According to Mark Cuban, U.S. taxpayers rarely pay doctors directly, with funding flowing to states via Medicaid, to hospitals and providers via traditional Medicare, to insurance carriers via Medicare Advantage and ACA plans, and indirectly through tax benefits for individuals and employers (source: Mark Cuban on X, Nov 29, 2025). He says the system overpays because carriers are incentivized to scale, contract at inflated prices, invent fees, and delay or deny care, with PBMs contributing to the problem (source: Mark Cuban on X, Nov 29, 2025). He proposes breaking up big carriers by vertical and requiring intercompany transfers at Medicare rates or best price until structural changes are made (source: Mark Cuban on X, Nov 29, 2025). He calls to remove formularies from PBMs and to count extra cash drug purchases toward patient deductibles (source: Mark Cuban on X, Nov 29, 2025). He urges nonprofit hospitals and providers to publish every general ledger entry and to stop 340B abuse (source: Mark Cuban on X, Nov 29, 2025). He adds that caregivers benefit the least financially and argues doctors should be able to operate independent practices and receive the same Medicare rates as hospitals for the same work (source: Mark Cuban on X, Nov 29, 2025). He challenges employers to disclose their insurance and PBM choices and to walk away from the biggest carriers and their PBMs (source: Mark Cuban on X, Nov 29, 2025).