Entrepreneur Mark Cuban discusses the vital role risk mitigation plays in rising healthcare costs, the effect medical school costs have on access to quality care, and how AI could impact the medical community. Can transparency impact the cost of care? Would offering medical education for free mitigate the proclaimed physician shortage? Does AI make sense as a tool in the medical industry? Mark shares his knowledge and wisdom surrounding the climate of healthcare and how these changes could impact doctors and patients.

Here are five takeaways from the conversation with Mark Cuban:

1. Transparency in Healthcare Pricing

Mark Cuban emphasizes the need for transparency in healthcare pricing to eliminate unnecessary costs and improve efficiency. By publishing negotiated prices and contracts, his Cost Plus Wellness initiative aims to reduce administrative overhead and ensure fair pricing for patients.

2. Challenges with Insurance and Hospital Costs

Dr. Ned Palmer discusses the complexities of hospital pricing and insurance negotiations, highlighting how cash prices are often lower than negotiated insurance rates. This discrepancy is due to the lack of transparency and the administrative burden placed on hospitals.

3. Innovative Healthcare Models

The conversation explores innovative models like direct primary care and subscription-based healthcare, which aim to provide affordable access to medical services, especially in rural areas. These models focus on risk mitigation and community involvement to sustain healthcare facilities.

4. Student Debt and Medical Education

Mark Cuban advocates for free medical education to address the maldistribution of doctors. He argues that eliminating student debt would allow for a more equitable distribution of healthcare professionals across specialties and regions.

5. The Role of AI in Healthcare

The discussion touches on the potential and limitations of AI in healthcare, with a focus on its role in improving efficiency and decision-making. However, concerns about data sharing and the effectiveness of AI models are also raised.

Transcript

Mark Cuban:
There’s all these extraneous rules that are invented to try to maximize revenue as opposed to wellness. And so what we’ve said with Cost Plus Wellness is, okay, how do we eliminate all of that?

Michael Jerkins:
Welcome back to The Podcast for Doctors (By Doctors). I’m Michael Jerkins.

MJ:
And we are excited to present our conversation, our second half of our conversation with the one and only Mark Cuban, where we talk about all sorts of additional topics in healthcare and other topics too.

NP:
We do. I’m really excited to bring this after our part one conversation where we dove very deep into pharmacies, pharmacy benefits managers, Cost Plus Pharmacy, what it’s doing. And to get broader here talking about, I’m really excited to explore with Mark his other passions. So healthcare, sports, which we’ve alluded to somewhat, some of his interests in politics and how that intersects with the healthcare game.

MJ:
Yep. I think I learned a lot, especially in part one on pharmacy. I learned a lot on part two on policy and thinking again, his big thing is transparency. And so really excited to present the second half of our conversation with Mark Cuban.

NP:
How do we extend the transparency? I love the argument that transparency is there. The ACA tried to do a lot and keeps pushing for transparency from hospital pricing, procedure pricing, CMS’s charge master list. How do we push transparency further?

MC:
Okay, so on the hospital side, the challenge with hospitals, all those prices are great, right? When there’s single instance type support or mediation, whatever, however you want to describe it. Whenever the care is only a single transaction, it’s really simple. And the simple thing, you know, what I tell our folks and what we do is we just, here’s the company credit card, walk in there and ask for the cash price. And if it’s simple, like if it’s an MRI, if it’s an X-ray, if it’s fixing a broken bone, even if it’s a hip replacement, then you get a single price and the cash price is always lower. And it’s crazy to think that the biggest insurance companies, when they negotiate, the price that they negotiate is much higher than the cash price. And the reason for that wasn’t initially intuitive to me, but it’s obvious now.

MC:
So when somebody goes to the hospital to see you guys, for whatever reason, right? Whether it’s emergency room or scheduled or whatever it may be, 99% of the time, if they’re insured, they have a deductible or copay or coinsurance. And the coinsurance, if it’s an operation, is gonna cost more than a couple thousand dollars. There’s a really good chance the amount’s gonna exceed their obligation. So they’re gonna have to pay their full deductible. And most people, there’s an affordability issue, but the bigger point here is that the hospital or the provider or your practice is responsible for the credit risk. And literally, depending where your hospital is located, you might have a 60–70% write-off of all your deductibles. And so if you pay cash, that deductible risk is gone. But wait, there’s more.

