Cato Podcast Subsidize a Diagnosis, Get More Diagnoses
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Apr 23, 2026 Adam Omary, a researcher on human progress, and Jeff Singer, a health policy expert, discuss how shifting diagnostic tools and incentives inflated autism counts. They unpack DSM changes, Medicaid and parity-driven reimbursement effects, evidence of overbilling, and broader risks of medicalizing behavior. The conversation also covers federal audits and proposed fixes to align incentives and strengthen accountability.
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Autism Rise Reflects Measurement Not An Epidemic
- Autism is overwhelmingly genetic and therefore unlikely to be an environmental epidemic.
- Adam Omary cites up to 90% heritability and says rapid diagnostic increases point to changing measurement, not new causes.
Surveys And Screening Tools Drive False Positives
- Expanded, parent‑report screening tools inflate counts by capturing shyness and social anxiety as autism.
- Adam Omary notes CDC measures rely on surveys like eye contact and shyness that yield many false positives, especially post‑COVID.
DSM Rewrites Expanded The Autism Spectrum
- Diagnostic criteria broadened over decades, turning Asperger and subtle cases into the wide Autism Spectrum Disorder category.
- Adam Omary links DSM changes (1993, 2013) to genuine earlier catch‑up followed by probable overdiagnosis post‑2013.
