D&D (2024) The Problem with Healing Powercreep

Daztur

Hero
The Problem with Healing Powercreep

I just went and crunched some numbers so see how healing stacks up across the different editions. For all of the different editions I’m assuming 4 PCs of the classic four classes (fighting-man/fighter, cleric, thief/rogue, and magic-user/wizard). To try to make my comparisons at fair as possible, I’ve assumed that all Clerics have 16 Wisdom and spend all available spell slots on healing and that all PCs have 14 Constitution. In order to not have this take all day I’ve only crunched the numbers out to 5th level as that was enough to see some really stark differences emerge. In all cases the clerics DO NOT take healing/life domains and I’m assuming two short rests for 5.*e.

Some differences between editions are not being captured by this analysis, such as lot of old school characters having lower stats and how easy it was to make CLW wands in 3.*e but I think I’m getting the big picture here.

If you want to see my work, look down to the first reply to this thread as I didn’t want to gum up this post with a wall of numbers.

Here’s what I got for how much healing the party can pump out in one adventuring day as a percentage of total HPs across the first five levels:

0e

1st 0%
2nd 17.65%
3rd 23.38%
4th 18%
5th 14.4%

1e/2e (I couldn’t find any differences between the two)
1st 83.38%
2nd 56.25%
3rd 37.5%
4th 35.16%
5th 28.13%

3.0e/3.5e (I couldn’t find any differences between the two)

1st 38.89%
2nd 39.17%
3rd 60.12%
4th 72.22%
5th 92.42%

4e
Very approximately 250% across the board. See below for a more in-depth discussion of 4e healing and why it is hard to make apples to apples comparison of 4e healing vs. healing in other editions.

5e
1st 151%
2nd 149.97%
3rd 171.20%
4th 168.22%
5th 182.67%

5.5e
1st 190%
2nd 178.79%
3rd 219.57%
4th 214.41%
5th 247.20%

The Power Creep

We can see some pretty big differences in healing capacity across editions. 0e clerics just aren’t capable of pumping out much healing. Our 1/2e cleric did a lot better due to getting bonus spells for high Wisdom but then falls off badly as there are no 2nd and 3rd level healing spells in core 1e/2e. Meanwhile 3.*e clerics start off a bit behind due to 1st level PCs having max HPs and the changes to bonus spells for high Wisdom but then go quadratic. By 5th level 3.*e clerics are already capable of pumping out vast amounts of healing and they’re just starting to go quadratic at that point and the ratio of party HPs vs. clerical healing just gets absolutely nuts at higher levels in 3.*ed. This doesn’t come as a big surprise as everything goes nuts at higher levels in 3.*e.

Then we come to 4e, 4e is really hard to compare to other editions due to how Healing Surges work. The main upshot here is that 4e PCs don’t need a cleric in the same way that 3.*e PCs are absolutely and completely dependent on some form of magical healing. 4e Clerics can squeeze a bit more healing out of Healing Surges and do some very minor healing that doesn’t cost healing surges, but in 4e healing is pretty closely linked to Healing Surges that scale VERY tightly with HP. The other thing to note about 4e is just how MUCH the party can now heal, while the 3.*e cleric eventually goes quadratic enough to equal the entire output of a 4e party’s Healing Surges this takes a while and requires the cleric to sacrifice all of their non-Domain spells, while a 4e party can spend their Healing Surges with far FAR less in the way of opportunity costs.

Then, like with a lot of things, 5e is a messy compromise. You have a heavily nerfed version of Healing Surges in Hit Dice that are in addition to not instead of magical healing, but 5e healing spell scaling isn’t as nuts as in 3.*e which makes downtime magical healing very good to have but not utterly essential in the way it is in 3.*e. Also, it’s interesting to note that if you get two short rests, Second Wind can account for an absolutely massive amount of healing at level 1, although it does fall off to relative irrelevance later on. Still, while not being as potent as 4e healing, 5e healing is comfortably more generous than lower level 3.*e healing and you can do more of it before you start blowing your spell slots. However, a lot of 5e healing is gated behind Short Rests in a way that older edition healing isn’t.

5.5e provides a mild buff to Second Wind (while giving it other uses that make it unlikely to be used much for healing beyond the first few levels) and a big buff to Cure Wounds (you literally roll twice as many dice now). Due to this buff, a 5.5e party is quite a lot better at healing than any non-4e party and if we continue to look at how the numbers scale beyond 5th level you’ll find that the 5.5e party can soon crank out healings the like of which D&D has never seen before.

And this is a bad thing.

Out of the Newbie Trap and Into the Fire

I’ve seen some people complaining that the buffs to Cure Wounds in 5.5e makes fights too easy, but I don’t think that’s the real problem. In every edition except 4e, healing in combat was generally a sucker’s bet as you’d save more HPs by using your spell slots to kill the enemies faster. Again and again in non-4e D&D I’ve seen newbie clerics spend a lot of time healing in combat and then end up feeling bored and/or weak. Giving in-combat healing a nice fat buff to make it not be a newbie trap anymore is just good design.

The problem with the 5.5e power creep to healing is the enormous amount of downtime healing that 5.5e parties can now crank out. With 5.5e clerics now incentivized to spend more spell slots on Cure Wounds, they start off strong and then shoot through the freaking moon at higher tiers of play, increasing much faster than total party HPs. This means that if you want to attrition down a D&D party across a serious of fights, it’ll take longer than in 5e. For me, the single biggest problem I had with 5e was that attrition took too damn long and now it’s significantly worse.

So Who’s Going to Play the Cleric This Time?

One problem that a lot of people had with 3.*e was that parties NEEDED magical healing which meant that if someone wasn’t cranking out fistfuls CLW wands (which was really bad for the game as it basically took HP attrition off the table completely) you NEEDED a cleric or another similar dedicated healer. This lead to people feeling pressured into playing a class they wouldn’t have chosen otherwise and WotC raining down buffs on divine classes to make them more attractive (the infamous CoDzilla).

