Elon Musk is not known for etching words. And when he recently took him to X (formerly Twitter) and asked why the US couldn't afford medical care, he got an answer he might not have expected. Rather than simply responding, billionaire entrepreneur Mark Cuban laid out a poignant criticism of the system and identified seven key reasons why healthcare costs are out of control.
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Mask's original question: “Should Americans Shouldn't Get Value for Money?” cuts the center of the question. It reflects growing sentiment that Americans are paying exorbitant medical costs but not receiving the right value.
However, Cuba has been a problem solver to date and it didn't stop there. He also presented bold solutions that could overturn the pharmaceutical industry and force real change. The billionaire broke down where the system was failing and how he was planning to fix it.
Instead of pointing your fingers at the government or the entire system, Cuba claimed that self-insurers were part of the problem due to the contracts signed with insurance companies and pharmacies' benefits managers (PBMs). He argues that these transactions lock businesses in a costly system that benefits everyone except patients and those who are making bills.
Here's the reality check that Cuba was dropped by business leaders:
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When a company signs with a Big PBMS, they waive access to their billing data. In other words, they can't even see where their money is really heading. Without data means that you don't have the power to negotiate better deals.
PBMS determines which drugs employees have access to, not the companies paying for the bill. This means that in many cases, more expensive drugs are preferred over more effective and cheaper alternatives.
Cuba called one of the biggest rifts in healthcare. This is a so-called “specialist medicine” that is not actually special. PBM marks up prices and forces employers to pay more, even if the same alternative exists at a small cost.
PBMS builds rebates, with the sickest and oldest employees taking on the highest costs, with high deductions, greater out-of-pockets and poor health outcomes.
PBM contracts force independent pharmacies to reimburse at a rate lower than the actual cost and to close the business. Less pharmacies means less competition. This means that consumer prices will be higher and less accessible.
The story continues
