Loading summary
Transcript114 lines
- [00:01]
A
Ryan Reynolds here from Mint Mobile. With the price of just about everything going up during inflation, we thought we'd bring our prices down. So to help us, we brought in a reverse auctioneer, which is apparently a.
- [00:11]
B
Thing Mint Mobile unlimited premium wireless.
- [00:14]
A
30.
- [00:15]
B
30 bid to get 30. Get 20. 20, 20. Better get 20.
- [00:17]
A
20. Better get 15.
- [00:18]
B
15, 15, 15.
- [00:19]
A
Just 15 bucks a month.
- [00:20]
B
Sold.
- [00:21]
A
Give it a try@mintmobile.com switch. $45 upfront payment equivalent to $15 per month. New customers on first three month plan only. Taxes and fees. Extra Speed slower above 40g. Detailed.
- [00:32]
B
Mark Cuban, big name. Probably watch or listen just because of him. But he is going to tell you what's going on with our ability to get and afford medication that will blow your mind. I'm Chris Cuomo. Welcome to the Chris Cuomo Project. Mark Cuban is known for a lot of things. He was very high profile in the last election. Him talking about what he now understands about the pharmaceutical industry and more importantly, the business. What he learned about politics, what he sees as solutions. And then this really crazy story about Megyn Kelly. Here it is. Support for the Chris Cuomo Project comes from Factor. Notice how the days are shorter, but the to do lists keep getting longer. What are you supposed to do? Factors. No prep, no mess, meet. Man, I gotta tell you, as we have gotten into the macro game and people are worried about the quality of their nutrition, you gotta start looking at factor. Breakfast, to dinner, anything in between. Factor has easy, nutritious options to keep you fueled and feeling your best. You want your routine or you wanna mix it up, it doesn't matter. Factor has you covered. They got 35 different delicious meals every week and over 60 additional convenience options that you can add to your box. Like what? Keto cookies, pressed juices, smoothies. So don't let the shorter days slow you down. Stay energized. America's number one ready to eat meal service is Factor. Head to FactorMeals.com Cuomo50 and use the code Cuomo50 and you'll get 50% off your first box, 20% off your next month. That's code Cuomo50@FactOrMeals.com Cuomo50 50% off your first box. 20% off your next month. While your subscription is active, support for the Chris Cuomo Project comes from Shopify. Now here's why we all need this. I'm trying to sell my free agent gear, right? But how? How do I get it out to people? How do I make sure that it is an efficient and accelerated process to manage my inventory? The transactions and just where I'm putting them and how I'm getting them. That's Shopify. Shopify Pay is their product and it boosts conversions, meaning the rate of people seeing my offer to buy versus actually transacting. They can boost it up to 50%, meaning way less carts going abandoned. So upgrade your business and get the same checkout untuck it uses. Sign up for your $1 a month trial period at shopify.com chrisc all lowercase Chris C go to shopify.com Chris C upgrade your selling today where shopify.com Chris C support for the Chris Cuomo Project comes from Cozy Earth. Look, I use the bedding, okay? I even have a set of the jammies. I'm not a big jammies guy like Greg Ott is. He has all these different jammies with footies and all these things. Not my thing. But they are really cozy and I wear them around the house. And the sheets are just no joke. You want your Cozy Earth pajamas by Christmas, you better order by December 13th. And by the way, you'll get free shipping. Oh no, I missed it. You can still get expedited shifting until December 20th. That way you get in there in time. Don't wait. Go to cozy earth.com Chris use my exclusive code. Chris. You can get up to 40% off. That's crazy. Give the gift of luxury this season, okay? It's the holidays. Do it right. Cozyearth.com Chris if you get a post purchase survey, please tell Cozy Earth that you heard about them from the Chris Cuomo Project podcast. It'll help us keep doing business. Mark Cuban, where are you sitting?
- [04:43]
A
I'm in Dallas, Texas, in my office with my background. Because my office is a mess right now at the dump.
- [04:50]
B
I like it. Well, I have to tell you, I think there are a lot more people who are interested in what you have to say than what is represented over your shoulder right now, which is no. 1.
- [04:58]
A
Yeah, you know, basketball is basketball, but there's a lot of fun stuff going on.
- [05:03]
B
People were surprised when you went heavy in to health care, specifically pharmaceuticals and how people get them and how it's priced. What do you believe in your education of that process? People don't get about the dynamic of getting medicine and treating illness in America.
- [05:26]
A
That it is the most opaque industry I've ever seen or been connected to. That the problem isn't the industry itself or even the supply chain so much as the lack of transparency. And that's what led to Cost Plus.
- [05:41]
B
Drugs.com being created when you say opaque, when you say lack of transparency, what should be happening that isn't?
- [05:47]
A
Well, let's start back to what is happening. So just think about the process. When you get a prescription, the doctor says you need drug abc. The next question is, you know, here are the different economic options. Let's talk about what you can or can't afford or what your deductible is. It's a simple question, what pharmacy do you use? And if you have a deductible that is more than your savings account, fear immediately sets in because you don't know what that price of medication is going to be. And so what we just, well, what I pushed through was, okay, let's create a company that is very straightforward. When you go to costplusdrugs.com you look up the name of the medication, whatever it may be, Metform, it could be admitted, whatever it is. And if it's one of the 2500 we carry, then it'll come up. And one of the first things you'll see is we show you our actual cost. That is what we truly pay for it. Then we show you There's a 15% markup, which we thought was fair, allows us to stay in business, but isn't outrageous. And then there's a five dollar fee for the pharmacist to review. We ask you what other medications you're taking, et cetera. And then there's a five dollar shipping fee if you want a mail order. And we have other options where you could pick it up at a local pharmacy through our network. And by doing that, that transparency literally changed the game. So people were able to see what they actually were going to pay for a drug before they did so. And that fear, all of a sudden, those stories that you heard about, you know, somebody standing in line at the pharmacy, realizing what it costs and not being able to afford it and having to walk away, those stories ended.
