India's medical tourism sector is currently experiencing a downturn, with foreign patient arrivals plummeting from nearly 700,000 in 2019 to approximately 500,000 in 2023. This decline is attributed to several factors, including strained diplomatic relations with Bangladesh, which has affected patient inflow, and visa processing times that can extend up to 60 days. Additionally, India is facing fierce competition from countries like Thailand, Malaysia, and Singapore, which are becoming more attractive destinations for medical tourists. A proposed tax on medical referrals is expected to drive costs higher, further complicating the landscape for India's medical tourism. However, there is a silver lining; the average revenue per patient is increasing as high-value procedures, particularly in oncology and cardiac surgery, now dominate the market. Host Anirban Chowdhury discusses these issues with ET’s Forum Gandhi and pharma editor Vikas Dandekar, exploring the reasons behind the downturn and potential solutions.