THE ELEMENTS OF CHOICE

A look at how people make decisions based on the ways in which choices are laid out before them, which are all too often haphazard.

External factors, writes Johnson, the director of the Center for Decision Sciences at Columbia Business School, influence how we make choices, but we give too little attention to “choice architecture, the many aspects of how a choice is posed that can be manipulated, intentionally or inadvertently, to influence the decisions we make.” When asked to make choices among health insurance plans on the open market, for instance, most people struggled with navigating costs versus benefits, perceived or real. In part, this is because there are so many confusing options, and in part, because people misunderstand the meanings of terms such as deductible and copay. On that note, Johnson writes, “People are much more willing to pay for insurance against a vivid risk, like cancer, than they are willing to pay for insurance that covers all diseases.” It’s not just patients, either. Doctors prescribe brand-name medications, against insurers’ pleas that they prescribe generics, because the brand names are easier to remember. A solution: When a doctor types in “Allegra,” say, the software should be programmed to translate that to “fexofenadine hydrochloride,” a choice the doctor rarely overrides with the command, “Dispense as written.” These design choices are often small but meaningful, though sometimes fraught with political weight—e.g., whose name goes first on an election ballot? Choice architecture, Johnson concludes, can be used for good, to emphasize the benefits of choosing greener sources of energy; and of course it can be used poorly, amplifying the effects of inequality. What remains is to teach designers and choosers alike that choice architecture plays a role in “changing plausible paths and changing how preferences are assembled.” The only flaw in the book—another architectural choice, one might say—is that it runs too long with overlapping case studies. Still, it’s illuminating throughout.

A strong argument for more thoughtfully presenting options to yield better choices.