MEDIC!

This also meant that if your PC was a cleric in 3.*e you’d be under a good deal of pressure to spend a chunk of your spell slots on healing, even if that wasn’t what you really wanted for your character. This results in your having less chances to spend your slots on more fun spells like my beloved Command. 4e deep-sixed this dynamic for the most part and in 5e healing spells are more an emergency back-up than the cleric’s main job. But 5.5e’s buff to Cure Wounds is going to put more pressure on clerics to focus on healing, especially if monster damage gets cranked up to compensate for the overall powercreep we’re seeing in 5.5e.

There Are No Clerics on the Oregon Trail

My preferred play-style of D&D is exploration-based survival gaming. It’s all about the players slowly getting deeper and deeper into a dangerous area while their resources are slowly drained by environmental obstacles and small skirmishes until finally things start to get desperate and the party has to retreat to safety. The genius (to me) of this approach is that none of the individual encounters have to be all that life-threatening for the PCs to feel like they’re in constant danger. Even a minor skirmish with some goblins that costs the party 10 HPs can get their hearts pounding as those 10 HPs are not coming back and every HP lost brings the party that much closer to death.

You can still approach things in this way in 5e but it’s harder. Due to what big bags of HPs a lot of 5e monsters are, it’s a lot harder to run a serious of short skirmishes which was my bread and butter with TSR-D&D and 5e players have so many more resources than TSR-D&D PCs that the whole process of grinding them down until they’re out of spells and HPs and running in panic out of the dungeon just takes a lot longer and can dampen the fun of the kind of campaign I like best.

5.5e’s buff to healing just makes this worse. Downtime healing is now so generous that it’ll take even longer to grind down a party. Small skirmishes to with a few goblins that costs the party a few HPs stop being anything but a boring timewaster when the party can crank out big fat gobs of healing. Of course you can crank up the difficulty by adding nastier monsters in 5.5e, but that runs the risk of making combat take longer (already a big problem for me in 5e) and if you start upping the damage monsters are doing to compensate for how much clerics can heal now then you can end up screwing over parties that don’t have a cleric, which brings us back to the “So Who’s Going to Play a Cleric This Time?” problem.

The Illusion of Difficulty

As I said upthread, if the PCs suck at healing then even a five minute skirmish can be exciting as it costs previous HPs that are not coming back. But if the party has big gobs of healing than short easy fights become boring and pointless. That means that the more downtime healing you give PCs the more each fight has to MATTER and be difficult in and of itself (rather than mattering because it’s a step on the short road to being tapped out). One problem with this is that fights that matter generally take a long time and I prefer short fights. And also if you make EVERY fight be a real challenge to the PCs then you have a few choices:

A. Run fewer fights. A higher percentage of fights can be epic show-downs if there aren’t many fights. The problem with this is that 5.*e’s wheels fall off if there are few fights per adventuring day. Having the PCs nova most every fight causes a lot of issues and explodes any pretense of balance.

B. Kill a lot of PCs. If death is at least potentially on the line in most every fight then you’re going to have a lot of dead PCs. Most DMs don’t want that. I certainly don’t.

C. Fake the difficulty. A fight can look evenly matched in a lot of ways but if one side is MUCH better than healing than the other (especially healing KOed people) then the decision is never going to be in much doubt. Alternatively the DM can just fudge.

I don’t think any of these are good solutions but this seems like the corner that 5.5e is backing DMs into. Luckily there’s a pretty simple solution.

Bring Back Healing Surges

So how to make healing useful in combat without making attrition take all day? Simple: take a page from 4e and have basically all healing cost Hit Dice. That way you can have a cleric give out big stonking heals during a fight without letting the well of healing that a party can draw on across an adventuring day get too deep. Healing Surges got a bad rap because there were just too many of them, but the basic idea of putting a hard cap on healing was pure genius and this is coming from someone who REALLY didn’t like 4e as an edition of D&D.

Having Cure Wounds heal a big bucket of HPs is still workable if is eats Hit Dice as PCs will soon run out of Hit Dice if the Cleric is healing left and right, but it still lets the Cleric feel like a Big Damn Hero for healing a big stack of HP with one action while not locking them into being a walking Band-Aid.

There are a couple different ways to implement this and most any of them would fix the basic issue as long as they fix the basic problem of reigning in the excessive healing powercreep that 5.5e has.
 

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Daztur

Hero
Too Many Numbers

0e

Hit points: fighting-men get 1d6+1 HPs at first level, 2d6 at second level 3d6 at third level, 4d6 at fourth level, and 5d6+1 at 5th level, clerics and magic-users gain HPs slightly slower. Thieves aren’t core so we’ll throw in a second fighting man. 14 Con isn’t enough to give anyone bonus HPs in 0e.

Healing: clerics get no spells at 1st level, but the first level spell Cure Light Wounds heals 1d6+1. There are no second level healing spells. So…

1st Level HPs: 4d6+2 (16) Healing: 0 Healing as % of HPs: 0%

2nd Level HPs: 7d6+1 (25.5) Healing 1d6+1 (4.5) Healing as % of HPs: 17.65%

3rd Level HPs: 11d6 (38.5) Healing 2d6+2 (9) Healing as % of HPs: 23.38%

4th Level HPs: 14d6+1 (50) Healing 2d6+2 (9) Healing as % of HPs: 18%

5th Level HPs: 17d6+3 (62.5) Healing 2d6+2 (9) Healing as % of HPs: 14.4%

1e/2e

1e gives us both more HPs and more healing. 14 Con still isn’t enough to give anyone bonus HPs but clerics get 1d8 HPs, Fighters 1d10, Magic-users 1d4, and Thieves 1d6. Our cleric’s 16 Wisdom is enough to give them two extra 1st level spells and two extra 2nd level spells.