NP:
There’s also the insurance risk, right? On top of the deductible risk and your rejection risk.

MC:
Right, right. So let’s just say, if they don’t have insurance and it’s a cash pay, that’s a different beast. Because you’re dealing with different circumstances and there’s dis reimbursement and all that, and if you’re profit versus… So let’s put that aside for a minute. But let’s talk about with the insurance companies. It’s a given that they’re going to want to preauthorize. Put aside the deductible. The deductible is also a risk. So they’re going to go through it even though they know that it has to take place. This has to happen.

And they’re going to deny it very often. And then they’re going to put the onus on you to explain it. And that’s going to go not only to you, but to whatever support you have and whoever else is at the hospital or wherever you work. And that’s also a burden and overhead that’s involved there. And so finally, more often than not, get it approved. They just try to delay you so that the patient maybe comes back, you miraculously healed, I don’t know.

Then, yeah, or not. And so then you do the work and they bill whoever the client is. More typically it’s an employer. And so that employer gets a bill that’s going to be higher than what they negotiated with the patient, with the hospital rather, with the provider. So there’s spread pricing there.

But wait, there’s more. When they decide to pay the hospital whatever it is that they’re gonna pay them, they always short pay. Always short pay. So a couple things happens as a result of that. One, the legal department has to get involved to try to contest it, and the administrators have to do all the administrivia to support the hospital, the provider’s side.

MC:
So that jacks up your cost, that takes up a lot of real estate, that’s a lot of administrative overhead. And the estimates that we’ve been told is that’s about 2% of revenue that they end up getting underpaid because the insurance companies short pay them. And then from there, you’ve got to have all the people in place to deal with the pre-auths and getting that approved. Then all the other… So what Cost Plus Wellness looks at and says, okay, we’re going into hospitals and we’re saying, number one, before we even talk to you, anything we negotiate, we’re going to publish. Because the reason the insurance companies like the PBMs are able to get away with this is because there’s no transparency. You don’t know what another hospital, provider, or practice does because the first line in that contract says, you can’t talk to anybody else about what you’re doing.

MC:
And the response a lot of hospitals have because of all this incremental cost that is added, they start inventing all kinds of costs and complicating things. So you have facility charges that came out of left to right, which is insane. You get the inflated band-aid charges that we’ve all heard about and whatever else they can think of. Everything they could possibly charge, they are going to charge you for because they know that the value chain is such that everybody’s got to arb their piece. Everybody’s got to extract whatever rent they can, wherever they can, because they know the insurance company has complicated everything.

So you’ll see things to the extent that, you know, if they stay four days… Well, I’ll tell you what happened to my mom when she had cancer. It was brutal. And this pissed me off too. She had lung cancer and they told her she had lung cancer. We got the scans back and then we wanted to do a PET scan. She was in the hospital and they wouldn’t let us do a PET scan because she had to leave for three days and then come back to do the PET scan. And hell had no fury like me—pissed off. So this is the hospital where I grew up, and so I was pissed, but it just goes to the point that…

MC:
There’s all these extraneous rules that are invented to try to maximize revenue as opposed to wellness. And so what we’ve said with Cost Plus Wellness is, okay, how do we eliminate all of that? Because if the basis of all these extraneous charges and arbitrage efforts is the fact that nobody gets paid what they expect to be paid, there is no true transparent pricing.

And the more complicated the event, the more complicated the pricing. And the greater the opportunity for the pricing to be complicated by the provider and see that as a revenue opportunity. Because my mom’s got cancer, who the hell is gonna be upset? You know, you’re just gonna, and can afford it, right? Just give her good care. So you just grab everything you can.

So what we’re saying is, we’re walking into providers and saying, okay, we’re gonna trust the doctors until you give us reasons not to trust the doctors by doing too many of everything, and we’ll be transparent. So you’ll see the data, we’ll see the data, and you’ll know and we’ll know upfront if it’s a bad doctor from a performance perspective or a bad doctor from a revenue—they’re earning a commission perspective. And you guys know exactly what I’m talking about.

