“Resort therapy is the 4th pension pillar”

The share of prevention and rehabilitation in the Estonian medical budget is too small, admitted the participants of the representative international conference of the Setomaa Union and the Värska Health Resort Center held in Värska on September 3, 2022. In this way, spa rehabilitation could find a secure place among the healthcare services supported by the Estonian Health Insurance Fund in Estonia, similar to Latvia and Lithuania.
“Resort therapy is the 4th pension pillar,” concluded Dr. Annelii Jürgenson, head of the PERH rehabilitation clinic. According to Jürgenson, spa rehabilitation allows in many cases to avoid expensive medical operations, such as hip or knee joint replacements. In Estonia, thousands of people are waiting for these operations, many of whom give up when they receive expert help to improve the functionality of their joints without surgical intervention. Unfortunately, hospitals do not deal with such patients, as their rehabilitation departments are already overloaded. And to receive help at a spa, the citizen must pay for the entire service themselves.
“There will probably be no changes to the list of healthcare services that will be approved soon,” said Marko Tähnas, head of the partner relations department of the Health Insurance Fund, in the discussion following the presentation. Dr. Le Vallikivi, head of the Estonian Association of Family Physicians, pointed out that several types of spa rehabilitation, such as physiotherapy and mud therapy, are already on the list of services ordered by the Health Insurance Fund, but their implementation is quite limited and hospitals do not provide many other services typical of spa treatment institutions.
The experience of Lithuania also shows that preventive and functionally improving spa rehabilitation requires special conditions, confirmed Rūta Kapačinskaite, who presented at the conference as a representative of the Birštonas resort area. The concept of Birštonas spa rehabilitation is based on the philosophy of Sebastian Kneipp, which combines water and exercise therapy, the healing properties of plants with a healthy diet and an environment that restores harmony. According to Kapačinskaite, restoring harmony is the most difficult thing today, in addition to stressful work, and therefore resort areas away from business centers have a certain place in health promotion, since it is easiest to switch off from the usual work rhythm away from the usual environment.
According to Vello Saare, head of the Värska Health Resort Center, it is regrettable that the Health Insurance Fund and the leaders of the Estonian healthcare system have not yet recognized spa treatment institutions as equal contractual partners, although companies belonging to the Estonian Spa Association have the ability to offer high-level spa rehabilitation treatment, which is in no way inferior to hospital rehabilitation departments.
Thus, spa treatment companies currently operate primarily as health tourism providers and have been heavily affected by the restrictions during the pandemic, similar to all other tourism and hospitality companies. “Currently, Estonia is at the same starting line as major tourist countries, and our future success in the post-pandemic world depends on how quickly and skillfully we can realize our potential,” said Piret Mürk-Dubout, member of the Tallink Grupp board, in her presentation “Is there hope for the hospitality business?”. In her opinion, the high-throughput service provider most lacks efficient universal IT solutions that would allow it to continue operating even under restrictions during the pandemic.
Liina Maria Lepik, head of the Tourism Development Center of EAS, confirmed that several campaigns introducing Estonia to foreign markets are already ready and are waiting for the right time. According to Andres Sut, Minister of Enterprise and Technology, we also need to understand the caution of the Finnish government, because in the opposite situation – if Finland’s infection rates were several times higher – Estonian leaders would also be faced with difficult choices regarding cross-border traffic.
At the local level, the way in which the local government is able to develop the infrastructure of its resort area plays a significant role in realizing tourism potential. According to the mayor of Haapsalu, Urmas Sukles, tourism development has also contributed to the progress of the service sector. According to the mayor of Setomaa, Raul Kudre, guests of the Värska Spa and Wellness Centre also enjoy the hiking and skiing trails located outside the company.
It was the first conference on health, tourism and hospitality entrepreneurship in a long time, where nearly fifty participants met physically in the same room. The conference was supported by the Setomaa Programme.