Billionaire entrepreneur Mark Cuban is known for shaking up industries — and he continues to propose bold ideas to reform the U.S. healthcare system. In a series of posts on X, Cuban laid out a framework that shifts power away from insurance companies and toward patients and providers.
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A Broken System: Clawbacks and Underpayments
Cuban’s comments came in response to a video shared by @WallStreetApes, highlighting an American surgeon’s experience with insurance “clawbacks.”
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According to the post, the surgeon submitted a bill for a patient’s surgery and received only one-third of the requested payment from the insurer. Months later, the insurance company demanded a refund — claiming it had overpaid — and withheld future reimbursements when the surgeon didn’t comply quickly enough.
Cuban weighed in: “This is one more reason why companies should direct contract with providers. Insurance companies underpay providers all the time.”
Cuban’s Healthcare Vision: A Cash-Pay, Patient-Centered Model
Asked what he would do if he were in charge of U.S. healthcare, Cuban offered a multi-part response. His ideas center on patient choice, price transparency, and shared responsibility between patients and the government.
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Under Cuban’s suggestions:
- Patients would choose any provider offering a “cash pay” option with publicly posted prices.
- Patients would commit to paying what they can afford — supported by documentation.
- The government would finance the remaining cost.
- Patients would repay the government through paycheck deductions, capped at 10% of income.
- After 15 years, any remaining medical debt would be forgiven without penalties.
“There would be zero premiums to insurance companies,” Cuban wrote. Instead, individuals would pay $400 to $500 monthly for family “re-insurance,” capped at $50,000 annually. This limit would prevent patients from facing catastrophic costs.
No More Middlemen: Eliminating Insurance and PBMs
Cuban’s framework removes traditional insurance companies and pharmacy benefit managers from the equation entirely. He has long said that these intermediaries drive up costs without improving care.
He also suggests eliminating employer-provided health insurance, allowing people to buy private plans if they wish, and switching Medicare and Medicaid to net pricing for prescription drugs.
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Concerns About Rising Prices and Access
While Cuban’s ideals about the U.S. healthcare system are praised by some as a fresh take focused on incentives rather than buzzwords, it also raises questions.
Entrepreneur and investment educator Matt Allen asked what would prevent providers from raising prices once the government covers the balance. He also pointed out the issue of limited provider choice in rural areas, where patients can’t easily shop for lower-cost care.
Cuban responded that because patients are still financially responsible — through paycheck deductions — they’ll be motivated to shop for value. Providers, in turn, would have to compete on price and service. “But it’s not free money,” he added. “Patients will have to pay out of their paycheck every month. They are on the hook for the care no matter what.”
A Conversation Starter, Not a Final Plan
Cuban emphasized that his ideas are a work in progress and based on his companies, not finalized policy. Still, his willingness to outline a detailed approach sparks renewed discussion around healthcare reform — particularly around affordability, transparency, and who should bear the burden of cost.
For many Americans frustrated with rising premiums and complex billing practices, Cuban’s approach might offer a starting point for reimagining care.
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