And so by being straightforward with them and upfront that we’re going to publish everything, that creates a level of honesty because we’re saying we’re going to give you all the money we promise you and we’re going to give it to you upfront. Everything that we contract for, everything that is in this deal, when NP or MJ says, okay, Mrs. QBid, you have lung cancer, unfortunately, you’ve got to do A, B, C, D. We’re going to say, okay, we believe you, we trust you. We’ve negotiated based off all the DRGs and everything we can think of.

This is the price. And actually that price ends up being relatively close to the Medicare price, in some cases even less, because you’re guaranteed the minute, you know, in this case, Mrs. Cuban walks into the hospital, she’s got her credit card and it’s being paid immediately, or we’ve already sent you the money, unless some places prefer to bill because that’s their system and we have to pay within 15 or 30 days. Either way, you’re getting your money relatively upfront.

MC:
And that reduces all that. There’s no deductibles, there’s no co-pays, there’s no co-insurances, there’s no payment risk, there’s no negotiation, there’s no pre-auths, right? It is. NP or MJ said this is what we need to do, yes. This is the price we negotiated, yes. If anybody’s unsure about what that price is and how it was calculated, here’s the contract online, yes. Everybody gets to look at it.

And when every other provider either looks at it and likes it or doesn’t like it because some big hospitals and some big brands aren’t going to like that, because they want to be paid a premium for the brand. And that’s fine. There’s certain places you want to go because you think they’re the absolute best or they have this doctor or that doctor who can do this operation or whatever it may be. Great. You get paid more. But if you do a deal with us, even though it’s higher, we’re all going to know what it is upfront. And there’s no pre-op because all these things just introduce more and more stress to the system and cost—stress to you guys in terms of the system and cost in terms of all the games hospitals have to play, all the extra administration, all the real estate for those administrators, all the overhead and benefits and everything for all those people as well. All the parking spaces, all the cafeterias, all that adds up really, really fast to increase the price of healthcare.

And we feel like by paying upfront and using us as—know, eating our own dog food and using us as the first case and then letting people copy us, the same thing will happen. It will be slower and take a lot more time because it’s a lot more complicated than just issuing a prescription. But with CAR T therapy and everything, we have to bring people in and all these high-end specialty therapies that are going to cost a million dollars, and they have to be administered. That’s on the healthcare side, and even these contracts will apply to that.

And so by being transparent with our contract, everybody gets to contrast and compare and learn. And we won’t get it right the first five iterations, but hopefully by making this public and everybody telling us how stupid we are on these 17 different things, everybody will get smarter.

NP:
Yeah, it sounds like you’ve built a really interesting blended model of some of the benefits of a capitated model, which is, you know, there are a lot of policy advocates—and we’ve had one on our show—very much in love with the idea of a capitated model, but then some of the value of at least a transparent fee-for-service model. You have a captive population you want to deliver value-based care to, but at the end of the day, the rubber meets the road and you still have to pay for episodic care. So at least bringing that transparency and shining a light…

MC:
Well, that’s the whole point, right? Because why do you do capitation? Because you want to push off the risk. It’s just a risk mitigation thing because you don’t trust the lack of transparency and you don’t trust the people defining the prices. And it’s the same thing with value-based care. Sounds great, right? We think that this is the value of a hip replacement. We think we can save you 75% because this is the average price. But how that reference price is set is everything. And so if it’s based off a system that is inferior or cheating in a lot of respects, you’re not mitigating a lot of risk and reducing costs relative to what you could accomplish. And so that’s why we’re doing what we’re doing.

MJ:

Can you talk a little bit about the strategy on the wellness side—where you’re really going to see the demand and where you’re going to start with? One slightly biased take is just, NP and I see this: on these critical access hospitals, these rural hospitals shutting down. They don’t have the overhead to play these games and the compressed margins. Are they in the market for you guys to approach on this wellness piece?

MC:
Yeah, of course, but the problem isn’t the pricing, as you said. The problem is just the population and the ability for the population to afford it. But if it’s transparent, at least wherever their support may come from—whether it’s communities within X number of miles, the state, federal, whatever—it at least gives hope for transparency. Like I literally looked at buying a hospital just to be able to prove the point. And it was a community hospital, but they had so much debt against it, and their projections were so insane relative to the population.

