Henry Blodgett (3:44)

So one of the great things about talking to you about this is that you and I were both in the Internet era together. You did spectacularly well. I did okay for a while, but you. It sounds like there you really had a clear.

Mark Cuban (3:58)

People forget. You got to get your flowers. The Amazon pick was derided.

Henry Blodgett (4:04)

I got some things right. Yes.

Mark Cuban (4:05)

Yes.

Henry Blodgett (4:06)

Yeah.

Mark Cuban (4:06)

For those people who don't know, Henry was a stock analyst, and when the Internet boom was just starting, he's like, Amazon, it might have been $50 is going to $400. And everybody just laughed at him. Laughed at him. And that probably was, you know, a $2 billion market cap, $4 billion market cap, whatever. And now it's worth trillions.

Henry Blodgett (4:27)

So you're very kind. It was basically the only one of those stocks that went on for 25 years to do very well. But it did. It bailed out a lot of losses. But so. So you say you're not sure where it's going, but you're seeing it and everything. So what are you seeing in the companies that you're investing in? Are you talking to people?

Mark Cuban (4:45)

Sure. I'll just tell you how we're using it, right? So with Cost Plus Drugs, we have a manufacturing facility, and we use it to watch everything, to record exceptions, to keep track of everything, and to set alerts. And then once we get that data out, it analyzes it and then tells us what's good or bad, you know, and to allow us to continue to optimize. Because AI, just at its most basic, can process information more quickly and be aware of things that as a person just can't catch every time through. It's like the alt, it's, it's like the, the most anal person you've ever met to catch errors and information and only it never makes a mistake and it never goes to sleep.

Henry Blodgett (5:29)

And another thing people are worried about is that this is going to cause a massive wave of unemployment and, and so forth. Are you seeing that? And what do you think will happen on that front?

Mark Cuban (5:39)

So I think it's changing a lot of things. I think the most prevalent change I'm seeing is that for big companies with thousands or more employees, it is changing their hiring habits and that's creating a lot of problems for kids coming out of school because you know, they went into college four years ago and the expectation was if I was in stem, I, you know, I majored in computer science. I'm good, I'm set, right. And that hasn't been the case because larger companies have been able to use AI to undertake a lot of things that an entry level person would have done, particularly with programming. I mean, I remember in 2017 I said AI was going to replace not just entry level programmers, but most programmers for a long time. And you know, that came to fruition. But, but on the other side, small to medium sized companies don't have the institutional knowledge and the depth of IT capabilities. And so where a lot of changes are going to occur, like when I go talk to college groups, like I just spoke to, you know, one the other day, I was like, don't be looking for jobs, particularly if you're in it. And no, AI, don't look in the big companies, look in the small and medium sized companies because you're going to be able to be that person that comes in and find processes that can be automated using agentic AI and save that company a boatload of money and make them dependent on you. And so, you know, and there's a whole lot more small to medium sized companies than there are large companies.

Henry Blodgett (7:08)

So from what you're saying sounds like that it's a repeat of what happened with the Internet, which is there is job destruction, but there's also enormous new job creation with new skills and.

Mark Cuban (7:21)

Right. Well, I mean you're an entrepreneur, so you know in every business you've started or run, right? That there are things, you know, you could do better. There are Things, you know, processes, you know, you could optimize better, that would save you more money. But the cost benefit isn't there. The cost to hire somebody to look at this, to deal with this, to manage that paperwork, to review your financials, to review, you know, your shipping, whatever it is. You can't do everything. But with agentic AI, if you have somebody that you just hired right out of college that knows Python and has spent time, you know, knowing what MCP is and writing agents, they're going to save you a ton of money because the agents will do the work as opposed to the individual having to review all those processes and implement those changes themselves and then, you know, make them happen every single day. So I think, you know, the opportunity is really straightforward and the best part is it's not hard stuff. You know, it's almost like when, during the early days of the Internet when somebody would write, put together a webpage, you know, there'd be a 16 year old kid who knew HTML and JavaScript and they would, we would say they're a genius because they put together these web pages and then they would go take it public right until they couldn't. But it's very similar right now. We look at it as being very difficult. It's really not. So if you're confident enough as a new graduate to walk into a company and learn as much as you can about that company, just tell the owner or CEO, let me just dive in and I'll automate things. You're going to be way ahead of the game and you're going to give that company a competitive and profitability advantage. And so in terms of overall employment, you know, small medium sized businesses generate 62% of, of new jobs. So I think the upside is definitely there from AI. But again, people are going to have to adapt.

Henry Blodgett (9:15)

How do you think the government policy and the valley and society in general, are we doing a good job of balancing the risk and reward with AI development here?

Mark Cuban (9:24)

Well, we don't really know what it is, right, that's the problem. We don't know how far it can go. Do I think you know the Terminator is going to come down from Skynet? No, I'm not concerned about that because right now AI is stupid. It is really, really dumb in basic things like a one year old or two year old understands the laws of phys without having to be told a second or third time. Your, your little infant child knows if they push a cup over the edge of their, the, the chair, right, that it's going to fall and it might break if it's glass. AI doesn't know that unless you just explain all of it. Here's a circumstance it doesn't just automatically see everything and pick up context. And until it does, it's going to be limited and it's going to be very limited in what it can do. You know, it's for the same reason that, you know, Elon had been saying full self driving cars are going to be here, you know, 2018, 2020, whatever it was. And even though it's come miles and it's incredible, you know, there's a reason why it's hard for them to open up in a new city and that's because they have to map out the entire cities and map out the routes they're going to take so that there's fewer potentials for exceptions or things that could, that can screw them up.

Henry Blodgett (10:42)

Or in Elon's case a very stubborn insistence that you don't need to map that, all you need is cameras. And Waymo's got it wrong, it's too expensive even though Waymos are working great. So and so you've also talked about the, the relationship with China and the global impacts here. Is the US policy smart with regard to AI industry development?

