Ana Jover | Alicante
The influx of international visitors leaves a clear imprint on Spain’s services and employment, shaping an industry that is broad and influential. Within this sector, healthcare services stand out as a critical element of the experience for many travelers. What do foreign visitors actually do when they come? A wealth of benefits has been created, but questions remain about gaps, gaps that have persisted, and how well the system serves people from abroad. As European elections approach, there may be new offers and even clarifications about enjoying the region responsibly, including the use and potential misuse of the European Health Card and the broader health risks and opportunities created by cross-border mobility.
The European Union has already affirmed commitments to employment and to tourism as a driver of growth. One major initiative, smart tourism, is supported by the Recovery, Transformation and Resilience Plan with European funding, implemented in Spain to promote digitalization and sustainable travel. Near the national average, roughly 100 million euros are allocated annually to digitize services and push sustainable tourism forward.
The city of Benidorm has been highlighted as a model smart destination. The practices promoted by the Spanish administration have influenced urban planning, mobility, and employment. Europe emphasizes supporting micro, small and medium enterprises and aims to preserve rural jobs to sustain regional vitality. The 9J strategy will reveal whether the plan continues in its current course or shifts, given that the financial involvement of autonomous communities and local councils can affect fund justification.
On health, Europe has progressed since launching the European Health Card in 2012, with further improvements following the pandemic. Yet pairing this basic service with tourism in Spain raises two opposing points: access for visitors and safeguarding against misuse. For years, data on foreign tourist expenditures in Spain have included a line on Voluntary health expenditures. INE data show 83.52 million euros spent in 2023, a 39 percent rise from the previous year. This includes clinics, hospital visits, wellness treatments, and other care-related items. Health tourism accounts for a minor share of total expenditures, dominated by entertainment and holidays at 93,412 million euros.
Against these figures, a broader debate exists about the right to services and fraud. The European Union has a role to play here. A Court of Accounts report indicates that as of January 1, 2018, invoices awaiting collection in EU countries related to healthcare amounted to 138.6 million euros. Professional associations have voiced concerns about fake tourists for years. One of the recurring cases involves hip surgery where a fall is simulated and the injury later shown to have occurred earlier.
With elections approaching, it remains undetermined how extensively the EU will regulate or respond. The European Health Card is linked to a data network, and outstanding questions include the degree of autonomy claimed by member states and whether British travelers will retain these benefits once Brexit concludes. The discussion continues, with health policy increasingly intertwined with travel and cross-border cooperation.
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