Cuban's spot on about insurers' ULCD tactics (underpay, late pay, claw back, deny) controlling cash flow and warping incentives across the system. Hospitals leverage market share too, with facility fees and charge-master games adding distortion. Data from NBER, Health Affairs, and others shows both sides' concentration drives higher prices/premiums, but patient inability to shop transparently or meet deductibles is a core flaw. Direct contracting cuts middlemen, boosts competition, and often lowers costs for routine/self-insured care via published rates. Solid path forward.