Elon Musk Wants to Know Why Healthcare Costs So Much — Mark Cuban Gives Him 7 Brutal Reasons Why CEOs Like Him Are Making It Worse

Elon Musk knows rockets, AI, and electric cars, but does he understand healthcare? Mark Cuban seems to think he doesn't.

When Musk posted on X in December questioning why Americans pay so much for healthcare without seeing real value, he echoed a frustration shared by millions. Citing the fact that the U.S. has the highest healthcare administrative costs among Organization for Economic Co-operation and Development countries, an account called The Rabbit Hole pointed out the disparity.

Musk responded bluntly: "Shouldn't the American people be getting their money's worth?"

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Cuban fired back in response to the post, and he didn't just blame the government. Instead, he put the heat on CEOs of self-insured companies, including Musk, for signing contracts that make drug prices worse.

"The key is the contracts CEOs of self-insured companies sign. The PBM contracts YOU have signed for Tesla, SpaceX, and X have more impact on healthcare costs than anything you can do with DOGE."

PBMs, or pharmacy benefit managers, are intermediaries between insurers, pharmacies, and drug manufacturers that negotiate lower drug prices and manage prescription drug benefits.

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Mark Cuban's 7-Point Reality Check for CEOs Like Musk

Cuban laid out seven ways those contracts are keeping drug prices high and hurting employees. His exact list stated: 

1. Don't control your claims data 
2. Don't control your formulary
3. Have to pay more for "Specialty Drugs" that have nothing special about them
4. Get rebates that are paid for by your sickest and oldest employees and result in higher deductibles and co-pays that impact the wellness of your workers and their families.
5. Cause independent pharmacies to be reimbursed for less than their costs for brand drug scripts for your employees and families, causing them to go out of business.
6. Can't talk to manufacturers to put together wellness programs for things like GLP1s.
7. Signed a PBM contract with an NDA which prevents you from publicly discussing your PBM contract, resulting in an opaque, inefficient market, which leads to higher prices and lower quality of care for the entire country.

"All of this allows the big PBMs to continue to distort the pharmacy market for literally EVERYONE," he wrote. 

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Cuban's Plan to Fix It

Cuban is not just pointing fingers. His company, Cost Plus Drugs, is working to cut PBMs out of the equation entirely and sell drugs at transparent, low-cost prices directly to consumers.

Here is how it works:

• Direct Negotiation – Instead of going through PBMs, Cost Plus buys directly from manufacturers and passes the savings on.
• Transparent Pricing – They show the actual cost of the drug, add a 15 percent markup, and charge a flat three-dollar pharmacy fee and five-dollar shipping.
• Manufacturing Their Own Generics – Cuban is building a drug manufacturing plant in Texas so Cost Plus can produce generics at rock-bottom prices, especially for life-saving medications that PBMs drive up.

Will CEOs Like Musk Step Up?

Cuban's argument is simple. CEOs have more power than they realize.

Whether Musk and other CEOs take action is uncertain, but PBMs are facing more scrutiny than ever. With rising frustration over healthcare costs, more companies may start questioning the contracts they sign and looking for better ways to manage prescription drug expenses.

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