An Open Letter (Again) to Mark Cuban on Behalf of American Patients

AN OPEN LETTER TO MARK CUBAN
Or: How I Learned to Stop Worrying and Love Recruiting A Billionaire

Dear Mark,

It's me again. Your friendly neighborhood 30-year cancer survivor, patient rights activist and civic organizer.

At this point, I've written about you so many times that my LinkedIn followers probably think I'm angling for a job at Cost Plus or trying to get courtside seats at a Mavs game. For the record, I don't understand basketball. Something about putting a ball through a hoop? Sounds stressful. If you're tired of me by now, the unfollow button is right there. I'll understand. I'll cry into my generic metformin that I buy from your company for $12 instead of wasting a $30 copay like some kind of chump, but I'll understand.

I've spent months building CubanWatch like it's my own little Shark Tank audition, except I'm not pitching you a product. I'm pitching you a movement. And unlike most Shark Tank contestants, I actually did the math. So here it is: the thing I've been building toward, the reason I keep showing up in your notifications like a golden retriever who won't stop dropping the ball at your feet. I love what you're building. But there's a hole in your equation.

THE RECEIPTS

Let me be clear about what you've done right, because the list is long and I want you to know I've been paying attention.

You walked into the Senate with spreadsheets and receipts while lobbyists choked on their coffee. You called the PBM industry what it is: a cartel. You proved that drugs cost 99% less to make than what patients pay, humiliated Optum CEO Patrick Conway on live television, and made the room applaud their own guilt. You told senators that heart surgeons saving lives make less than hospital parking garages. You dropped Imatinib from $10,000 to $32 and made the pharmaceutical industry's theater visible to everyone. You saved Medicare $2 billion on seven drugs, and that's not disruption. That's evidence of decades of theft.

You built Cost Plus Drugs on radical honesty: show the markup, name the price, let patients decide. That transparency cracked open twenty years of pharmaceutical grift and reminded Congress that capitalism without conscience is theft. Not innovation. Not competition. Theft. Most billionaires spend Sunday evenings on yachts or at galas. You doom scroll the healthcare feed and signal boost the people doing the work. You're paying attention, and that matters more than you know.

Chef's kiss, Dr. Cuban. And yes, if you're looking for brand ambassadors, you already know where to reach me.

THE HOLE

But here's where your equation breaks down.

You gave Congress four fixes that would work tomorrow, so who's gonna pass them? The same Congress that takes checks from the people doing the overbilling? Math doesn't show up at town halls. Spreadsheets don't primary incumbents. Receipts don't vote. You've got FU money and a platform, but transparency doesn't unseat the politicians protecting the grift. Data doesn't show up in November. Numbers don't knock on doors.

I scroll your feed and I see consultants, analysts, pharmacists, podcasters. All important. All fighting the good fight. Industry insiders talking to industry insiders about how broken the industry is. But where are the patients? The patient communities, the ones actually drowning in denials, rationing insulin, and losing access to oncologists mid treatment, are largely absent from the conversation. They're not in the room. Not as anecdotes. Not as partners. That's the gap in your math.

THE BODIES WE BURIED

Let me tell you who's missing from your equation.

The 35 million cancer survivors. The diabetics rationing insulin like it's artisanal caviar. The seniors who just got dumped from Medicare Advantage so UnitedHealth could restore its "swagger." The families who buried someone because the bill came before the treatment.

I was 21 when doctors told me I wouldn't see 1997. Brain cancer. Medulloblastoma. Rare, aggressive, and not something young adults were supposed to get. There were no roadmaps, no support groups, no acknowledgment that people like me even existed in the system. I survived, but the bills almost killed my family after the tumor couldn't. That was 1995. We're still having the same conversation in 2026 because the cruelty is the point.

I spent the next three decades building the young adult cancer movement from scratch, and I've buried more friends than I can count. Every one of them died knowing the system could have saved them if profit wasn't the point. I know where the bodies are buried. Literally. I buried them. The people bleeding under these policies don't need another pilot program or another panel or another working group. They need enforcement, subpoenas, and jail time. And they need someone who can make the system blink.

THE MISSING VARIABLE

You've got 95% of it right: the math, the transparency, the rage at the machine. The other 5% requires sitting with patients who know where the bodies are buried. Because we buried them.

Here's what we bring to the table: we're not anecdotes. We're a voter bloc. And we're organized. We're building something that scares the same people your spreadsheets scare, but the difference is that we show up in November. We show up at town halls. We show up in the primaries where incumbents think they're safe.

You said healthcare is simple: "What does it cost? How will you pay?" But there's a third question you're missing: "Will they let you?" The same PBMs blocking your Cost Plus expansions will find ways to corrupt whatever comes next. You called them cartels, and you were right. But cartels don't reform. They adapt. We don't need workarounds. We need enforcement. And enforcement requires political power. Not money. Not platforms. Votes.

THE INVITATION

The invitation stands. It's been standing for months. Come sit down with us.

Come to Washington and sit with survivors whose names never make quarterly reports. We survived what your spreadsheets call acceptable loss. Talk to the patient community, not as a photo op, but as partners. We're building a voter bloc stronger than the NRA. We're organized. We're ready. And we're still waiting for that meeting.

You've got FU money and a platform. We've got bodies buried and ballots ready. You changed the game. Now help us end it. Your Cost Plus model proves profit doesn't require victims. Now help us prove reform doesn't require permission.

I wrote about you being our accidental patron saint. Time to make it intentional.

Mark Cuban, you're reading this. Let's talk.

Welcome to 2026: The Year of the Patient where the sick shall inherit the ballot.

Respectfully (and relentlessly),

Matthew Zachary
30-Year Brain Cancer Survivor
Co Founder, We The Patients
Author, We The Patients: Understanding, Navigating, and Surviving America's Healthcare Nightmare (Wiley, May 2026)
Host, Out of Patients, the #1 independent healthcare podcast
Your friendly neighborhood patient stalker

#WeThePatients #CubanWatch