For healing, we get Cure Light Wounds at 1st level (for 1d8 healing) but there are no 2nd or 3rd level healing spells (Cure Serious wounds in a 4th level spell):

1st Level HPs: 1d8+1d10+1d4+1d6 (16) Healing: 3d8 (13.5) Healing as % of HPs: 84.38%

2nd Level HPs: 2d8+2d10+2d4+2d6 (32) Healing: 4d8 (18) Healing as % of HPs: 56.25%

3rd Level HPs: 3d8+3d10+3d4+3d6 (48) Healing: 4d8 (18) Healing as % of HPs: 37.5%

4th Level HPs: 4d8+4d10+4d4+4d6 (64) Healing: 5d8 (22.5) Healing as % of HPs: 35.16%

5th Level HPs: 5d8+5d10+5d4+5d6 (80) Healing: 5d8 (22.5) Healing as % of HPs: 28.13%

So in 1e, healing starts out as quite important at level 1 (mostly because our 16 Wis cleric gets two bonus first level spells) and then drops off quickly after that. Still, healing is much more important than in 0e.

3.*e

For the first time everyone having 14 Con actually gives them more HPs. +2 HPs per level for everyone on top of max HPs at 1st level. Our cleric’s 16 Wisdom gives us a bonus 1st, 2nd, and 3rd level spell. To keep things simple our cleric won’t take the healing domain but now instead of getting no healing at level 1-5 except Cure Light Wounds (which now does 1d8+caster level healing), we also get Cure Moderate Wounds (2d8+caster level) and Cure Serious Wounds (2d8+caster level). Those caster levels are capped but those caps don’t matter here. Although it doesn’t matter much, clerics also get a healing cantrip that heals 1 HP, but cantrips aren’t at-will in 3.0e.

1st Level HPs: 36 (36) Healing: 2d8+5 (14) Healing as % of HPs: 38.89%

2nd Level HPs: 1d8+1d10+1d4+1d6+44 (60) Healing: 3d8+10 (23.5) Healing as % of HPs: 39.17%

3rd Level HPs: 2d8+2d10+2d4+2d6+52 (84) Healing: 7d8+19 (50.5) Healing as % of HPs: 60.12%

4th Level HPs: 3d8+3d10+3d4+3d6+60 (108) Healing: 10d8+33 (78) Healing as % of HPs: 72.22%

5th Level HPs: 4d8+4d10+4d4+4d6+68 (132) Healing: 16d8+50 (122) Healing as % of HPs: 92.42%

So in 3.0ed we get linear HPs, quadratic cleric for the first time. As you can see the amount of healing a cleric can pump out relative to total party HPs starts fairly low but rises each level. It would rise quite a bit faster if we had this cleric take the healing domain. One of the things that really pumps up our cleric’s healing is the bonus spells for high Wisdom but going beyond 5th level our cleric won’t need that boost anymore in order to start cranking out massive amounts of healing relative to party HPs.

4e

Things work quite differently in 4e. Healing tends to cost healing surges which heal 1/4 of your maximum HPs. Different classes get different numbers of healing surges plus your Con mod.

Since all of our characters have 14 Con that means that our cleric can heal 225% of their HPs, the fighter 275% of their HPs, and the rogue and wizard 200% of their HPs. There are a few powers that add to his healing for example clerics can use Healing Word twice per encounter which lets someone spend a Healing Surge + 1d6 (scaling at higher levels), Beacon of Hope gives the Cleric and nearby allies 5 HPs and boosts subsequent clerical healing by 5 for the rest of the encounter, Consecrated Ground gives a mild AoE regen effect, while the fighter’s Boundless Endurance gives a self-only regen power. However, none of these effects really add up to big numbers and they’re so situational that it’s hard to nail down a hard number for the amount of healing that a 4e party will put out.

But 250% of total party HPs seems like a good ballpark figure for a party in which everyone has 14 Con. Also note that the 4e party has to pay a lot less in terms of opportunity cost in order to do this as healing surges can only be spent on healing while spell slots spent on healing spells aren’t being used to cast other useful spells so in actual play the 4e party is going to be pumping out MUCH MUCH more healing than the 3e party, especially at lower levels.

5e

Things go back to something similar to the 3.5e baseline with a few changes: wizards and rogues get more HPs, no healing cantrips, no bonus spells for high wisdom, bonuses to curing spells are based on wisdom mod not caster level, fighters get second wind, and everyone gets Hit Dice. To keep things simple we’ll get everyone’s constitution at 14 and the cleric’s wisdom at 16 and we won’t take the life domain which would boost healing. We’ll assume that the party gets two short rests so the fighter can use Second Wind three times.

1st Level HPs: 36 (40) Healing: 4d8+4d10+1d6+17 (60.5) Healing as % of HPs: 151%

2nd Level HPs: 2d8+1d10+1d6+48 (66) Healing: 7d8+5d10+2d6+31 (97) Healing as % of HPs: 146.97%

3rd Level HPs: 4d8+2d10+2d6+56 (92) Healing: 14d8+6d10+3d6+51 (157.5) Healing as % of HPs: 171.20%

4th Level HPs: 6d8+3d10+3d6+64 (118) Healing: 8d8+4d10+4d6+32 (198.5) Healing as % of HPs: 168.22%

5th Level HPs: 8d8+4d10+4d6+72 (143) Healing: 26d8+8d10+5d6+82 (260.5) Healing as % of HPs: 182.67%

Interestingly, due to the lack of bonus spells due to wisdom and 5e clerics not adding caster level to healing, 5e clerics are actually slightly worse at healing than 3e clerics but with the addition of Second Wind and (especially) Hit Dice the 5e party blows the 3e party out of the water in terms of potential healing, although they need short rests to tap into their healing reserves while the 3e party can spam cure spells quickly out of combat.

Due to so much of the healing coming from hit dice, second wind slowly dropping off in its relative power, and 5e clerics not being quite as quadratic as 3e clerics the scaling is a lot smoother, but as the levels rise the party becomes capable to putting out a quite enormous amount of healing relative to their total HPs.

