A private hospital with avg spend of even 300 cedis can generate almost 1m cedis monthly in just one branch if they can average 100 visits a day. There's no way private healthcare need to overcharge the way they do. Some are selling drugs at markups exceeding 5x cost. Imagine you run even 10 branches, you can negotiate better prices and longer payment terms with suppliers. Most people also pay in person without insurance so you'll effectively a negative working capital business. It requires some competence that I believe is not common in ghana that's why it's not happening. In most countries running a hospital is very expensive because of regulations alone. In ghana you can turn a three bedroom house into a clinic/hospital and no one will bat an eye. No zoning, no permits. Hefra will happily give you certification and labor is relativel cheaper.