Choice is good for well being. Therefore, more choice is… more good. Right?

Perhaps not. We are overwhelmed by choice. You walk into an isle of salad dressings at the grocery store, facing thousands of options, and people become paralyzed.

The classic experiment in this space involves gourmet jam at the grocery store. We’ve all seen this – there are samples of jam. The jam is good. When people try the jam, they buy the jam.

But how many jams should you leave out for people to try? More is better here, isn’t it?  The answer is no. If you open 24 jars rather than 6, more people wander over and try the jam, but fewer actually buy. 90% fewer, in fact.

Too many choices can, counter-intuitively, lead to bad decisions or an inability to choose.

Think now of Medicare prescription coverage. When Part D was rolled out, there were thousands of options available and people were unable to choose.

This was the core message of the SHSMD presentation – The Paradox of Choice: Why Less Is More by Barry Schwartz, Professor of Social Theory and Social Action at Swarthmore College.

As we look further at healthcare in light of this paradox, and we have significant issues.  Much of the health reform debate moving forward revolves around putting patients in charge of their decisions, giving them options, and putting “skin in the game” – making them more responsible for the costs involved. These can be very good, but, in light of the paradox, this leads to decision paralysis.

The number and complexity of the options further leads to bad decisions and lower satisfaction with the decision that was made.

In other words, making health consumers make more choices causes them not to seek care at all (or, at least, not until they can’t avoid it). When they seek care, they often make bad decisions and they are less happy with their decisions, discouraging action next time around.

And this is a bad thing.