Mark Cuban (11:06)

I don't think we're dumb. Right. And the reason for that is there's not a whole lot the government can do one way or the other. Right. We saw this in the early days of the Internet where there are, or more so with search later days of the Internet where there's death wars, right. Where it's, you know, we don't know if Gen AI, particularly the app driven Gen AI is going to be winner take all. We don't know if it's going to be, you know, five leaders and they're all about the same in market share or one has 80% and the rest, you know, is it because remember there was Lycos, there was all, you know, all Yahoo, right. Yahoo was the leader until it wasn't, you know, and then Google came along and just crushed them. Well now you've got, you know, Gemini, Meta, you know, Perplexity, Cloud, et cetera and they're all spending billions. Like Meta literally is trying to spend, you know, 50, 60 billion dollars a year. A year.

Henry Blodgett (12:03)

It's shocking.

Mark Cuban (12:03)

Yes. How much you're spending right now. A lot of that goes to data, data centers. Right. Because you need that to push to drive it. But we don't know which one's going to be America Online. We don't know which one's going to be Yahoo. We don't know which one's going to be Lycos. We don't know which one's going to be, you know, go.com to bring them out of the books. Right. And so I'm really pushing the limits of history here because people forget history all the time, but we don't know how that's all going to play out. And, but that, you know, leading to, you know, the other, the next topic, you know, why is it that, you know, Zuckerberg et al are going to Trump and bending the knee because they see it as a zero sum game, that they see it between, you know, a 20, $30 trillion market cap delta, that one swipe of the pen could ruin you. And so you ha. It's, it's their fiduciary responsibility to their shareholders to kiss Trump's ass.

Henry Blodgett (13:05)

So let's stay on AI for just a second, which is on this question about the Internet. Early in the days of the Internet, people forget this now talking about, forgetting history. Everybody was talking about, is it a bubble? These crazy companies, they're so small, they have such high valuations. It's crazy. And from 1995 right. Through 1999, every year, these predictions of doom, it's going to be catastrophic. These investors are so stupid. The fortunes made in those years were astonishing.

Mark Cuban (13:33)

Thank you very much.

Henry Blodgett (13:34)

Yes, exactly. I was gonna say lots of. We're gonna get to that, which is that lots of them were then lost.

Mark Cuban (13:43)

Yep.

Henry Blodgett (13:44)

You were not one of the ones who lost. And you, I remember this marvelous moment. You sold your company for a huge amount of money. And shortly thereafter, I think I saw you on CNBC where the CNBC hosts, I guess stocks had gone up a little bit since you sold. Hey, Mark, don't you feel like such an idiot you've missed all this upside and you said, yeah, I feel like.

Mark Cuban (14:06)

A real idiot on my G5. Right. Yeah, exactly.

Henry Blodgett (14:10)

And then you turn around and buy a sports team, just as everything else craters. It was just the most remarkable timing. And when I look back on that era, that's what it's about. It's actually about timing. There are two times to make money. You get in early and you get out early. And then you wait for the crash and then you get in again. That's the second time. And you can make a huge amount then.

Mark Cuban (14:29)

Exactly right.

Henry Blodgett (14:30)

Given all that, what's going on in AI is astonishing. The amounts of money make the Internet look like penny poker. It's crazy. And this New latest thing that's come out is now Nvidia, the chip company is committing to giving $100 billion of cash to its biggest customer to then turn around and buy itself, buy their product.

Mark Cuban (14:51)

That sounds like the Internet. That sounds like the Internet.

Henry Blodgett (14:53)

I know, but it's the kind of thing that after the Internet wreckage was all over the place, everyone's like, oh, this was the problem and this can never happen again. And here it's happening again at, at 100x. So question for you is, does it look like a bubble to you?

Mark Cuban (15:10)

No.

Henry Blodgett (15:11)

No.

Mark Cuban (15:12)

So, so, okay, there's two elements, two sides of this question here, right? There are the public companies, you know, the Mag 7 that are in this death war to see if they're going to win. They already have sustainable ancillary businesses that are the core. Right. Amazon has every, you know, Meta has Facebook and Instagram. It's. Right. Or broadcast.com it wasn't like, you know, we were all in on one concept. You don't see that with AI right now in the public markets, in the private markets. Yes. And so if we were where we were back in, you know, 98, where there are 8,500 public companies and companies were coming public every single, you know, day the market was open, then we would definitely be in a bubble. What's happening now instead is, you know, all the pitches I'm getting AI this, you know, AI to understand what your dog says, AI for wellness, AI for, you name it, right? For your basketball shooting. Those are all private companies that don't really have prospects of going public in the near term, if at all. And so there are bubbles in the valuations there without, without question, like startup, pre revenue stuff are is coming in, you know, 30, $50 million market caps for nothing. That's spectacular. And so they're going to fail. Right. But in the public side, I don't see it as a bubble.

Henry Blodgett (16:39)

Right? So it's happening in the private market and at some point we probably get a big correction and most folks get wiped out and everybody seems to agree with that. Do you feel like based on your sense of the private market, are we getting close to that 1999 peak or are we in 1997? Which is, by the way, I'll give my view, who knows the future. But that's what it feels like to me. It's like 1997.

Mark Cuban (17:02)

No, and here's the reason, here's the difference, right? So like 95, 96, 97, there was always new technology to keep things going. Like with Broadcast.com, there was, you know, new streaming methodologies, there were new broadband methodologies, there were new servers that kept things going. And then things kind of slowed down and came to almost a stop and your business had to stand on its own. With AI, the technology continues to change rapidly. You're seeing technology, technology changes in terms of how models are trained and how they're made more efficient and could generate more tokens for less money and all that kind of stuff. And I don't see that slowing down. And so because that's not slowing down, there's always going to be a way to improve the. Improve what you do with AI in your private startup.

