Healing. Keeping the group alive.

The trick to making healing work isn't just having one character keep the other characters alive, it is making it work so that it doesn't kill your gaming group because the person playing the healer couldn't be bothered showing up. After all, this was the player who got most the blame when things went bad and none of the glory when  they went well.

For people not familiar with it here is a quick summary of how healing works in 4E.

Each character has a number of healing surges based in their class.
Each character has a number of hit points, and a surge value equal to one quarter of their hit points.
Each character can use an action to spend a healing surge and regain their surge value in hit points. This can be done once per encounter and recharges after a 5 minute rest. So with a long enough break a character could make themselves ready for battle again.
Healing characters can take actions to allow themselves or an ally to spend extra healing surges beyond the one they can do themselves, generally giving bonus hit points back. These are generally actions the healer can take in addition to their main action.

This had several significant improvements over all previous healing systems.

It put the onus on maintaining healing resources onto the person taking the damage. A fighter or barbarian would have more surges, so could take more damage during a day. A rogue or wizard would have less, which would mean they would need to be more careful.

This was important because in previous editions the person playing recklessly wasn't the one paying for that recklessness. They would take lots of damage, keeping the person playing the healer doing nothing but keeping them alive, until the healer ran out of spells and then it was the healer who was responsible for needing to take the break or letting someone die. The reckless player was rewarded by hogging all the glory while the other players struggled to keep them alive.

In 4E if a player does that they run themselves out of surges, and they are the ones who can't continue. The healer could heal them if they hadn't wasted their own endurance. It was a simple mechanic for having someone who has taken too much damage to just be worn out.

The hit point system was always an abstraction. It wasn't realistic even within a fantasy setting, it was just a mechanic for tracking if someone was alive or dead and allow them to engage in battle and not fall down to the first hit. Healing Surges brought a level of storytelling that worked, because it was a system used in action movies since the action serials of the late 40s. The hero takes damage, shrugs it off before the next encounter, and eventually has taken so much damage they need to recuperate. Excellent storytelling.

The other important thing 4E brought to the gaming table was classes who healed not being limited mostly to only healing. Cleric, warlords, bards and the other healing classes were all very different, because in addition to healing they got to do other things. They didn't just run in to heal and maybe cast a buff at the start of a fight like in previous editions. They would hinder enemies, assist allies, provide direction and even get to do some damage to their foes, all while keeping the party alive. They became a utility rather than a single use gimmick.

No longer was a player sacrificing themselves by agreeing to play a class that could heal. All of a sudden they were able to contribute in other ways, and they got to have a lot of fun. When someone ran themselves out of healing surges, they were blamed for not having enough healing, they weren't made to feel responsible for another players actions.

Healing Surges also worked because the use of potions generally required the person to spend a surge. This meant you couldn't overcome recklessness with gold or DM bribery. In 4E a character could be reckless when the story called for it, and had to be careful at other times. In previous editions this character trait never had to be tempered by caution, and it became repetitive and boring very quickly.

Healing is required in a fantasy game like D&D, so much that pretty much all gaming systems of all genres use it. If you have combat, you need a way for your character to recover from that combat. For too long Healing was something that someone had to volunteer to do at the expense of getting involved. 4E fixed this, and gamers everywhere need to hope that D&D Next doesn't return us to the days where someone at the table needs to have less fun in order to make the hit point mechanic work.