Dr Shetty is planning to build a similar hospital in the Cayman Islands for Americans so I have to assume it has to do with government regulation. Is the health care system less socialized in India? I would guess it is.
However, I think this sort of innovation was way more likely to occur in a developing country, regardless of if the individual or the tax payer is picking up the bill. It is a case of simple market forces as hinted in the article by:
On returning to India in 1989, Dr. Shetty performed the first neonatal heart surgery in the country on a 9-day-old baby. He also confronted the reality that almost none of the patients who came to him could pay the $2,400 cost of open-heart surgery.
"When I told patients the cost, they would disappear. They literally didn't even ask about lowering the price," he says.
It was good to see the article mentioning that the quality/success rate is as good as the US.