Henry Blodgett (17:53)

So even earlier in your view in the curve, then.

Mark Cuban (17:57)

Yeah, because so much is going to change. You don't hear anybody saying, boy, it's slowing down. You know, the rate of change is slowing down. I don't know what we're going to do next. We have, like, for us, it was like we needed more bandwidth. Okay. We were trying to put in multicast, and I literally was paying ISPs to upgrade their Cisco routers to add multicast so that we could be more efficient with bandwidth. There just wasn't any other way to improve. It wasn't like software changed it, and it was just consumer marketing for us at that point in time, or B2B marketing. You don't see that with AI at all. You see, it's like, how do we keep up with it? There's so many changes, whether they're coming from other countries, particularly China and the research there, or they're coming from us. You know, you see, you know, why would mark Zuckerberg give 10 figure, what is it, you know, nine and 10 figure bonuses if he thought everything was stagnating?

Henry Blodgett (18:54)

Yes. Although I will say there was a lot of behavior in 1999 in presidency.

Mark Cuban (19:00)

Oh, yeah, insanity. Yeah, there was a lot of insanity. Right.

Henry Blodgett (19:03)

So. And all right, so you mentioned Mark bending the knee to President Trump and others. And one of the things that happened in the last election that I think surprised a lot of us who watched the tech industry was that there seemed to be a big surge of support for President Trump and a big shift in the Valley from being reliably Democratic to that.

Mark Cuban (19:22)

I.

Henry Blodgett (19:22)

How do you, from what you hear, are folks in that community happy with the way things have gone? Have they gone?

Mark Cuban (19:27)

I try not to talk to them, but it's bifurcate, bifurcated, you know, And I think so. When I was campaigning for Kamala, one of the things I Heard all the time when I talked to tech people was that Biden wouldn't talk to us. Biden want to talk to us. I'm sure you heard the same thing. Like even me wanting to talk to him about cost plus drugs didn't want have any interest in talking. He didn't want to talk to, you know, high end business people or the wealthy, whatever, US oligarchs. And that drove people to Trump, you know, it really, really did. So now your question is, you know, are they happy with what they see? Well, in AI specifically, I think they are. Right? Because he really hasn't put any roadblocks in. He's letting them do what they need to do. He's not making it harder to raise money, he's not making it harder to spend money. You know, maybe stopping windmills outside of Rhode island, if that's where it was. Right. Is somewhat of a negative when you're trying to maximize the power availability. And like in the state of Texas, 27% of energy is natural energy here. But beyond that, I think the AI contingency in Silicon Valley is very happy. Now if you sell products and you're impacted by tariffs, you're not happy at all. You know, and we see that. I see that in talking to folks, you know, that are in media, that are in ad tech because that, that impacts their ability to sell and make money. And I definitely see it on my shark tank companies, but that's a different beast.

Henry Blodgett (21:00)

And going back to what you just said, which is that the perception that Biden won't talk to us so we're going to Trump, is that I, I've heard that before and it's amazing to me that the power that seemed to have there really was a sense of entit, like it's actually unusual that Biden wouldn't talk to us. You know, we deserve that. So is that something that's widespread in the valley and elsewhere that you put it, you oligarchs, do you expect to have a direct line in and your complaints will be taken?

Mark Cuban (21:30)

Obama did you know? Obama wanted to learn. He may not have agreed. He may have said I'm not going to do what you're asking or suggesting, but he listened a lot, like there was no problem getting an audience with Obama. There was no problem getting an audience and Trump won none. Right now. He, you know, AI was a little bit early then and really wasn't part of what people were focused on, but Biden went the exact opposite direction.

Henry Blodgett (21:56)

So it was just a real miscalculation yeah.

Mark Cuban (22:00)

You have an EV event, you don't invite Elon. That's just dumb. Yeah. There were a lot of unforced errors in the Biden administration and that was one of many.

Henry Blodgett (22:10)

And, and what is the. You said you don't talk to him, but what do you hear about the reaction with speech and we just had the former head of the FBI indicted.

Mark Cuban (22:19)

And they don't really get, you know, it's just not their business. Right. They just, they're focused on their business. The biggest of the big, you know, the Googles, the Metas, et cetera, they're just about winning right now. It is a lot like the days, the early days of the Internet when it was ready, fire, aim. Only that, like you said, the dollars are so much higher. You can't concern yourself with that stuff. You want to see what's best for the United States of America. And they're not stupid people. So they understand and they hear. But if you think that the end all be all is artificial intelligence and the United States of America has got to be the leader, well, you're going to put up with a little, you know, Donald Trumpisms in order to get there. That's the way I see it. That's what I hear.

Henry Blodgett (23:06)

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Mark Cuban (23:51)

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Henry Blodgett (23:59)

They will be battling it out to.

Mark Cuban (24:01)

See who can impress the world's biggest brands.

Henry Blodgett (24:03)

This is a huge opportunity.

Mark Cuban (24:05)

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Henry Blodgett (24:08)

This is not Play Play. We're spending millions of dollars.

Mark Cuban (24:11)

I'm so excited to embark on this.

Henry Blodgett (24:12)

Adventure with all of you.

Mark Cuban (24:13)

May the best idea win on brand with Jimmy Fallon tonight on NBC.

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Henry Blodgett (24:52)

Let's talk about another topic we mentioned before. You surprised everybody and then later thrilled everybody. You bought the Mavericks. You had this marvelous road to the championship, which I'm not a huge NBA fan, and I watched you because I knew you, and you got close, and then you see that. Yeah.

Mark Cuban (25:10)

You see that shiny thing back there?

