Recently, I had the opportunity to spend nearly three hours in conversation at the Care Foundation, graciously hosted by its CEO, Mr. S. G. Prasad, whose quiet commitment to accessible healthcare has sustained many meaningful initiatives over the years. The meeting brought together Mr. B. V. Satya Sai Prasad, a lawyer-turned-industrialist now deeply engaged in promoting artificial intelligence in healthcare, and his daughter Deepti, a biomedical engineer whose professional journey mirrors the global evolution of modern medicine itself. Deepti had worked at the Care Foundation in 2009 before moving to the United Kingdom, where she spent fifteen years within the National Health Service, contributing to healthcare technology and digital transformation programs. She has now returned to India to assume leadership at Ozone Hospitals in Hyderabad, an institution established by her father. What began as a cordial meeting soon grew into a long and searching conversation about the future of healthcare in India—not merely as an industry, but as a moral and technological system still in transition.

There is little intellectual value today in endlessly debating whether healthcare has become commercialised. That question has already been settled by history. Modern medicine is inherently technology-intensive: linear accelerators that deliver precision radiotherapy, robotic surgical platforms, molecular diagnostics, advanced imaging systems, and intensive-care monitoring infrastructures all require enormous capital investment and continuous maintenance. Hospitals, therefore, operate within economic realities. To lament commercialisation without proposing structural alternatives is to engage in nostalgia rather than reform. The real question is whether anything can be done to prevent healthcare from drifting further away from equity and accessibility.

The healthcare industry, as it has evolved, is marked by a striking paradox. Hospitals accused of profiteering remain perpetually full. Physicians celebrated for compassion often live lives of remarkable prosperity, their appointment calendars filled far into the future, serving those who can pay huge fees. Meanwhile, ordinary patients struggle through fragmented care pathways, delayed diagnoses and financial uncertainty. This contradiction is not merely ethical; it is systemic. Healthcare today suffers less from a lack of knowledge than from flawed design.

Our discussion naturally returned to Dr. A. P. J. Abdul Kalam, whom Mr. Sai Prasad had met in 2001 when Dr. Kalam was serving at Anna University as Professor of Technology & Societal Transformation. Dr. Kalam consistently pondered how advanced technology could become both expansive and affordable for the common citizen. Healthcare was central to that inquiry. I gifted Deepti a copy of my book, Innovate Locally to Win Globally, which recounts the journey of Mr. D. A. Prasanna, the founding CEO of Wipro GE Medical Systems, and the emergence of India’s medical technology industry from near-total import dependence in 1990 to a multibillion-dollar export ecosystem today. The lesson from this transformation is clear: affordability does not arise from rejecting technology but from indigenising and democratising it.

Indian hospitals today are undeniably world-class. Patients arrive from Africa, the Middle East, Europe, and even the United States seeking cardiac surgery, oncology care, transplantation, and advanced diagnostics because outcomes are comparable while costs remain reasonable. Medical tourism quietly affirms India’s clinical excellence. Yet a deeper question remains unresolved: what about the ordinary citizen? How can quality healthcare become routine rather than a premium service? Mr. Sai Prasad reflected on his involvement in shaping the Aarogyasri Scheme introduced by the late Chief Minister Dr. Y. S. Rajasekhara Reddy, a program that enabled government-funded treatment of economically disadvantaged patients in private hospitals. It was an unconventional solution that liberated many patients from infrastructure limitations within parts of the public system. He recalled attempting to advocate a revenue-neutral sustainability model, though political realities constrained structural redesign. Nevertheless, Aarogyasri demonstrated that policy innovation, when aligned with financing mechanisms and institutional participation, can rapidly expand access.

Since that period, India has witnessed three transformative developments that together form the foundation of equitable healthcare delivery: digital identity through Aadhaar, enabling authenticated patient records; expansion of publicly funded health insurance programs; and massive investment in public medical infrastructure through new AIIMS institutions, cancer centres and medical colleges. Equally significant has been the Jan Aushadhi Yojana, which provides quality-assured generic medicines at nearly one-fifth the cost of branded equivalents. I have personally used these medicines for more than a year and have found them clinically reliable, reminding me that the cost of medicines is often shaped more by market forces than by production costs. The architecture for inclusive healthcare already exists; what remains is intelligent integration.

It was at this point that artificial intelligence entered our conversation—not as a matter of technological enthusiasm but as a practical necessity. Three possibilities appeared almost self-evident. It starts with the prescription of medicine. Despite the widespread availability of generics, prescription behaviour remains influenced by the legacy of brands. AI-driven clinical decision support systems integrated into electronic prescribing platforms could automatically recommend bioequivalent generic alternatives aligned with national formularies. Machine-learning models analysing prescription patterns could detect statistical anomalies suggestive of sponsored prescribing practices, allowing transparency rather than enforcement to reshape behaviour. Technology may accomplish what regulation alone rarely achieves—a form of creative destruction where unethical practices gradually lose viability.

The second possibility lies in strengthening primary healthcare, historically the weakest link in India’s medical ecosystem. Many rural and peri-urban centres function without physicians, prompting patients to bypass primary care and overwhelm tertiary hospitals. Imagine instead AI-enabled primary health nodes where nurses, community health workers, or trained volunteers use AI-powered smartphones capable of clinical speech recognition, symptom capture and triage decision support. Through telemedicine connectivity with central physician command centres, prescriptions could be validated remotely while electronic health records are generated at first contact. Vital signs monitoring, probabilistic risk stratification, and structured referral pathways would ensure continuity of care. Except in emergencies, hospital visits would follow digital registration, transforming healthcare from episodic treatment into longitudinal care management. Intelligence would become distributed even when doctors remain scarce.

The third domain concerns trust—particularly billing transparency. Healthcare billing remains opaque to patients who lack the technical ability to question complex invoices generated through Hospital Information Systems and Management Information Systems. AI-based audit engines could analyse billing patterns using anomaly detection algorithms, comparing procedures, consumables and clinical pathways against evidence-based norms. Outliers could be flagged automatically, while blockchain-backed audit trails create immutable records accessible to patients themselves. Technology would not accuse; it would illuminate, restoring balance in a relationship historically weighted against the patient.

No external agency will design this future for India. Just as the nation built Aadhaar, transformed payments through UPI, expanded access to generic medicines, and scaled public health insurance, the next transformation must emerge from Indian entrepreneurs, clinicians, engineers and institutions acting together with clarity of purpose. Artificial Intelligence must not merely assist diagnosis; it must audit systems, democratise access and restore trust. As our meeting concluded and Mr. Sai Prasad and Deepti departed—encouraged by Mr. S. G. Prasad’s quiet optimism and the shared promise of bringing together people of conscience—I felt not merely hopeful, but deeply reassured. India is not only attempting to solve its own healthcare challenges; it is slowly shaping a template for nearly five billion people across the Global South who face similar constraints of affordability, workforce shortages and uneven infrastructure. If guided by conscience as much as computation, AI may yet return technology to its original purpose—improving lives by bettering livelihoods. Perhaps that was always Dr. Kalam’s nascent vision: not a quest for admiration, but a responsibility for action. Technology fulfils its purpose only when it serves the last person in the queue.