Riddles that have no answers

Alice was touched by the well wishes following her retelling of the citizenship saga. But also a little concerned that she must have come across as a right whinger – the health issues were included for comic effect and to drive forward the narrative; they were only significant in that, without them, Alice would probably still be floating in Brexit-induced limbo.

That said, Alice, preferring to have a plan rather than just wait around until something magical occurs, has decided to sign up for what is called 'rehabilitative sport' whereby, rather than waiting until her back gets sore again, Alice will join a group of geriatrics once a week for a back health course to strengthen her core muscles and increase her flexibility. This preventive measure is covered by Alice's public health insurance.

So Alice went to her GP, who had suggested the option in the first place, and asked for a referral. “Of course!” replied the doctor, delighted to be able to prescribe something that would be of great potential benefit to a patient but that at the same time would have no effect on her practice treatment budget. Alice does not fully understand the German healthcare system*, but knows that the magic words are 'budget neutral'. “All you have to do is find a spot in a suitable exercise group,” continued the doctor, “and I'll write you a prescription.”

“That sounds straightforward enough,” thought Alice. A short burst of internet research revealed three potential options. Alice looked at the FAQs for each of them. On each site, under “How do I sign up?” stood clearly, in black and white, “Simply go to your doctor and ask for a prescription. As soon as we are holding that magical piece of paper in our little paws, you can join any back health group that has spaces available.”

“Of course,” sighed Alice, wearily.

* The system is very complicated, to be fair to Alice, with a mixture of public and private insurance, but also very good. It is, however, as many things are, difficult to navigate.

When Alice and the White Rabbit first arrived in Germany, they were told that, as both foreign and freelance, there was not a chance that they would be admitted to public healthcare, which would have been their first choice. “Oh, but private is much cheaper!” was the mantra chanted breezily by every insurance advisor they saw, leaving out the essential caveat “...at the moment, while you're still young and healthy. But just you wait until age catches up with you and you start to disintegrate, when your premiums will rise to astronomical levels just as you grow too infirm to cover them....and of course once you have joined the private health insurance system, there is no way out, unless you leave the world of freelance work and get yourself taken on as a company employee.” Which is easier said than done when one's career is in an industry that is increasingly run on gig economy lines, as is the case for the White Rabbit.

Plus, Alice and the White Rabbit are strong supporters of a redistributive system of public healthcare. Bring on compulsory state health insurance for all. Having said that, Alice has recently seen numerous think pieces about the way that the current system fosters research and innovation in medicine in a way that would not be the case in a system based purely on public insurance. Alice is unsure what to think. Well, on that particular issue. Overall, she is strongly in favour of access to healthcare for all, in combination with research and innovation in medicine. And is rendered all but speechless by the stupidity that allowed measles to be exported recently from Germany to Guatemala, where the disease had been eradicated, as a direct result of parental foolishness.

Vaccinate your kids, people. And register as stem cell donors. And give blood. Unless they won't take your blood because you lived in the UK in the 1980s since, to paraphrase, “Of course you've got mad cow disease. They've all got mad cow disease there.” And now vaccinate your kids again, because these things need to be kept up to date.

Alice now has a job, and was therefore admitted to the privileged circle of the publicly insured. Which means she can compare the two systems. Several years ago, with a suspected detached retina (it turned out to be nothing except some residual dodginess after a minor infection! No need for sympathy!) she was packed off to the eye clinic. As a private patient, Alice was ushered through the linoleum-floored waiting room, up to a carpeted area with fancier magazines and subtler lighting. Where she waited for four hours, because instead of a nurse administering her atropine eye drops, as a private patient she was 'entitled' to have a doctor do it. Which meant she had to wait until the doctor had finished treating the patients in the linoleum waiting room, whose eye drops had been administered, much more quickly, by a nurse.

Alice is very happy to have found her way into the linoleum waiting room. Now she just needs to work out how to get that prescription that will unlock access to a back health course, when said prescription cannot be issued unless the would-be recipient of the prescription has already been granted access to the course.