Henry Blodgett (25:13)

I do, yeah.

Mark Cuban (25:14)

That's my buddy, Larry o'. Brien.

Henry Blodgett (25:18)

So that was triumphant. And it was such a great counter move because everybody else is still investing in the Internet and you go buy a sports team. And sports teams in general have been seemingly brilliant investments because they seem to be one of the only things in the entertainment world that hasn't been changed, continue to accrete value. So, given how amazing your timing was in the Internet when you sold. I was struck when you sold a controlling share of the Mavericks. Is this a timing thing, or is it about some of the other things you talked.

Mark Cuban (25:51)

Yeah, it's all about all the other things that I talked about. You know, family and, you know, social media and not wanting to put my kids through that and, you know. Cause it becomes your. Your identity. You know, my identity was the Mavericks, then it was the Mavericks in Shark Tank. But it was never just me. Right. And so I wanted my kids to. To find their own way. I didn't want them to feel. Cause I'd seen it, you know, with other teams in the NBA and other sports where, you know, the male children in particular were presumed to take over the empire and run the team. And it didn't work very well at all. The social media environment that we live in, the trolling and the hate is through the roof. Why would I want to put my kids through that? And so, you know, I just. And plus the amount of time it took. And so that's why I got out of Shark Tank. I, you know, got out of the Mavs. I still go to the games, but now, you know, I'm not missing birthdays as much. I'm not missing anniversaries. You know, they don't have to fly to me. I'm home. And so, you know, it all made sense to me.

Henry Blodgett (26:50)

That's great. And it Certainly makes sense to me too. It's not something as you say, you see very often. I mean, given that and given that you are an owner of a sports team and I think from what I've read, you're putting together funds to buy pieces of other sports team versus sports minority ownerships.

Mark Cuban (27:06)

Yeah, minority ownerships, yeah.

Henry Blodgett (27:07)

Which sounds terrific. I mean, please open that up to the small people. That would be great. We all want to own some sports teams. What do you think about sports gambling?

Mark Cuban (27:15)

You know, that's a great question. It's a two sided coin, literally. Right. I think for high end casino gaming, I'm all for it. Right. If, you know, I talked about it with our partners in the Mavs now with the Sands Corporation. If you want to put up Bellagio in downtown Dallas and it has a sports book. Yes, right. Because it's not, there's a threshold that you have to be above to be able to afford to play it online gaming, daily fantasy, like I originally was a huge component of daily fantasy. It scares me a little now simply because as young guys in particular with all the online, the online attitudes now, I think it, it's become more of a sport itself and that drags down a lot of people and I think that's a problem. And so, and just Putting, you know, a 1-800-gambling number for addiction I don't think is enough. So it's something that scares me. But I think the cat's out of the bag and I don't know, there's a lot we can do and I.

Henry Blodgett (28:17)

I, I was libertarian about it when I was just hearing the sort of outside, you know, people want to entertain themselves that way. Seems, seems reasonable. I then listened to Michael Lewis's series on sports gambling where he went into it and yes, the online stuff where as soon as they figure out you're smart, they throttle you and you're limited to the $5 bets and, but all the suckers are welcome and.

Mark Cuban (28:41)

Well, exactly. Just like Vegas. Right.

Henry Blodgett (28:43)

Well, okay, I was going to ask you. So, so with the big. If they put a Bellagio in, is Bellagio acting the same way?

Mark Cuban (28:49)

It's like, yeah, but you know what, but you're, there's a lot more to it. Right. The gaming is a de minimis part of the overall picture. It's kind of like what gets people in the door because they can play a few jams of blackjack or craps or whatever. But it doesn't have, I shouldn't say it doesn't, but to me it's a Little bit less so of the addictive nature because it's expensive to play.

Henry Blodgett (29:11)

The other thing I was struck by in Michael Lewis series was the impact on the players. And so this is terrific.

Mark Cuban (29:18)

It just sounds awful, awful, awful. Right. So now you've got particularly on social media because players want, you know, for the longest time, you could go to Twitter and you could get some trolls and some hate, but there would be a foundation of people that were supportive that you could engage with. Now, you know, why the fuck didn't you, you know, make this shot? Or why did you dribble out this quarter when I needed Da, da, da, da, da, you know, to get the over for halftime that, you know, all these parlays and everything are just insane and, you know, players hate it. I mean, you saw Johnte Porter, one NBA player, get banned. They literally changed the rules because guys would go at halftime, guys would go into the locker room and look to see what people were saying about their first half ago.

Henry Blodgett (30:03)

Oh, it's brutal. And then you think of that with college students and then high school students. Same thing.

Mark Cuban (30:07)

Even worse.

Henry Blodgett (30:08)

Yeah, yeah. So I was, when I, when I got into the details of it, I was also troubled by online as well. All right, let's go to healthcare.

Mark Cuban (30:17)

Sure.

Henry Blodgett (30:18)

You have spoken for a lot of people by referring to the United States healthcare system as, quote, insanely broken and, quote, horrific.

Mark Cuban (30:27)

Yep.

Henry Blodgett (30:28)

What's the problem?

Mark Cuban (30:30)

One, there's no transparency. Two, the regulatory capture exceeds any other industry in the history of industries. Three, the primary companies, because there's been so much vertically integration, are so big that they control the economics from start to finish. And by being able to control the economics and by having no transparency, they set the rules for patients and providers and everybody who participates in the ecosystem. And there's never been an industry like it.

Henry Blodgett (31:00)

And so how does that perpetuate itself? Because I do feel like 30 or 40 years, there's been a lot of frustration.

