I’ve been playing Democracy 4 for a few days now. Played some enjoyable games in US, UK, and Germany.
Something that is bothering me, however, is the Hospital Overcrowding situation. As it stands right now, having a fully funded State Health Service does not come close enough to eliminating the problem. At the same time, said State Health Service practically eliminates Private Healthcare, which exacerbates the problem.
From a gameplay standpoint, it appears almost impossible to eliminate this problem, as it’d require full funding and implementation of the State Health Service and all the stuff to boost Private Healthcare, which I wouldn’t be able to afford without taxes being sky high (and possibly not even then).
There are a couple of changes that would allow a skilled player to resolve this issue. One or more of the following:
- Nerf the effect Technology has on Healthcare Demand, and by extension Hospital Overcrowding.
- Buff the effect of Private Healthcare and/or the State Health Service on reducing Overcrowding.
- Nerf the effect Healthcare Demand has on Hospital Overcrowding (not preferred).
- Add additional policies to the game that reduce Hospital Overcrowding or Healthcare Demand.
- Allow more existing policies to reduce Hospital Overcrowding or Healthcare Demand.
- Rebalance State Health Service’s effect on Private Healthcare to make it easier for them to coexist.
- Buff the effect that a high Health stat has on reducing Healthcare Demand and/or Hospital Overcrowding.
The point being, a modern, wealthy state that actually makes the effort to fully fund a well-equipped, universal healthcare system shouldn’t be experiencing a shortage in hospital beds.
Interesting, I’m always able to get rid of hospital overcrowding in my first term, without even touching state health or healthcare vouchers. I always try to get rid of obesity/respiratory disease, while increasing health as much as possible and decreasing healthcare demand (through right to die and social care). I’ve never had a problem with it. Perhaps you are not addressing enough of your underlying health problems to be able to get rid of overcrowding? It doesn’t matter if a modern, wealthy state has a well-equipped, universal healthcare system if its citizens are too unhealthy and need constant care.
Never had a problem with it either (on 200 %).
Hmm, I know it takes me a long time to address obesity and respiratory disease. Perhaps by the time I do solve it, technology has advanced to the point where healthcare demand stays too high, and I can never hope to solve it beyond that point?
It’s pretty easy to get rid of obesity: junk food tax, healthy food subsidies, healthy food campaign, food standards and bike subsidies are all cheap. I usually start with that since health seems to have a massive impact on productivity.
Respiratory disease is a pain because you have to save the environment to get rid of it. That’s usually pretty late.
Maybe you can get rid of it early by maxing out tobacco tax. Never tried that - don’t know how feasible that is.
*Now that I think about it: Tobacco tax is really expensive, I think. You probably can’t do that “early”.
That’s probably the most likely explanation. Also, by that late in the game when your technology is high, your lifespan is also probably high too, which increases healthcare demand. That’s why it is critical to address obesity and respiratory disease early on, so you’re not stuck with overcrowded hospitals for the rest of the game. They really should be one of the first things you should try to address, especially since it is so hard to get rid of respiratory disease once your GDP is really high and environment tanks.
Maybe Stem Cell Research should have a bigger effect. Although it increases overall health, it seems to me like it would also have a direct effect on decreasing healthcare demand since it opens up the door to simpler treatments or preventive treatments. I think it actually increases healthcare demand since it increases your tech level
There seem to be only socialist or authoritarian solutions to this crisis, are there other ways of stopping this? Liberal/Capitalist. The Liberal/Capitalist solutions that I am aware of are just as expensive as the socialist ones. So, maybe the real question is, can there be a liberal, cheap and capitalist way of solving this problem?
I can think of one policy:
Citizen’s Health Brigades. Volunteers paid a small stipend in their free time to look after the ill.