Berlin

Criminally uninsured

Will fasting, yoga and acupuncture keep the doctor away? Our writer hopes so – because otherwise, she´s screwed. She shares her experience.

Will fasting, yoga and acupuncture keep the doctor away? Our writer hopes so – because otherwise, she’s screwed. She shares her experience.

Image for Criminally uninsured
Illustration by Agate Sasiuk

I’d always been pretty sensible and law-abiding: I started keeping financial records at 11, began filing my taxes at 15, did things by the books. Until I came to Berlin from Australia in spring 2002, decided to stay, and learned that concerning health insurance, a precariat like me would have to bend the rules.

I’m a Renaissance do-it-all person – journalist, proofreader, performer, English teacher. In other words, I’m broke. A yoga classmate’s PhD research on two Berlin creative sectors found their average yearly profit was just €10,000. In 15 years here, mine’s never been that high.

When the bare-bones, €50-a-month student policy I had for my first two years here expired, I realised just how limited my options were. I looked into state insurance:15 percent of your income, everyone said. My arse! A recommended statutory insurance company quoted me €220 minimum monthly payments, based on Berliners’ average income reckoned by the Federal Ministry of Labour and Social Affairs (currently €2660!). Forty percent of my 2004 monthly take of €560? Nein. Since most of my money came from teaching English, the Künstlersozialkasse was out. One member of my singing group told me about misrepresenting her income for her KSK application; I was appalled at her ethics. Naive me!

So I went without, and I freestyled. I ate well, fasted regularly to bolster my immune system, walked a lot, swam on discount cards, and did workouts, sauna and yoga three times weekly on a €40 monthly gym membership. Keeping in mind an uninsured UK-born collaborator who’d footed a €4000 bill after cracking an arm in a fall, I didn’t ride my beloved bike. When I got hit from behind by a footpath cyclist she just glanced back then rode away, leaving me with osteopath bills and a year-plus of back pain. Otherwise, I saw a Czech Republic dentist for a fraction of prices here, boosted necessary shots and managed costs as they arose.

Bureaucratic Hell

That is, until January 2009, when having health insurance became mandatory. So I went back to a private policy, even as its price crept up from €90 a month in 2009 to €132 by 2012. A year later, having scored a part-time writing and editing employment contract but still no closer to solvency, I finally decided to try my luck applying for a Hartz IV subsidy. If I qualified for a government top-up, it’d be reasonable to assume I’d qualify for state insurance.

Turns out, not so much. The Jobcenter would only subsidise state insurance – but according to a paragraph in 2009’s Hartz IV reforms, as a freelancer applying for welfare who’d previously only been privately insured, I couldn’t qualify for it. Kafka would approve. I sent the Jobcenter a copy of the 2009 law, proving exclusion from the insisted-upon insurance type, to no avail. Rolling my eyes, I went south to rural Italy for winter.

By April 2014, the Jobcenter had finally agreed to accept private insurance. I sent them a quote from the well-known foreign insurer ALC, for €237 a month. It took the Jobcenter till the end of July to say they’d “only accept quotes in German”, and there had to be old-age care insurance as well. I got a quote: €80 monthly extra, in a binding contract I had to sign for old-age care I never want to avail myself of. No.

Meanwhile, I wasn’t feeling so great . A combination of ongoing pain from my footpath cyclist collision, a brutal winter flu virus and the return of a familiar enemy from 30 years before, Chronic Fatigue Syndrome, made everything overwhelming, including chasing insurance. My GP ran swathes of tests that found nothing; I paid the €120 bill over four months. To exempt myself from the Hartz IV obligation to look for work, I applied for medical assessment via the Jobcenter: their doctor diagnosed depression. Which I didn’t agree with, but at least I got written out of the workforce for six months. I alternated yoga and gravity-light swimming; recouped, bone-weary, on the Sommerbad FKK lawn.

I tried insurance hunting again. The Jobcenter directed me to an impotent social worker, who sent me to a charitable citizen’s advice agency, who informed me German private insurers were legally forced to accept me on the so-called Basistarif, €646 per month – half that for welfare recipients. But I had to sign an 18-month contract, and if I needed to leave Germany again for family reasons, I was liable for the full amount. A choice from neo-liberal hell. Advice shelved.

Getting By

And so I remain a criminal. I’ve tried hacking the system: with a friend’s advice, I filled out pages of financial aid and symptom forms with St Hedwig Hospital’s TCM clinic and received free acupuncture treatment. I signed up for drug trials, but got refused due to lack of insurance (“but legally, we can’t put that in writing”, I was told). I went to the free Gesundheitshaus and met with a slacker psychiatrist who showed up 25 minutes late for our appointment, worse than useless.

If nothing else, I’ve learned the value of self-care. It’s a meticulous, profound process, but fortunately I became a pre-emptive wellness and nutrition wanker decades ago. I fast, up to four days at a time, and do gallstone cleanses with Epsom salts and a vile grapefruit juice-olive oil cocktail. In summer in a tent in the forest, I spent 10 days doing yoga, singing, resting and fasting on a modified intake of 450 calories a day.

In my day-to-day life, I go to the gym, make liberal use of red Tiger Balm and observe extreme care in snow and ice. I’ve cut all alcohol, most animal protein and non-complex carbs. A raw food diet maybe next. Sigh. But in becoming my own case manager, I suspect I might’ve finally found a crack through Germany’s byzantine insurance maze. Given its inequity, culture of over-priced hyper-treatment and lack of transparency, remaining uninsured is a risky act of civil disobedience. The ghoul of retrospective payments for cover I was never able to receive could loom ahead. Probably an acceptance letter and that bill will come when I’ve already healed myself.