Mark Cuban (31:09)

Yeah. So think about what happens. Right. Healthcare on its own is very simple. You go to the doctor, you either get good news, medium news or bad news. Right. Good news is you got nothing to do, go home. Bad or medium news is you need to get something done or you need to buy something. And at that point in time, there's only two questions. What does it cost? And how do you pay for it? The what does it cost? Does anybody ever really know what it costs? Why? Why is that uncertainty there? Well, because there's six give, give or take, six big companies that basically define what something costs. So that's part one. And then how do you pay for it? Well, the insurance companies and the pharmacy benefit managers that they own or own them control exactly how the prices are set and how. And if you can afford and pay for it and how you pay for it. You know, think about how do you get your, your health insurance right now?

Henry Blodgett (32:10)

COBRA. Because I left the company because of course you have to work. This is one of the insane things about it. You can't leave your job, you have to work for a big company. You can't be an entrepreneur because for whatever reason you have to work for a big company. So, yes, anyway. Yes. So. COBRA.

Mark Cuban (32:24)

Okay, so do you know what your deductible is?

Henry Blodgett (32:28)

Too high.

Mark Cuban (32:29)

Too high, Right. Yeah. So think about the process for healthcare insurance. First of all, insurance has become a proxy for healthcare itself. It's not. And if you start thinking about the process of all of this, which for whatever reason it seemed like nobody really dove into it, the health insurance companies create plans that they take to employers, self assured or group employers, or to the individual market. And they try to create a balance between the premiums and the deductibles. But they know that the deductibles, the higher they go and they just keep on going higher and higher and higher, the lower the premiums people pick. Right. But that's good for the insurance companies because 40% of people in this country don't have $400 to their name. And nobody's ever done a credit check before. Somebody bought a high deductible plan. And by a high deductible, anything over 1500, anything over $500 is high deductible for most people. 1500 is considered more, you know, more than middle for high deductible. So what ends up happening is the insurance companies create these plans knowing that people can't afford the out of pocket costs, so they get to pocket all the premiums. And then when, because the people can't afford the premium, the deductibles, when you go to the doctor or go to the hospital, the hospital's kind of in a catch 22 position because if Henry doesn't have enough money to pay the deductible, when you walk in there, they really can't do anything for you. So they loan you money. And you know, there's a variety of ways to finance it or get you money. So now then they become a subprime lending organization that's loaning all these patients money so that then the provider can get access to the insurance money. And the insurance company knows that they control all of it because they have the ability to do pre authorizations and denials. And even though they negotiate prices with the hospitals and providers, they don't even pay the full price they negotiate, they game that system. And so all these, these big companies that control the economics game the entire system, which makes it impossible for patients, impossible for doctors.

Henry Blodgett (34:45)

And are insurance companies the big bad guy here.

Mark Cuban (34:48)

The vertically integrated companies, the biggest companies in the vertical integration are the insurance carrier side of the business and the pharmacy benefit manager side of the business. Together they create multi hundred billion sales companies. In fact the biggest of them, they have over 2,000 subsidiaries. And the intercompany transfers between those subsidiaries are over $160 billion, which makes it 0.3% of the GDP of the country. Just for the intercompany transfers for one company, that tells you all you need to know about how this industry works.

Henry Blodgett (35:28)

And I, I assume, tell me what you, when we're trying to fix this, that a company like, let's just pick UnitedHealth Group, right. $300 billion of revenue, I'm sorry, market cap, $20 billion of profit, 400,000 employees, who by the way, care about the employees. You don't want to just sort of vaporize the insurance company. That's a lot of jobs and livelihoods and so forth. But is it just the weight of a company of that size being able, possible to make changes?

Mark Cuban (36:01)

Yeah, in some respects, yes. It's that they control the entire economics of the healthcare system that, you know, the Uniteds, the Blue Cross, Blue Shales, et cetera, they call them the Bukas. Right. And so between all of them, there's, you know, 800, I don't even know the total sales. But they define the marketplace. They completely control. And, and it's almost impossible to stop them right now. But that's what we're working on.

Henry Blodgett (36:33)

And so talk about it. So you focus on one small corner of the industry right now.

Mark Cuban (36:38)

Right? So let me go through everything we do. So, you know, I got a cold email from a Dr. Alex Oshmiansky, like six years ago, give or take, and he wanted to create a compounding pharmacy where you can make drugs in this factory that are generics and injectables. And he wanted to make it for generic injectables that were in short supply, believe it or not, things like Pitocin, PDF, cancer drugs, they still go in short supply. And so he wanted to build a manufacturing plant that can take care of those. And we did that. Right. So we have this robotics driven manufacturing plant that makes those drugs specifically. But as I was talking to him, that was right when Martin Shkreli, the farmer bro, was going to jail. And I was like, how did this dude get away with this? You know, buying out the capacity of one drug and then jacking up the price to, you know, egregious levels. And as I looked into it, it was obvious there was no transparency. You know, we've all heard the stories about people standing in line at the pharmacy and then turning around because they realized they couldn't afford their drugs, or people having to ration their medications because they couldn't afford them. I was like, how do I find the price of anything and how do I know if it's a fair price? And so in response to that, we created costplusdrugs.com and what makes us different is when you go to costplusdrugs.com and put in the name of the medication, let's use imatinib, which is a cancer drug for leukemia. Before we started, if you were just to walk into a pharmacy, regardless of who owned it or what, chances are you were gonna pay $2,000 for that medication. Why $2,000? Just because it's a cancer drug. So they call it a specialty drug. Was there anything special about it? No, it's a pill. It's no different than every other pill. It's not more expensive, a little bit more expensive to make, but not much more. Right. And so what we said was when you go to costplusdrugs.com, you put in a matnib, we're gonna show you our actual cost, and then we're gonna show you that our markup is 15%, because we want you to know that this is a fair markup. And then if you order, mail order, which at the beginning, that's all we were, there's a $5 shipping fee and $5 for the pharmacist to handle it all and check all the information. And in doing that, with only a 15% markup, our price for the exact same drug that might cost $2,000 at a cash pay at a pharmacy, 3,450, you know, and there's 30, 40, 50 other drugs that we carry in the same boat where I'll get emails saying I was looking at spending $900 at this pharmacy, but then somebody told me about cost plus and it was $21. And so the fact that we only had a 15% markup and the fact that we showed you our cost. Now as our volumes have grown, our costs are going down and our pricing continues to go down. And that's allowed us to help millions of people. People.