- [07:27]
B
Are you saving people money?
- [07:29]
A
Oh my God, yeah. I mean, it's non stop. I mean, I use the example of imatinib. It's considered a quote unquote specialty drug when there's nothing special about it other than the fact it's used for chemotherapy. Well, there's still to this day for that fact. If you walk into, excuse me, the biggest chain pharmacy, there's a good chance if you say you need to pay cash, you're going to pay $2,000. And depending on the strength, if you go to costplusdrugs.com and put in a Matinib if it's the lowest strength, you're paying $13.50, give or take. Wow. Yeah. I mean, I can give you example after example after example. I mean, there are, you know, dozens, if not hundreds of drugs where the disparity in pricing is that dramatic. You know, one of the other things that we did that was a true industry changer was we actually published our complete price list. It's shocking to think that there is not one other company that publishes a complete price list of the medications they sell. Not one. And so, you know, if you're a company looking to save money on medications, we can send you our price list. And you. You're able to compare, you know, this just. Well, there are researchers that have gone out there and said, okay, let's look at what Medicare is paying for specific medications, oncology medications, whatever it may be, and done studies where it said, okay, if the government bought these drugs through costplusdrugs.com these nine oncology drugs, we could save $3.6 billion a year. Or these 11 drugs, we could save, you know, $3.6 billion or 6.3 or whatever the number is. The savings would be insane. And those studies were never even possible prior to us. Prior to us using or promoting our price list.
- [09:18]
B
So it's that they just want to make more money than you do. So it's just about the margins. Are you willing to work with the Trump administration? I guess Bobby Kennedy on my.
- [09:31]
A
I don't care who. Look, we sell to anybody. We don't judge and we don't care. Our price is the same for everybody. It could be the government. It could be, you know, Chris Cuomo. It could be Mark Cuban. It could be someone walking in off the street. I could care less. Our price doesn't change by the name of the customer. And so, yeah, and, you know, the other thing is our volumes go up, our prices go down. We have literally reduced the price of at least one medication every single weekday for over a year now. And so we completely pass through, which obviously, for the government, would be a big benefit.
- [10:04]
B
Do you think the government can do anything to make this situation better? And what should they do to make it better?
- [10:13]
A
Yeah, it's really simple. All they have to do is require that all contracts between government agencies and any pharmaceutical or any healthcare company for that matter, are published. The problem, the reason the cost of drugs have gotten so out of whack is because it's an open market where anybody can enter, but it's not an efficient market. There's no Price discovery at all other than the price list that we publish. And so if the government were to say, look, any contract, any state does, any federal agency does, it's all published. And if they're able to just say any contract that any company does is also published, the game's over. All the, you know, effectively all of healthcare right now is an arbitrage where all the different players in the supply chain try to introduce some fee or some margin and it to just grab their little piece of the piece. And if you make it transparent so that everybody sees what those pieces are and what the margins are, then people can negotiate. And I'll clarify it further. So let's just say you're a company that has a thousand employees and covers 2000 lives, families, and everything. You really don't know what your cost of medications are. You don't know what your healthcare costs are, for that matter. So if Chris Cuomo, you get your insurance through, you know, whoever it may be, that that entity does not know what they're paying for the medications that you take or anybody in your family takes, that's just wrong. And it makes it almost impossible for companies to negotiate the best pricing, whether it's medications or it's health care.
- [11:54]
B
So if it's that obvious and you've had Democrats and Republicans in power, why hasn't it changed?
- [12:00]
A
That's a good question. You know, we've been saying this exact same thing for the past four years. I mean, it's just, you know, there's lobbyists, there's big companies called pharmacy benefit managers that don't want to see it change. There's big insurance companies, they call them the bucas, the largest insurance companies. They don't want to see it change because the more opaque it is, the more money they make.
- [12:26]
B
I. When you were first enlisted or really enlisting yourself to help the Harris campaign, I talked to one of her staffers and I was like, hey, is this about cost plus drugs for Cuban? Because, you know, you usually keep arm's length. And she said, no, there's no quid pro quo. Mark just believes in it. So he wants to do it. So let me flip it. Why not? Why didn't you go to them and say, yeah, I'll help you. I'll lend you my cachet, my platform, my reach, but I want to do it because of this. I never talked to you during the campaign about what we're talking about now.
