Few modelling studies have been carried out to investigate patients’ involvement in the decision-making process in a healthcare system. Here we perform theoretical and simulation analysis of a healthcare business model involving three populations: Public Healthcare Providers, Private Healthcare Providers and Patients. The analysis contributes to healthcare economic modelling by analyzing the dynamics and emergence of cooperative behavior of agents within the three populations. Resorting to agent-based simulations, we examine the effect of increasing behavioural mutation and providers’ capacity on patients’ cooperative behaviour. We show that the former introduces more randomness in agents’ behaviors enabling cooperation to emerge in more difficult conditions. Moreover, when the providers’ capacity to meet patients’ demand is limited, patients exhibit low levels of cooperation, implying a more difficult cooperation dilemma in a healthcare system that needs addressing.