Henry Blodgett (39:33)

And so what is it that causes the drug to be $2,500 at the pharmacy? Is that the pharmacy benefit management that you talk about?

Mark Cuban (39:41)

Pretty much, yeah, pretty much. And so the pharm, particularly with insurance. So most companies are self insured, most employees are under self insured programs. And that self insured company will work with the pharmacy benefit managers to help them set what's called a formulary, which is a list of the drugs that, that you make available to your, your employees and their families. And then that also is used to set the price of each medication. And then they also handled the claims processing. Well, there was no competition, quote unquote, for pricing because nobody knew what the actual price was. So when you had a claim, let's just say you needed a Matinib, you have leukemia and you had a claim and your boss was going to pay that or you had to pay part of it as part of your co pay or coinsurance insurance. There was no competition. So they got to set that price to whatever they wanted.

Henry Blodgett (40:38)

And I'm sorry to be lost in details, but so who's they that's setting the point?

Mark Cuban (40:43)

The PBMs. The PBMs.

Henry Blodgett (40:44)

The PBMs, okay. It's not the local pharmacy where somebody's working 18 hours a day.

Mark Cuban (40:48)

Not where there's insurance involved. Yeah, not where there's insurance involved.

Henry Blodgett (40:51)

Okay, so it's the PBM that's setting the company, and the insurance company has the ability to negotiate it down with them or not.

Mark Cuban (40:58)

Well, the insurance company defines the plan that the patient is using and then the plan. And the insurance company uses their captive PBM to manage the formulary, which in turn sets the prices. And I know it's complicated, but the bottom line is when you need that medication, what you're thinking in your mind is now being a patient is what's my copay? Do I have coinsurance? And the pharmacy benefit managers would do things like create tiers of drugs. So they'll say basic things like metforin or amoxicillin, inexpensive generics, that's tier one. But because this drug is for cancer, we're gonna call it a specialty tier. And because we're calling it a specialty tier, we're gonna charge more. Is there anything special about it? No, except that we're charging you more.

Henry Blodgett (41:50)

And so looking at the system and we'll come Back to the details of Cost plus in just a second. But so looking at the system that one of the things that I'm always struck by is going back to UnitedHealth Group. So, so they are sucking out $20 billion of profit out of all these transactions and they're huge. So they have a lot of leverage. When we go to try to fix the whole system. And you look at nationalized health insurance or what have you, you don't have these humongous entities sucking that much profit out of the system. And that seems to be the core of the problem. It sounds like you are not, you're not sucking a huge profit out at cost.

Mark Cuban (42:26)

No, we're not sucking a huge profit. But you know, it is a huge part of the problem because they control the economics, you know, across the six companies, they're the equivalent of the NHS in uk, right? They pretty much set all the rules. And they even do this to the detriment of the pharmaceutical companies, the brand name pharmaceutical companies. Like you would think it makes perfect sense for Eli Lilly or Novo Norris to get copies, de identified copies of claims of people who are taking their GLP1s so they can understand about adherence, they can understand about if there's any side effects, all those types of things, right? No, the PBMs don't allow that information, not only to go back to the manufacturers unless they pay for it, but they don't even. Unless you're a huge, huge company with, you know, hundreds of thousands of lives. They don't even allow the companies that are paying for all of it to have copies of their claims. They don't allow those companies to audit their claims. They set all these rules that make it increasingly difficult for companies to understand what they're actually paying for. This episode is brought to you by Indeed. When your computer breaks, you don't wait.

Henry Blodgett (43:42)

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Henry Blodgett (44:21)

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Henry Blodgett (45:08)

And so going back to Cost Plus. So how's it going? Is it.

Mark Cuban (45:11)

It's going great. It's up and to the right. It's Internet days, right? It's up and to the right. It's awesome.

Henry Blodgett (45:17)

And full country.

Mark Cuban (45:18)

Country like, oh, yeah, yeah. All over the country. We get inquiries from all over the world because our generic prices are cheaper than the uk, cheaper than Canada, but there's so many laws, we can't, we can't sell them there. But because we pass through, you know, it's always, it's based off of cost. As our volumes go up, our prices go down. And what's better than, you know, you're stuck having to take a medication and your price goes down, which is, you know, unique in this industry.

Henry Blodgett (45:46)

And for most of your customers, there's no insurance involved.

Mark Cuban (45:49)

You're just, well, there's some. So we, there's, there's the big PBMs that we talked about that create problems. And then there's what's called transparent PBMs that are truly transparent. And there's like 25 of them. And we partner with them. And those transparent PBMs will work with companies like 711 Box.com, tyson Foods, and a long list of others. Right. And because they're processing the claims of those companies for pharmacy benefits, they work with us and say, look, if Cost plus is the lowest price, which we typically are, then we're gonna pass those prescriptions through Cost Plus. So now we're working with insurance, just not through the biggest PBMs.

Henry Blodgett (46:30)

And does the industry view you as a threat?

Mark Cuban (46:33)

No. I mean, the pharmaceutical manufacturers love us. Generic brands manufacturers love us. You know, brands love us. You know, the big PBMs kind of prevent them from working with us, but they see us as an ally. It's really the biggest insurance companies and the vertically integrated insurance companies Are the ones that don't like us because they see the writing on the wall and.