- [13:04]
A
Yeah, because I didn't need to. Right. The tipping point for changing the health care industry isn't about what government does. Honestly, the tipping point is educating CEOs. It's not the core competency of any CEO to truly understand their benefits, whether it's the health care side or the pharmacy side. You know, they don't get into the details there, despite the fact that it's their second largest expense item after payroll. And so my job, you know, going out and talking about political candidates, that really doesn't change that at all. But going and meeting to with individuals or CEOs or groups of CEOs, that's led to significant change. So when I sit down and I talk to a CEO and I say, look, do you know how these costs came about or the breakdown of your healthcare or pharmaceutical costs? The answer is always no. And then I just go through it with them step by step. The company, you know, the way the pharmacy side of the world is broken up, most of the scripts go through these things called pharmacy benefit managers. And there are three big ones that control 85% of the market. I won't name them. And most big companies deal with one of those big three companies, and they just take it as, you know, standard issue that they're going to deal with those companies because they always have. And those companies realize that they don't really get questioned much anymore. And so they just keep on adding incremental costs and, you know, excluding things and doing things that just add up the cost of care for those companies. So when I sit down with the CEO, I say, look, if you truly want to reduce the cost of your, your pharmaceutical benefits, then you need to know the actual price, the actual net price that you're paying. Do they give you a price list of actual net price? No. Have you ever seen a price list? No. Would that benefit you and your analytics of pharmaceutical costs? Yes. Okay, well, that's part one. Part two, there's this thing called the formulary, which is where companies choose what drugs are available to the lives that they cover, the population they cover. And I asked the CEO, do you know what's allowed or not allowed in your formulary? No. Do you know which GLP1 you can or cannot offer? No. That's a big issue, isn't it? What if there's a new drug that's more effective and less expensive? Are you allowed to just add it? I would presume so. No, you're not. What about the claims data when someone gets sick? I'm not saying down to the patient level, but you want to know, across the population that you covered, whether a lot of people have A certain illness and you could put together a wellness program. You want to know how many people are using GLP1. So you can do get that claims data? No, we tried to get that. Well, what happens when you try to get it? Well, they want us to pay for it and it takes nine months to get it. Well, okay, so why are you continuing to do these things? But wait, there's more. You know, are you allowed to discuss any of these contractual terms that you have with other companies to see, you know, if there's best practices? No. Are you allowed to even talk to pharmaceutical manufacturers to determine if there's a program that they may be able to work with you on to improve the wellness of your employees? No. And so once you go through the list of elements that they're not getting access to and that are, you know, detrimental to the wellness and the cost of their companies, they start to open their eyes. And then here's the kicker. There have been multiple lawsuits, what they call a resale lawsuits, where there is a fiduciary responsibility of the companies to make sure that they're taking the appropriate steps to keep costs down and optimize wellness for the lives they cover. Well, when you just work through these big PBMs and you don't have any of the information I just discussed, you're not living up to your fiduciary responsibility. So you've seen companies like Wells Fargo and JJ and others getting sued and people are plaintiff lawyers are just waiting to see what happens with them. And then it's going to be, Katie, bar the door. I mean, there's going to be so many class action suits. And so when I tell this to them, all of a sudden they start getting nervous. And that's where we're at right now, going around in my Talking to these CEOs and groups of CEOs and telling them, here's the solution. There are the biggest PBMs that are doing all these negative things that we just discussed that aren't acting in your best interest. And there's about 25 of what they call pass through PBMs. And what the pass through PBMs do is they take the actual cost of the medications and they pass through that cost, they take all the data and they pass them through to you. So you own all your own data. They take the formularies where drugs are chosen and let you set the formulas, they let you work with the manufacturers, etc. And then they just charge you either a transaction based fee or they charge you a monthly fee to give you whichever you prefer per employee per month. That gives you complete control of all your data. So what I've been doing and to answer your question, why not politics? Well, if I can convince enough of these big companies and they change over to These pass through PBMs and we're starting to see that start to happen, then the tipping point happens within the next two to five years and at that point and things become truly transparent, all of healthcare changes and we're starting to do some of the same things on the healthcare side, but we're just getting started there.
- [18:28]
B
Support for the Chris Cuomo Project comes from Everyday Dose. Say hello to the next generation of a cafe. Everyday Dose. I use it. I even dig the bag. It's got this kind of trippy, psychedelic, shimmery star thing going on. Everyday Dose combines coffee, but it's not all coffee. That's the combines part. Functional mushrooms, nootropics, collagen protein. Why do you want all that stuff? Focus, clarity, energy, sleep. Not just caffeine. Also helps boost immunity. It ups your coffee game. I dig it, I use it. I put it right in my coffee maker by the way. Head over to everydaydose.com Chris and you will get 25% off plus five free gifts with your first order. The first month you get a USB rechargeable frother works well. Gunmetal Dose spoon works good and I can bang my son on the head with it. Breathwork app by Othership Wellness booklet and sticker every month after you get amazing free gifts with your order. So go to everyday-.com Chris get 25% off plus five free gifts with your first order. Support for the Chris Cuomo Project comes from Oracle. Even if you think it's a bit overhyped and I don't, AI is going to be all over whether it's self driving cars, molecular medicine, business efficiency anywhere. AI needs a lot of speed and computing power. So how do you compete without costs? Going crazy? Time to upgrade to the next generation of the cloud. Oracle Cloud Infrastructure OCI OCI is blazing fast and it's a secure platform for your infrastructure, your database, application development, plus all your AI and machine learning work workloads. OCI costs 50% less for computing and 80% less for networking, so you're going to save money. Thousands of businesses have already upgraded to oci, including MGM Resorts, Specialized Bikes and Fireworks AI and they're offering to cut your current cloud bill in half if you move to OCI. For new US customers with minimum financial commitment, offer ends 1231. See if your company qualifies for this special offer. Just go to oracle.com CCP for the Chris Cuomo project. With so many different things that you're invested in and passionate about, did you ever imagine that you would have this granular and understanding of something as recondite, as complicated as this and what drives the passion?
- [21:16]
A
Yeah, the answer is no. And, you know, the thick apart about the healthcare industry, particularly pharmaceuticals, is there are more acronyms than there are in all of professional sports combined. You know, in analytics and sports, there's all these acronyms, and you got to figure them out. In pharmacy, the. The number of acronyms and their meetings are insane. And there's even like duplicates, right, where you got to know the context of which acronym that you're using. But to answer your question, no, I never possibly imagined. But, you know, the whole genesis of the whole of what happened was going back to 2017, when there was discussion of the ACA being overturned. I talked to some folks here in Texas and I started, you know, geeking out on healthcare. Okay, that's pretty cool. What if I can come up with an alternative and see what happens? And I, and I worked on this thing called the 10 plan that had some traction, but not enough, and went and even met, you know, with the White House and talked to people there. Brooke Rawlings, Donald Trump, you name it. But they really didn't get any traction because the ACA didn't go anywhere. But that got me into health care. And then in 2018 or early 19, I got a cold email from a Dr. Alex Oshmayansky, and he wanted to create a compounding pharmacy for generic drugs that were in short supply. And I said to him, you're thinking too small. You know, let's think of something bigger that can impact more people. And that was right around the time the farmer bro was going to jail. And I asked them the question, how is it that this one individual can completely distort the pricing of this one drug, Deram? And we went through it, and it was obvious to me that the problem was a lack of transparency. The industry was opaque, like we discussed. But that led into me saying, you know what? This industry may not be all that hard to disrupt. And the reality is we started shipping January 19th of 2022, and here we are a little bit more than two and a half years later. And I think we've had a major impact. And truly, this has been the easiest industry to disrupt of any I've ever worked in, because it's just A matter of publishing our price list and making the data available and you're seeing the head of CVS talking shit about us. I mean it's just we don't even have 60 employees and we're literally changing this industry by just introducing transparency.
