Hospital Thoughts

[TL_]

Everyone else has been giving feedback on physicians, game rules, plague deadliness, et cetera, but I think that's all in a good place. Instead, I want to talk about something that hasn't been talked about a lot - hospitals.

• I like the ability to get university-like upgrades with bonuses to tech for a lot of money
• Good buildings variety
• I'm glad most of the buildings only take about a year to build, because usually something this expensive is multi-year and you don't have long to react to a major epidemic.
• The cost of upgrades feels a bit too extreme. Buildings which cost more than a new city is a huge disincentive.

From one of the last streams, the devs said they wanted hospital upgrades to be very expensive and they achieved that, although in my experience, by the time the Black Death arrives in Dynamic and Delayed Dynamic modes, the word generally has about four hospitals total and none of them have the first hospital level upgrade.

The one game where I was able to upgrade my hospital level, I tried the 1066 start as a merchant republic and attempted to divide my time between upgrading holdings for money generation (to acquire hospital upgrades) and the upgrades themselves before the plague hit. I managed to sink 1,100 gold into the hospital and... the Black Death went around India and never arrived.

The high price of leveling up hospitals seems to encourage building a lot of un-upgraded hospitals all across your country (I could have had 11 hospitals instead of leveling up that one) instead of one high quality one in the capital which seems... unintuitive? Unrealistic? The AI certainly never invests in high level hospitals anyway from what I've seen.