Aarokya
Affordable Healthcare for EVERYONE
Affordable healthcare for everyone — a vision for building AI-enabled, empathy-driven healthcare infrastructure through Health Savings Accounts, preventive care, and hyperlocal delivery. Starting with India’s 200 million gig worker families.
The Numbers That Matter
India has 300 million families. Of these, roughly 200 million work in the informal and gig economy — drivers, delivery workers, domestic help, cooks, guards, electricians, tailors, construction workers — serving the top 100 million households.
These 200 million families form the backbone of India’s daily life. They deliver our food. They drive us to work. They keep our homes running. They build the cities they often cannot afford to live in.
And almost none of them have meaningful healthcare.
Over 62% of all healthcare spending in India comes directly out of people’s pockets. Every year, 55 million Indians are pushed into poverty by medical costs alone. Government spending on health is barely 1.5% of GDP — and even the United States, spending nearly 18% of GDP on healthcare, has failed to achieve universal coverage.
The arithmetic is clear: the state alone cannot fund healthcare for 1.4 billion people. But the arithmetic also reveals something hopeful — if we look at it differently.
100 Million Families Can Support 200 Million
Here is the structural insight at the heart of this vision.
A gig worker doesn’t have one employer. A delivery rider works across Swiggy and Zomato. A driver works across Namma Yatri and Uber. A domestic worker serves three or four households. A support worker gets tasks from multiple platforms.
That means healthcare contributions don’t need to come from one employer in one large payment. They can come from many sources, in small amounts, continuously.
Imagine a Health Savings Account — a digital piggy bank dedicated to healthcare. Not a regular bank account. A purpose-driven account where money can only be used for healthcare: insurance premiums, doctor visits, medicines, diagnostics, emergencies.
Now imagine how this piggy bank gets filled:
- A delivery rider completes 20 deliveries a day. ₹2 per delivery flows into his HSA from the platform. That’s ₹40 a day, ₹1,200 a month.
- The three households where a domestic worker serves each contribute ₹100 a month. That’s ₹300.
- A customer on Namma Yatri chooses the “health tip” option — ₹10 goes straight to the driver’s HSA.
- An employer sets up a monthly ₹200 auto-contribution for their household staff — like a SIP for worker health.
- The worker herself saves ₹5 a day when she can. That’s ₹150 a month.
- A CSR program tops up accounts that are close to insurance eligibility.
- A family member — a son working in the city — contributes ₹500 during Diwali into his mother’s HSA.
Small amounts. From many hands. Flowing into one account. Building up, month after month, into something that can actually protect a family.
At ₹3,999 a year, a family can access real health insurance through providers like Narayana Health. At ₹10,000 a year, coverage reaches ₹5–25 lakh. The HSA makes these premiums reachable — not through a single painful payment at the worst moment, but through thousands of tiny acts of support accumulated over time.
If 100 million families each contribute even ₹100 a month toward the healthcare of those who serve them, that is ₹12,000 crore a year flowing into the health security of India’s most vulnerable workers. Add platform contributions, CSR flows, worker savings, and government co-pay — and the numbers become transformative.
This is not charity. This is infrastructure. This is a new digital model for a new economy — where benefits are composable, portable, API-driven, and embeddable across every platform where work happens.
But This Vision Has Grown Larger
The HSA is the foundation. But what we are building is not just a savings account.
Because saving for healthcare is necessary — but not sufficient. The deeper question is: what kind of healthcare system does that money buy into? If the system remains broken — if insurance companies deny claims, if hospitals overbill, if preventive care doesn’t exist, if the nearest doctor is two hours away — then the money in the account only delays the problem. It doesn’t solve it.
So the vision has expanded. Into three interconnected layers:
Save. The Health Savings Account — the piggy bank, the rails, the collective funding mechanism. Multiple sources contributing small amounts into a purpose-driven account that builds toward insurance and healthcare access.
Prevent. AI-powered preventive healthcare — starting as a chat interface in the app, in local Indian languages, with voice support. AI workflows that screen, triage, collect health histories, detect risks, send reminders, and escalate to nurses and doctors. Not replacing human care — amplifying it. A doctor who sees 30 patients a day, supported by AI triage and nurse-led screening, can effectively serve 300 or 3,000. That is the 10x to 100x multiplier that makes preventive healthcare possible at India’s scale.
