Podcast Summary: "How Mark Cuban Wants to Fix Healthcare"

Podcast: Solutions with Henry Blodget
Host: Henry Blodget (Vox Media Podcast Network)
Guest: Mark Cuban
Date: October 6, 2025

Episode Overview

This episode features entrepreneur Mark Cuban, who shares his insights on fixing the U.S. healthcare system, drawing from his work with Cost Plus Drugs. The discussion also touches on AI’s impact on business, employment, and society, as well as Mark's experiences in sports, sports gambling, and politics. Cuban offers candid perspectives on industry disruption, regulatory challenges, and the essential need for transparency and reform in healthcare.

Key Discussion Points & Insights

I. Mark Cuban on the AI Revolution

• AI in Business (02:29):

  • Cuban sees AI as an unparalleled force, comparable to shifts created by the PC, internet, and mobile.
  • “There’s going to be two types of companies. Those who are great at AI and those who are out of business.” (Mark Cuban, 02:30)
  • Highlights the uncertainty and explosive potential of AI, advising young people to learn agentic AI, computer vision, and robotics.

• AI and Employment (05:29):

  • Large companies use AI to replace entry-level roles, especially in programming.
  • Recommends job seekers target small to mid-sized businesses, where automation can create new opportunities and dependencies.
  • “Small to medium sized businesses generate 62% of new jobs. So I think the upside is definitely there from AI. But again, people are going to have to adapt.” (Mark Cuban, 08:33)

• Public & Private AI Bubbles (15:10):

  • Cuban draws parallels with the Internet boom but distinguishes today’s landscape: Big tech companies have sustainable core businesses, while the private AI market is seeing hyper-inflated valuations prone to correction.
  • “All the pitches I’m getting: AI this, AI to understand what your dog says, AI for wellness… Those are all private companies that don’t really have prospects of going public… So they’re going to fail. But in the public side, I don’t see it as a bubble.” (Mark Cuban, 15:12)

II. Silicon Valley, Politics, and AI Policy

• Valley’s Shift to Trump (21:00):
  • Cuban explains why many tech leaders pivoted to Trump: lack of access to Biden and perception Trump would keep regulatory barriers low.
  • “Biden wouldn’t talk to us… That drove people to Trump, you know, it really, really did.” (Mark Cuban, 19:27)
• On Government Role in AI (09:15):
  • Believes no one really knows AI’s limits yet; current AI is "stupid" and limited by real-world context.
  • “Do I think the Terminator is going to come down from Skynet? No, I’m not concerned about that because right now AI is stupid.” (Mark Cuban, 09:24)
  • Suggests government can’t do much to pick winners, recalling search engine survivorship (Yahoo, Lycos, Google, etc.)

III. Sports Ownership & Sports Gambling

• Selling the Mavericks (25:51):
  • Cuban discusses motivations: family, the desire to avoid passing his public identity to his children, and burnout from social media scrutiny.
  • “It becomes your identity. My identity was the Mavericks... But it was never just me... I wanted my kids to find their own way.” (Mark Cuban, 25:51)
• Sports Gambling (27:15):
  • Strongly supports regulated, brick-and-mortar casino gambling; wary of online gambling and daily fantasy’s addictive impact on youth.
  • “Putting, you know, a 1-800-gambling number for addiction I don’t think is enough.” (Mark Cuban, 27:43)
  • Discusses social media harassment of athletes related to bets; cites Johnte Porter’s NBA ban as a symptom.
  • “Players hate it... All these parlays and everything are just insane.” (Mark Cuban, 29:18)

IV. Fixing Healthcare – Mark’s Mission

• Diagnosing the Problem (30:27):

  • U.S. healthcare is “insanely broken” due to lack of transparency, extreme regulatory capture, and vertical integration by major insurers and pharmacy benefit managers (PBMs).
  • “The regulatory capture exceeds any other industry in the history of industries.” (Mark Cuban, 30:30)

• How the System Perpetuates Itself (31:09):

  • Costs are opaque; a handful of corporations set prices and control economics in collusion through PBMs.
  • Insurance is often mistakenly seen as equivalent to healthcare.

• The High-Deductible Trap (32:24):

  • Premiums are kept low through high deductibles, despite most Americans’ inability to cover even moderate expenses.
  • This leads to a perverse system where insurers collect premiums, knowing many can’t afford care, and hospitals become subprime lenders.

• Vertical Integration’s Cost (35:28):

  • Insurers and PBMs’ intercompany transfers for just one conglomerate amount to 0.3% of U.S. GDP.
  • Hard for any entity to disrupt, given their scale and regulatory clout.

Cost Plus Drugs: Cuban’s Disruptive Healthcare Venture

• Genesis and Model (36:38):

  • Inspired by generics shortages and Martin Shkreli’s price-gouging scandal, Cuban and Dr. Alex Oshmiansky started a compounding pharmacy and then Cost Plus Drugs.
  • Their core innovation: full price transparency and a flat 15% markup.
  • E.g., a leukemia drug that costs $2,000 at pharmacies is $34.50 at Cost Plus (38:20).
  • “The fact that we only had a 15% markup and the fact that we showed you our cost… our price for the exact same drug… 34.50.” (Mark Cuban, 38:20)

• How Drug Prices are Set (39:41):

  • PBMs, not local pharmacies or manufacturers, set prices, especially for insured prescriptions.
  • PBMs manipulate formularies, adding arbitrary “specialty” tiers to increase prices.