And really, you talk about capitation—the best model we considered in doing this is charging almost like season tickets to the mass. When there’s a new team that goes to a new market, like when the NHL went to Las Vegas, they said, “Well, we can sell X number of season tickets, then we can afford to come.” Well, the same thing applies to a hospital. If we can get X number of families and businesses to commit to $25, $50, or $100 a month for at least a three-year initial contract, then we can afford to put a hospital here for you. We understand not everybody’s going to be able to stay up with that obligation. People are going to lose their jobs and yada yada. But as long as we hit X percent penetration of it, fine.

That’s how, initially, I think it was in Chicago, the initial concept of insurance happened. There was a hospital about to go out of business and they got the local community to pay them upfront.

NP:

Buy a subscription.

MJ:

Well, it’s like direct primary care now.

MC:
And it’s all about risk mitigation. When you’re in a rural area, risk is far harder. It’s harder to reach that threshold of breakeven because of uncertainties based on the population. And it’s a vicious cycle: people move because they don’t have access to care. People have to leave, lose their jobs because they don’t have access to care.

MJ:

The big thing there—and NP can speak to it more because he works in critical access hospitals very often—is that doctors… there is an argument on if there actually is a shortage or not. We’ve actually had someone else on the show argue there isn’t a shortage. But there is a maldistribution. We’re all concentrated in the same general areas. Just because you have insurance doesn’t really mean you’re healthier. If we got everyone insured, it doesn’t mean everyone’s healthy. Eventually, they actually have to receive treatment somewhere.

MC:

Nobody dies healthy. So back to your point in terms of care and access, it’s just hard to reach. It’s hard. You’re talking about mitigating risk. Even for primary care or concierge care, why do they charge a monthly fee? Why does my doctor charge me? They charge me for access, but they do it so they can hit their nut immediately.

Going back to doctors, there is not a shortage, but there is a misapplication because of how they have to pay for med school. If med school was free, you would see a completely different distribution of doctors by specialty. You wouldn’t have as many dermatologists or orthopedic surgeons.

MC:
Right, because they go where the money is. And I’ve been an advocate—I’ve said this many times—that med school and public university should be free. There are programs in place if you’re willing to go work in areas with doctor shortages and deserts. But you still have to pay that money up front, and that’s difficult. It’s scary as hell to have to borrow. So I think med school should be free with an obligation, or you can just pay it and pursue higher-paying specialties.

MJ:
Ned, what was our combined debt for med school?

NP:
$740,000 between the two of us. Yeah.

MC:
Hey, nuts, that ain’t shit. You guys are busy about your business.

NP:

Several beautiful homes or one piece of paper. The frustrating part is that there are programs like the National Health Service Corps, set up 15–20 years ago to pay doctors to go to rural areas, but they haven’t kept up with reality of med school tuition. $50,000 of forgiveness is frankly… I graduated with $420,000, he had $330,000. $50,000 is a drop in the bucket.

MC:

So here’s the math: at any given time there’s about 9,000 doctors in med school.

NP:
Okay, yeah, I would have thought more.

MJ:
There’s about 30–40,000 participating at each match, so it’s probably more than that.

MC:
Okay, I’m sorry, about 9,000 in each class. That’s what it was. Each class. Right, right.

NP:

Yeah, yeah, yeah, sorry. It’s year of, yeah, going through. Yep.

MC:

Yeah, each class. So if it’s $36,000, let’s say, and it’s $100,000 each, right? And so you just do the math. And is that cheaper? Is it $3.6 billion? I don’t know. You do the math. Whatever—$3.6 or $36. It’s not the minimum amount, but it’s cheap relative to the impact.

MJ:

The interesting thing we talk about a lot is there’s really no accountability with the schools. The school gets the money from the government. What incentive do they have to keep the prices low?

MC:

Well, now you can’t write yet, you’ve gotta give it to—yeah.

MJ:
Yeah, yeah. And so this debt cancellation thing—which, of course, I want people to have less student debt, I’m an advocate for that—my issue is it doesn’t really solve the problem when the schools will continue to charge and charge and charge.

