Simulation

In "Precession of Simulacra" on p.3 of Simulacra & Simulation, Jean Baudrillard differentiates between pretending [dissimulation] and simulation. Dissimulating leaves the principle of reality intact. The difference is always clear, it's simply masked, whereas simulation threatens the differentiation between true and false. "Whoever fakes [dissimulates] an illness can simply stay in bed and make everyone believe he is ill. Whoever simulates an illness produces in himself some of the symptoms." Is the simulator sick or not?