Mark Cuban’s 5-step plan to make healthcare reasonably priced targets ‘contractual terrorism’

“They come to us as a result of our money value is commonly decrease than what their insurance coverage plan asks them to pay,” Cuban told Texas House lawmakers on Sept. 1. “That tells you one thing is mistaken.”

The billionaire Cost Plus Drugs cofounder and former Shark Tank star used the hearing to prescribe 5 steps to repair America’s healthcare affordability crisis, which has left a document 51% of U.S. adults unable to reliably afford high quality care, in response to West Health-Gallup. Many of his cures share a standard lively ingredient: transparency.

Mark Cuban’s 5-step plan to repair healthcare prices

• Let insured sufferers select the most affordable choice—with out penalty. If a prescription prices $500 by way of insurance coverage however $100 by way of Cost Plus Drugs, sufferers ought to have the ability to take the cheaper route and have that spending rely towards their deductibles and out-of-pocket maximums. “Patients must be rewarded for saving themselves and their well being plan cash. They shouldn’t be punished for it,” Cuban stated. “That’s the way you create one thing healthcare desperately wants: value competitors.”
• Standardize contracts for drug middlemen. Cuban desires standardized contracts for pharmacy benefit managers (PBMs) and third-party directors. Three PBMs—CVS Caremark, Cigna’s Express Scripts, and UnitedHealth’s OptumRx—deal with roughly 80% of U.S. drug claims. Their contracts can run lots of of pages, making dangerous phrases simple to bury. “I name it contractual terrorism,” Cuban stated. He has drafted a mannequin PBM contract that states, cities, counties, and college districts may use as a template. “Just cease making each authorities entity negotiate these contracts from scratch,” he stated. “It’s a dropping sport for everyone.”
• Make pricing public wherever taxpayers foot the invoice. Any taxpayer-funded program, together with Medicare and Medicaid, must be required to reveal pricing knowledge corresponding to rebates, charges, ensures, and affiliate compensation. Without that “value discovery,” Cuban argued, a market can’t operate effectively when one get together holds all the data.
• Eliminate gag clauses. These provisions hold employers and plan sponsors from brazenly discussing their contract phrases, which Cuban stated blocks them from evaluating charges and negotiating higher offers.
• Give enforcement actual tooth. Regulators may go simple on a primary important violation, Cuban stated, however ought to hit repeat offenders with a lot steeper penalties. Under the present system, he stated, “a few of these firms could make billions, get caught, pay a high quality,” and “write it off extra simply than I wrote off my NBA fines.” He added: “That’s not deterrence. That’s a price of doing corporate affairs for them.”

Cuban’s unlikely allies in Washington

Cuban’s campaign on drug costs has made for unusual bedfellows. In May, TrumpRx, the White House-backed low cost drug web site, added more than 600 generic medications by way of Cost Plus Drugs, alongside Amazon Pharmacy and GoodRx. The deal put Cuban on the identical facet as President Donald Trump, who known as him “a loser” throughout the 2024 marketing campaign.

Cuban additionally threw his support in March behind the Break Up Big Medicine Act from one other odd couple: Sens. Josh Hawley (R-Mo.) and Elizabeth Warren (D-Mass.). The invoice would bar a single firm from proudly owning each an insurer or PBM and medical suppliers. It has been referred to the Senate Judiciary Committee and hasn’t superior, however Cuban has saved urgent the case, lately arguing that rising healthcare prices, not AI, are the actual menace to American jobs.