We've got a few decent speech synths, but information about how things should be read out isn't passed through to them. That's handled by a screen reader program… except screen readers can't represent half the semantics they should, so people regularly bypass them, which leads to (a) UI inconsistency; and (b) the systems being useless if you need something other than a screen reader. AI scraper bots are the straw that broke the camel's back, so virtually no (current) website is accessible via a basic web browser any longer. UI customisability was low in the Windows 95 days, but we've managed to go backwards from there.
We might as well go the whole way, and design something that's actually usable, then put together case-by-case compatibility layers. Here's how we translate Home Office Design System HTML, here's how we translate Stacks Design System HTML, here's how we translate MediaWiki HTML, here's how we translate Wordpress Gutenberg HTML, here's how we translate Moodle HTML… here's how we represent the OpenDocument content model for reading and writing, here's how we represent the SVG content model for reading and writing, here's how we represent a login flow…
You're right to point out issues with "ghetto systems" – but we don't have a single computer system that actually works, and everything that does exist has fundamental design flaws that make accessibility prohibitively difficult. (Wayland somehow managed to be a downgrade from X11, which is quite a feat.)
I think a basic ghetto system with a full development environment and easily-accessible documentation would rapidly become not a ghetto system.
Good news, everybody! Rewriting everything from scratch has recently become a lot, lot easier, and much more fun!
Leela AI (not to be confused with Turanga Leela) learns to speak in LLOOOOMM / Cursor:
https://youtu.be/Sn057QrCUm8?t=5367
https://leela.ai/how-leelas-ai-is-different/
PS: Does anyone know how to make the Mac "say" command use a new fangled "Personal Voice" that you can record of your own?
Perhaps a bit wasteful, but feels more likely than getting the entire software industry (including companies with inverse financial incentives) to get on board.
A current-gen AI system has all the problems of a ghetto system (see https://news.ycombinator.com/item?id=44297481), with the added bonus of being inherently unpredictable.
https://www.bemyeyes.com/ serves a similar role: higher-latency, different privacy concerns, way better accuracy (most of the time). You can see why this isn't the same genre of thing as "make computer systems that people can actually use without assistance".