Henry Blodgett (46:55)

Is it a matter of time and scale where your scale becomes so huge that they have to start dealing with.

Mark Cuban (47:02)

You at some point? Yeah. As we help the pass through PBMs grow and take business away from the biggest PBMs, those big six, then yeah, it's just inevitable there will be a tipping point. Like I spend most of my time talking to CEOs explaining their, their healthcare benefits. And the reason I do it is it's not their core competency to have to understand it. I mean you realize that when you look at your expense listings on, on your P and L, you're going to see payroll and then most likely then most, the next expense, most expensive expense line is healthcare benefits. And so we're working with them. And so it's really easy sale for me to walk in and say, look, work with this pharmacy benefit and Cost Plus. We're gonna give you everything you got right now, but you're gonna save a whole lot more money and you're gonna have control of your claims, which gives you control of your wellness, you know, and so many other things with pre ops and all that. So, you know, it's an easy sale, but it takes time.

Henry Blodgett (48:01)

And so. So you're focusing on the drug side. Are there other opportunities that you see?

Mark Cuban (48:06)

Oh yeah, for sure.

Henry Blodgett (48:07)

System as a whole. Such as?

Mark Cuban (48:08)

Oh yeah. So we created something called Cost Plus Wellness that has costpluswellness.com that has not launched yet. And so, so for the members that I cover, the employees and their families that I cover, it was crazy to me. Like literally my daughter broke her hand playing basketball. And when I looked at the insurance price that this company had negotiated for me, you know, that I thought they were helping me out versus the cash price. If I just use my credit card there, the cash price was like a third of the price to get the X ray. And I'm like, this is insane. And then I went out and started meeting with healthcare hospital in particular CEOs and CFOs and they went through the whole the way the money flows, right? And there's a reason why when you talk about healthcare in this country being $5 trillion, people say 20 to 30% of it is administrative costs. Well, when you hear that the biggest insurance companies like the ones you mentioned, negotiate with a hospital and any schmo with a credit card can walk in off the street to get an MRI or get other services for, you know, half of the price, something's wrong. So we created Cost Plus Wellness with the idea that we're going to direct contract with these hospitals and providers and we're going to negotiate cash prices. So we're going to say, you know, for. My company's eating our own dog food first. If somebody comes in, like my daughter needs an X ray or mri, we want your cash price. We'll pay you cash right up front. You don't have to worry. There'll be no pre authorizations. You don't have to worry about that negotiated amount, that cash price. We're not going to renegotiate it at all. And if it's more serious, you know, somebody's in the hospital, we'll pay your cash price there, too. But again, no pre authorizations, straight cash price. And doing this, we're saving 10, 12% per month. But that's not the golden ticket. The golden ticket in doing this is, for the first time ever, we're publishing those contracts that we've negotiated with the hospitals and doctors so that, that any company, once we launch, hopefully, I thought we'd be launched this month, maybe it might be a couple more months. Then any company can say, look, I just want the same deal that you gave Cost plus for their employees, and I want to use it for my employees. And those providers will say yes, and that will save them money. And that'll start the process, just like we started the process on pharmaceuticals. That'll start the process on medical and healthcare benefits.

Henry Blodgett (50:37)

And what's the answer for doctors? Because I've also heard you as you.

Mark Cuban (50:41)

Yeah.

Henry Blodgett (50:42)

Diagram.

Mark Cuban (50:43)

Yes, doctors need to get paid more. They're. They're underpaid. I was talking to one doctor who does foot surgeries, foot and ankle surgeries, and he basically says that he's got to do 10 a day because he gets paid a thousand a day. And he has to pay out expenses out of all that as well. So these doctors are having to just cram in as many operations as they possibly can, which has got to be exhausting. You know, I don't want my doctor exhausted. I wanted them fresh from the golf course. Right. I want them. I want them taking off Wednesdays again, going golfing, because there's enough money in them in it for them to do. So I'd rather. Oops. I'd rather see it come from the big insurance companies than the PBMs to do it because they all just complicate the system. And because the insurance companies and the PBMs complicate the economics, then the hospitals have to Compensate for that. So they do things like facilities fees and all these other charges that they've created just recently to compensate for what they're, you know, what they're not earning. And then the doctors pay their share of that, too, which makes it harder for them to earn enough money.

Henry Blodgett (51:52)

And so do you think that we will eventually rebuild and fix the system by the approach that you're taking, which is entrepreneurs coming into it, or do we need help from the government?

Mark Cuban (52:02)

That's my mission. That's my mission. Right. I mean, would it be nice if the FTC and Department of justice did their jobs and paid attention to the restraint of trade and, you know, you know, the laws that are being broken. Yeah, it sure would. And am I sure they are being broken? Yeah. But when I talk to them, they're like, where's the smoking gun? I need a smoking gun that is like on fire. Otherwise they're not going to touch it.

Henry Blodgett (52:26)

And what laws are those that are being broken?

Mark Cuban (52:29)

Well, like you telling companies that they can't do business with us. Right. The perfect restraint of trade. Right. Or saying that you can't audit your own claims. You know, again, I forget what they. They told me the name of it was, but there's all these laws. I'm not the lawyer, so I could tell you all the exact laws, but yeah, so they're interested. The FTC and Department of justice are interested. And they're not talking to us because they don't think there's anything there. But these big companies aren't dumb. They don't put it in writing.

Henry Blodgett (53:02)

And is this what you meant in the beginning when you said regulatory kind of capture?