- [23:40]
B
What have you learned in your time and your exposure about what is going on in America in terms of how much medication we take versus what we actually need?
- [23:54]
A
No, it's a great question.
- [23:55]
B
Right.
- [23:55]
A
Because there's always that push, pull trying to find that equilibrium about being overmedicated with prescription drugs versus eating the right food and getting exercise and doing all the things we need to try to optimize our health. On one hand, we don't try to judge a costplusdrugs.com we want to carry every FDA approved medication we're legally allowed to and trust doctors to do what they do. We're not going to try to to think for them. On the other hand, my partner from Broadcast.com and so many other things, Todd Wagner has been just an amazing advocate for the elimination of ultra processed foods. He's got a, he released the movie Food Fight USA 2 and has an organization, Food Fight USA. And so I'm a big advocate there. We partnered with a group called Yuka who is which is an app. If you've never seen it, it's amazing. Go to the store and you scan the barcode and it tells you how processed it is, how processed the ingredients are. So like, you know, my family, we really try to stick to ultra non ultra processed foods despite having three teenagers who, you know, vehemently disagree with that approach. And so I, that's important to me. I created a site called Food Guides.com where people can go in who have GERD and acid reflux and get all kinds of information and recipes and access to good products. So it's not like we're just saying let's just medicate everybody for everything. It's saying, you know, when the doctor decides medication is a necessity, we'll trust them and we'll do the best pricing that we possibly can so that people don't have to make the choice between rent and food and daycare, etc. But we're also going to try to create options where people can best educate themselves to optimize their health.
- [25:42]
B
Have you ever found a bag of Takis in your house?
- [25:46]
A
So many that I can't even begin.
- [25:49]
B
I mean that stuff is like crack.
- [25:51]
A
No, Let me just tell you, there's Reese's Pieces sitting in the kitchen and I took One that was like my give. I took the two. Two little Reese's. You know how hard it is to only eat two?
- [26:01]
B
That is impressive.
- [26:02]
A
And. And that. No, because that thing's going to be sitting there because my kids are at home from school and I can't move it. They get pissed off. You know how it goes, right, with kids. And so, like, this is going to be my dilemma for the rest of the day. I'll be looking at that box of Reese's Pieces.
- [26:15]
B
But you get how it works, man. You see how we get seduced by salt and sugar and processed foods. You know, Bill Maher the other night said to me on the show, we were talking about this, and Dr. Casey Means, who's got the number one New York Times bestseller right now called Good Energy, and she was talking about how, look, I'm not about politics, but I'm for Bobby Kennedy doing what he wants to do and looking what's in our food, just like you're saying right now. And of course, she got trashed by some for supporting Bobby, but she only supports this one thing. And Bill says, well, we know why this stuff's in our food. And I'm like, you know, the industrial complex. And he's like, no, it tastes good. He's like, this stuff tastes amazing. So how do we deal with that?
- [27:02]
A
So Todd Wagner again, I'll keep on name dropping him. He went to Gavin Newsom and he showed him a list of chemicals that are in foods that our kids are eating that are not in European foods. There's a term for it, and I don't recall it, but they're not legal in Europe for the most part. And he showed him the list and got him to sign the legislation that removed it. That was step one. And now he's extending that to other things as well, with the hope that California, the People's Republic of California, usually is the first to take action on these things. And then other states, once they realize that it's the right thing to do, follow, follow through. Look, I'm not the world's biggest fan of, of Bobby Kennedy Jr. For a lot of different reasons, but it really comes down to what activity is actually going to happen. And that's where I give Todd credit. He wasn't out there making it political at all. He was going out there and actually doing the meetings, giving the data to show. Here are the food elements that may extend the shelf life of bread. As an example. Like, he'll tell the story all the time. Bread lasts three days in Europe and It lasts a week or more here. How does that happen? You know, and we've all heard the stories about the food intolerances and et cetera. And the difference is there and here. And he always makes the point very clearly that when you extend shelf life, that's money in the bank. When you put more sugar, it tastes better. Whatever all those chemicals are, they're there for a reason. And so by going after the ingredients themselves and making the data case that they. They're more harmful than good, sure, there's going to get. There's going to be opposition from the big food companies, but hopefully the data supports, or the data does support, and hopefully, you know, the politicians on a state by state basis and maybe even a federal basis, will take these steps.
- [29:00]
B
One step sideways on this. And then I want to ask you about something that's a passion project for me.
- [29:04]
A
Sure.
- [29:05]
B
The step sideways is help me understand, as you wade into the political waters, how is it that the guy who eats fast food all the time, and that is Trump? I mean, I don't care what anybody says. The guy eats it all the time. Is the campaign that wound up being about this issue. How. How did he get ownership of this issue?
- [29:26]
A
You know, who knows? It's. You know what we're gonna find out? This is. Until the season starts on January 21st, it's all hype. It's all hype, and we don't know. And so I'm just gonna hold on and wait to see what happens. You know, I'll. I'll. I'm not gonna guess. I'm not gonna make projections because it's all masturbation.
- [29:46]
B
Yep.
- [29:46]
A
And so there's just no point. And so we'll see what happens.
- [29:50]
B
Well, it's a huge point to masturbation, but I agree this is masturbatory.
- [29:53]
A
But you get my point, right?
- [29:55]
B
I'm staying away from it.
- [29:56]
A
To me, it's like sports, right? In the preseason, you have your draft picks, and your draft picks are the best picks ever. Until they're not. Until they play in the actual games. So we'll see what happens when they play in the actual games. Can they produce?
