The last few Legends & Lore posts have touched on issues around healing in D&D Next, as have a number of the blogs I read, so this is me, casting my chapeau in again... jauntily, of course. As one does. The driving conflict here is whether D&D Next will adopt 3.x-and-previous approaches to healing and game-pacing (informed, in limited ways, by 4e), or 4e's approach to healing (through the lens of 3.x-and-previous delivery methods). To state that less opaquely: do characters heal overnight (or, more radically, every battle) basically for free, or do they suffer attrition, and if so, to what degree?
Boiling this down about as far as it will go, hit points are the progress track toward catastrophic character failure. Here I use the word "failure" without prejudice - taking damage in battle is a normal part of play, unless your group's gameplay involves hard-line strategic combat where you focus on how to think your way around every problem, to the point that no one really gets to make an attack. If it makes you feel better, call it the progress bar toward enemy success. Healing, then, is erasing enemy success, and the game's approach to healing as opposed to simply granting more hit points is that the players, as a group, must either resolve the current threat (every form of out-of-combat healing) or expend power and/or actions that could be used some other way (in-combat healing, and the fast versions of 3.x-and-prior out-of-combat healing) in order to heal.
Another view: sometimes that which opposes you in the game makes progress toward your defeat not because you have erred, but because chance has dictated that it come to pass. Perhaps you got hit by a sword or a spell; perhaps you failed a Jump check at the wrong moment. Whatever it is, you take damage for reasons that don't involve bad gameplay - you're playing adventurers, so optimal behavior still carries risks. If it didn't, then you probably should have been taking on a bigger challenge, or the hand of narrative drama probably should have come up with a spanner to throw into your works.
Moving on - taking damage and expenditure of consumable items and per-day abilities are the kinds of lingering consequences that the game offers. I know of groups that start essentially every fight with 100% of their normal resources, on the reasoning that this gives the DM the best grounds for estimating the party's capabilities and keeps the action going - an extreme solution to the problem of the 15-minute adventuring day. (Since at least one of those DMs regularly reads this blog, I invite him to clarify or expound upon this argument - any misrepresentation on my part is not malicious.) 4e is also much less directed toward tactical use of consumable items than 3.x; while it does include such items, in my experience they are far less central to gameplay. In particular, healing potions are a far less popular option here than in 3.x-and-prior. As they heal a fixed number of hit points that is often less than a player's healing surge value, but still cost a healing surge, they are tools of last resort rather than go-to healing solutions. (I'm lumping the more-efficient wand of cure light wounds in with the healing potion, on 3.x's side; wands are not 50-charges-ever items in 4e, so that parallel is completely broken.)
For my part, though, I look at attrition as an important aspect of gameplay. I don't want the game's design to tell me that anything less than four combat encounters a day is too easy because of insufficient attrition; there's a middle ground in which the characters should prefer to avoid unnecessary combat, but still feel like they have the strength to continue. With attrition as a mechanic, healers traditionally have to select in favor of healing both in terms of actions during combat (4e did address this, at least) and in terms of spending daily abilities on healing instead of something else. This puts pressure on the cleric's player to save spell slots for healing, even though the cleric has lots of other firepower in its spell list and ending a fight sooner is even better than healing afterward. The cleric's magical reserves are the party's ability to recover from failure, and (since gaming turns us into masters of risk-assessment, and character attachment creates risk-averse behavior) no one wants to go into a new encounter while heavily injured.
My other problem with an attrition-free game is a simulationist and world-building one. Why are other characters incapacitated by wounds in ways that characters are not? There are always going to be story needs for a NPCs suffering from terrible wounds. Can we really preserve verisimilitude if NPCs so blatantly operate on different world rules from the PCs? There will be those who are completely comfortable with this, or who offer supernatural explanations and interventions to support that difference, but that's not where I am with the stories I want to tell in tabletop games.
I'm about to demonstrate that I have no idea what I want by contradicting that. I'm trying to say this is complicated, because to one degree or another I think a whole lot of the fanbase is in the same place. According to the traditions of internet gaming arguments laid down in ancient days by our tribe, this is the part where someone mentions that lost hit points != horrific wounds, because high-level fighters, that's why. I get that, and that brings me into my next point. (It also makes me consider whether I could bolt SIFRP's Injuries/Wounds system onto D&D. The answer is "a definite maybe." Since I came up with this idea right now, I'll come back to it in a future post.)
At the same time, I'm all in favor of making natural healing faster than the 1-2 hit points per character level per day of 3.x, because hit points also stand in for fatigue and cinematic improbability. Though possibly realistic, using eight hours as the unit of time means that it's irrelevant to any part of what's going on right now. Mearls has proposed 1 hit point per character level per hour, which has the benefit of being easily tweaked, and of being a short enough span of time that you can just continue adventuring in the same day. I'm not crazy about this idea, though I can't yet put my finger on why. Mostly I am happy in concept with the Hit Dice mechanic already in the game, and I think the answer is to alter its scaling or something.
Just to emphasize how contradictory my thoughts are on this topic, I'll mention that I'm completely happy with the way healing works in Ro3 LARPs. Untreated-but-nonlethal wounds take weeks to heal, minimally-treated wounds take 8 hours to heal, and with a combination of personal resilience and medical treatment that time can go all the way down to 15 minutes. Magical or pharmaceutical aid can take this down to one minute. Observe the tension between the principle that wounds are serious and should matter and the principle that players want to get back to having fun before too long. Here too it is entirely possible for a healer character to dump all of his mana, Fatigue, Production, or the like on healing effects. We haven't tended to regard that as a major problem, though, because once we're talking about a playerbase larger than a single adventuring party; as the sample size increases, you're more and more likely to include people who enjoy healing-as-gameplay. I won't get into the social pressures on healers to play one way or another, except to say that it would make this already long post vastly longer.
