Billionaire venture capitalist Mark Cuban has founded or invested early in hundreds of startup companies over the years. But only one of them, founded in January 2022, bears his name.
The Mark Cuban Cost Plus Drug Co. seeks to disrupt the $365 billion U.S. prescription drug market, which is rife with pricing inefficiencies. For example, one tablet of the Type 2 diabetes treatment Metformin costs over $500 at retail prices. But through Cubans company, the same tablet is just $46.20.
The company offers 350 prescription drugs at cost, plus a fixed 15% margin that still makes some prescription drugs significantly cheaper than their retail prices. The savings are made possible in part by eliminating the middleman in the prescription drug industry: Cubans company bypasses health insurers to negotiate directly with drug manufacturers.
The startup could have saved Medicare up to $3.6 billion in 2020 alone, according to a study by Harvard Medical School. But as significant as that number is, it pales in comparison to an even lower-hanging fruit in the fight to drive down healthcare costs: targeting the nationwide stress epidemic.
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Stress costs the U.S. economy as much as $300 billion per year, according to the American Psychological Association. A huge source of this is healthcare costs, with 65% of households reporting high levels of stress or anguish over treatment costs. Cubans company, should it succeed in slashing prescription drug prices across the board, could provide tremendous relief on this front.
But one startup is tackling stress directly. Founded in 2019, Sensate is the company behind a patented relaxation device that it says is the first of its kind. The novel patented technology uses infrasonic therapy to help the bodys nervous system recover from daily stresses.
Sensate grew revenue by 363% from 2020 to 2021, when it hit $2.8 million in revenue. Prominent venture capital backers include TenOneTen, Unlock Venture Partners and Expert DOJO.
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And tens of billions of pounds of borrowing depends on the answer – which still feels intriguingly opaque.
You might think you know what the fiscal rules are. And you might think you know they’re not negotiable.
For instance, the main fiscal rule says that from 2029-30, the government’s day-to-day spending needs to be in surplus – i.e. rely on taxation alone, not borrowing.
And Rachel Reeves has been clear – that’s not going to change, and there’s no disputing this.
But when the government announced its fiscal rules in October, it actually published a 19-page document – a “charter” – alongside this.
And this contains all sorts of notes and caveats. And it’s slightly unclear which are subject to the “iron clad” promise – and which aren’t.
There’s one part of that document coming into focus – with sources telling me that it could get changed.
And it’s this – a little-known buffer built into the rules.
This says that from spring 2027, if the OBR forecasts that she still actually has a deficit of up to 0.5% of GDP in three years, she will still be judged to be within the rules.
In other words, if in spring 2027 she’s judged to have missed her fiscal rules by perhaps as much as £15bn, that’s fine.
Image: A change could save the chancellor some headaches. Pic: PA
Now there’s a caveat – this exemption only applies, providing at the following budget the chancellor reduces that deficit back to zero.
But still, it’s potentially helpful wiggle room.
This help – this buffer – for Reeves doesn’t apply today, or for the next couple of years – it only kicks in from the spring of 2027.
But I’m being told by a source that some of this might change and the ability to use this wiggle room could be brought forward to this year. Could she give herself a get out of jail card?
The chancellor could gamble that few people would notice this technical change, and it might avoid politically catastrophic tax hikes – but only if the markets accept it will mean higher borrowing than planned.
But the question is – has Rachel Reeves ruled this out by saying her fiscal rules are iron clad or not?
Or to put it another way… is the whole of the 19-page Charter for Budget Responsibility “iron clad” and untouchable, or just the rules themselves?
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Is Labour plotting a ‘wealth tax’?
And what counts as “rules” and are therefore untouchable, and what could fall outside and could still be changed?
I’ve been pressing the Treasury for a statement.
And this morning, they issued one.
A spokesman said: “The fiscal rules as set out in the Charter for Budget Responsibility are iron clad, and non-negotiable, as are the definition of the rules set out in the document itself.”
So that sounds clear – but what is a definition of the rule? Does it include this 0.5% of GDP buffer zone?
The Treasury does concede that not everything in the charter is untouchable – including the role and remit of the OBR, and the requirements for it to publish a specific list of fiscal metrics.
But does that include that key bit? Which bits can Reeves still tinker with?
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