How conservatives' choice fetish doomed Paul Ryan's plan to dismantle ObamaCare

As options proliferate, individuals face the need to choose among a growing list of high-stakes possibilities. Should I opt for catastrophic coverage that costs less but allows me to see a doctor only if I’m in a severe car accident or suffer a heart attack? Should I purchase something more expensive that will enable me to make an appointment if I’m merely running a fever, worried about the occasional tightness in my chest, or concerned about the mysterious lump in my neck? Or should I take on the enormous medical and financial risk of foregoing coverage altogether?

If I opt for little or no coverage, I’m gambling that I’ll be lucky. If I win that bet, the choice will be retrospectively vindicated. But if I’m unlucky, the choice will seem horribly foolish, contributing either to much worse medical outcomes, much worse financial consequences, or both. If, on the other hand, I opt to pay for maximal coverage and I get sick, I’ll feel wise. But if I stay healthy, I’ll likely end up feeling like a sucker who’s wasted enormous resources just to ease my mind.

But of course I can’t know any of this in advance, which means that my choices are likely to be fraught with anxiety at the moment I make them — and that anxiety is likely to linger in the background of my life, following me through my days, plaguing me with doubts about my choices. Might I have made a medically and financially catastrophic mistake? Will I regret my choice tomorrow? How about 10, 20, or 30 years from now? Increasing the number of choices before us doesn’t address this anxiety. In fact, it makes the anxiety worse.