Bryan Lord’s Post

"We’ve turned hospitals and doctors into subprime lenders without assets." In one sentence, Mark Cuban cuts straight to the heart of what’s broken in American healthcare, and this 4 minute video clip will summarize everything that’s wrong. Mark is a brilliant communicator, and perfectly captures the hidden consequences of what is ultimately a moral victory: 𝘥𝘰𝘤𝘵𝘰𝘳𝘴 𝘢𝘯𝘥 𝘩𝘰𝘴𝘱𝘪𝘵𝘢𝘭𝘴 𝘵𝘳𝘦𝘢𝘵 𝘱𝘢𝘵𝘪𝘦𝘯𝘵𝘴 𝘧𝘪𝘳𝘴𝘵, 𝘢𝘯𝘥 𝘢𝘴𝘬 𝘧𝘰𝘳 𝘱𝘢𝘺𝘮𝘦𝘯𝘵 𝘭𝘢𝘵𝘦𝘳. And as an ER doctor, much of this comes from EMTALA, the law that says we don’t let people just die on the streets. In the ER, we’ll see you no matter what. But because EMTALA is an “unfunded mandate” — meaning the government won’t pick up the tab if you can’t pay — doctors and hospitals have to just take on a ton of “subprime” risk (and debt). And how do hospitals balance their books if a third of the time their services are essentially free? 𝗧𝗵𝗲𝘆 𝗷𝗮𝗰𝗸 𝘂𝗽 𝗽𝗿𝗶𝗰𝗲𝘀. Then Cuban exposes the vicious cycle between payors and hospitals: 🏥 Hospitals Inflate Prices: To offset unpaid bills, hospitals charge inflated prices to insurers who they know will pay. An MRI might cost $450 for cash-pay patients, but if billed to insurance? $2,000. 🏦 Insurance Companies Benefit: Thanks to the Affordable Care Act (ACA), insurers must spend 85% of premiums on healthcare costs. Higher hospital prices mean insurers can justify higher premiums—and take a larger profit. 🤒 Patients Lose Twice: Patients face inflated bills they can’t pay, leading to bankruptcies. Meanwhile, cash prices are often cheaper than insured prices, making the system feel completely 𝗿𝗶𝗴𝗴𝗲𝗱. I will say this until I’m blue in the face: honestly at least a third of ALL the healthcare spending in the US is just to counter, pivot, and adapt to the fundamentally broken system. Payors do this? Insurers do that.  Doctors do this? Pharma does that. The rules of the game clash with the values of our people—and this friction leaves everyone, from patients to providers, deeply unhappy with what we’ve built.