- [30:08]
B
All right, now here's. And I think it's very cool. And I hope the audience picks up on the fact that even though Mark Cuban was an outspoken critic of the campaign, he says, I'll work with him in a second. That's very cool. And we need more of that. So long, Covid. What have you observed in terms of clinicians trying to use drugs off label to deal with this monster of an emerging reality of long Covid and vaccine injuries.
- [30:37]
A
You know, I don't have any data one way or the other on long Covid or vaccine injuries. I just read the same things from JAMA and others that everybody else reads. And so I really can't add anything to the discussion. I know a lot of people who feel like they have long Covid. So to me it's real. The data seems to say that it's real, so I'm not going to question it. And vaccine injuries, I don't have any data at all. I played around with bars and downloaded the database and you could say that a Martian gave you this illness and people aren't going to know. So it's hard for me to say.
- [31:15]
B
Yeah, VAERS is not the solution. Are you open to that avenue of revenue and access though, that like long Covid and vaccine injuries, they're going to be things that get solved through a concoction, like a cocktail of different medicines that are obviously weren't made for that. And there's going to be an opportunity to platform what clinicians come up with and they're going to need a home. Is that something that cost plus drugs is open to?
- [31:47]
A
Yeah, I don't see us really. I don't want us to get into picking winners and losers business. You know that that's a whole different game. But I get your point that, you know, but I'm a believer in science and the scientific method. You know, that if there are clinicians that come up with combinations of drugs just like Ivermectin was, you know, HCQ were options and then the studies were done and we saw the results. And I think the same thing will happen here. You know, we don't try to invest in new drugs or discovery of drugs. We just, you know, like I said, we have 60 employees and we try to stay lean and mean because that's how we're going to offer the lowest cost. That's how we're going to be the lowest cost option. And so I don't want to get into a whole different business. I just really want to stay focused because in my mind, if we can bring transparency, if we can reduce costs as much as we think we can, then that changes healthcare enough for people to be able to afford other options, for more money to be spent on research for new things or to do the analytics to determine if this, this or this or that works.
- [32:51]
B
You were talking about the TENT program earlier as a supplement to the aca. The propaganda I would call it of getting rid of the ACA has died down in Trump land. Now he's talking about fixing it. If anything, he hampered it in his first administration, cutting marketing money, getting rid of the individual mandate through the court system. Do you believe the ACA is a sustainable model and what does it need?
- [33:18]
A
Yeah, it's certainly a sustainable model. You can tweak it in a lot of different ways. What's the medical loss ratio? How is it accomplished? What's included or not included? I think you can deal. I think the more important thing, though, is when you bring the challenge with the aca and any solution is if you don't have good pricing data, you don't really know how well it could work with any tweaks or changes. You know, you can say the same thing with single payer. If I know what the cost of every single medication is on a net basis, no rebates, no nothing, just an absolute cost, well, then there's no reason why we couldn't replicate what Canada does to a certain extent and say the city of Dallas says, you know what, we're going to pay for all the medications on this list for the entire city, because we can, you know, actuarially determine how much is going to cost us on an annual basis and we can afford it. Or a company can just say, look, no cost for drugs, 0,0 co pay, because now we know the actual cost and we've been able to negotiate them down. And the same to a certain extent on healthcare. Once you know definitively what something is going to cost, then you can come up with a budget. And if you can afford to cover that budget, whether it is in a household, in a company, in a state or the entire country, you can talk about single payer as an option. I'm not saying it's the best option, but you can consider it. You can't do that without transparency in prices on the pharmaceutical and the healthcare side. Without transparency, there's always going to be uncertainty about the aca because the underpinning of the uncertainty is the cost, the cost of premiums, the cost of the deductible, who's subsidizing what and for who. If you push the price down, the costs down, all those discussions become far easier.
- [35:04]
B
So I should ask you this question, like third, but why is that? Most service industries, of course, you have to show your pricing structure with your, you know, prospective buyers. Why isn't that the case here?
- [35:18]
A
Just the way the industry has evolved, you've got players that have come in and They've become vertically integrated. And the number one, you know, the number one rule of pharmacy benefit contracts, the number one rule of all health care contracts is you don't talk about health care contracts. They literally say right at the beginning you not, you cannot disclose any of this. And you know, going back to politics maybe, you know, that is the solution. Take out non disclosures from any health care contract. And my preference is they're published because why would you not publish it? Because it's in the best interest of the consumers. The best interest. You know, if I'm if with my companies, why not publish? Right? That helps your marketing. So you know, I think the reason why it's been distorted like this is because it's economically viable. It really helps the big companies and the more they vertically integrate, the more control they have over contracts. And if there's non disclosures in those contracts, you can introduce anything and nobody knows.
- [36:18]
B
You know, I don't know about you, but I am very non conspiratorial. I believe that that's intellectually lazy.
- [36:25]
A
I'm the same way.
- [36:26]
B
Big pharma's getting close. Just the other day, the idea that they buy up over 70% of the commercial time on cable television or whatever it was, I had no idea. And I'm on cable television and I had no idea. Is it naive to think that with the, you know, literally nine digits of lobbying that they spend on a regular basis that you will see anything that changes their profit model?
