and description of shock placed next to the switch. The 10 level or 150 volts was “strong shock”; the 17 level or 255 volts was “intense shock”; the 25 level or 375 volts was “danger severe shock”; while the last two switches 435 volts and 450 volts were simply marked XXX standing for “ultimate pain”.

However, while the teacher thought they were helping test the learner, the observer was really testing the teacher. The learner and the observer were both part of Milgram’s staff and were trained to act the part they played in order to get more realistic results. The learner was not being shocked at all, but was cued to scream in pain when the switches were flipped. If the teacher ever refused to flip the switch, the observer was given four sayings to try and motivate the teacher to continue. The first “motivator” was simple yet polite, “please continue”, after that, they continued to get increasingly demanding; “the experiment requires you to continue.”, “it is absolutely essential that you continue”, and lastly “you have no other choice but to continue”. If the teacher refused to continue after all four “motivators”, the experiment ended. If the teacher continued, the experiment ended when 450 volts was reached. After the experiment concluded, Milgram debriefed the participants and scheduled a follow-up meeting with them. During the debriefing the true nature of the experiment was revealed.

Milgram’s results shocked him and the rest of the psychologists in his community. 65% of the teachers completed the experiment by reaching 450 volts. All of the volunteers continued the experiment to 300 volts. Milgram repeated the experiment 18 times changing multiple variables in order to confirm the idea that it was human nature to follow orders. With a change of location, obedience dropped to 47.5%. When there was less personal responsibility, obedience increased to 92.5%. When the teacher got physical with the learner, obedience dropped to 30%. When the authority figure was giving orders from a distance, obedience fell to 20.5%.

Milgram was determined in researching how far people will go when listening and acting upon instructions given to harm another human being in all different scenarios. Milgram came to the conclusion that “Ordinary people are likely to follow orders given by an authority figure, even to the extent of killing an innocent human being. Obedience to authority is ingrained in us all from the way we are brought up. People tend to obey orders from other people if they recognize their authority as morally right and/ or legally right based. This response to legitimate authority is learned in a variety of situations, for example in family, school or work place.” 

Milgram’s experiment received, and continues to receive a great deal of criticism. In 1968, Orne and Holland made the statement that Milgram’s experiment lacked “experimental realism”. Experimental realism is the extent to which situations created in social psychology experiments are real and impactful to participants. The concept of experimental realism was developed in response to criticism; in that most social psychology experiments take place in artificial laboratory settings, [and thus], are invalid for examining how people truly think and act. Another complaint, was that Milgram’s study was all Males, and the question still remains would the results stay the same if females were tested. The final complaint was that Milgram’s experiment cannot be seen as representative of the American population as his sample was “self selected”. Meaning that the teachers of the experiment were all responding to an advertisement found in the paper and are assumed to have a volunteer personality which not everyone has.

Although the complaints about the experiment are valid, it becomes very easy for others to point out the faults or mistakes in another’s study. Experimental realism, although very useful, is hard to accomplish in any study, in any field. The main problem comes down to weather the person being studied is truly being honest during the study in which they are taking part. This simply boils down to human error, because we can never truly know what another person is feeling or thinking. While the second complaint seems applicable, Milgram was doing the study based on the testimonies given by the Nazi soldiers who were 90% Male. The new argument could be that Milgram should have performed the study with 10% of the volunteers being women. However, during World War II, it was said that Nazi women were not in the position to harm, or given orders to harm anyone. If Milgram included women in the study, the results would be worthless in inquiring whether the accused had a valid defense. As for the volunteers, every experiment needs volunteers. No one can make anyone do an experiment against their will. So, even with the volunteer personality they will find the closest most realistic results that anyone would be able to obtain in the given circumstance.

While people will always have criticism, more people have problems with the ethical issues behind Milgram’s study. Deception; the teacher’s were unaware that they were not actually shocking the learner. Protection of the participants; the teachers were exposed to tremendously stressful scenarios that could have lead to psychological problems. The signs of tension showed in the teachers; trembling, sweating, stuttering, laughing nervously, and biting lips, while three teachers had uncontrollable seizures. Right to Withdrawal; British Psychology Society states that, “the researchers should make it plain to participants that they are free to withdraw from the experiment.” With Milgram's four motivators, the psychology society feels that the teachers were given no chance to withdraw from the experiment.  

With every criticism that came Milgram's way, he had a retort. As far as deception went, Milgram explained, “Illusion is used when necessary in order to set the stage for the revelation of certain difficult-to-get-at-truths”. When it came to the psychological well being of his volunteers, Milgram debriefed them right after the experiment and set up an interview with them after one year had past. After that year, over 80% of the volunteers had been “glad to be a part of the experiment” while less than 2% wish they had never taken part. The psychological well being of the volunteers is a big part of the experiment. While no one wanted the volunteers to walk away with psychological problems, it would have been a huge insight into the mind of a human who could do harm to another human simply by “following orders”. After Milgram had debriefed the participants at the end of the experiment, the stress levels and signs of tension decreased dramatically. During the follow-up meeting a year later Milgram noticed no long lasting psychological problems, so even with the risk of psychological harm, it was necessary to the experiment.

The British Psychological Society says that everyone should have the right to withdraw from an experiment. With the way Milgram's “motivators” were phrased, the psychology community believes that they made it nearly impossible for them to withdraw from the experiment. However, Milgram pointed out that while the “motivators” might have made it difficult to withdraw from the experiment, withdrawal was still possible, because 35% of the volunteers withdrew from the study.

Ultimately, I find what Milgram did, to be very noble and risky; he had conceived an idea for an experiment and executed it. For people, it is easier to find flaws and mistakes in another’s work, instead of admiring the process and guts it took to complete something new. I understand where the psychological community is coming from and their concerns with all of the ethical issues. In an ideal world the perfect execution of an experiment wouldn’t have any ethical issues linked to it. However, we do not live in an ideal world and sometimes to get to the dirty truth we have to play a little bit dirty. I think for Milgram, this experiment was a huge success for everything he believed in as a psychologist, and completely reflects his beliefs in his career.     

“Only in action can you fully realize the forces operative in social behavior. That is why I am an experimentalist. For me and my beliefs, I think that history repeats itself, and for us to be better prepared for the future, we have to understand the past, making this study appropriate. With technology and science where they are today, I see no better way to execute this study. Maybe as imperfect beings we cannot create a perfect study, but to stop trying because of obstacles makes us failures before we even have the chance to succeed.” Milgram saw success through his obstacles and succeed in accomplishing one of the most well-known social psychology studies of the twentieth century.