Tech billionaire Elon Musk, now the head of the Department of Government Efficiency, questioned why the U.S. can’t afford healthcare and why medical costs keep rising.
Posting on X, the social platform he owns, Musk cited that the country has the highest healthcare administrative costs among Organization for Economic Co-operation and Development countries.
“Shouldn’t the American people be getting their money’s worth?” the Tesla owner asked.
Musk’s remarks were met with pushback, with Mark Cuban pointing out that CEOs like Elon Musk are in fact a huge part of the problem.

According to Cuban, the government isn’t the one to blame for the problem entirely. On the contrary, he stated that it is the CEOs of self-insured companies who sign 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,” Cuban said.
With a seven-point list, Mark Cuban explained to Elon Musk exactly how these contracts affect the prices of the drugs.
His list stated:
- Don’t control your claims data
- Don’t control your formulary
- Have to pay more for “Specialty Drugs” that have nothing special about them
- 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.
- 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.
- Can’t talk to manufacturers to put together wellness programs for things like GLP1s.
- 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.

Cuban, however, says his company, Cost Plus Drugs, is trying to provide solutions.
They are trying to take the PBMs out of the equation and sell drugs directly to the customers at more reasonable prices. The pricing would be transparent, showing the actual cost and the 15% markup. It would also feature a flat $3 pharmacy fee and $5 shipping.
Amid the rise of the healthcare costs and the frustrations that grow bigger with each passing day, the PMBs (pharmacy benefit managers) are under the spotlight as never before with many questioning their agreements with them.
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