- [36:59]
A
Well, there's, there's a lot to unpack there. The when I talk about the pharmacy benefit managers, not only are patients and the companies that pay their insurance bills for those patients disadvantaged, but so are the manufacturers and the rebate system that these pharmacy benefit managers have implemented. What they push up the price, the retail price of medications and they obfuscate the net pricing of those medications to the self insured companies and self or uninsured patients. And so part of the response is why are they spending so much in advertising? Is a lot of it's because they have to, because they have to generate as much sales as possible because the net revenues they get aren't nearly what you believe them to be. I'm not saying I'm not pleading poverty for them at all. All I'm saying that this system is so convoluted and backass half words that it also negatively impacts the manufacturers. And I've seen that firsthand from the pharmacy benefit managers. Now those pharmacy benefit managers also intimidate those pharma manufacturers. And I'LL give you the example, and that's costplusdrugs.com There's a lot of branded medications that we can't sell, not because the pharma, the pharma manufacturers don't want to sell through us, but because they know that if they work with us and our pricing is transparent. Those big pharmacy benefit managers that control access for drugs to hundreds of millions of people, they're going to take them off their formularies or de. Emphasize them on the formularies, and that's going to cost them hundreds of millions, if not billions of dollars. And so when they go out there and advertise all the time, I kind of get it and why they're doing it. But it also says that there's a lot of margin there, right? And so if they pull that back, so if we can, if we can fix it from top to bottom, starting with the pharmacy benefit managers, starting with the vertical integration with insurance companies, and get down to net pricing so it's transparent, then there's a lot of foundation to go to the pharmaceutical companies and say, look, we know what your net price is now. We know what you're able to sell because all this data is now readily available. The fact that you're marketing it, why, you know, why is that margin dollar there? And part two to that, this is probably if, if we were on Shark Tank and I was pretending to work for a pharmacy manufacturer, they don't see their claims data, they don't know who they're selling to, not individually, but the types of sales. They don't have access to all their claims data. So even with GLP1, where everything is focused right now, they don't really get access to data. They try to buy it through the PBMs. PBMs don't sell them everything. So in a lot of respects they're flying blind. And then there's these other 340B programs where, you know, certain providers will double dip and charge them twice. There's, there's, it's such an opaque industry that all these costs add up for everybody. And the primary beneficiaries are the pharmacy benefit managers.
- [40:14]
B
You don't want to pick winners and losers. How do you balance that with any concerns that you or the team has with you? Talking about GLP1's the idea of Ozempic and that whole class of drugs that are very fatty right now, pun intended, that, ooh, wow, are we selling something or making it easier to buy something that a lot of people are using that shouldn't Yeah, I can't.
- [40:41]
A
I gotta trust doctors at some point. You know, if we want to have a conversation of our doctors doing what they're supposed to do, is there self interest? Are too many of the big companies, big insurance company or big hospital networks buying up too many private practices and doctors and literally controlling them? That's a conversation to be had. But from my position, I can't be in the job of trying to pick winners or losers or second guess doctors. To me, that just complicates things even more and adds cost to the system, makes it more opaque. Why did you make this decision, Mark? Well, let me explain it. Well, that I don't agree with you, you know, yada yada, versus, okay, if there's a doctor like we saw in the opioid crisis, if there's a doctor that's a pill mill or, you know, a GOP one mill, then if we're transparent and the data is readily available to the sponsors, the people paying for it, then we have a path with which to deal with it. If it's opaque like it was with the opioid crisis, then, you know, you may recognize it, but it's much more difficult to deal with.
- [41:48]
B
Do you have the ability to crunch data and let public officials know, hey, people are buying a lot of oxycodone in this one place.
- [41:58]
A
We don't, because we don't sell controlled substances. Yet we've made the choice not to because like, so we've only been doing this two and a half years and we've got to, you know, really get organized and be able to scale. But at some point when, when we do, we'll be able to. And it won't be because, well, we, we'd be able to see the scripts that were coming from all. From one doctor or two doctors or three doctors for this practice. And so, yeah, we'd be able to call attention to it. And I think legally we'd be required to.
- [42:30]
B
Oh, I don't. I wonder if you would. I wonder if.
- [42:33]
A
I believe so, but I'm. Yeah, ethically we would for sure. But we're not selling those controlled substances yet.
- [42:42]
B
After this is. This has been your most high profile political activity to date, may not be in the future. I'm a big buyer of Mark Cuban on the national landscape. You know this well, but what were the three lessons?
- [42:56]
A
I mean, it doesn't matter. You know, I'm not gonna. It's like last season's last season. The minute the Mavs lose the last game, if we don't win a championship, all. Everything changes by the next season. New draft picks, trades, etc, and there's no reason to relitigate last season. And that's the way I'm looking at this. You know, I'm gonna go in with an open mind. I'm gonna go in, you know, with a positive attitude. And come January 1st, we'll see what happens. You know, we'll learn lessons. I can guess, but we don't really know. You know, like I said before, I just don't want to add myself to the pile of people who are guessing and relitigate what happened. What matters is what starts on January 21st and when they play the games, to use the metaphor, we'll see what his. His draftees do, and we'll see how they perform, and then it's fair game. Just like they took, you know, shots deservedly many times that Biden and Kamala Harris. Well, we'll have the same opportunity and, you know, come 2026, we'll. We'll know a lot about how people feel about the first two years of this upcoming administration and, you know, we'll go from there.
- [44:04]
B
I get it. In terms of the autopsy of the campaigns, I don't want you on that pile either. Personally to you, what do you know now about that game that you didn't know before you stepped up, that it's.
- [44:15]
A
Not as brutal as sports is? You know, I got a lot of crap from a lot of people about a lot of things, but that's nothing compared to when the Mavs lose. It is nothing. You know, I mean, people are very emotionally invested in politics and sports, but the level is far greater in sports. And while, you know. And, you know, part two to that is it really go. It really depends on where you go look for information, you know, and where you get feedback from. If you're on Twitter, I'm, you know, I'm public enemy number one, you know, or at least top 10. I'm. I'm on the FBI's most. Twitter's most wanted list. But anywhere else that's not the case. In real life, the same people who might bash me, you know, and comment about my classes aren't saying anything to me face to face.
- [45:05]
B
And especially six four, like £230.
- [45:09]
A
No, no, no, not six, two.
- [45:10]
B
But.