Mark Cuban (53:06)

Oh, yeah, for sure. Yeah. It's scale and regulatory capture. Some companies are so big that they get to dictate what happens. It's like right now the pharmacy benefit managers are getting a really awful rap. Right. It's deserved. But they're getting kicked out of Louisiana, you know, restructured in Virginia, now in Texas, has got the Texas Pharmaceutical Initiative. They all know the writing's on the wall. And one of the things that these big pharmacy benefit managers do for brand medications, if you pick them up, if you have a prescription for Eliquis and you just go to your local pharmacy, not Walgreens, not CVS, but just the local guy that's been there for 30 years and you try to get it filled, you would think that that pharmacy at least gets their cost back on that prescription and does not lose money. That's not the case. They lose money. Every GLP1, every brand prescription, they lose money because the PBMs underpay them. And the pharmacies, when they try to renegotiate, to try to get paid enough, the big PBMs basically say screw you, there's no renegotiation. And so now they're coming out and saying, well we're going to change that. And they just announced something where they said for 2,300 pharmacies, which is 0.3% or 3% of the pharmacies that are out there, right then we're going to make a change. But they didn't say what it was, which is what they do. You know, they manage by press release because they get, you know, the trade organizations just to talk up what they're doing, but it changes nothing. And that's my mission, right? To educate CEOs and the decision makers and patients and the marketplaces in states and governors. You know that we are getting ripped off. If you just take any of the big PBMs and you just googled name a PBM fraud, you know, the list of responses is insane. When I go into CEOs, I'll say, say ask to audit your claims to see if you're, if you're getting charged the right net price on all the medications that your members need. They won't even let you do it. They'll say I'll limit you to 300 claims or you have to use our in house or affiliated auditor in order to look. Anytime somebody actually goes through the process and audits it, they'll find enormous, very meticulous, you know, 10, 20, 30, 40% variations and the variations never to the benefit of the pbm.

Henry Blodgett (55:42)

And is, is Medicare a good solution? One of the things that every time it comes up, which is now one once every 10 years, something like that, people think about, okay, what's the quick fix? And one of the ones you hear is Medicare for all or at least a Medicare option for all. Is that a real potential solution?

Mark Cuban (55:59)

Medicare Part A is great and that's for your hospital stays. It's amazing. It's means tested for how much you pay per month in premiums, but you don't have big out of pockets, if at all. Medicare Part B, which is doctors and providers, is not a great thing because there's no limit on it unless you buy, there's no out of pocket limit unless you buy supplemental insurance. And that supplemental insurance I'm pretty sure is run by private insurance companies. And then you have Medicare Part D which is the pharmaceutical benefits and those are all run by independent companies and independent PBMs, then you have Medicare Advantage, which is all run by independent insurance companies. And so just to say Medicare for all, okay, if we want to start with Medicare Part A and we can come to an agreement on the price that should be paid because some hospitals want to get paid more and the Medicare rates for the, to doctors like we talked about isn't enough, then there's a conversation to be had. But even though I believe that Medicare is a right, when you actually read the documentation, the, the legislation that's been proposed, the first thing it says in the very first paragraph, this shall be implemented at the discretion of the Secretary of Health and Human Services. Well, how's. How would that be working right about now? Right. And when you compare it, you know, then the next comment always is, well, every other western country has got universal healthcare, but the difference is they started in 1893, 1942, 1971, before a lot of the investments that were made here were made. Right. So now you've got these huge capital investments that. And that give us the most advanced technology of anywhere in the world. Well, how do we compensate the investors and compensate the, the people who own and run those assets? It's. It's a difficult situation to try comprehend. So from my perspective, my mission, if you will, is 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. I think it was, and I may be wrong on the Dayton province, but I think it was 1947 in Alberta, where the province of Alberta just said, we have an idea of our population and what their healthcare needs are. With this budget, we'll cover the cost. Here's what we cover, here's what we don't. That worked out well, and it took 18 years, but it got to the rest of Canada. I think we can do something similar where if we know what all the pharmaceutical costs are, if we know what all the healthcare costs are and the city of Dallas has all their claims, well, then you can extrapolate that data and say, well, golly, it's only going to cost us $2.2 billion to do it, you know, by us doing it ourselves. And we have $2.2 billion dollars hypothetically. And so we'll cover the healthcare of all those, the residents of the city of Dallas, you know, or your employer might say, wow, the prices have gone down that low and we're able to do this direct contracting at a cash price. I have one company, that's exactly what they do. They say you buy, you get all your meds from Cost plus. And there are no premiums, no deductibles, because the cost, they know exactly what the cost is going to be. It's small company, but still.

Henry Blodgett (59:30)

All right, so a huge amount of work to do. And if nothing else, I'm reminded just how complex the whole system is.

Mark Cuban (59:38)

But, you know, we've made it complex, right? We've made it complex. Healthcare itself, like I said earlier, is easy. It is simple. Doctors and hospitals do what they do, and for the most part, they do it well. 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.

Henry Blodgett (59:58)

Mystery.

Mark Cuban (59:59)

99% of the time, unless it's Cost plus, the how much for drugs, the how much does it cost for medical benefits is absolutely a mystery 99% of the time. And that's part of what we're trying to change. But until we remove that mystery, it's impossible to get to Medicare for all or any universal healthcare because we don't know what things cost.

Henry Blodgett (60:24)

Well, I and a lot of other Americans are wishing you luck and thrilled that you're on it. And taking such a big swing is a huge problem that causes a lot of pain and anxiety to people. So very much cheering for you. And Mark, thank you so much. It's always such a pleasure to have you.

Mark Cuban (60:39)

My pleasure. I apologize about my voice, but it was fun to talk to you. Henry.

Henry Blodgett (60:44)

It's all good. Great to talk to you. Solutions is produced by Meghan Cunnane. Jim Mackle is our video editor. Our our theme music is by Trackademics. Nishat Kurwa is Vox Media's executive producer of podcasts. Thanks for listening to Solutions from the Vox Media Podcast network. I'm your host, Henry Blodgett. We'll see you soon.

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