5.5e

Unless I’m missing something there are two changes we have to consider:

-Second wind can now be used proficiency times per day and one use gets restored each short rest. That means that if we assume two short rests then our fighter can use second wind a maximum of four times at levels 1-4 and five times at level 5.
-All the Cure Wounds dice get doubled. Unlike the 5e cleric, the 5.5e cleric is clearly better at healing.

1st Level HPs: 36 (40) Healing: 6d8+5d10+1d6+17 (76) Healing as % of HPs: 190%

2nd Level HPs: 2d8+1d10+1d6+48 (66) Healing: 10d8+6d10+2d6+31 (118) Healing as % of HPs: 178.79%

3rd Level HPs: 4d8+2d10+2d6+56 (92) Healing: 22d8+7d10+3d6+51 (202) Healing as % of HPs: 219.57%

4th Level HPs: 6d8+3d10+3d6+64 (118) Healing: 28d8+7d10+4d6+65 (253) Healing as % of HPs: 214.41%

5th Level HPs: 8d8+4d10+4d6+72 (143) Healing: 42d8+10d10+5d6+82 (353.5) Healing as % of HPs: 247.20%
 

mellored

Legend
4e

Things work quite differently in 4e. Healing tends to cost healing surges which heal 1/4 of your maximum HPs.
Any PC could freely use healing surges out of combat. So really, i would consider them as an extension of the HP pool, not as "healing".

Thus 4e cleric is only adding 1d6 * 10 surges = 10d6 = 35 HP of actual healing.
Also, since 4e went to level 30, I would say they scaled to 2d6 (70 healing) at level 4.


Similarly, I would also include hit dice as part of the 5e HP pool, not as healing.


That said. I do think it's a better system. IMO 5e should look something like...

Healing Word: bonus action
Target can expended a hit dice and gains extra hit points equal to your casting modifier. If they don't have any hit dice they gain advantage on their next death save.

Cure Wounds: action
The target gains hit points equal to your casting modifier. They can also expended a hit die and maximize the roll.

Divine Protection: action
Target gains 2d8+mod temporary hit points.
 

Stormonu

NeoGrognard
It's certainly a matter of preference. When I first started 5E it felt like healing spells were just awful. Until I grokked how Hit Dice work.

Current 5E has plenty of healing and you don't have to rely on the "traditional four", nor does someone who plays a Cleric have to frontload Cure spells and sit on their hands not getting to do anything else other than run around as a field medic. It can get really silly if the group picks up something outside of the traditional four - say a Paladin instead of a Fighter, or Bard instead of Rogue, or a Favored Soul Sorcerer.

I think 5.5 is trying to compensate for that "feel bad" use of in-combat spells (and I think it's a big mistake) as you mentioned but I DO NOT want to move to healing surges. Unfortunately, I don't have a real good answer other than getting players to be more aware early on for how much healing is available in the game already, and give the DM some tools for how to properly handle the ebb and flow of danger without making it either too easy or too difficult.
 

MarkB

Legend
One thing missing here is magic items. Back in the 3.5e days, we wouldn't leave home without at least one fully-charged Wand of Cure Light Wounds, and we'd expect to burn through it, maybe even multiple wands, during the course of any even modestly-sized dungeon. Downtime healing was quite simply however much the party could afford, and generally speaking they could afford a lot.
 

tetrasodium

Legend
Supporter
Epic
One thing missing here is magic items. Back in the 3.5e days, we wouldn't leave home without at least one fully-charged Wand of Cure Light Wounds, and we'd expect to burn through it, maybe even multiple wands, during the course of any even modestly-sized dungeon. Downtime healing was quite simply however much the party could afford, and generally speaking they could afford a lot.
That has a degree of "but we need to o be careful and Bob you must stop acting like Leroy Jenkins" to it though. Sure those CLW wands were reasonably affordable as levels went on, but reckless overuse would eat into funds that could otherwise be going towards better gear and various powerful consumables. Since the system math expected that you had that better gear and assortment of consumables Bob's reckless behavior was a double penalty of incentives to shape up as falling behind the curve meant needing to buy/use more of those CLW wands anyways until eventually the good suck.fot to be so dramatic that Bob was born longer able to continue pretending his recklessness was anywhere near acceptable.
 

MarkB

Legend
That has a degree of "but we need to o be careful and Bob you must stop acting like Leroy Jenkins" to it though. Sure those CLW wands were reasonably affordable as levels went on, but reckless overuse would eat into funds that could otherwise be going towards better gear and various powerful consumables. Since the system math expected that you had that better gear and assortment of consumables Bob's reckless behavior was a double penalty of incentives to shape up as falling behind the curve meant needing to buy/use more of those CLW wands anyways until eventually the good suck.fot to be so dramatic that Bob was born longer able to continue pretending his recklessness was anywhere near acceptable.
Except that with linear hit points and exponential treasure rewards, that cost became less and less significant as you gained levels.

In any case, this was just to point out that, for earlier editions, looking only to the healing available through the casters' own spell slots did not tell the whole story.
 

clearstream

(He, Him)
The Problem with Healing Powercreep

I just went and crunched some numbers so see how healing stacks up across the different editions. For all of the different editions I’m assuming 4 PCs of the classic four classes (fighting-man/fighter, cleric, thief/rogue, and magic-user/wizard). To try to make my comparisons at fair as possible, I’ve assumed that all Clerics have 16 Wisdom and spend all available spell slots on healing and that all PCs have 14 Constitution. In order to not have this take all day I’ve only crunched the numbers out to 5th level as that was enough to see some really stark differences emerge. In all cases the clerics DO NOT take healing/life domains and I’m assuming two short rests for 5.*e.

Some differences between editions are not being captured by this analysis, such as lot of old school characters having lower stats and how easy it was to make CLW wands in 3.*e but I think I’m getting the big picture here.