- [45:10]
A
Yeah, I get your point. But the. But if I go on Blue sky, which I really like now, it's a completely different tenor. If I go on Threads, it's, you know, a little bit, you know, but it's completely different tenor All I have to do is stay off of Twitter and life is grand. And that's actually the lesson, if you will, that we live in a social media environment. And when you're on the biggest social media platforms, your algorithm is geared uniquely to you. What you see on YouTube, what you see on Instagram, what you see on Facebook, what you see on Twitter, those platforms define their feeds based off of how you flip through and how you scroll through. And if there's a lesson to be learned, not from me personally, but, but from a more general perspective, I think companies, not just candidates, have to recognize that, particularly now in more AI driven world, you have to create an unlimited number of advertising or limited number of content so that you hit the feed that you're trying to hit. And all those pieces of content have to be uniquely, are, have to be different and in some cases unique be. And that's where AI will play a big part. We've seen, you know, the funny videos that show Trump and Biden together smoking a cigar or bowling or whatever. You know, imagine millions of those, tens of millions of those, and they're put out there and loaded and advertising is bought with the goal of Chris getting the video that's designed for Chris, Mark getting From Mark, the 16 year old, our kids each getting their own. It's scary in some respects, but that for me, from a, a candidate and a corporate perspective, that's the lesson that's part one. Part two is communities drive everything. And you saw Trump community on Twitter that grew and grew and grew. A lot of it because of Elon and him pushing the algorithm that direction and him being the largest account. But again, even for corporate programs, whether it's talking about cost plus drugs, talking about selling cars, whatever it is, communities are stronger now because people use social media for so much of their time that they connect to people more strongly on social media because it's easier. It's the path to least resistance to find common interest for better or worse. And so I think that is going to be the lesson that candidates and parties and products all take from the lesson. And then finally, and I said I wasn't going to get too political, but.
- [48:00]
B
Finally, this isn't political, this is citizenship that you're talking about.
- [48:03]
A
Well, no, yeah, but still, you got to be a good salesperson. You got to be able to sell your product. This is no longer people like, oh, it's the Republicans and it's the Democrats. Neither party really matters anymore. They're fundraising mechanisms. But Donald Trump took over the Republican party and made it a family business. Kamala Harris did her best in 120 days or whatever it was to take over the Democratic Party and make it about her. And it was really those two candidates against each other. And who do people trust more? And they trusted Trump a little bit more. And those 240,000 votes across those seven swing states, that's all it took. We can argue about why, but Donald Trump was the better salesperson. He built a better community. And they trusted him more for. Because he, in my mind, because he was a better salesperson. And because, you know, going back to the tech side of it, they're still learning how to use candidates and companies are still learning how to use social media and that the uniqueness of every feed to their advantage.
- [49:05]
B
Yeah, it's so, it's so. It's so comical to me. The media loves to eat itself, loves to criticize itself.
- [49:16]
A
Right.
- [49:16]
B
Loves to criticize other people even more. But the latest round of that, in my opinion, is the impact of the podcast. There's no question that podcasting is a thing. Digital media is a thing. But the idea that Rogan is now the new place where every candidate has to go. Yeah, well, he has amazing reach. People go on Rogan, not so much for him, but because of his reach. Right. And he has his reach because of.
- [49:43]
A
And he turned that reach to his credit. He's earned that reach.
- [49:46]
B
Absolutely.
- [49:46]
A
He wouldn't have me on. I DMed him twice, multiple times. Have me on. He won't have me on.
- [49:51]
B
He doesn't want to have you on because he is in the open ended conversation business with people that he largely agrees with. And you are a tough interview.
- [50:04]
A
Oh, I am?
- [50:05]
B
Yeah. Oh, yeah. I'll tell you why. You have a ton of information coming out of you. You can dominate a space if you want to. I mean, I've found you fairly collegial. But you are not a joke. You know what you're talking about. And you have a very definite point of view. So if someone, you know the way that his. Well, yeah, but isn't that kind of weird? Like what you're doing? Isn't that kind of weird? You know you are.
- [50:33]
A
Yeah, I'm gonna give you boom, boom, boom.
- [50:35]
B
Yeah, you are like, no, it's not weird. What's weird is that you said that. And I'm gonna give you three reasons. And there is a compliment in him not wanting you on. I interviewed, I sat down with Tucker Carlson and I said to him, man, why. Why did you tear into my ass so much when I was at cnn, I didn't even know you like. And he goes, well, you were the big dog over there, and I'm a dick, but you were the big dog. So we went after you. And I realized that you had arrived in that way within the campaign dynamic when Megyn Kelly, who, you know, did what they're all doing now, which is bowing to Trump. Right. Because you need his audience if you wanna be on that side of the. Of the. Of the. Of the line. And she said, I love owning Mark Cuban. And I was like, I don't even remember this. So I went back and looked, and obviously they were taking something you had said out of context. But she. I don't even know what she was referring to, that she had owned Mark Cuban. And I'm going back and looking for interviews and looking for things, because I've never seen that happen to you, because you never go into a place not knowing.
- [51:37]
A
I'll tell you what happened with Megan Keller.
- [51:39]
B
Yeah, well.
- [51:41]
A
So, like four years ago, she started her podcast or interview program, whatever it was, and she had me on, and I had a nice relationship with Megan. And so I thought, sure, I'll come on just to be nice. And the interview started off very cordial. My family, my background, business, this and that. Then all of a sudden it was like, well, what about the NBA and you in China? And that was a very dicey issue because that was when Daryl Mor said something about Taiwan and it created all these issues. And I had to talk around it a little bit. What about the Uyghurs? I talk around a little bit, but gave her an answer that, you know, I'm against all human rights violations, and she didn't go for it. And that. That got picked up a lot. But what she didn't say, and I'm. This is probably the first time anybody's hearing it, is she had asked me questions in that interview, starting off, and I don't remember it verbatim, starting off talking about Nazis and Hitler. I'm like, are you sure you want to go in this direction and ask me questions like that? And she cut the whole thing out.
- [52:43]
B
Why was she talking to you about that?
