It is estimated that the size of the medical tourism market in the country will be Rs 1,95,000 crore in 2012. Based on a literature review of healthcare business media, policy documents and a few academic papers, this essay looks at the scope for medical tourism in India and situates it within the Asian context. It traces shifts in policy with the growth of a tertiary corporate health sector that is urban-centric, and subject to minimal regulation and monitoring. The State acts primarily as a steward. The essay also examines the implications of medical tourism for general medical care and how such policy shifts distort health systems. This analysis raises questions of accessibility, affordability, and ethics in medical care, and asks if it is sensible to promote medical tourism in a democratic welfare state, with poor public healthcare facilities for the masses.