If you want to see my work, look down to the first reply to this thread as I didn’t want to gum up this post with a wall of numbers.

Here’s what I got for how much healing the party can pump out in one adventuring day as a percentage of total HPs across the first five levels:

0e

1st 0%
2nd 17.65%
3rd 23.38%
4th 18%
5th 14.4%

1e/2e (I couldn’t find any differences between the two)
1st 83.38%
2nd 56.25%
3rd 37.5%
4th 35.16%
5th 28.13%

3.0e/3.5e (I couldn’t find any differences between the two)

1st 38.89%
2nd 39.17%
3rd 60.12%
4th 72.22%
5th 92.42%

4e
Very approximately 250% across the board. See below for a more in-depth discussion of 4e healing and why it is hard to make apples to apples comparison of 4e healing vs. healing in other editions.

5e
1st 151%
2nd 149.97%
3rd 171.20%
4th 168.22%
5th 182.67%

5.5e
1st 190%
2nd 178.79%
3rd 219.57%
4th 214.41%
5th 247.20%

The Power Creep

We can see some pretty big differences in healing capacity across editions. 0e clerics just aren’t capable of pumping out much healing. Our 1/2e cleric did a lot better due to getting bonus spells for high Wisdom but then falls off badly as there are no 2nd and 3rd level healing spells in core 1e/2e. Meanwhile 3.*e clerics start off a bit behind due to 1st level PCs having max HPs and the changes to bonus spells for high Wisdom but then go quadratic. By 5th level 3.*e clerics are already capable of pumping out vast amounts of healing and they’re just starting to go quadratic at that point and the ratio of party HPs vs. clerical healing just gets absolutely nuts at higher levels in 3.*ed. This doesn’t come as a big surprise as everything goes nuts at higher levels in 3.*e.

Then we come to 4e, 4e is really hard to compare to other editions due to how Healing Surges work. The main upshot here is that 4e PCs don’t need a cleric in the same way that 3.*e PCs are absolutely and completely dependent on some form of magical healing. 4e Clerics can squeeze a bit more healing out of Healing Surges and do some very minor healing that doesn’t cost healing surges, but in 4e healing is pretty closely linked to Healing Surges that scale VERY tightly with HP. The other thing to note about 4e is just how MUCH the party can now heal, while the 3.*e cleric eventually goes quadratic enough to equal the entire output of a 4e party’s Healing Surges this takes a while and requires the cleric to sacrifice all of their non-Domain spells, while a 4e party can spend their Healing Surges with far FAR less in the way of opportunity costs.

Then, like with a lot of things, 5e is a messy compromise. You have a heavily nerfed version of Healing Surges in Hit Dice that are in addition to not instead of magical healing, but 5e healing spell scaling isn’t as nuts as in 3.*e which makes downtime magical healing very good to have but not utterly essential in the way it is in 3.*e. Also, it’s interesting to note that if you get two short rests, Second Wind can account for an absolutely massive amount of healing at level 1, although it does fall off to relative irrelevance later on. Still, while not being as potent as 4e healing, 5e healing is comfortably more generous than lower level 3.*e healing and you can do more of it before you start blowing your spell slots. However, a lot of 5e healing is gated behind Short Rests in a way that older edition healing isn’t.

5.5e provides a mild buff to Second Wind (while giving it other uses that make it unlikely to be used much for healing beyond the first few levels) and a big buff to Cure Wounds (you literally roll twice as many dice now). Due to this buff, a 5.5e party is quite a lot better at healing than any non-4e party and if we continue to look at how the numbers scale beyond 5th level you’ll find that the 5.5e party can soon crank out healings the like of which D&D has never seen before.

And this is a bad thing.

Out of the Newbie Trap and Into the Fire

I’ve seen some people complaining that the buffs to Cure Wounds in 5.5e makes fights too easy, but I don’t think that’s the real problem. In every edition except 4e, healing in combat was generally a sucker’s bet as you’d save more HPs by using your spell slots to kill the enemies faster. Again and again in non-4e D&D I’ve seen newbie clerics spend a lot of time healing in combat and then end up feeling bored and/or weak. Giving in-combat healing a nice fat buff to make it not be a newbie trap anymore is just good design.

The problem with the 5.5e power creep to healing is the enormous amount of downtime healing that 5.5e parties can now crank out. With 5.5e clerics now incentivized to spend more spell slots on Cure Wounds, they start off strong and then shoot through the freaking moon at higher tiers of play, increasing much faster than total party HPs. This means that if you want to attrition down a D&D party across a serious of fights, it’ll take longer than in 5e. For me, the single biggest problem I had with 5e was that attrition took too damn long and now it’s significantly worse.

So Who’s Going to Play the Cleric This Time?

One problem that a lot of people had with 3.*e was that parties NEEDED magical healing which meant that if someone wasn’t cranking out fistfuls CLW wands (which was really bad for the game as it basically took HP attrition off the table completely) you NEEDED a cleric or another similar dedicated healer. This lead to people feeling pressured into playing a class they wouldn’t have chosen otherwise and WotC raining down buffs on divine classes to make them more attractive (the infamous CoDzilla).

MEDIC!

This also meant that if your PC was a cleric in 3.*e you’d be under a good deal of pressure to spend a chunk of your spell slots on healing, even if that wasn’t what you really wanted for your character. This results in your having less chances to spend your slots on more fun spells like my beloved Command. 4e deep-sixed this dynamic for the most part and in 5e healing spells are more an emergency back-up than the cleric’s main job. But 5.5e’s buff to Cure Wounds is going to put more pressure on clerics to focus on healing, especially if monster damage gets cranked up to compensate for the overall powercreep we’re seeing in 5.5e.

