Remove 3 Insurance limit from sandbox mode/maybe whole game

As written.
Reason: When changing insurance companies, you get a drop in patient numbers first. Since hospitals are a bit difficult to balance finance-wise, this is not necessary and hampers fun playing the game or deters new users as they might not get why their hospital goes broke. Also, when opening new departments, you only get your patients diluted to the departments active. This will mean, you hire a full set of employees, but the patient number stays roughly the same. Whilst the game encourages you to try all departments, it throws a spanner into the gears with this mechanism. High-end insurances can only be contacted, when there is a certain infrastructure, but why should we not accept other insurances anymore or people with cash? Expanding the hospital should bring rewards and not more burdens. After opening my 3rd department I can only keep my hospital alive by clicking the event button once or twice a day. So...we have too few patients for 3 departments so we need a magic button to spawn more as you will go bankrupt without is not an intuitive solution.

There are mods in the Steam workshop who increase the amount of insurance companies to 6

3 insurance limit, hmm, are you referring to the patient limit in ambulances? Or the limit on insurance companies? I'm a bit confused.

Limit on insurance companies. I know there is a mod but as the game is subject to constant changes, I would like to have it 'official'. As far as I found out, your hospital grows over time and is hard-capped by insurances sending you patients unless you unlocked events, which requires some work to be done beforehand and then resources get scarce. Now, If I am running a hospital, I am not rewarded by opening new departments but as the patients are divided, each department now earns less (creates more wages because of staff requirements). Changing insurances also somewhat penalizes the player. Your intake sinks from about 25 down to 7 again. That smarts and under these conditions you are to do more quests and evolve your hospital. The one thing, opening a new department offers is that it makes the game interesting. Without being backed up by patients, however, it is a money sink only. And frankly, you should get more patients for more departments as you can now treat more different cases. So the insurance system is not very rewarding as it stands currently. Better to have new groups of patients occurring once your hospital has reached a certain size and renommé. And I highly doubt, that a hospital will turn away cases that pay with cash, thus uninsured. Why they even count as insurance company is beyond me.

yeah, I satisfied with the ability to tweak the number of insurance companies and earning greater capacity through challenges. And while yes, opening new depts (if) one is not increasing the number of patients provided thins out the numbers for each dept, it also increases them so as long as total patients increases. I doubt you'll see much of what you're hoping for from the devs. I may be wrong though.

Well, lets present some numbers, shall we??

You got first 3 insurance companies maxed out thus 75 patients a day hard cap. You have an average income of...in my case it were about 20k+ per day with moderate staff pay, also heavily depending on cases coming. Only common cold cases with no surgeries can hit your wallet occasionally. Same for events that lower insurance payment or patient intake.

Opening a second department reduced this to about 15k+ per day without no further benefits. Same number of patients, but more personal on the payroll.

Opening third department dropped this to even lower numbers fluctuating from 5k+ to under 10k each day, mostly less unless you fire an event to spawn more patients manually. Beware that you must pass or lose 5k on top.

So what gains are there in opening more departments if the patient number is always the same?
Changing insurances from say uninsured to Quick Snap (tier 4) brought an increase of +40% in payment 80% to 120% but reduced patients from 25 down to 7 and decreased ambulance cases as well. This accumulates to -70% income unless you build it up granular.

So why forsake an insurance and not start with another +7 patients once you unlock tier 4 instead of losing 18 first? Patient number now grows with your hospital size and you get better contracts because your hospital will most likely have regional impact as it covers more cases.

Why do uninsured count as insured or better: as an insurance?

I am not satisfied with tweaking the game but with a game mechanic well done. 'Get yourself a mod' is a lame excuse. And this current mechanism is too arbitrary and reduces fun in expanding your hospital. Imagine doctor's mode: on highest difficulty you want all those diseases to be diagnosed blindly and those you get depend on departments opened already. You won't get cases for neurology if you do not have one. The mechanism puts constraints on the game where it should lend encouragement to treat various cases. I do not need thinning out options but encouragement for indulging in the game and trying out all its facets.

I agree completely. I know I'll have this problem. I didn't get yet becase I've been too busy with the poorest pathing I ever seen in a game.

DocDesastro wrote:Well, lets present some numbers, shall we??

You got first 3 insurance companies maxed out thus 75 patients a day hard cap. You have an average income of...in my case it were about 20k+ per day with moderate staff pay, also heavily depending on cases coming. Only common cold cases with no surgeries can hit your wallet occasionally. Same for events that lower insurance payment or patient intake.