- [52:46]
A
I don't remember specifically what the reference was to. And right afterwards, I asked the producer for a copy of the entire interview, and they would give it to me, and they cut it out of the final interview. So, you know, if she wants to think she owns me, that's great. I don't take anything away from Megan, you know. You know, that's. There's more Money on the right in terms of podcasts and advertising, despite what a lot of people think or say. And more, you know, subscribers to things. So more power to her, you know, she's doing the best she can. She's had her ups and her downs and she's fighting her way back. So I. Nothing personal against Megan.
- [53:23]
B
Okay, now here's the question that you hate, and I ask you it all the time in full disclosure. I do it in private as well as personal. I think that one of the problems we have in our country, okay, not just our politics, we have so many amazing people in this country and they don't get into service because it's so ugly, because of people like me and tearing up and finding out the one time that, you know, you got a shot pinned in a basketball game and, you know, whatever stupid thing I can find. So it's not worth it. It's not worth it to the family, it's not worth it to the business, it's not worth it to the legacy. Even though you'd like to serve, I put you very high on that list of proof of concept that we got Mark Cuban in this country finding all kinds of ways to do shit. He can't be running for office. What's the answer?
- [54:10]
A
Ranked choice voting.
- [54:12]
B
Ranked choice voting because you get away from the polar opposites, correct?
- [54:17]
A
And so you have to get through a primary system where it doesn't require a lot of votes and the most extreme candidates get the most attention and enough money to put them over the top to be the candidate in the general. And with ranked choice voting, you know, it's just like, you know, you can have 4, 5, 6, 7, 10 candidates and you get to pick your best candidate. And if that candidate doesn't get 50%, then the next your vote goes to your second choice until one of the candidates gets more than 50%. It's simple, it's easy, it works. And what's crazy, like if you look at Maine and Alaska, the two senators from Maine and Alaska, they're able to, you know, when the whole impeachment thing with Trump, they were able to vote against them. You see them going against other Republicans all the time. Because in a ranked choice world, you don't, you don't worry about being primaried by somebody who's extreme. And so, you know, I'm a huge proponent of ranked choice voting. The incumbent parties don't like it because it takes away a lot from the power structure. It reduces the impact of money, it opens the door for people outside the parties to run and succeed. And so it makes sense that they wouldn't be for it. They come up with all, oh, it takes too long to calculate. Well, damn, California still hasn't finished calculating, so it can't take that long. So the resistance is kind of ridiculous. But to me, that is the delta, because you can't. When the focus is on two candidates, you get one level of attention. When you have to really address five, and you don't really know. And just think about it, right? If there were, you know, five, if you could pick. If there were two more candidates and you could rank your votes just in the presidential election, right, we might have a completely different outcome.
- [56:09]
B
100%. Mark Cuban, I appreciate you taking the opportunity. I want the audience to know I chase after Cuban on a regular basis, and thank God he doesn't have an Apple phone, because I thought he had blocked me, like, three years ago because the messages were going green.
- [56:26]
A
I've got one of everything. I've got an iPhone, I got an Android, Droid, you name it.
- [56:30]
B
But I'm a big fan, and I'm a big believer in what you do.
- [56:34]
A
Thank you.
- [56:35]
B
And you always have an opportunity on any platform I'm on at any time, and if you need anything, I'm a call away.
- [56:41]
A
Yeah, I appreciate it. And I. When you were chasing me, you were nice about it, and, you know, I always responded.
- [56:46]
B
Always.
- [56:47]
A
Most of the time. Most of the time responded. Maybe a couple times I missed. But, you know, because I respect you, Chris, and I respect the work you do, and, you know, you keep on grinding, and that's always important because you have something to say and you do the work. That's the more important part. I like how you're prepared.
- [57:02]
B
Thank you very much, Mark Cuban. If there's anything I can do. As you guys go to the next phase with cost plus drugs.com, let me know, because it's part of the solution.
- [57:11]
A
Please, please, everybody go check out. No matter what medication you have, go to costplusdrugs.com, put in the name of the medication, and if we carry it, compare it to the price you pay. Compare it to your deductible, because there's a really, really good chance, particularly if it's generic medication, which is 92% of prescriptions, there's a really good chance we're less than your deductible.
- [57:31]
B
I'm not saying this should be the tagline, but a friend of mine uses this service, and I was like, why that one? He goes, cuban doesn't need the money. That's what he said. He's like Cuban, doesn't need the money.
- [57:42]
A
So if he's doing it, change my life. But it feels really fucking good to turn this industry upside down.
- [57:49]
B
Well, I appreciate you. Good luck and I'll talk to you again.
- [57:53]
A
Thanks, Chris. Take care, buddy.
- [57:59]
B
I really do believe that you may not vote for him, but isn't that the caliber of people that we should have leading us in America, or at least competing to? I mean, I don't know. I think talent is a big thing, but I have to tell you, the idea that they don't have to show their prices before our insurance plans decide what we're going to pay for the drugs and medicines that we need is cray cray. What did you think? Let me know. Thank you for subscribing and following here at the Chris Cuomo Project. I'll see you at News Nation every night, 8p Eastern weekday nights. Of course. I don't work weekends. Work on my tan. Hey, I like the podcast, but I wish there hadn't been those ads. I love my advertisers, but if you don't like it, please subscribe to the substack. Don't follow at the substack because you're not going to get any content. 5 bucks a month you get this pod ad free. You get it first. More importantly, you get my doctor, who is a big shot in the long Covid and longevity space, telling you all of these great understandings about what's going on after Covid, what's going on with vaccine injuries, what you can do to help your own longevity, doing it yourself, why you do it that way. You get my Walk and Talk series, which is all the lessons I've learned about life that I don't pay attention to well enough in my own, but you can in yours, all for five bucks a month. And I'm using a chunk of the money to help my doctor treat people with long Covid who can't afford it. Come on, you know it's a value. Let's get after it. Can.