There Are No Clerics on the Oregon Trail

My preferred play-style of D&D is exploration-based survival gaming. It’s all about the players slowly getting deeper and deeper into a dangerous area while their resources are slowly drained by environmental obstacles and small skirmishes until finally things start to get desperate and the party has to retreat to safety. The genius (to me) of this approach is that none of the individual encounters have to be all that life-threatening for the PCs to feel like they’re in constant danger. Even a minor skirmish with some goblins that costs the party 10 HPs can get their hearts pounding as those 10 HPs are not coming back and every HP lost brings the party that much closer to death.

You can still approach things in this way in 5e but it’s harder. Due to what big bags of HPs a lot of 5e monsters are, it’s a lot harder to run a serious of short skirmishes which was my bread and butter with TSR-D&D and 5e players have so many more resources than TSR-D&D PCs that the whole process of grinding them down until they’re out of spells and HPs and running in panic out of the dungeon just takes a lot longer and can dampen the fun of the kind of campaign I like best.

5.5e’s buff to healing just makes this worse. Downtime healing is now so generous that it’ll take even longer to grind down a party. Small skirmishes to with a few goblins that costs the party a few HPs stop being anything but a boring timewaster when the party can crank out big fat gobs of healing. Of course you can crank up the difficulty by adding nastier monsters in 5.5e, but that runs the risk of making combat take longer (already a big problem for me in 5e) and if you start upping the damage monsters are doing to compensate for how much clerics can heal now then you can end up screwing over parties that don’t have a cleric, which brings us back to the “So Who’s Going to Play a Cleric This Time?” problem.

The Illusion of Difficulty

As I said upthread, if the PCs suck at healing then even a five minute skirmish can be exciting as it costs previous HPs that are not coming back. But if the party has big gobs of healing than short easy fights become boring and pointless. That means that the more downtime healing you give PCs the more each fight has to MATTER and be difficult in and of itself (rather than mattering because it’s a step on the short road to being tapped out). One problem with this is that fights that matter generally take a long time and I prefer short fights. And also if you make EVERY fight be a real challenge to the PCs then you have a few choices:

A. Run fewer fights. A higher percentage of fights can be epic show-downs if there aren’t many fights. The problem with this is that 5.*e’s wheels fall off if there are few fights per adventuring day. Having the PCs nova most every fight causes a lot of issues and explodes any pretense of balance.

B. Kill a lot of PCs. If death is at least potentially on the line in most every fight then you’re going to have a lot of dead PCs. Most DMs don’t want that. I certainly don’t.

C. Fake the difficulty. A fight can look evenly matched in a lot of ways but if one side is MUCH better than healing than the other (especially healing KOed people) then the decision is never going to be in much doubt. Alternatively the DM can just fudge.

I don’t think any of these are good solutions but this seems like the corner that 5.5e is backing DMs into. Luckily there’s a pretty simple solution.

Bring Back Healing Surges

So how to make healing useful in combat without making attrition take all day? Simple: take a page from 4e and have basically all healing cost Hit Dice. That way you can have a cleric give out big stonking heals during a fight without letting the well of healing that a party can draw on across an adventuring day get too deep. Healing Surges got a bad rap because there were just too many of them, but the basic idea of putting a hard cap on healing was pure genius and this is coming from someone who REALLY didn’t like 4e as an edition of D&D.

Having Cure Wounds heal a big bucket of HPs is still workable if is eats Hit Dice as PCs will soon run out of Hit Dice if the Cleric is healing left and right, but it still lets the Cleric feel like a Big Damn Hero for healing a big stack of HP with one action while not locking them into being a walking Band-Aid.

There are a couple different ways to implement this and most any of them would fix the basic issue as long as they fix the basic problem of reigning in the excessive healing powercreep that 5.5e has.
Does the above take into account the full replenish with a long rest? And relatedly, have you considered removing that replenish?
 

clearstream

(He, Him)
The Problem with Healing Powercreep

I just went and crunched some numbers so see how healing stacks up across the different editions. For all of the different editions I’m assuming 4 PCs of the classic four classes (fighting-man/fighter, cleric, thief/rogue, and magic-user/wizard). To try to make my comparisons at fair as possible, I’ve assumed that all Clerics have 16 Wisdom and spend all available spell slots on healing and that all PCs have 14 Constitution. In order to not have this take all day I’ve only crunched the numbers out to 5th level as that was enough to see some really stark differences emerge. In all cases the clerics DO NOT take healing/life domains and I’m assuming two short rests for 5.*e.

Some differences between editions are not being captured by this analysis, such as lot of old school characters having lower stats and how easy it was to make CLW wands in 3.*e but I think I’m getting the big picture here.

If you want to see my work, look down to the first reply to this thread as I didn’t want to gum up this post with a wall of numbers.

Here’s what I got for how much healing the party can pump out in one adventuring day as a percentage of total HPs across the first five levels:

0e

1st 0%
2nd 17.65%
3rd 23.38%
4th 18%
5th 14.4%

1e/2e (I couldn’t find any differences between the two)
1st 83.38%
2nd 56.25%
3rd 37.5%
4th 35.16%
5th 28.13%

3.0e/3.5e (I couldn’t find any differences between the two)

1st 38.89%
2nd 39.17%
3rd 60.12%
4th 72.22%
5th 92.42%

4e
Very approximately 250% across the board. See below for a more in-depth discussion of 4e healing and why it is hard to make apples to apples comparison of 4e healing vs. healing in other editions.

5e
1st 151%
2nd 149.97%
3rd 171.20%
4th 168.22%
5th 182.67%

5.5e
1st 190%
2nd 178.79%
3rd 219.57%
4th 214.41%
5th 247.20%

The Power Creep

We can see some pretty big differences in healing capacity across editions. 0e clerics just aren’t capable of pumping out much healing. Our 1/2e cleric did a lot better due to getting bonus spells for high Wisdom but then falls off badly as there are no 2nd and 3rd level healing spells in core 1e/2e. Meanwhile 3.*e clerics start off a bit behind due to 1st level PCs having max HPs and the changes to bonus spells for high Wisdom but then go quadratic. By 5th level 3.*e clerics are already capable of pumping out vast amounts of healing and they’re just starting to go quadratic at that point and the ratio of party HPs vs. clerical healing just gets absolutely nuts at higher levels in 3.*ed. This doesn’t come as a big surprise as everything goes nuts at higher levels in 3.*e.

