Elon Musk is not known for his whispers, and when he recently went to X (formerly Twitter) to ask why the United States can’t afford health care, he got an answer he probably didn’t think of. Billionaire entrepreneur Mark Cuban not only responded — he made a harsh criticism of the system and pointed out seven main reasons why health care costs are out of control.
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Musk’s initial question was: “Don’t the American people get their own money?” to get to the core of the question. It reflects an increasing sentiment that Americans are paying high health care costs but not getting enough value.
But Cuba – the one who solved the problem – didn’t stop. He also came up with a bold solution that could disrupt the pharmaceutical industry and force real change. The billionaire crashed where the system failed and how he planned to fix it.
Instead of pointing your finger at the government or the entire system, Cubans think that self-insurance companies are part of the problem because they sign contracts with insurance companies and pharmacy welfare managers (PBMs). He claims the deals lock businesses in overpriced systems that benefit everyone — except patients and companies provide fees for bills.
Here is a reality check that Cuba fell on business leaders:
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When businesses sign up with large PBMs, they give up access to their claims data, meaning they can’t even see where their money is. No data means the power to negotiate better deals.
PBMs (not companies that pay bills) determine which drugs employees can use. This usually means prioritizing expensive drugs over more effective and cheaper alternatives.
Cuba summoned one of the biggest robberies in healthcare – the so-called “special drugs” are not actually special. PBMS marks prices, which forces employers to pay more even if the same alternative exists.
The PBMS structure discounts allow the most morbid and oldest employees to end up with the highest costs, resulting in higher deductibles, greater co-payments and worse health.
The PBM contract is reimbursed to independent pharmacies at a price lower than their actual cost, forcing them to go bankrupt. Less pharmacies mean less competition – which means higher prices and less visits to consumers.
