While ethical arguments for fairness in healthcare AI are well-established, the economic and strategic value of inclusive design remains underexplored. This perspective introduces the ``inclusive innovation dividend'' -- the counterintuitive principle that solutions engineered for diverse, constrained use cases generate superior economic returns in broader markets. Drawing from assistive technologies that evolved into billion-dollar mainstream industries, we demonstrate how inclusive healthcare AI development creates business value beyond compliance requirements. We identify four mechanisms through which inclusive innovation drives returns: (1) market expansion via geographic scalability and trust acceleration; (2) risk mitigation through reduced remediation costs and litigation exposure; (3) performance dividends from superior generalization and reduced technical debt, and (4) competitive advantages in talent acquisition and clinical adoption. We present the Healthcare AI Inclusive Innovation Framework (HAIIF), a practical scoring system that enables organizations to evaluate AI investments based on their potential to capture these benefits. HAIIF provides structured guidance for resource allocation, transforming fairness and inclusivity from regulatory checkboxes into sources of strategic differentiation. Our findings suggest that organizations investing incrementally in inclusive design can achieve expanded market reach and sustained competitive advantages, while those treating these considerations as overhead face compounding disadvantages as network effects and data advantages accrue to early movers.

翻译：尽管医疗AI公平性的伦理论证已得到广泛认可，包容性设计的经济与战略价值仍未得到充分探索。本文提出"包容性创新红利"这一反直觉原则——为多样化、受限使用场景设计的解决方案，反而能在更广阔市场中产生更优的经济回报。借鉴辅助技术发展为千亿美元主流产业的演进路径，我们论证了包容性医疗AI开发如何创造超越合规要求的商业价值。我们识别出包容性创新驱动回报的四种机制：(1)通过地理可扩展性与信任加速实现市场扩张；(2)通过降低整改成本与诉讼风险实现风险缓释；(3)卓越泛化能力与减少技术债务带来的性能红利；(4)人才获取与临床采纳方面的竞争优势。我们提出医疗AI包容性创新框架（HAIIF）——一套实用的评分系统，使组织能够基于捕获这些效益的潜力来评估AI投资。HAIIF为资源分配提供结构化指导，将公平性与包容性从监管复选框转化为战略差异化来源。我们的研究结果表明，逐步投资包容性设计的组织能够实现市场覆盖扩展与持续竞争优势，而将相关考量视为间接成本的组织将面临复合劣势——因为网络效应与数据优势会持续积累给先行者。