Then we come to 4e, 4e is really hard to compare to other editions due to how Healing Surges work. The main upshot here is that 4e PCs don’t need a cleric in the same way that 3.*e PCs are absolutely and completely dependent on some form of magical healing. 4e Clerics can squeeze a bit more healing out of Healing Surges and do some very minor healing that doesn’t cost healing surges, but in 4e healing is pretty closely linked to Healing Surges that scale VERY tightly with HP. The other thing to note about 4e is just how MUCH the party can now heal, while the 3.*e cleric eventually goes quadratic enough to equal the entire output of a 4e party’s Healing Surges this takes a while and requires the cleric to sacrifice all of their non-Domain spells, while a 4e party can spend their Healing Surges with far FAR less in the way of opportunity costs.

Then, like with a lot of things, 5e is a messy compromise. You have a heavily nerfed version of Healing Surges in Hit Dice that are in addition to not instead of magical healing, but 5e healing spell scaling isn’t as nuts as in 3.*e which makes downtime magical healing very good to have but not utterly essential in the way it is in 3.*e. Also, it’s interesting to note that if you get two short rests, Second Wind can account for an absolutely massive amount of healing at level 1, although it does fall off to relative irrelevance later on. Still, while not being as potent as 4e healing, 5e healing is comfortably more generous than lower level 3.*e healing and you can do more of it before you start blowing your spell slots. However, a lot of 5e healing is gated behind Short Rests in a way that older edition healing isn’t.

5.5e provides a mild buff to Second Wind (while giving it other uses that make it unlikely to be used much for healing beyond the first few levels) and a big buff to Cure Wounds (you literally roll twice as many dice now). Due to this buff, a 5.5e party is quite a lot better at healing than any non-4e party and if we continue to look at how the numbers scale beyond 5th level you’ll find that the 5.5e party can soon crank out healings the like of which D&D has never seen before.

And this is a bad thing.

Out of the Newbie Trap and Into the Fire

I’ve seen some people complaining that the buffs to Cure Wounds in 5.5e makes fights too easy, but I don’t think that’s the real problem. In every edition except 4e, healing in combat was generally a sucker’s bet as you’d save more HPs by using your spell slots to kill the enemies faster. Again and again in non-4e D&D I’ve seen newbie clerics spend a lot of time healing in combat and then end up feeling bored and/or weak. Giving in-combat healing a nice fat buff to make it not be a newbie trap anymore is just good design.

The problem with the 5.5e power creep to healing is the enormous amount of downtime healing that 5.5e parties can now crank out. With 5.5e clerics now incentivized to spend more spell slots on Cure Wounds, they start off strong and then shoot through the freaking moon at higher tiers of play, increasing much faster than total party HPs. This means that if you want to attrition down a D&D party across a serious of fights, it’ll take longer than in 5e. For me, the single biggest problem I had with 5e was that attrition took too damn long and now it’s significantly worse.

So Who’s Going to Play the Cleric This Time?

One problem that a lot of people had with 3.*e was that parties NEEDED magical healing which meant that if someone wasn’t cranking out fistfuls CLW wands (which was really bad for the game as it basically took HP attrition off the table completely) you NEEDED a cleric or another similar dedicated healer. This lead to people feeling pressured into playing a class they wouldn’t have chosen otherwise and WotC raining down buffs on divine classes to make them more attractive (the infamous CoDzilla).

MEDIC!

This also meant that if your PC was a cleric in 3.*e you’d be under a good deal of pressure to spend a chunk of your spell slots on healing, even if that wasn’t what you really wanted for your character. This results in your having less chances to spend your slots on more fun spells like my beloved Command. 4e deep-sixed this dynamic for the most part and in 5e healing spells are more an emergency back-up than the cleric’s main job. But 5.5e’s buff to Cure Wounds is going to put more pressure on clerics to focus on healing, especially if monster damage gets cranked up to compensate for the overall powercreep we’re seeing in 5.5e.

There Are No Clerics on the Oregon Trail

My preferred play-style of D&D is exploration-based survival gaming. It’s all about the players slowly getting deeper and deeper into a dangerous area while their resources are slowly drained by environmental obstacles and small skirmishes until finally things start to get desperate and the party has to retreat to safety. The genius (to me) of this approach is that none of the individual encounters have to be all that life-threatening for the PCs to feel like they’re in constant danger. Even a minor skirmish with some goblins that costs the party 10 HPs can get their hearts pounding as those 10 HPs are not coming back and every HP lost brings the party that much closer to death.

You can still approach things in this way in 5e but it’s harder. Due to what big bags of HPs a lot of 5e monsters are, it’s a lot harder to run a serious of short skirmishes which was my bread and butter with TSR-D&D and 5e players have so many more resources than TSR-D&D PCs that the whole process of grinding them down until they’re out of spells and HPs and running in panic out of the dungeon just takes a lot longer and can dampen the fun of the kind of campaign I like best.

5.5e’s buff to healing just makes this worse. Downtime healing is now so generous that it’ll take even longer to grind down a party. Small skirmishes to with a few goblins that costs the party a few HPs stop being anything but a boring timewaster when the party can crank out big fat gobs of healing. Of course you can crank up the difficulty by adding nastier monsters in 5.5e, but that runs the risk of making combat take longer (already a big problem for me in 5e) and if you start upping the damage monsters are doing to compensate for how much clerics can heal now then you can end up screwing over parties that don’t have a cleric, which brings us back to the “So Who’s Going to Play a Cleric This Time?” problem.