MC:
That’s a whole different thing. When you have easy money, that’s an incentive to raise tuition and all your costs because they know the students—though I’ve had other conversations—put a cap on how much families can borrow from federal sources. Or, talking to the Harris camp, it’s like, look, you put out to bid one school per DMA, one school per region, and let that school win to be the free school. You make it a 10- or 20-year contract. Now all the other schools have to compete with the free school. That’s opposed to “colleges free,” because otherwise they’ll just jack up what they charge. It’s the same thing with Medicare for all. It’s not that it’s not a valid opportunity—it’s just PBMs and hospitals are smarter than the government, and they’ll grab every penny they can.

Until it’s completely transparent. Once you have all the claims data, the PBM for Allegheny County in Pittsburgh knows all the claims. Then they can say, “We have the budget to pay that.” So we’ll make pharmacy free for all citizens in our county, comparable to what Canada does by province. They have a budget. But Canada charges, like we do, the provinces, right? So if there’s no transparency, it’s impossible to get the price.

NP:
We’ve beaten up the schools appropriately, the Department of Education, hospitals, healthcare, prescription policy. What do you think is going right in the healthcare system?

MC:
I think you’ve got good doctors, obviously. Doctors still care. Out of 990,000 practicing—or whatever the number—you’re going to have some bad apples, but doctors still care. Nurses still care. People still trust their doctors. That’s what’s going right. Doctors are continuing their education. We’re evaluating AI for better or worse.

AI is a tool. AI has become a typing hack as much as anything else. You can get AI to do the initial typing and then you just fix it. Before, your assistant typed everything and you reviewed it for changes. Now AI can do all that. It’s also nice to ask for a suggestion—“Oh, that’s stupid, that’s a hallucination,” or “I didn’t think of that, that’s a good idea.” The challenge with AI on a macro basis…

NP:
I’m fascinated about your approach to AI and healthcare.

MC:
Yeah, of course. There are a lot of opinions to be had. I’ve had conversations with people in charge of healthcare and AI at Microsoft and other companies. The challenge is branding. There won’t be five, two, or one major healthcare model that everybody connects to.

MC:
MD Anderson, Mayo, Stanford—they ain’t sharing anything. They pay their doctors a premium and fund research for prestige and to have first access to information. Without everybody contributing, AI becomes ineffective and almost negative unless you understand who’s been excluded from the model. For the basics, great, but you won’t get all information that’s fit to print.

NP:
What you’re describing is that under the ACA and some meaningful use rules, one of the biggest points was sharing health information between health systems. That hasn’t happened. They’ve neutered that. It’s just lip service. It’s really consolidation of electronic health records.

MC:

And that’s patient information, right?

NP:

That’s patient owned information.

MC:
Yeah, and that’s all siloed into the most locked-out silos imaginable.

NP:
You’re describing the same for AI. There’ll be a Harvard model, a Stanford model, and they’ll feed in their own data and concentrate on it.

MC:

There are going to be hundreds of millions of AI models—not 10, 20, or 50, hundreds of millions.

MC:
My kids are teenagers now. Do you guys have kids?

MJ:
10, 8, and 5, almost 6.

MC:
The six-year-old, the eight-year-old, maybe the 10-year-old—they’ll have their own model by the time they go to college.

NP:
Based off their own data. Probably wearable data, etc.

MC:
Yeah, I talked to my son about this who apparently then at school goes and has philosophical questions about how AI is taking people’s jobs. That’s not coming from the home. I don’t know where he’s getting that, or how they can use it.

MC:
My daughter is about to be a junior at Vanderbilt. We talk about words that trigger teachers to know she used AI. You can’t use ChatGPT all the time—you’ve got to mix it up. You still have to know when it hallucinates. You still have to know the subject matter. You can’t cheat, but you can shortcut.

MC:
You saw Michael Cohen, the former Trump guy, use AI and hallucinate law cases that didn’t exist. That’s the risk. You can’t prevent hallucinations because AI doesn’t have wisdom.

MC:
If you ask AI, “Tomatoes are fruit. Can you put tomato in a fruit salad?”

MC:
It’ll say yes. Nobody puts a tomato in a fruit salad. That’s wisdom.

NP:

What kind of sociopath would put a tomato on a fruit salad?

MC:

There’s no wisdom in AI—there’s knowledge, information. When it tries to create wisdom, that’s where it hallucinates.

