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Message: <blockquote data-quote="GreyICE" data-source="post: 6004924" data-attributes="member: 6684526">I've suggested this before, because I've used it successfully:  Introduce a Fatigue system, and use endurance roles after a player uses Healing Surges (and possibly Daily powers) to determine the fatigue buildup.  The fatigue buildup should reduce the maximum healing surges.It allows you to limit healing without directly attacking the core mechanics of 4E, the results of which can be... unsatisfying.  There are a lot of mechanics you can tinker with in 4E, but the healing surge mechanic is so very central to the entire equation that things start to become ugly if you tinker too hard. As a side note, eliminating Second Wind has very minimal effects, except for Dwarves and Wardens (both of which should get it back, Dwarves as a Minor Action, Wardens as usual, because without it they're both terrible choices).  Second Wind is rarely a good use of your time and effort in 4E.  My suggestion would be:1) Eliminate Second Wind, except as above (Dwarves and Wardens)2) Restrict out of combat healing to 1 surge+bloodied level (aka 3/4ths of HP) (this chosen because otherwise players could choose to 'lockdown' a single minion to get someone back on their feet with what they have during combat, and also entering combat with 6 HP is no fun).  Optionally allow them to spend 1 surge to reach this level, because they'll definitely be hurting.3) Eliminate Leaders as a choice.  Eliminate Paladins as a choice.  4) Restrict all powers that say "spend a surge" to 1 per character5) Introduce fatigue - for every 2 surges they spend, they take 1 point of fatigue.  Fatigue should heal slowly, and your plot should force them to enter combat quickly - we're talking maybe 3 days to a week to heal 1 point and a plot that forces them into combat regularly.  I'd also suggest keeping combats as EL+0 or even EL-1 for all but the biggest of fights - deprived of their healing surges and subject to multiple brutal 4E combats (EL+3 or EL+4), most parties will simply fold unless they're full of vicious optimizers.</blockquote>

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