Access. A hyperlocal, decentralized care network — transforming local pharmacies and neighborhood health points into testing centers, sample collection points, teleconsultation nodes, and first-line care providers. Healthcare that is within walking distance, not a bus ride to a distant hospital. Many pharmacies are under pressure from e-commerce — instead of being bypassed, they become digitally empowered partners in the healthcare fabric.
And Then, Something Deeper
Here is where the numbers give way to something else.
The name of this platform is Aarokya. It comes from ārogya in Sanskrit and ārokkiyam in Tamil — meaning wholistic wellbeing.
But listen to it again:
Aarokya … ok ya? … Are you ok?
Kya tum theek ho?
That is not a marketing line. That is the emotional center of the entire idea.
Most people don’t have a health insurance at all. They have no plan, no savings, no safety net. And then illness strikes — suddenly, without warning — and they face a healthcare expense they simply cannot afford. They borrow at terrible rates, sell what little they have, or they just go without care. That is the reality for hundreds of millions of families.
Aarokya exists to change that. Not by adding another layer to a broken insurance system, but by building affordable insurance from the ground up — powered by the HSA, rooted in preventive healthcare, and enabled by cutting-edge AI. The app checks in. It notices. It asks: are you okay? It screens for risks before they become emergencies. It nudges toward checkups, tracks medication, flags early warnings — so that the catastrophic hospital visit never has to happen.
This is healthcare that begins with caring, not with crisis. And it is built with the conviction that the best healthcare system is the one that keeps you healthy — not the one that waits until you’re desperate.
Insurance, Reimagined
The current system is a broken triangle. Brokers take large commissions. Insurance companies often don’t want to pay. Hospitals can overclaim. The patient sits outside this triangle — vulnerable, confused, alone.
Aarokya reimagines this. If millions of people build health savings balances through their HSAs, those contribution flows create the foundation for a fundamentally different insurance model. One where hospitals themselves become part of the insurance and preventive care system. When hospitals have incentive not merely to bill but to keep people healthy, the entire dynamic shifts. Preventive care becomes economically aligned with care delivery. The system rewards early action instead of late catastrophe.
Dr. Shetty has already proven this is possible. Narayana Health performs heart surgeries at ₹1.5–2 lakh — procedures that cost ₹7–10 lakh in the US. Through the Yeshasvini scheme, millions of farmers were insured at premiums as low as ₹60 per year. The IRDAI created space for hospitals to become licensed insurers. The lesson: when volumes rise, costs fall. When incentives align, care improves.
The Three Phases
Phase 1 — The Foundation (30–45 days to first launch). Aarokya is open source, built by Juspay — the 1,600-member engineering organization behind HyperSwitch (open source payments) and Namma Yatri (open source ride-hailing). A founding hackathon with the HyperSwitch team kicks off the backend; Namma Yatri’s team brings the frontend. The target: a working HSA app with contribution rails, platform SDKs, and first pilot users within 30 to 45 days. Not a prototype — a real product in real hands.
Phase 2 — Preventive Intelligence. Once funding rails exist, layer in AI-powered preventive care. Chat and voice interfaces in Indian languages. Screening, triage, risk detection, health profiles, reminders. AI augmenting nurses and doctors to serve at 10x–100x capacity. The goal: catch problems before they become catastrophes.
Phase 3 — Hyperlocal Care Network. Connect the digital platform to the physical world. Pharmacies, local labs, testing points, sample collection, teleconsultation. Make healthcare geographically close, distributed, and practical. Not every issue should escalate to a big hospital too late.
The Moral Case
Dr. Shetty’s vision is that in the age of AI, empathy will matter even more.
The future is not AI alone. The future is AI with care. AI with empathy. AI with human purpose.
India — with its population, its healthcare needs, its community structures, its digital rails, and its deep culture of mutual support — can become not just a technology center, but an empathy center. A care center. For India, and eventually for the world.
This is about saying that gig workers matter. That the people who deliver our food and drive our children to school and keep our homes clean deserve the dignity of healthcare. That small contributions from many hands can become large protection. That a society can organize care better than what we have settled for.
Affordable Healthcare for EVERYONE is not just a dream. It is a design challenge. It is an engineering challenge. It is a moral challenge.
And this is the kind of collective effort worth dedicating ourselves to.
The chapters that follow lay out the full vision — the architecture, the economics, the technology, the phased roadmap, and the case for why India can lead the world in building healthcare that is both intelligent and humane.