NP:
I heard it described as a stochastic parrot. I liked that nerdy definition. Reading an article about it.

MC:

It’s autocorrect—a big version of autocorrect.

MJ:
You mentioned talking with the Harris camp on student debt. What’s interesting is that in this presidential campaign, we haven’t heard much about healthcare. It’s not a major piece. Are there any politicians on healthcare policy who actually have a clue?

MC:
I’m not going to talk about Republicans; my feelings are public. Well, I’d probably vote Republican if it was a non-MAGA candidate. On the Democratic side, she hasn’t put out policies yet. It’s only been three weeks. Think of it like you’re VP of a hospital and the board just removed the CEO. You follow the CEO’s course—every doctor thinks they know everything. If you become head of the hospital, you need your own strategies, policies. That’s what she’s doing: people first, strategy second. She hasn’t published policies yet, which is fine.

Today, the CEO of Starbucks got fired and replaced by someone from Chipotle. That person isn’t going to say day one, “Here’s all my politics.” They need to learn about the people, the issues, the culture. Over time, they develop a 100-day plan. That’s what Harris is going to do. And Biden got an earful from me.

MC:
But it wasn’t as he was more concerned with Medicare. But the Harris camp has gotten a dozen earfuls from me and they know all about Cost Plus. They know all about PBMs now. They know all about the good and the bad of the IRA. And you know, the good of the Medicare caps at $2,000 for next year. But they’re formulating it, but it’s going to be.

I don’t see it—and this is just my guess—I don’t see it going to anything very super progressive. I think they understand that without transparency, you can’t get a progressive solution.

MJ:

That makes a ton of sense.

NP:

If it were yours, if you did have not just Vice President Harris’s ear, but also some authority and control over it, where would you see driving toward transparency? How do you, policy-wise, drive toward transparency? Because it seems we’ve seen that and they’ve been interdicted by…

MC:
So you just say very simply, you go to Congress and pass the law saying every medical contract must be redacted for personal information.

Ned Palmer:
That’s it. And just create a database like the Sunshine Act, right? We’ve done public databases before, so there’s even a precedent for it.

MC:
Yeah, you just publish it. I mean, it’s really easy and people will put it into AI. You can search and replace, right? You can download it, review it, analyze it, scrub it however you want, and use it. Because once you have that transparency, the market starts to become efficient.

That’s not to say someone couldn’t abuse it. There’s regulatory capture and there’s scale capture. The reason these big three PBMs have gotten so much business…

There used to be a saying: no one ever got in trouble for buying IBM. CEOs, even at your hospital—I’ve talked to world-leading hospitals, asked them about their PBMs and insurance companies—and they don’t fully understand how they work. And the issues, right? A CEO of a company, typically, that’s not their core competency to know.

So by creating transparency, if I was in charge of healthcare, I’d create transparency, go meet with all these big CEOs, and explain to them how all this works, and how they’re getting ripped off. Telling them, “Yeah, you’re getting rebates from these PBMs, but let me tell you: you think the manufacturers pay for those rebates, but it’s your sickest employees that actually pay for it. Because the higher the rebate, the higher the deductible. And who has to pay up to the full deductible? The sickest employee.”

Let’s just say you have great insurance and it’s a $1,500 deductible. Somebody’s making $50,000 a year, after taxes $30,000. Now 5% of their income, they have to have in cash off the bat. Forget it. People just don’t have that kind of cash to go pay that deductible. Now they’re going on their credit cards, and it’s a slippery slope to financial ruin.

MJ:
Terrible. Well, I know we’re wrapping up and you’re super busy. I had a couple of True-False statements. All right—True or False: AI advances will result in net job loss over the next 10 years.

MC:
False.

MJ:
Okay. The Celtics will repeat as NBA champs next year.

MC:
Double super false.

MJ:
Sticking with sports, LeBron James will be on the next Olympic men’s basketball team.

MC:
False.

MJ:
True or False: Donald Trump will win the election in November.

MC:
It’s been fun, you guys. I’m not gonna jinx myself.

MJ:
Well, one last question. We always ask this to our guests: what is one thing that you’ve recently changed your mind on? We, as doctors, are presented with data. We change our minds all the time. What’s one thing you’ve changed your mind on? And then we’ll wrap it up.

