Billionaire entrepreneur Mark Cuban is once again calling out the U.S. health care system, this time focusing on the role of high deductibles.
In a post on X, Cuban said, “The real health insurance scam is that they know as their deductibles go up, fewer people can afford to use their insurance. Which means they don’t have insurance. Despite having to pay premiums.”
Why Deductibles Matter
A deductible is the amount you pay for covered health care services before your insurance kicks in.
According to Healthcare.gov, after hitting that amount, you usually just pay copays or coinsurance.
Some plans cover preventive care even before you meet your deductible, but many people still struggle to afford the upfront costs.
Cuban’s point is that if you can’t afford to reach your deductible, you’re functionally uninsured, despite paying monthly premiums.
He wrote, “It may sound counter intuitive, but if you can’t afford your deductible, you MIGHT be better off not getting insurance.”
The Case for Paying Directly
Cuban suggested that paying your doctor or hospital directly might save you money.
“When you need care, primary, preventive or worse, your doctor or hospital has financing plans,” he said. “And, their cash price that they finance will be cheaper than what your insurance company or employer negotiated.”
He admitted this isn’t yet easy or convenient, but added, “Now is the time to find a doctor who is willing to work with you directly and let you pay them directly. See what works for you.”
Pushback and Cuban’s Response
Some commenters pushed back on Cuban’s suggestion.
One person replied, “Bad advice, Marcus. 1. Preventative care is free from a deductible. 2. Foregoing preventative care / insurance, you wouldn’t address what may be a growing issue. 3. These add up to the emergent/higher acuity care, which is $$$.”
They argued the real solution lies in “a uniform rules & fee schedule for all payers.”
Cuban responded: “You can get preventive care with the money you save on premiums. That’s why you find a doctor for PC [primary care].”
Another person pointed out that insurance often drastically reduces costs through negotiated discounts: “The average lab bill is cut 90-95% – individuals don’t have that kind of negotiating power.”
Cuban countered: “Cash price is almost always cheaper than insurance negotiated price. Go to a hospital website and look at the pricing they are required to pay.”
What About High-Deductible Plans with HSAs?
One person defended high-deductible health plans (HDHPs) paired with Health Savings Accounts (HSAs), saying they offer tax advantages and lower premiums.
Cuban pushed back again: “Unless you can’t afford the deductible. Or can’t afford to contribute to the HSA. Notice, they never check your net worth before letting you get a HDHP.”
His argument is simple: the system assumes a level of financial flexibility many Americans just don’t have.
A System in Flux
While Cuban admitted his suggested approach is “far from perfect,” he believes a shift is starting to happen where more people seek direct payment arrangements with their doctors.
“There is still a lot of work to be done before this is easy and convenient. But it’s starting to happen,” he said.
As the debate continues, Cuban is urging people to explore all their options: “See what works for you. This isn’t a perfect approach, so all feedback welcome!”
With health insurance premiums climbing and deductibles rising, Cuban’s argument hits at a growing frustration: paying for insurance that feels impossible to use.
IMAGE CREDIT: “Mark Cuban” by Gage Skidmore, via Flickr. Licensed under CC BY-SA 2.0. Image adjusted for layout.