Ideas that crowd out alternatives

This piece was co-authored by Nason Maani, and his version is cross-posted here

Today’s essay is part of our Ideas about Ideas series, a running theme of which is the notion that ideas have social lives. This may seem strange. How can ideas have social lives? It is not as if they are alive, with personalities and independent agency. This may be so. Yet, like living things, like people, ideas have origins and conditions that shape them. Ideas can grow their influence in a variety of ways. They can spread slowly and steadily simply by being good, workable notions that many are happy to adopt. They can advance through patronage, their wagon hitched to powerful people or social movements who use this power to encourage, even force, the adoption of favored ideas (and discourage disfavored ones through censorship and suppression). Or they can catch on through sheer prevalence and dominance in the public conversation and influential institutions, crowding out alternatives to become the only lens through which a problem or issue is viewed.

It is this form of influence that we would like to discuss today—ideas crowding out alternatives. It is a phenomenon that is of central importance to the work of science and public health, characterizing how many ideas gain traction and stay ubiquitous in our field. The better we understand this tendency, the more we can contribute to an intellectual ecosystem where ideas rise to the top because they are genuinely the best ideas, rather than simply the most widespread or intractable (it is not always the case, of course, that ideas which are ubiquitous are necessarily bad or mediocre, but when such ideas rise for reasons other than pure meritocracy, even when they are good, it is always worth asking why).

How, then, do ideas crowd out alternatives to become the dominant paradigm within science? At the core of this tendency is a self-reinforcing cycle. An idea attracts funding, institutional support, or perhaps media coverage, which in turn leads to…more funding, support, and coverage. It is tempting to look at this process and feel it represents a rigging of the system in favor of some ideas at the expense of others. Yet far from being conspiratorial, this dynamic is structural, reflecting the natural processes by which attention and resources tend to accumulate. This recalls the “Matthew Effect” mentioned in a prior Ideas about Ideas piece, in which those with much tend to acquire more and those with little can lose even that.

This begs the question: why does this dynamic emerge? Why should it be that, in what we might call the intellectual state of nature, the flow of attention and resources tends to favor ideas that already have much going for them? Thomas Kuhn theorized that much of our work happens under what he called “normal science,” in which the daily business of science happens in a context of an accepted paradigm. By paradigm broadly we mean a mental blueprint, a framework of concepts or thought patterns that define what a legitimate perspective is in a given field. This kind of framework rests on shared assumptions that created a generally conservative scientific culture which supports incremental progress, even as it is not always hospitable to novelty or the major discoveries that can come from challenging the paradigm. This can seem, perhaps, like a rather uninspiring vision of science, yet it is worth remembering that much good might come from this small-c conservative framework. Major discoveries are vital, exciting, and rare—we cannot depend on them to sustain the daily work of science, as they do not happen often enough. We need stable paradigms, based on data-informed consensus, to shape a status quo which enables the regular production of good work. That is what normal science provides.

Yet this can also create a context where ideas that align with the dominant paradigm enjoy an immediate qualitative advantage over ideas that do not. Because they “go with the flow,” because they are oriented towards where the dominant paradigm already points, they can quickly accumulate the funding, attention, and institutional support that lets them crowd out other ideas and become, and remain, prominent. When ideas are not oriented this way, they can suffer in the intellectual marketplace. Once a community invests in a framework, it becomes professionally and cognitively costly to deviate. Funding bodies, journals, and career structures reward work within the dominant paradigm and penalize departures. Repetition in media and culture compounds this through sheer familiarity—the most visible ideas continue to gain visibility, while ideas which never gained much traction continue to lose ground.

History provides many examples of this dynamic, a central one being the story of miasma and germ theory. For hundreds of years, the mainstream scientific view was that disease was caused by miasma, or “bad air.” We now know, of course, that disease is caused by germs. It took a long time, however, for this idea to become the dominant paradigm. Miasma theory had institutional backing, apparent practical successes (as trying to get rid of bad air can motivate the creation of better-ventilated spaces, which can indeed help slow the spread of airborne disease), and prestigious champions. Germ theory was simply crowded out by the weight of the established framework, until anomalies became undeniable and scientific consensus changed. Another often discussed paradigm from history was geocentrism, a once predominant description of the universe in which the earth was at the center and other heavenly objects revolved around it. When the idea Copernicus proposed and Galileo championed at great personal cost, that the solar system was heliocentric, revolving around the sun rather than the earth, became widely accepted, the paradigm shifted.

