When people want "balanced" combat in Dungeons & Dragons, they don't want combat that is a 50/50 chance of either side winning.
They want combat that the PCs will almost always win, but *feels* like they might lose.
As you might expect, this is a bit tricky to pull off!
— Merric Blackman (@MerricB) November 19, 2021
5e’s death saves system has made this a lot easier. The bit that really counts (which was introduced in 4E) is not having negative hit points. When any healing adds from a starting point of 0, it makes a big difference to survivability.
— Merric Blackman (@MerricB) November 19, 2021
Do you think negative HP would be a tidy patch for the yo-yo effect you get with fallen party members in 5e (while keeping death saves)? It's the interaction between that 0 HP and healing word that creates the yo-yo effect, I think. (It's mostly the entire purpose of healing word).
In 4E, because you were spending your surges to use it, you were very limited. Perhaps if healing word required a HD expenditure?
— Merric Blackman (@MerricB) November 19, 2021
Negative hit points would significantly affect the use of healing word. I’m trying to think when you’d use it if the 0 hp rule wasn’t there (because the amount it heals is negligible compared to damage amounts at most levels). Versus standard healing it's pretty fair, since it can be done at range.
Healing is just bad in 5e.
— ThinkDM.org (@ThinkingDM) November 19, 2021
Both. It's really difficult as a writer, because you don't know what the PCs can do, but it isn't easy for a Dm either, even when they know the PCs!
— Merric Blackman (@MerricB) November 20, 2021