Attention in recent months has focused on Arab investment, after security concerns derailed the acquisition of U.S. port operations by an Arab company, Dubai Ports World. But a decline in Middle Eastern spending has also hit service sectors including tourism, education and health care, triggering business-strategy shifts in such places as Cleveland and Rochester, Minn.

A hallmark of past oil booms was that money America spent on oil and gas got cycled back into the U.S. economy as investment and spending on U.S. goods and services.

Middle Eastern investors and consumers aren't completely ignoring the United States this time: They are major buyers of U.S. government bonds and have purchased U.S. hotels, such as New York's Essex House, and real estate in the South.

But America's allure appears to be waning, and travel to the United States from the Mideast has dropped. U.S. visits by Saudi Arabians, for example, fell to 18,573 in 2004, the last year for which statistics are available, from 72,891 in 1999, U.S. Commerce Department figures show. That represents an especially pronounced drop in tourist dollars because Saudi visitors spend three times more per person than any other group of U.S. tourists: $9,368 per trip, according to the Commerce Department.

Visa hassles have hurt export businesses, too, Arabs and Americans say, by placing a wall between U.S. companies and prospective clients who may turn to countries where travel is easier.

Arab tourists, deterred in part by U.S. visa hassles, are flocking to other burgeoning destinations close to home, such as Dubai in the United Arab Emirates, which offers resort hotels, theme parks and shopping malls patterned on U.S.-style attractions.

Jay Rasulo, chairman of Walt Disney Parks and Resorts, has been outspoken about how the visa process deters tourists. Rasulo told a recent travel-industry gathering that the U.S. share of international travel has dropped by "about $20 billion a year" since 2000, to its all-time low.

The U.S. Department of Homeland Security said it does its best to process visas quickly. "We definitely want to make it easier for those who are trusted to enter the U.S. to come in the time they want," said department spokeswoman Joanna Gonzalez. "But if decreasing wait time means softening security, then [the wait time] is not our problem," she said.

In the health-care industry, the number of Arab patients at high-end U.S. medical centers such as the Cleveland Clinic and the Mayo Clinic fell immediately after Sept. 11, by 20 percent to 50 percent, according to industry officials.

The fallout hit more than the clinics. High-profile Arab patients often came to the United States for lengthy treatments accompanied by large families and staffs.

When former UAE president Sheikh Zayed bin Sultan al-Nahyan traveled to Cleveland in 2000 for a kidney transplant, he and his entourage of hundreds stayed for four months. All needed to be fed, transported and housed.

The Mayo Clinic in Rochester, where King Hussein of Jordan received treatment in the late 1990s, has worked hard to draw patients, flying doctors to the Mideast after Sept. 11. Recently it opened a cardiovascular clinic in Dubai, which coordinates travel to the United States for further treatment, if necessary.

As for education, U.S. colleges and universities, once highly desirable destinations for wealthy Arabs, have seen a steep drop in Middle Eastern students, losing as much as $43 million a year.

The steepest decline comes consistently from Saudi Arabia, which sent 14 percent fewer students to the United States last year, according to the Institute of International Education. Enrollment by students from Muslim nations in general has fallen steeply, evidence that Middle Easterners aren't alone in finding America a more forbidding destination since Sept. 11.

Robert M. Gates, a former director of the CIA who is president of Texas A&M University, has been a forceful voice for improving the visa process. Gates's worry extends beyond monetary losses.

"In the last half-century, allowing students from other countries to study here has been the most positive thing America has done to win friends from around the world," he said.

But the U.S. consulate in Jiddah has been closed since November due to security concerns; another consulate in Dammam, Saudi Arabia, hasn't been open since 1999. This has meant applicants have to travel long distances to Riyadh, where the workload has kept applicants waiting up to several months for appointments.

Even among students who go to the United States, the experience is often mixed these days. Saeed Abdullah, a PhD student from the United Arab Emirates who is studying at Texas A&M, said that before Sept. 11, his friends used to prolong their studies -- taking seven years to complete four-year degrees. "America was about the social life as well," he said. Now they often try to squeeze the four years into three. "Now we come for a mission -- to work as hard as we can to get our degrees as fast as we can and then leave."