Economic Impact on Thermal Towns

 



France’s thermal spa towns are not just health destinations — they are economic lifelines for thousands of small communities. Cities like Vichy, Dax, Amélie-les-Bains, and Bagnères-de-Bigorre depend heavily on thermal tourism, which fuels local hotels, restaurants, and transport services.

If the reimbursement rate is lowered, many patients may no longer afford these treatments, resulting in a significant decline in visitors. According to the French Thermal Federation, a reduction in spa attendance by even 20–30% could cause some smaller establishments to close entirely. That’s why industry representatives warn that up to 80% of activity could disappear, threatening around 10,000 direct and indirect jobs.

Health Implications

Beyond the economic perspective, the decree raises public health concerns. For decades, thermal treatments have been prescribed for conditions like arthritis, respiratory diseases, and post-cancer rehabilitation.

Doctors argue that reducing access to these treatments could worsen chronic illness outcomes, increase pain-related conditions, and even lead to higher long-term healthcare costs due to increased medication use or hospital stays.

Supporters of thermal medicine insist that the government should evaluate the broader medical and preventive benefits rather than focusing only on short-term financial savings.
Government’s Justification

The French government defends the proposed decree as a necessary measure to control public health expenditure. Officials claim that certain spa treatments lack sufficient scientific evidence to justify full reimbursement under ALD (long-term illness) status.

The goal, they say, is not to end thermal care, but to align reimbursement policies with medical efficacy and the broader reform of France’s social security system.

However, critics argue this move comes at the worst possible time — as many spa towns are still recovering from the financial impact of the COVID-19 pandemic.
Industry and Local Response

The thermal spa sector has reacted with unified opposition. The National Council of Thermal Establishments (CNETh) has issued formal appeals, warning that this reform could “jeopardise the future of an entire ecosystem.”

Local mayors, particularly in rural areas, have written open letters to the Health Ministry urging reconsideration. They highlight that thermal tourism sustains local infrastructure, housing, and seasonal employment, and that its decline could accelerate rural depopulation.
Potential Outcomes

If the decree is enacted in 2026 as proposed, the impact could unfold gradually. Larger spa towns might adapt through private insurance partnerships or promotional health packages, but smaller family-owned spas risk closure.

Experts suggest that to prevent this collapse, the government could:

Introduce a partial subsidy system for low-income or elderly patients.


Promote research to validate the therapeutic effectiveness of spa treatments.


Encourage eco-tourism and wellness diversification to attract self-paying visitors.
Conclusion

The proposed decree to reduce reimbursement for thermal spa treatments has ignited one of the biggest debates in France’s health and tourism sectors in recent years. While the government seeks to modernise healthcare spending, critics warn that this reform could devastate the thermal industry, a symbol of both French medical heritage and rural vitality.

Whether compromise can be reached will depend on how both sides weigh economic sustainability against public health and social equity in the months ahead.