SHARK
First Post
I think most of the problem is terminology. Most of the argument comes because they are called Hit Points, Damage and Healing Surges.
In D&D combat there are only two states Combat Effective and Not-So. If you have "Hit Points" left you are combat effective. That swing from your sword can do damage to your opponent when you have 40 hit points or 1. However, when you drop to 0 you are no longer combat effective. You can't even swing the sword.
Damage is also "esoteric" in the sense that not every "hit" is really a hit. Some times you are losing "Hit Points" because you are winded, you got lucky and the"hit" was not solid, etc.
Long Term injuries (broken bones, torn ligaments, etc.) have never been a part of D&D. D&D has never had a "death spiral" mechanic either, where your combat effectiveness gets worse as you lose hit points. If you fell of a high cliff and only took half your hit points in "damage" you were still as combat effective as if you had not fallen down.
So the only sticking point about this is about "long term" recovery. 4e does not provide a mechanic for "long term injury" recovery without house ruling it. When I see some of the complaints, they seem to boil down to that point. However, the previous edition did not provide for that either. The default assumption of the game provided for magic to "heal" to be prevalent at almost any level. So if you wanted to model "long term injury" recovery you had to house rule it too.
Me, I'm having a great time playing and DMing and worrying about this particular aspect is handled the same way I did before. If I want long term injuries I house rule them.
Greetings!
*Exactly*

"Fine. We're done here in this castle/dungeon/lair/wilderness for now. We go back to town or city, get as much necessary healing as we can, and hang out recuperating at the Tavern/Temple/Barracks/Castle. When everyone is healed up and ready for action, we'll go back to wherever we need to go."
They either did that, or any wounds were taken care of within an hour or a few at most of *in-game* time between magic/herbs/skills and rest. If they could move on after an hour or so, they did. If not, they would camp and fortify, and sleep/regen for the next day, then proceed with the mission.
I guess I'm not seeing it. It all takes but a few minutes of *real time* and whatever is needed is figured out. Bottom line is, the players want to be up and going after the mission. How much of *game time* that may or may not take isn't especially important, is it?
(1) Either you're fully healed and ready to go in moments;
(2) Either you're fully healed and ready to go in 1-3 hours;
(3) Either you're fully healed and ready to go over an 8-hour rest/sleep period;
(4) Either you're fully healed and ready to go after healing/resting for a few days;
(5) Either you're fully healed and ready to go after recuperating for days/weeks/months
With any of these, isn't it all just abstracted in a few minutes of discussion and notes, one way or the other, so that in 10 minutes of *real time* you guys are back in the saddle pursuing the adventure?
Semper Fidelis,
SHARK