The Illusion of Difficulty

As I said upthread, if the PCs suck at healing then even a five minute skirmish can be exciting as it costs previous HPs that are not coming back. But if the party has big gobs of healing than short easy fights become boring and pointless. That means that the more downtime healing you give PCs the more each fight has to MATTER and be difficult in and of itself (rather than mattering because it’s a step on the short road to being tapped out). One problem with this is that fights that matter generally take a long time and I prefer short fights. And also if you make EVERY fight be a real challenge to the PCs then you have a few choices:

A. Run fewer fights. A higher percentage of fights can be epic show-downs if there aren’t many fights. The problem with this is that 5.*e’s wheels fall off if there are few fights per adventuring day. Having the PCs nova most every fight causes a lot of issues and explodes any pretense of balance.

B. Kill a lot of PCs. If death is at least potentially on the line in most every fight then you’re going to have a lot of dead PCs. Most DMs don’t want that. I certainly don’t.

C. Fake the difficulty. A fight can look evenly matched in a lot of ways but if one side is MUCH better than healing than the other (especially healing KOed people) then the decision is never going to be in much doubt. Alternatively the DM can just fudge.

I don’t think any of these are good solutions but this seems like the corner that 5.5e is backing DMs into. Luckily there’s a pretty simple solution.

Bring Back Healing Surges

So how to make healing useful in combat without making attrition take all day? Simple: take a page from 4e and have basically all healing cost Hit Dice. That way you can have a cleric give out big stonking heals during a fight without letting the well of healing that a party can draw on across an adventuring day get too deep. Healing Surges got a bad rap because there were just too many of them, but the basic idea of putting a hard cap on healing was pure genius and this is coming from someone who REALLY didn’t like 4e as an edition of D&D.

Having Cure Wounds heal a big bucket of HPs is still workable if is eats Hit Dice as PCs will soon run out of Hit Dice if the Cleric is healing left and right, but it still lets the Cleric feel like a Big Damn Hero for healing a big stack of HP with one action while not locking them into being a walking Band-Aid.

There are a couple different ways to implement this and most any of them would fix the basic issue as long as they fix the basic problem of reigning in the excessive healing powercreep that 5.5e has.
On a more motivations-of-play note: I have been reading Peterson's new edition of Playing At the World and thinking about the way D&D was rooted in wargaming. Whereas I believe one observes in the latter part of the half-century arc an almost paradigmatic shift in motivations (away from wargaming). If so, then concern for wargamerish attritional challenge may be lessened as a priority for design.
 

Daztur

Hero
Any PC could freely use healing surges out of combat. So really, i would consider them as an extension of the HP pool, not as "healing".

Don't think that's too much of a distinction, all forms of healing work out as extensions of the HP pool, although using spell slots that way has an opportunity cost (can't use the spell slots for other stuff) which Healing Surges don't have.
That said. I do think it's a better system. IMO 5e should look something like...

Healing Word: bonus action
Target can expended a hit dice and gains extra hit points equal to your casting modifier. If they don't have any hit dice they gain advantage on their next death save.

Cure Wounds: action
The target gains hit points equal to your casting modifier. They can also expended a hit die and maximize the roll.

Divine Protection: action
Target gains 2d8+mod temporary hit points.

Yes, that's exactly the sort of design I'd like for 5.*e but instead we get a bit of weird hybrid design with vestigial Healing Surges (Hit Dice) hanging off of a more 3.*e healing system without meshing well.

It's certainly a matter of preference. When I first started 5E it felt like healing spells were just awful. Until I grokked how Hit Dice work.

Current 5E has plenty of healing and you don't have to rely on the "traditional four", nor does someone who plays a Cleric have to frontload Cure spells and sit on their hands not getting to do anything else other than run around as a field medic. It can get really silly if the group picks up something outside of the traditional four - say a Paladin instead of a Fighter, or Bard instead of Rogue, or a Favored Soul Sorcerer.

Yeah, 5e is a clunky messy compromise in this, but like a lot of other parts of 5e design it ends up holding up better in actual play than you'd expect.

I think 5.5 is trying to compensate for that "feel bad" use of in-combat spells (and I think it's a big mistake) as you mentioned but I DO NOT want to move to healing surges. Unfortunately, I don't have a real good answer other than getting players to be more aware early on for how much healing is available in the game already, and give the DM some tools for how to properly handle the ebb and flow of danger without making it either too easy or too difficult.

Well 5e already has Healing Surges (of a sort) in Hit Dice, just would like to see Hit Dice and healing spells work together under the same overall system instead of being compartmentalized, with something along the lines of mellored's suggestion upthread.

As far as getting DMs tools to handle the ebb and flow of combat, I would really prefer for that not to be necessary as that kind of active stage management of combat undermines the the more gamey aspects of D&D that I like: namely that PCs succeed or fail largely because of player skill. In any case these changes in 5.5e make that kind of management harder as clerics will now be incentivized to heal more, which will require DMs to do more damage, which can lead to problems if the PCs don't have a cleric, much like in 3.*e, that don't crop up quite so much in 5e.

One thing missing here is magic items. Back in the 3.5e days, we wouldn't leave home without at least one fully-charged Wand of Cure Light Wounds, and we'd expect to burn through it, maybe even multiple wands, during the course of any even modestly-sized dungeon. Downtime healing was quite simply however much the party could afford, and generally speaking they could afford a lot.

This goes into the "bug not feature" file for me. "Fistful of CLW wands" gameplay really made 3.5e less fun for me as once the PCs had enough money to churn out CWL wands HPs stopped being a strategic resource entirely, which made the game a lot less fun.

Does the above take into account the full replenish with a long rest? And relatedly, have you considered removing that replenish?

No it does not, in part because often in my experience a lot of pre-4e sessions ended with "and now you go back to the town to rest, we'll start the next session completely fresh." The having to heal people right at the start of a day as soon as the cleric got their spells back only cropped up a lot for us during extended overland travel which generally wasn't the norm (at least for me). In any case adding in healing as a part of taking a long rest is impossible to get precise numbers for so I had to Spherical Cow it away.
 

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