I highly doubt it deserves a mere 5.5. This game is fantastic!
Graphics: 8/10
At the time, I barely noticed them. I only cared about the gameplay, really. Although, looking back, they were mediocre for the time, yet they convey everything needed for the game to function well. I like the cutscenes, the different menu bars, but the tiny resolution irks me, as does the occasionally simple sprite.
Audio: 4/10
Music: 9/10
The audio, while reasonably true to a hospital, remains hindered by one thing: the horrific announcer. This nasal woman will work as the P.A. system over your hospital, giving you helpful tips on what is needing repair or staff, but she is obnoxiously loud and has one of the most annoying voices in any game I've ever played. And she pops up a hell of a lot. The music, on the other hand, is addictive in its simplicity. Around 10 audio tracks that play on a loop, each is a different style that rarely gets repetitive.
Gameplay: 10/10
The meat and potatoes of every game. The gameplay is simplistic: build a hospital, compete with three other hospitals in your region, try not to kill any people and clean up the vomit on the floor. However, quirks are added in each level, from contagious virus outbreaks to emergency situations (which are sent in by helicopter) to hilarious illnesses such as "Baldness" and "Invisibility". While the game does hide behind a layer of humour, difficulty sets in around the fifth level, when the earthquakes start destroying expensive medical equipment, and your doctors are all ridiculously underqualified. You have to manage well your funds and your staff happiness, or else you'll be restarting a level in frustration.
Extras (Honorable Mentions):
Multiplayer: 6/10
Don't let the score fool you, the multiplayer is fantastic. However, getting it to run on systems in this day and age is nigh-impossible.
Humour: 9/10
The game is just funny. From small things like naming the opponents "Deep Thought" and "HAL" to almost every illness, as well as the occasional funny comment from the nasal P.A. woman (Patients are reminded to have their checkbooks ready."
Total: 8.9
Definitely buy it. Although it may not be anywhere but the bargain bin, it is worth any amount you'd need to pay for it. Especially if you can get multiplayer working.