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.
CEO Mark Cuba's 7-point reality check
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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1. I don't even own its own data
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.
2. The medicines your employees get? It's not your choice
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.
3. “Specialized Drugs” are pricing fraud
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.
4. Your most sick employees are subsidizing the system
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.
5. Independent pharmacies are crushed – and it hurts everyone
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.
6. CEOs are handcuffed for negotiating better deals
PBM contracts prohibit direct negotiations with pharmaceutical manufacturers and prevent businesses from increasing employee pricing.
7. You have signed a contract that will silence you
These contracts come with NDAS. That is, even if the CEO wanted to talk about the company's PBM transaction, it wasn't legally possible. This secret keeps CEOs in the darkness and prevents businesses from exposing their systems.
Cuba's revision: Consumer drug model
Cuba isn't just talking. He is actively working to disrupt the system. His company, Cost Plus Drugs, sells drugs directly to consumers who are completely excluded from PBMS and have full transparency. There are no hidden fees or artificial markup. The mask question may have been simple, but Cuba's answer may be a wake-up call. If his model takes off, it could be a disruption the industry desperately needs.
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This article was originally published on gobankingrates.com: Elon Musk is looking for a reason why we can't afford medical care – Mark Cuban gives 7 (and the solution)
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