Opening a second department reduced this to about 15k+ per day without no further benefits. Same number of patients, but more personal on the payroll.

Opening third department dropped this to even lower numbers fluctuating from 5k+ to under 10k each day, mostly less unless you fire an event to spawn more patients manually. Beware that you must pass or lose 5k on top.

So what gains are there in opening more departments if the patient number is always the same?
Changing insurances from say uninsured to Quick Snap (tier 4) brought an increase of +40% in payment 80% to 120% but reduced patients from 25 down to 7 and decreased ambulance cases as well. This accumulates to -70% income unless you build it up granular.

So why forsake an insurance and not start with another +7 patients once you unlock tier 4 instead of losing 18 first? Patient number now grows with your hospital size and you get better contracts because your hospital will most likely have regional impact as it covers more cases.

Why do uninsured count as insured or better: as an insurance?

I am not satisfied with tweaking the game but with a game mechanic well done. 'Get yourself a mod' is a lame excuse. And this current mechanism is too arbitrary and reduces fun in expanding your hospital. Imagine doctor's mode: on highest difficulty you want all those diseases to be diagnosed blindly and those you get depend on departments opened already. You won't get cases for neurology if you do not have one. The mechanism puts constraints on the game where it should lend encouragement to treat various cases. I do not need thinning out options but encouragement for indulging in the game and trying out all its facets.

I've mentioned this several times now, and either frankly, that you don't believe it isn't my problem. You can make money and have a successful hospital w/the current structure. I have all major depts operating, I have 6 insurances providing patients (some still to provide up to 10-14 more through incomplete challenges. I have really decent revenue overall most days, some days a bit lighter, others mega revenue. I like the variation, as this reflects reality. If you don't want to increase patient numbers via completed challenges that's on you. Run all or none of the hospitalization/specialty depts. In fact, I thought one could ultimately tweak the total number of patients they receive regardless per day. Though pathing in the game could still be improved, I've been able to watch my hospital grow through fits and starts, and now I'm starting to wonder about what I'm gonna do when I finally dress-out all the remaining areas I still need to furnish/improve capacity. Some days I have a profit of nearly 30-40k. Course if you wanna just complain about why the game's system of revenue and insurance structure doesn't work for you that's your prerogative.

Look, that is great that it is working for you and you have fun. Nevertheless, my concerns are of my own and voiced since my style of playing seems to differ from yours. In all your answers you tell us 'it is possible' but you do not give a little hint about how. Every player has his own approach to the challenge that this very good game offers and most of us were in a hospital before and come with certain expectations. If those are not met or we find stuff not logical in our eyes, we make a suggestion or give feedback for the devs.

For me the presented situation decreases my fun and good experience with the game at some parts. If it is still fine for you, then so be it. I do not begrudge you having fun with the game. I have fun most of the time and just tell what is not to my palate or could be done better in my eyes. And since I strongly believe that you are not a kind of hired spam-filter for oxymoron, I ask myself, why you always pop up both here and at steam discussion forums, when the game is criticized in other ways than of having bugs to be fixed and try to defend or talk down something that means change or is not idea the devs had. You do not need to. I understand the game works fine for you and you like it. I however, am not 100% content and voice my concerns hoping the devs will read them. What they will do is up do them. Let us just agree to disagree on this one shall we?

DocDesastro wrote:Look, that is great that it is working for you and you have fun. Nevertheless, my concerns are of my own and voiced since my style of playing seems to differ from yours. In all your answers you tell us 'it is possible' but you do not give a little hint about how. Every player has his own approach to the challenge that this very good game offers and most of us were in a hospital before and come with certain expectations. If those are not met or we find stuff not logical in our eyes, we make a suggestion or give feedback for the devs.

For me the presented situation decreases my fun and good experience with the game at some parts. If it is still fine for you, then so be it. I do not begrudge you having fun with the game. I have fun most of the time and just tell what is not to my palate or could be done better in my eyes. And since I strongly believe that you are not a kind of hired spam-filter for oxymoron, I ask myself, why you always pop up both here and at steam discussion forums, when the game is criticized in other ways than of having bugs to be fixed and try to defend or talk down something that means change or is not idea the devs had. You do not need to. I understand the game works fine for you and you like it. I however, am not 100% content and voice my concerns hoping the devs will read them. What they will do is up do them. Let us just agree to disagree on this one shall we?

I noticed the same thing. This guys seems like a militant

Anywhoo...

