Healthcare systems worldwide are failing. Costs are rising, waiting lists are growing, and chronic disease is reaching epidemic proportions. Artificial intelligence promises to fix all of this - and it won't.
Not because the technology isn't ready. It is. AI systems can read scans, predict deterioration, draft clinical notes, and in some domains outperform human specialists. The failure lies elsewhere.
Healthcare institutions are not designed to improve healthcare. They are designed to reproduce existing distributions of power, income, and authority - and they are extraordinarily good at it. Every technology that has promised to transform medicine has instead been absorbed, domesticated, and repurposed to serve the system it was meant to disrupt.
AI will be no different, unless we understand why.
Drawing on institutional economics, political economy, and decades of clinical and computational experience, this book explains why the most powerful technology in human history is losing to an institution that was never designed to be efficient. It argues that the future of AI in healthcare is not primarily a technical question, but a question of power - and that until this is addressed, the promise of transformation will remain unrealised.
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