Earlier quoted context omitted.
Well, no. He has a perfectly stable, high-population city, but it has none of those things except crime-free status "There are a lot of other problems in the city hidden under the illusion of order and greatness: Suffocating air pollution, high unemployment, no fire stations, schools, or hospitals, a regimented lifestyle - this is the price that these sims pay for living in the city with the highest population. It’s…
I don't know how the game works so this may not even be part of it, but it's incredible if such a high density population was able to keep growing for 50,000 years without being constantly devastated by disease and epidemics, despite not having any hospitals.
All a hospital will do is cure a small number of people in a small scale epidemic. But lets face it, if Mangasanti is your goal, you are probably willing to let 20 people die of preventable diseases at home.