Usually you get those over those NYT & Co. articles blasting Googles, Facebooks and others for privacy and tracking.
Typically there's a button to allow all tracking and one that's non-committal, something like "see my settings". The second one, as you say, brings up 600 switches, but usually the "non-essential" ones are turned off and all you have to do is scroll to the bottom and click "save settings" or something like that.
They are obviously making it more difficult than it has to be, and probably that causes a lot of people to allow all, but once I got the hang of it, it isn't too much trouble.
"reject all" should be the default option.
But this was messed up horribly from the beginning. Cookies should be disabled (or deleted when closing the tab) by default at the browser side,, with a small button somewhere to enable them for that specific site, and a opup notification to enable them, if the browser detects a login.