For those not playing along in the Public Playtest, Hit Dice do double duty in D&D Next. Not only is it a phrasing of your hit point determination (as in 3.x-and-prior), but they also stand in for 4e-style Healing Surges. Therefore a third-level fighter can naturally heal 1d10+Con bonus, three times per day. This is not bad, though at low levels it feels particularly unreliable. I've addressed this to a modest degree with houserules in my Aurikesh campaign. First off, all characters have a five-point bump to their starting hit points, because otherwise it's really very easy to go from full starting hit points to stone dead, and I'd rather avoid that for now. This solution won't be for everyone, but we're pretty happy with it all the way around. Secondly, I've introduced Upkeep rules that siphon a lot of money off of the PCs (and I'm sure they're less fond of this than I am), but also grant bonuses to their Hit Die rolls for natural healing, simulating the idea that living in richer conditions - better food, better living quarters, better access to physickers - improves their health and resilience. At the higher levels of upkeep that the players don't usually go for, the benefits extend to extra Hit Dice of natural healing (though not actual hit points) in each day. If I were to apply this rule to a game without Upkeep rules, I'd probably settle for giving all characters 2-3 Hit Dice of natural healing per day at first level, but have that number scale independently of the character's Hit Dice for hit points. It's aesthetically messy design that works rather well on throughput.
On the magical healing front, Stands-in-Fire has better-developed thoughts than I do. I'll try to sum up, and he can elaborate in comments if he likes. Healing is not presented as very interesting gameplay, because there are not many options to weigh against one another once it's clear that some healing needs to happen. I wish D&D Next had retained the healing word spell - initially, cure wounds spells were touch-range and standard-action but more effective, while healing word (there were no higher-level versions released at that time) took a minor action to cast and had a 50-foot range, but was, on average, a third as effective (1d8+4 vs 1d6). It's not the world's most complicated choice, but it does give the healer a reason to move around the battlefield, while also having an alternative if that's not an option.
The other problem that particularly needs to be solved is that, in the case of a dungeon crawl where the PCs determine their own pace, the burden will consistently fall upon the cleric to keep the party patched up and continuing. Thus far I've addressed this in Aurikesh by not presenting adventures in which the party can choose whatever pace they like. This doesn't mean that the PCs never run out of healing, as happened in the last session's big fight, but the party wasn't choosing between continuing to the next encounter or not. I'm not sure that this distinction meant much to them at the time, though, and I know the party's cleric would have been happier with a few more spell slots. As far as that goes, though, characters are going to have some kind of limit.
First off, a few ideas on making healing into more sophisticated tactical gameplay. Introducing a second progression of healing spells at each spell level, operating on different parameters, would be a good start. These could be more powerful spells that have drawbacks compared to the cure wounds spells, or smaller amounts of healing with side benefits, or any other configuration. Personally I find the structure of cure wounds spells sufficiently plain that I'd replace them with something more interesting in addition to adding in the alternative. (I have this complaint about a lot of spells in D&D Next. Just don't pile on the drawbacks, because then you wind up with every spell piquing the players' interest only to disappoint them.)
In the current packet, clerics do have another source of healing that is separate from their spellcasting, in the form of Channel Divinity. (Not all clerics get healing as a channeling option.) It does still expend the character's action (side note: D&D Next's action economy may or may not be good design, but it is a grammatical nightmare to be sufficiently specific). The healing throughput here is such that a party might be disappointed with a cleric who didn't take Channel Positive Energy. I'd like to experiment with a broader base of healing that doesn't compete for space in the cleric's spellcasting choices. It's a liberation-through-restriction principle.
This next idea is one possible implementation of something Stands-in-Fire has suggested. As a starting point, I'd try giving magical healing classes (2d8 + 1d8/class level) healing that they can distribute per day. Up to 2d8 can be channeled as word of power, while any number of dice of healing may be channeled to a target as a standard action. There are some number of effects they can use (as per-day abilities), preferably requiring an attack roll against an enemy in actual (not sparring) combat, that refresh one or more dice in this pool. If the healer really needs to continue beyond this point, I would be in favor of allowing empathic healing out to the limit of the cleric's hit points. Because of how healing up from negative numbers works, though, empathic healing into negative hit points would be an endless-healing exploit.
For healers that I want to theme some other way, such as artificers, bards, warlords, and everything else that the Wombat Warlord wants to play, giving them the per-encounter or per-day ability to let allies spend Hit Dice during combat, presumably with some kind of additional bonus. A very limited ability to refresh allies' Hit Dice would not be infeasible; I would particularly consider this for druid-only healing effects, because I'm picturing something like consuming the heart of a slain foe or a beast of particular potency as part of the effect. I've also posted healing-focused Specialties in the past, with an eye toward allowing the party to share around the healing burden. These have been reasonably popular in Aurikesh so far; of the thirteen characters in the game, six of them have taken one of my home-brewed healing Specialties.
I do think it strange that rogues and clerics can be good at weapon-based combat, anyone could be good at stealth, and clerics can be good at blasting things with magic... but the Heal skill isn't worth a damn (never has been, aside from 4e's Heal rituals) and the healing Specialty is barely better, so no class other than the cleric can heal with any competence. Mearls does explicitly state that druids and paladins (interesting move there, and one I welcome if there's going to be a paladin class at all) can match clerical healing, if they wish. I like the variety and parity of Leader classes in 4e, and if they're going for many-classes rather than very-few-classes, I would welcome the return of the ardent, artificer, bard-what-does-healing, runepriest, shaman, and warlord. Maybe we'd even see other classes gain healing as an internal build option, such as invokers?