Balesir
Adventurer
Very early in our play of 4E, one of the players in the game I'm running made a very perceptive comment. They said (words to the effect of - it was a while back): "Oh, my real hit points aren't what is listed as "hit points" here on the sheet - they are all my surges thrown in, as well!".The healing surge thing is bad when you have a Solo fight and you are new to the system and you aren't really maxed out or anything, and then the guy goes... OH! I GET ALL MY HIT POINTS BACK! You spent 1 hour fighting for no consequence because the players knew to make their healing surges really count, so everybody is at full health and the only thing that happened was everybody blew a bunch of healing surges.
Actually, the rate at which you can "cycle" HSs in combat can be critical, too, but at the same time this is true in a "strategic" sense. By spending surges, you are not making it so that "nothing happened" - you have lost some of your ultimate store of hit points...
If you really need a gritty, slow recovery feel to your 4E game, try a simple houserule: characters recover only (1+CON Mod) healing surges with an Extended Rest. This will have the downside of encouraging "15 minute workdays" - which is why I don't use it - but it will also make surges a more obviously valuable resource.