It really needs some country-based DLC to spice things up. For example:

Canadian Healthcare - If a patient is poor, depressed, or opposed to the government; they are offered and pressured to be euthanized.

Swedish Healthcare - If a patient dares to book an appointment, they are charged $20. In addition to this, it'll take three months to three years in order to receive a modicum of treatment for any serious ailment.

American Healthcare - If a patient comes in with a broken arm and does not have the right health insurance, they have to take a second mortgage out on their home or alternatively, declare bankruptcy.

The learning curve just to complicated compared to other sim games and right click just cant solved anything.. spending 10 hours just to understand how to hire and put department to work then comes the tiny problems like how to connect it to waiting room and janitors..

great game once figured out