Note by @fastfinge

@RegGuy @hosford42 The issue is that then you lose all semantic meaning. Older screen readers did, in fact, work like this, especially back in the DOS days. But also, you're conflating two different systems, here: the text to speech system, and the overall screen reading system. All the text to speech system does is take text, and turn it into speech. The screen reader is responsible for everything else. And in general, we have perfectly good screen readers. Screen readers can also, by the way, drive Braille displays and other output devices.