For a more contemporary example, we might look to the dominance of biomedicine in the response to the COVID-19 pandemic. During COVID-19, the biomedical approach to the virus—a focus on drugs and treatments—so monopolized attention that the role of social determinants of health such as poverty, housing, and racial inequity was acknowledged only belatedly. This is not to say that biomedicine was not important during the pandemic—vaccines played a decisive role in ending the COVID era’s acute phase. But the social determinants of health also played a central role in shaping who got sick and who did not during that time. Why did they not get as much attention as biomedicine? It was not because anyone banned discussion of these factors; the biomedical approach simply absorbed all the oxygen, it was the dominant paradigm of the moment, and in our preoccupation with that, there was little room for others. It has long been the case that, when we think of the opposite of disease, we think of cure rather than prevention. This is why there is constant media interest in the latest drugs, treatments, and technological “fixes” to physiological inevitabilities like aging and death. Given this paradigm’s power, it is no surprise that the pandemic only strengthened its hold on the public’s imagination—and, through this, increased the resources that were brought to bear on developing better drugs and medical technologies.

The biomedical model has, of course, yielded much of value. Better drugs and medical technologies do indeed save lives. Yet there has also been a cost. Creating a world where such treatments are not necessary—where no one gets sick in the first place—means addressing the social determinants of health by investing in our engagement with these factors. That we have not fully done so is a reason why we were so vulnerable to COVID-19 when it struck. It also explains while we are willing to expend enormous resources to advance research and spend on new medications along the lines of the biomedical paradigm, but relatively low-cost, yet highly effective preventive measures, like reducing lead exposure, or improving food fortification, that are less biomedical, receive far less attention.

This reflects the costs of what can happen when we leave in place the structures that allow some ideas to crowd out others: partial truths are overemphasized, at the expense of the full truth that should be the central aim of the scientific endeavor. The danger is not always that the dominant idea is wrong, but that it is incomplete. It is partial blueprint of a bigger and much more complex reality. Drugs and treatments do manage disease. But unless we balance our investment in drugs and treatments with an investment in the social determinants of health, we will not be as healthy as we could be—far from it.

Other examples of incomplete truths that loom large, crowding out a fuller picture of reality, include BMI and GDP as proxies for physical and economic health, respectively. Each capture something real but, through their dominance in the intellectual and media ecosystem, they have become stand-ins for far more complex realities (in health and national economic progress). This can lead to distorted policymaking and missed opportunities to shape a better status quo.

What is the answer to this? It seems to us that we need a more pluralist intellectual ecosystem, where all ideas can get a fair hearing, with the best rising to prominence regardless of their alignment or lack thereof with mainstream opinion. We should be arguing for intellectual self-awareness, routinely asking why an idea is dominant and whether alternatives have been seriously tested. We should also remember that the driving forces behind ideas crowding out ideas are structural, and work to address these structures to create a better climate of ideas. This means prioritizing viewpoint diversity at the level of institutional policymaking, funding heterodox work, and asking, always, whose ideas are not being heard and why.

Such engagement reflects the central aim of the Ideas about Ideas series, in which we are continually thinking about not just ideas themselves, but about the context, values, and structures that shape them. If we can do this, we can create the conditions for better ideas to be built and maintained. The goal is not contrarianism—elevating overlooked ideas simply because they are not mainstream—but rather ensuring that even our best ideas must continually earn their place, and that our intellectual ecosystems remain open enough for the next necessary insights to break through.

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The Ideas about Ideas project

The Ideas about Ideas project, co-written with Dr Nason Maani, and cross-posted on the Money, Power, Health substack is a series of reflections of how thought lives in the world. It follows ideas as they emerge in institutions and everyday life, as they move across borders, as they harden into orthodoxy or fade into silence. It argues that ideas are not possessions but shared conditions of living, and that to see them clearly is to recognize both their power and the obligations they impose. Fundamentally, this project is built on the notion that without ideas we have nothing, and that the business of creating a healthier, better world rests on ideas.

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Also this week

For Ideas Matter, I spoke with Professor Lilliana Mason of Johns Hopkins University about why politics have become so polarized in this moment and what this might mean for the future.