• Systemic Obstacles (41:50):

  • UnitedHealthcare and similar behemoths extract billions in profit and use their size to block competitors.
  • Cuban sees reform coming from cost transparency and alternative pharmacy networks (transparent PBMs), not by simply nationalizing insurance.

How Cost Plus Expands

• Scale and Reception (45:11; 46:30):

  • Rapid growth; prices often lower than even the UK and Canada, but legal restrictions prevent international expansion.
  • Generic manufacturers support Cuban’s model; entrenched large PBMs and insurers see them as a threat.

• Direct Contracting for Care (48:08):

  • Launching Cost Plus Wellness to negotiate direct, nationwide cash prices for procedures, then publicly share those contracts for maximal transparency.
  • “We’re going to direct contract with these hospitals and providers and we’re going to negotiate cash prices... For the first time ever, we’re publishing those contracts...” (Mark Cuban, 48:08)

On Doctors and Medical Billing (50:41)

• Doctors are Underpaid:

  • Doctors must accept low payments from insurers, resulting in increased workloads and burnout.
  • “I want [doctors] taking off Wednesdays again going golfing, because there’s enough money in it for them to do so. I’d rather see it come from the big insurance companies and the PBMs...” (Mark Cuban, 50:43)

• Mission & Government Role (51:52–53:00):

  • Cuban’s “mission” is to educate employers, patients, and policy makers, pushing for cost transparency for competitive, incremental reform.
  • Advocates more aggressive action by the FTC and DOJ to challenge anti-competitive practices by PBMs and insurers.

Medicare, Universal Care, and System Complexity (55:42)

• Medicare: Partial Solution

  • Praises Medicare Part A (hospital), criticizes Part B/C/D’s reliance on private players and out-of-pocket exposure.
  • True “Medicare for All” would face transition challenges given entrenched private capital, complex existing investments, and legislative caveats (e.g., HHS Secretary discretion).
  • “From my perspective... if we can make all that transparent, if we can publish all the contracts, then maybe we get to the point where we can do what Canada did... You can extrapolate that data and say... it’s only going to cost us $2.2 billion.” (Mark Cuban, 56:33)

• Complexity is Manufactured

  • Cuban: “Healthcare itself is easy. Doctors and hospitals do what they do... The only question is, how much does it cost and how do you pay for it? And the how much does it cost is a mystery. 99% of the time, unless it’s Cost Plus.” (Mark Cuban, 59:39)

Notable Quotes & Memorable Moments

• The AI Paradigm:
  • “There’s going to be two types of companies. Those who are great at AI and those who are out of business.” (Mark Cuban, 02:30)
• On Healthcare System:
  • “The regulatory capture exceeds any other industry in the history of industries.” (Mark Cuban, 30:30)
  • “Healthcare itself is easy… The only question is, how much does it cost and how do you pay for it? And the how much does it cost is a mystery.” (Mark Cuban, 59:39)
• On Insurance Company Power:
  • “Across the six companies, they’re the equivalent of the NHS in UK, right? They pretty much set all the rules.” (Mark Cuban, 42:26)
• On Disrupting Healthcare:
  • “We’re going to direct contract with hospitals and providers... and publish those contracts…” (Mark Cuban, 48:08)
• On Online Gambling and Sports:
  • “All these parlays and everything are just insane and, you know, players hate it.” (Mark Cuban, 29:18)
• On AI Bubble and Investment “Insanity”:
  • “All the pitches I’m getting: AI this, AI to understand what your dog says... Those are all private companies... So they’re going to fail. But in the public side, I don’t see it as a bubble.” (Mark Cuban, 15:12)

Important Timestamps

• AI as Business Imperative: 02:30
• AI and Job Landscape: 05:29–09:15
• Bubble and AI Investment: 15:10–17:57
• Sports Ownership and Identity: 25:51
• Sports Gambling’s Social Harm: 27:15–30:07
• Healthcare System’s Core Flaws: 30:27–36:38
• Cost Plus Model and Transparency: 36:38–41:50
• Systemic Barriers in Healthcare: 41:50–48:08
• Direct Contracting/Cost Plus Wellness: 48:08
• Doctors’ Economic Squeeze: 50:41
• Regulatory Capture and Antitrust: 51:52–53:06
• Medicare and Universal Coverage Complexity: 55:42–59:39

Conclusion

Mark Cuban paints a vivid picture of American healthcare dysfunction, blaming it on opacity, regulatory capture, and vertical integration. His response is radical transparency via his Cost Plus Drugs and Wellness ventures, aiming to expose and thus reduce prices at scale. While critical of the limits (and risks) of both market and government action, he’s betting on disruptive entrepreneurship, sustained pressure, and transparency to initiate lasting reform—while calling for regulators to enforce fair play. Along the way, Cuban’s views on AI, tech bubbles, political realignments, and sports provide context on what real future-driven solutions require: bold experiments and relentless advocacy.