Mark Cuban knows what it's like to sleep on apartment floors and pray nothing goes medically wrong. He also knows what it's like to have enough money that healthcare becomes a non-issue—you just write the check and move on. The problem, he argues, is that American healthcare only works for people at one extreme.
In a post on X last month, Cuban laid out his view of the system's dual failure modes. "There are 2 kinds of healthcare hellholes," he wrote. "1. You can't afford your care and you get more injured, sicker or die. 2. You go through the 'horrible' experience of travelling to a US Hospital and writing a check to get the care you want and need."
He's lived both realities. "I used to be the person who couldn't afford care. Now I can write the check for any care I need. Which do you think is better?"
The responses flooded in, sharp and grounded in frustration. One person captured the contradiction perfectly: "We have both the best and worst of healthcare. But more people experience the worst—no affordable access to basics, no help in emergencies." Another pointed to structural rot: "It's not just prices. It's monopolies, no price negotiation, no transparency. The U.S. spends more and gets less."
No Easy Answers
Cuban isn't offering simple solutions or bumper sticker slogans. He pushed back hard against the idea that America can just copy other countries' systems or trust the market to sort itself out. "There isn't a straight line from where we are today in the USA to single payer," he explained. "There are paths. But they aren't anywhere near saying 'the other countries do it, why can't we.' Nor is it anywhere near saying 'Free Markets are the solution.'"
His diagnosis of the problem is blunt: "Our healthcare is not a free market. It's not an efficient market. It's not a fair market."
The thread lit up with agreement. "It's a cornered market that needs antitrust enforcement to restore real competition," one person wrote. Another zeroed in on insurance companies: "The biggest middlemen are the insurance companies. They rake in profits, deny care, and advertise like they're saving lives." Someone else hit on the employment trap: "Tying healthcare to employment never made sense. Lose your job, lose your coverage? That's not a healthcare system. That's a gamble."
Building Something Different
Cuban isn't just complaining from the sidelines. He launched Cost Plus Drugs specifically to rip out the opacity and markup that make healthcare costs incomprehensible. The company cuts out pharmacy benefit managers and sells generic medications online at near-wholesale prices. The whole point is transparency—because you can't make informed decisions when you don't know what anything costs until the bill shows up.
"We can get to a point where we have enough transparency, enough efficiency and few if any, low value middlemen, that reveal understandable, affordable prices," Cuban wrote. Once that foundation exists, he argues, policymakers could actually make intelligent decisions about coverage and costs based on real data rather than negotiating in the dark.
Cuban's perspective carries weight because he's not theorizing from a think tank. He's been the guy living on mac and cheese, terrified of getting sick. He's been the guy who can afford anything. And now he's asking why a country this wealthy still forces people to choose between financial ruin and going without care.