MC:
Oh my God. It was on Twitter—somebody convinced me.

MJ:
I’ve never heard that sentence before. Can we pause for a second?

MC:
It was whether or not algorithms used on social media are a form of free speech. Initially, I was a no. And then I came around to, yeah, it’s just somebody making a determination about what the variables are and how they’re weighted in that algorithm. And that’s as much a free speech opportunity as anything else.

NP:

You can see, when you start talking about blocking that, the corollary becomes very concerning. You’re blocking the call-your-next-best-conversation. And that’s been a fundamental sales tool since the dawn of sales.

MC:

Just like I want to maximize my revenue, so I want an algorithm that increases engagement. And if that means I have a platform that has a lot of idiots, so there’s a lot more idiotic conversation, that’s my choice. That’s free speech. And so, if I want more idiots, more power to me.

MJ:
Well, this has been amazing. Thank you for your time.

MC:
By the way, that’s a great last question. That’s the best last question I’ve ever been asked in an interview, and it’s not even close. It really made me think hard.

MJ:
Good. So, tell everybody where they can find out more about Cost Plus and more about you and this effort to make things more transparent in healthcare.

MC:
Just go to costplusdrugs.com. And like you said, Epic and Cerner—we’re at Mark Cuban Cost Plus Drugs. Please use us, please spread the word, please check us out. You’ll be shocked at the drugs we carry. Things that your PBM or your healthcare system or your insurance provider will say are “specialty drugs.” There’s a really good chance we carry it.

MJ:
Excellent. Awesome. Mark Cuban, thank you for your time.

MC:
You guys are awesome, thanks guys.

NP:
Thank you very much, Mark Cuban, for joining The Podcast for Doctors (By Doctors). That was an incredible two-part series and a broad run-through of pharmacy, healthcare, policy, sports.

MJ:

I don’t remember any of that. What I remember is when he said my question was the best question he’s ever been asked in an interview. I’m sorry—we’ll have to re-listen to remember the other stuff.

NP:
I could see your head swell on our camera here. And I was afraid of that. Honestly a little concerned. At a certain size, there are engineering concerns. But it was pretty incredible. Obviously, I think we’ve both been fans of Mark and what he’s been doing for so many years now—his eagerness to dive into the healthcare space and to try to make things better for our community of doctors, for our community of patients. I’m over the moon on it, not gonna lie.

This is geeking out.

MJ:

And I’m interested to see how this Cost Plus Wellness develops, as he talked a lot about. We talked in part one about the Cost Plus Pharmacy and Wellness, and it bled into part two—this push for increasing the amount of information patients and other economic actors in the system actually have access to. That greater transparency, hopefully, leads to greater efficiencies.

NP:

We’ve all been talking about more transparency in healthcare for a long time—since the ACA, more than 10 years now. There have been some improvements, some headway. But without collective action, it’s going to be very challenging to improve across all systems. I’m very excited to hear that’s the focus. It’s not one unifying call like Medicare for All or universal healthcare or universal basic income. Instead, it’s more broad—that transparency will solve.

MJ:
And isn’t it crazy that it’s opaque to us, and we’re in it as doctors? If it’s opaque to us, what is it like to anyone who doesn’t work in it and hasn’t been steeped in it? It’s an incredibly inefficient and complex system, unfortunately. But I love that innovation and smart people are starting to really think and iterate new ideas.

NP:

What I heard from Mark is that there are absolutely opportunities for innovation here, and it doesn’t have to be piracy. You can do good, be good, and still find ways to succeed as a company, like he’s done with Cost Plus Pharmacy and Cost Plus Wellness.

This is how unwell I am: I can’t even conceive that there’s a Cost Plus Wellness program out there.

MJ:
Well, I hope you guys enjoyed it. Please don’t forget to share this with all your friends. Spread the word about Cost Plus and the great work Mark and his company are doing for providers and ultimately for patients.

NP:

Thanks for joining us this episode. You can catch the podcast For Doctors, By Doctors on Apple, Spotify, YouTube, and all the other major podcasting platforms. If you enjoyed this episode or learned anything here today, please take a moment to give us a rating and subscribe so that you don’t miss a single episode release.

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