Are the French falling out of love with spa cures?

Thermal spa cures are hugely popular in France - about half a million people do one every year and in certain circumstances the state will pay for it - but latest figures show that for the second year in a row attendance at spas has fallen.

Are the French falling out of love with spa cures?
Water treatments in the Bagnoles de l'Ornes thermal centre in France. All photos: AFP

One of the many great things about the French healthcare system is that in certain cases, you can get most of the cost of a spa treatment reimbursed by the state.

Sadly this isn’t for anyone who just fancies a nice day relaxing at the spa – you need to be prescribed the cure thermal (spa treatment) by your doctor and there is a list of 12 conditions it is officially approved for.

READ ALSO Five surprising things that are available on your carte vitale

The treatments themselves are generally hydrotherapy in thermal springs – or mud – or massages, so don’t try claiming back the cost of a facial.

But there are enough people who meet these conditions that in 2019 579,000 people in France had a spa treatment that was reimbursed through their carte vitale health card.

However that’s a drop off in numbers since 2018, when 598,000 were reimbursed for spa treatments, and numbers also fell from 2017.

Experts put the drop down to two factors; economic conditions and and the temporary closure of four spa treatment centres over the last two years.

The cost of a treatment is reimbursed up to 65 percent, so going for a cure thermal still involves some financial outlay.

And there may have been a problem with access, as four centres had temporary closures during 2019 – Brides-les-Bains in Savoie (12,000 spa visitors), due to work related to the presence of bacteria in the water, Bourbon-Lancy in Saône-et-Loire (4,500), due to a fire, Lons-le-Saunier in the Jura (1,800), due to redevelopment work, and Les Eaux-Bonnes in Pyrénées-Atlantiques (1,000), due to a problem with the structure of the complex.

“The main explanation is cyclical: it is the unusual closure of four thermal establishments”, Thierry Dubois, president of the CNETh (National Council of Thermal Establishments) told local newspaper Sud Ouest.

So how do you go about getting a spa cure?

Well firstly you need your doctor to write a prescription stating that you need one, and this doctor must be your registered medécin traitant – your GP or family doctor.

There are 12 things which make you eligible for a cure thermale, but some of the categories are pretty vague. They are;

  • digestive disorders
  • psychosomatic conditions
  • urinary disorders
  • dermatology conditions
  • gynaecological conditions
  • cardio-arterial diseases
  • neurological conditions
  • blood disorders
  • rheumatological conditions
  • developmental disorders in children
  • respiratory diseases
  • bronchial disorders
Once you’ve persuaded your doctor that a spa treatment will help, you may also be able to claim back some of the costs of getting to the treatment centre, depending on your personal circumstances.
As with all medical care in France, you pay upfront for the treatment and then claim the cost back using your carte vitale. In the case of spa cures you will get up to 65 percent of the cost back.
Although the French state has recently cut back some treatments that it will refund – including homeopathy – spa cures were spared and will continue to be reimbursed for the foreseeable future.
Perhaps unsurprisingly, the majority of people who take spa cures are pensioners, with the average age being 63.

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France brings in free contraception for all women aged 18-25

Free birth control for all women under 25 will be available in France from Saturday, expanding a scheme targeting under-18s to ensure young women don't stop taking contraception because they cannot afford it.

France brings in free contraception for all women aged 18-25
A doctor holds an interuterine contraceptive device (IUD) before inserting it in a patient. Photo: Adek Berry/AFP

The scheme, which could benefit three million women, covers the pill, IUDs, contraceptive patches and other methods composed of steroid hormones. Contraception for minors was already free in France.

Several European countries, including Belgium, Germany, the Netherlands and Norway, make contraception free for teens. Britain makes several forms of contraception free to all.

France announced the extension to women under 25 in September, saying surveys showed a decline in the use of contraception mainly for financial reasons.

The move is part of a series of measures taken by President Emmanuel Macron’s government to boost women’s rights and alleviate youth poverty. The free provision is supported by women’s groups including the association En Avant Tous.

“Between 18 and 25-years-old, women are very vulnerable because they lose a lot of rights compared to when they were minors and are very precarious economically,” spokeswoman Louise Delavier told AFP.

Leslie Fonquerne, an expert in gender issues, said there was more to be done.

“This measure in no way resolves the imbalance in the contraceptive burden between women and men,” the sociologist said.

In some developed countries, the free contraception won by women after decades of campaigning is coming under attack again from the religious right.

In the United States, former president Barack Obama’s signature health reform, known as Obamacare, gave most people with health insurance free access to birth control.

But his successor Donald Trump scrapped the measure, allowing employers to opt out of providing contraception coverage on religious grounds — a decision upheld by the Supreme Court in 2020.

Poland’s conservative government has also heavily restricted access to emergency contraception as part of its war on birth control.