Most employer sponsored health plans aren’t broken by mistake. They were broken by design to benefit middlemen—and are preserved by inertia.
If you’re a benefits leader or CFO, here’s the hard truth:
You probably don’t have the authority to fix the system alone.
That’s why this week’s issue isn’t really for you. It’s for your boss. Your board. Your CEO.
Because problems this big need executive action.
“We can’t solve our problems with the same level of thinking that created them.” That’s not just a quote—it’s a warning.
Fiduciary duty demands fresh eyes, new tools, and a willingness to challenge what’s always been done. Luckily, someone with a megaphone (and a media empire) is on your side.
Mark Cuban’s Wake-Up Call to Executives
In a private event filled with healthcare executives, Mark Cuban didn’t mince words. He called out the structural failures in our healthcare system—especially the shadowy role of PBMs. And he challenged executives to wake up and take charge.
“If you’re just letting your brokers make decisions… Then you’re abdicating your responsibility.” —Mark Cuban
What followed was a sharp, clear message aimed directly at leaders who still think the old way is good enough. It’s urgent. It’s bold. And yes—it’s personal.
Mark even made an extraordinary offer:
“If your CEO needs a wake-up call, email me at mark@costplusdrugs.com. I’ll talk to your CEO directly and let them know.”
Send This Email To Your Executives (Right Now)
You don’t have to wait for the phone call. We’ve captured the highlights of Mark’s talk in this boardroom-ready brief: Mark Cuban’s Advice to CEOs.
Send it to:
Your CEO
Your General Counsel
Any board member who needs to know the risk of what’s coming
The benefits leader stuck under a bad PBM contract
Because change starts with awareness—and accountability.
Mark Cuban’s Advice To CEOs:
“Stop Killing Employees for Rebate Money”
Maverick billionaire Mark Cuban didn’t hold back during a closed-door session with the National Alliance of Healthcare Purchaser Coalitions. In his remarks to health plan executives at large employers, he had strong words for CEOs and the actions they need to take to protect their organizations and employees from unethical PBM practices.
His message to America’s CEOs was blunt.
“Your employees are dying so you can brag about big PBM rebate checks and boost your balance sheet.”
Cuban wasn’t speaking as an outsider. He was speaking as a CEO who discovered he was complicit in a system putting profits over people’s lives.
“Those Rebate Checks? Your Sickest Employees Pay For Them.”
Cuban didn’t mince words:
“Every CEO loves those fat rebate checks. ‘Oh, that goes on my balance sheet. That looks so good.’ But here’s what you don’t see: Your employees are rationing insulin, skipping cancer meds, and choosing between groceries and prescriptions—while you cash rebate checks funded by their suffering.”
He continued with some details of an all too frequent story:
“Somebody making $30K after taxes is lucky if they have $400 saved. Those same people are the ones with the $5,000 high deductible plans, aren’t they? They want as much take-home pay as they can possibly get, because it’s tough out there and it’s not getting easier with all the uncertainty.”
The employee financial impact can be significant:
“They’re paying $250 a month out of pocket for their meds without seeing a dime of those rebates you’re bragging about.”
The Real Cost of Your “Savings”
Cuban’s own wake-up call was costly:
“I had the same consultant for 25 years. I thought he was my friend. Turns out we were overpaying by $150,000. He’s not my friend anymore. And when I found out, I looked in the mirror and said, ‘Mark, you’re one dumb ass.’ Because I signed that deal. I trusted him.”
But the real costs go beyond money or misplaced trust:
Your sickest employees miss 3x more work
They’re distracted, sick, or staying home
You’re one medical tragedy away from a front-page headline
“God help us if somebody in your company suffers the same fate as that 22-year-old kid in Wisconsin who died because he couldn’t afford his inhaler. You think you want to explain that on CNBC?”
Cuban’s Five Challenges For Corporate Leaders
Based on his own experiences, Cuban issued direct challenges to every CEO:
1. “Fire any consultant who won’t disclose PBM kickbacks”
“If they won’t tell you how they get paid, you already know the answer.”
2. “Demand every piece of your data or find out why they’re hiding it”
“It’s YOUR data. Why won’t they give it to you? It’s insane.”
3. “Run an open RFP and watch consultants panic”
“If they’re restricting bidders, they have favorites—and it’s not you.”
4. “Take control of your formulary”
“Build your own formulary. The PBMs’ power comes from owning yours—take it back.”
5. “Stop destroying local businesses with your contracts”
“PBMs under-reimburse local pharmacies. If a drug costs $150, they may only get reimbursed $125. You’re putting pharmacies out of business. You signed that deal. Fix it.”
The Trust Equation Cuban Lives By
Cuban spoke about working with vendors you trust:
“Trust equals Transparency divided by Self-interest. That’s why at Cost Plus Drugs we only have a 15% markup, so companies trust us. Most PBMs? Transparency: hell no. Self-interest: through the roof.”
“This Is Your Problem, Not Your Benefit Team’s”
Under ERISA, health plan fiduciaries—including CEOs, board directors, and executives—can be personally liable for mismanagement. The lawsuits against Johnson & Johnson, Wells Fargo, and JPMorgan Chase for PBM oversight failures aren’t anomalies—they’re the beginning.
“I’ve been fired from a lot of jobs,” Cuban said, “so I get that it’s hard to tell the CEO bad news.” But here’s what you have to say:
“Your employees can’t afford their meds. They’re getting sicker. They’re missing work. Their families are hurting. And you—yes, you—are legally responsible. You’re not just risking money. You’re risking your reputation, your legal exposure, and your employees’ lives.”
Cuban’s Call To Action: “Use Your Power or Answer For It”
Cuban’s message to the audience:
“You control 90 million lives. If you moved to transparent PBMs tomorrow, the industry would be transformed overnight. The only question is—will you?”
Cuban wasn’t just talking—he was making an offer:
“Ready to stop being complicit? Email me at mark@costplusdrugs.com. I’ll talk to your CEO directly. If not? I’ll go on TV and name names. ‘Yeah, I tried to talk to the CEO of [Company X]. What a dumb ass. Doesn’t care if employees live or die.’”
BOTTOM LINE: Your PBM rebates aren’t savings—they’re a tax on your sickest employees. Every day you do nothing, you’re choosing profits over people. Fix it.
Thanks, Mark!
We’re grateful to Mark Cuban for his unwavering support of PBM reform and the work we’re doing at Health Rosetta with the launch of our Nautilus PBM Field Guide and Nautilus Configurator—the tools that turn fiduciary frustration into action. Take Mark up on his offer and be part of the solution.
Want to see what’s next?
www.nautilushealth.org/PBM
Explore more executive resources, model PBM contract language, and downloadable guides. Apply for early access to the Nautilus PBM Configurator at: 🔗nautilushealth.org/pbm
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📬 PAY IT FORWARD: Feel free to forward this offer to your broker, PBM, or other vendors. Don’t hesitate to tell them you will favor validated vendors as part of your modernized procurement processes. Strong compliance and better benefits begin with validation.
Don’t be a bystander. Change the status quo and reap the benefits of The Health Plan Compliance Advantage.
