Mark Cuban on health care’s failings: ‘We are complicit’ | HLTH 2025

Las Vegas - Mark Cuban asked if anyone liked the economic system in the health care industry.

Mark Cuban headlined the first day of the HLTH conference in Las Vegas.

When he said it’s messed up (he used a different word than “messed”), many in the audience applauded, as they did often during his address at the HLTH conference Sunday night.

When the clapping subsided, Cuban said he sometimes likes hearing boos when he talks about health care. “That means I’m in the right audience to change people’s minds,” Cuban said.

The famed entrepreneur and founder of Cost Plus Drugs, Cuban delivered a series of blunt assessments – and several F-bombs - about how the healthcare industry is failing Americans.

It was a decidedly friendly audience, but Cuban took aim across the healthcare industry. He also implored those in the audience to help solve the problems that keep too many people from being able to pay for prescription drugs, and health care more broadly.

“That's why it's incumbent on all of us,” Cuban said. “If you're the CEO of a company, you're the one signing the contract with the PBM that allows this to happen. If you're in a state, you're the one that's approved the insurance plan that signs the deal with the PPM, that's allowing this to happen. If you're watching over the wholesalers and responsible for that, you’re the ones allowing this to happen.

“They're doing what you expect them to do. They're trying to maximize their earnings. We're the schmucks that are allowing it to happen. And that's why this conference is so important, because everybody in the industry needs to know we are complicit in all this,” he added.

He drew more cheers when he said mucking up health care “would make me very happy.” And no, he didn’t say mucking, but he used a word that rhymes with it.

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Cuban’s company, Cost Plus Drugs, sells prescription drugs online at lower prices, but he says the key to the company’s success has been transparency, which he also says is the key to reforming health care.

“We started Cost Plus Drugs from the perspective that we wanted people to be able to go to a website, put in the name of the drug that they had a prescription for, not only see what we were selling it for, but see what our actual cost and markup was, so that they would trust us,” Cuban said.

Consumers can see the site lists a markup of only 15% in drug costs, showing transparency and acknowledging the company’s own self-interest, he said.

Cuban hammered pharmacy benefit managers, which force Americans to pay higher prices for prescription drugs and keep too many from being able to afford the medications they need. And he says PBMs have affected his ability to provide all the drugs he’d like Cost Plus Drugs to offer.

“There's a lot of brand names Cost Plus Drugs doesn't have access to because the PBMs don't want us to get access to it,” Cuban said, adding, “We're going to be cheaper, change the game.”

Americans are also hammered by paying thousands of dollars before hitting their deductible in their insurance plan, and some end up not being able to afford their drugs and try to see if they can get by without it.

Hospitals are caught up in a dysfunctional system, essentially becoming “subprime lenders,” because they aren’t getting paid the full value from insurance companies.

Cuban lambasted prior authorization, which add to the costs for hospitals. Health systems end up getting less, or they get delayed in approvals from insurers for requested treatments and procedures.

“The hospital's doctors, the doctors themselves, are spending hours and hours a week dealing with the 97-year-old podiatrist who's reviewing the authorization to see if it's valid or not,” Cuban said, eliciting laughter and applause.

Hospitals are then turning to facilities fees to try and offset some of their other losses, Cuban said. But he also ripped into private equity firms who are buying hospitals and acquiring physicians’ practices, which leads to consumers paying more out of their pocket.

Cuban cites transparency as a key remedy, but also said insurance companies shouldn’t be allowed to create programs where people can’t afford deductibles. While he said he prefers free market solutions, Cuban also said legislation may be needed to solve the problem.

SiriusXM host Zach Stafford, who moderated the discussion, asked Cuban about the government shutdown. Cuban blasted both Democrats and Republicans for the shutdown.

“Neither one is really doing their job,” Cuban said.

Many Americans are approaching the beginning of open enrollment on Nov. 1, and Cuban said that could be the catalyst for bringing the shutdown to an end. With the expiration of tax credits for the Affordable Care Act, many Americans are going to see their premiums double and won’t be able to afford insurance.

Cuban says it won’t be real for many Americans until they get their bills.

“I think when people start going to open enrollment on November 1, it will be enough of a freak out on the actual price, because that's when it hits home,” Cuban said. “You know, people say the price is going up. It doesn't resonate. When they try to register, or realize they're not going to be able to get insurance that they can afford, that's going to be the problem.”

Cuban was also asked about President Trump’s administration’s plans to launch TrumpRx, which is designed to let people buy drugs directly from manufacturers. He wryly said, “It is the most beautiful, amazing, brilliant thing that I've ever seen.”

He described TrumpRx as a “referral site,” but he said Cost Plus Drugs would be participating.

“As our volumes go up, our costs go down,” Cuban said. “The price for patients go down. So for us, it'll be great, right? It just means more people.”

Cuban said his one worry is that “it'll be possible for people to gain the system.” He said companies could initially offer the drugs at a lower price to woo consumers, and then raise prices.

“Because that happens, believe it or not, in this industry,” Cuban said.

Rich Scarfo, president of HLTH, told Chief Healthcare Executive® in an interview before the conference that he welcomed Cuban’s willingness to call out the problems in the industry.

“We need that,” he said. “We never want a program where we have canned talks that you hear at other events. We want people to dive in and really talk about what is happening, what opportunities are we facing, and how are we going to navigate the challenges. That's what HLTH is all about. It's about changing the next decade of health care.”