Spa cures: the government wants to pass the bill to mutuelles

According to Le Monde, the spa town of Gréoux-les-Bains is worried about the government's savings plans. On 8 October, the government announced it wants to shift part of the cost of spa cures onto supplementary health insurers (complémentaires santé, the private top-up cover that sits alongside the state system), which are not obliged to cover them. One resident sums up his disbelief: "These people don't do any sums!" The dispatch we have does not detail the amount of savings targeted, the timetable, or the number of patients concerned. We will not invent them.

What we can say is what this mechanism means. What follows is our reading, not an established fact.

First, the word "shift" is elegant. It does not say "scrap". It says: the expense does not disappear, it simply changes pockets. Yet the insurer has no obligation to pay. It may reimburse, not reimburse, or reimburse according to the contract, which means according to the price you pay. A treatment that was part of a collective right becomes an insurance option. Whoever has the best company mutuelle will get it; whoever chains together precarious contracts or small pensions will go without, or pay out of their own pocket.

This is where the question of class arises, very concretely. A spa cure means three weeks of care for worn-out backs, damaged joints and tired bronchial tubes. These are often the bodies of people who have carried, cleaned, lifted and been trampled on all their working lives: care assistants, factory workers, supermarket checkout staff. Their health is the result of their work. Depriving them of it means making them pay twice.

Next, when care retreats, the work does not evaporate. It falls back on households. In practice this is the principle of social reproduction: care, health and looking after people is work that society must shoulder, failing which it is passed on to families and, in practice, to women, who accompany, nurse at home and give up work. A cure scrapped means one more pain to manage at home, one more sick leave, one more exhausted carer.

Finally, there is the town itself. A spa resort is an entire economy: care staff, hotels, shops, seasonal workers, often poorly paid and poorly protected. If patients become scarce, it is these jobs that take the hit. The resident quoted by Le Monde speaks of there being no calculation. One can think instead that there is one, but an accountant's one and a short-term one: a lighter line in the state budget, costs shifted elsewhere, onto people and territories that have no lobby.

We would like the government to say how much it hopes to save, and how much it will cost in GP visits, medication and sick leave. Until those figures are provided, the announced saving looks like a bill slipped under the neighbour's door. Except that the neighbour, here, has a bad back.