Getting back to the original post, I'm a little torn on this one.

Personally, I agree that I like to play with more patients than we typically would receive from the three insurance companies. This can be done (1) by increasing the number of insurance companies allowed or (2) increasing how many patients are sent when you have high prestige. I've modded the game both ways, each with their own pros and cons. Personally, I almost always play with one of these mods activated because I love insane patient numbers and fully departments and wards.

However, from a development perspective, I can understand why we are limited to three insurance companies. The minimum system requirement for this game is an i3 processor with a recommended i5 clocked at 3 GHz. In other words, almost any computer out there should be able to run this game and any gaming computer will crush these requirements. A wide player base is, generally speaking, good for the game and I can understand wanting to make this game was widely accessible as possible.That being said, this has also been a discussion that has occurred regarding the maximum number of staff allowed in the game. The modding community increased the maximum number and now the option to allow for unlimited staff is present in the game itself.

Personally, I don't mind increasing the number of patients through mods. Going to the Steam workshop and hitting "subscribe" isn't all that much work and even the tweakables aren't bad to edit if I want to change things myself. However, if there was a way to place the option in the game, I would also support that because it could lead to further optimizations and less challenges trying to figure out if a bug is related to the game itself (and worthy of a bug report) or due to a broken mod.

Agree. This should be in the option menu: 'number of insurance companies' with 3 as default and 6 as max. (with Doctor's DLC), otherwise 5. I do not know whether this is a small or big thing to implement, but in my book giving freedom to the players is always a good thing whilst keeping the rules.

DocDesastro wrote:Agree. This should be in the option menu: 'number of insurance companies' with 3 as default and 6 as max. (with Doctor's DLC), otherwise 5. I do not know whether this is a small or big thing to implement, but in my book giving freedom to the players is always a good thing whilst keeping the rules.

yeah, but how do we go about discerning where the line is between giving freedom to players and "keeping the rules." Especially when the players contend the "rules" are impeding their freedom.

In my personal view this would be a difficulty mode parameter to toggle. We are not changing radically, how the game works. We are only adjusting patient numbers in a stable environment outside mods that could be outdated with the next patch or potentially lead to conflicts. Higher patient numbers could lead to players being content, because current difficulty is too high or want to build bigger hospitals thus wanting to be more creative. I mean, we disagree on how payment is done and this would be a major change in the game, but this is - like Fading Qualia said, tweaking a number. You yourself advocated tweaking the numbers or mods. I just want players to be independent of being knowledgeable in modding as this is not supported or using mods.

DocDesastro wrote:In my personal view this would be a difficulty mode parameter to toggle. We are not changing radically, how the game works. We are only adjusting patient numbers in a stable environment outside mods that could be outdated with the next patch or potentially lead to conflicts. Higher patient numbers could lead to players being content, because current difficulty is too high or want to build bigger hospitals thus wanting to be more creative. I mean, we disagree on how payment is done and this would be a major change in the game, but this is - like Fading Qualia said, tweaking a number. You yourself advocated tweaking the numbers or mods. I just want players to be independent of being knowledgeable in modding as this is not supported or using mods.

hmm, yeah I'd be for the devs simply setting the default number of attainable insurances to 5-6 rather than 3. Heck I tweaked it so long ago that I didn't recall the default number. Three is too low. Course my hunch is they have their hands full with all the bugs introduced by the latest DLC (very concerned for this and what it means about the game's future) Thus, the present remedy is really very easy. simply locating the "tweakables" file and adjusting the insurances there. Course at some point "spoon feeding" certain players comes at the expense of robbing others of the challenge.

Well, you say it yourself - 3 is too low, but it is the default we got. Since the player can choose this himself with this suggestion, there is no 'spoon feeding' or 'robbing'. Nobody forces a difficulty level on you, if you may choose certain circumstances. At least sandbox mode should have that. I do not want to play with unlimited funds, but having even 4 instead of 3 insurances would help greatly or picking the appropriate number matching the planned hospital size

DocDesastro wrote:Well, you say it yourself - 3 is too low, but it is the default we got. Since the player can choose this himself with this suggestion, there is no 'spoon feeding' or 'robbing'. Nobody forces a difficulty level on you, if you may choose certain circumstances. At least sandbox mode should have that. I do not want to play with unlimited funds, but having even 4 instead of 3 insurances would help greatly or picking the appropriate number matching the planned hospital size

I hope you find the hospital game of your dreams someday. Course that would require you to know what that even is...
Best of luck.