Spiritual Guidance: Triage
by Dawn Moore 
Apr 25th 2010 at 6:00PM
Every Sunday, Spiritual Guidance shares all the insight on wielding the light as a discipline or holy priest. Priestess Dawn Moore does her best to guide innocent priests away from the shadowy influences of Fox Van Allen, propagator of gateway specs. She stands vigilantly, fighting to ensure that priests do not get lost in the dark world of demon pacts and mage hate. Remember: mages are our friends.
Last week, I began my weekly column by annoying you all with information about my GearScore. This week I will be repeating this needlessly pretentious practice by telling you my other GearScore. My other GearScore, you ask? Why yes, dear readers, surely you know that elite players such as myself have multiple gear sets for all of our PvE whims. So without further ado:
I have a 3390 GearScore.
CUT TO: INT. BEDROOM - DAY
Dawn is seen pecking away a laptop keyboard. An over-the-shoulder shot shows her computer screen just as she finishes highlighting the text "My other GearScore ..." We then see the cursor mouse over to a font styles menu where the following options are listed: Bold, Italic and Sarcasm. Dawn selects the last option.
Film school flashbacks aside, this week we are going to talk about triage. If you didn't already know, triage is the act of making a priority list for who to help first in a situation where several individuals require medical attention. Triage was referenced earlier this month in a forum post where Ghostcrawler answered some scrutiny to Blizzard's suggested healing philosophy for Cataclysm. Let's look at that post and talk about what it will mean for priests. I will also explain where I was going in my GearScore sequel from above.
The original poster in said forum thread suggests that the current model of damage and healing (where healers have infinite mana and players who fail to perform a key action in a fight will die faster than healers can respond) is superior to the model he observed in Burning Crusade, where good healers and tanks could carry other players through content simply by healing and tanking through it. The poster seems to imply that by making mana a commodity there is a risk that healers will be punished (by going OOM) instead of proper punishment being directed to irresponsible members in the raid who carelessly take damage. Ghostcrawler responded with:
GhostcrawlerI have found this philosophy to be a tough one to communicate. Painted broadly, we have some players who chose healing because they like to be challenged and we have some players who chose healing because they like to be the hero. In LK, raid healing can definitely be stressful at times, but we're not actually convinced the challenge is there. After a tough fight, whether it was succesful or not, ask yourself what you should have done differently. Did you use the wrong heal in the wrong situation? I'd suspect not since most healers have pretty stringent rotations these days where you use your strongest heals on cooldown and fill in the time left with your next strongest heals and so on. Did you heal the wrong person at the wrong time? Probably not because anyone you failed to heal was probably about to die. You probably overhealed a lot because there is little consequence for overhealing.
Go back and look at a few videos of BC raid encounters. A couple of points may be strking. One, several characters may be at various stages of injury -- the healers could not keep them all topped off. Second, the healers may be at various stages of mana -- in other words, it's not just a matter of having more GCDs before everyone is fine again. It's a matter of triage.
Triage is one of the things missing from today's healing game (even though you likely learned First Aid through a triage quest). Loosely defined, triage is deciding who needs immediate attention (vs. who is stable vs. who is a lost cause). We want healers to be able to make decisions like "The tank is wounded, but she is unlikely to die in the next few hits, and hots are ticking on her, so she's probably okay for a moment and I can heal this Ret paladin over here," vs. "The rogue is wounded, but my big heal would overheal for a ton and I need the mana, so I can use a small heal." We want the dps to likewise be thinking about ways to minimize damage on themselves, not because they'll die in a global (i.e. before they could respond anyway) but because the healers are going to risk running out of mana.
Today, in LK, healing risks feeling even more like whack-a-mole. Injury? Heal. Injury? Heal. You're testing your reflexes more than your decision-making ability. Whack-a-mole can be challenging, but it doesn't have much depth. It's easy to add depth though. Let's start with the notion that there are two hammers. The little hammer can dispatch most of those moles, but sometimes you can use your big hammer too. The big hammer has limited charges or whatever. Now let's have some of the moles pop out a little slower so that you have time to consider which hammer to use. See where I'm going with this?
Running out of mana doesn't have to be, and won't be, the only reason you fail an encounter. But it is a point of failure that we don't have today. Adding it back in will make the encounters feel more distinct from each other and will actually, we believe, make healing more interesting and ultimately more fun. I agree it's going to be a tough sell though. In one of our playtests recently, the healer came back frazzled. "I couldn't keep everyone topped off," she said. "It took me half the dungeon to realize that I didn't have to." Once that clicked, she said she started having fun. Hopefully it will click with other players quickly too.
Go back and look at a few videos of BC raid encounters. A couple of points may be strking. One, several characters may be at various stages of injury -- the healers could not keep them all topped off. Second, the healers may be at various stages of mana -- in other words, it's not just a matter of having more GCDs before everyone is fine again. It's a matter of triage.
Triage is one of the things missing from today's healing game (even though you likely learned First Aid through a triage quest). Loosely defined, triage is deciding who needs immediate attention (vs. who is stable vs. who is a lost cause). We want healers to be able to make decisions like "The tank is wounded, but she is unlikely to die in the next few hits, and hots are ticking on her, so she's probably okay for a moment and I can heal this Ret paladin over here," vs. "The rogue is wounded, but my big heal would overheal for a ton and I need the mana, so I can use a small heal." We want the dps to likewise be thinking about ways to minimize damage on themselves, not because they'll die in a global (i.e. before they could respond anyway) but because the healers are going to risk running out of mana.
Today, in LK, healing risks feeling even more like whack-a-mole. Injury? Heal. Injury? Heal. You're testing your reflexes more than your decision-making ability. Whack-a-mole can be challenging, but it doesn't have much depth. It's easy to add depth though. Let's start with the notion that there are two hammers. The little hammer can dispatch most of those moles, but sometimes you can use your big hammer too. The big hammer has limited charges or whatever. Now let's have some of the moles pop out a little slower so that you have time to consider which hammer to use. See where I'm going with this?
Running out of mana doesn't have to be, and won't be, the only reason you fail an encounter. But it is a point of failure that we don't have today. Adding it back in will make the encounters feel more distinct from each other and will actually, we believe, make healing more interesting and ultimately more fun. I agree it's going to be a tough sell though. In one of our playtests recently, the healer came back frazzled. "I couldn't keep everyone topped off," she said. "It took me half the dungeon to realize that I didn't have to." Once that clicked, she said she started having fun. Hopefully it will click with other players quickly too.
Ghostcrawler later followed up in the thread with the following:
GhostcrawlerQuote:
Punishment should be doled out primarily because I didn't diagnose or treat the patient properly, not because I ran out of bandages.
Punishment should be doled out primarily because I didn't diagnose or treat the patient properly, not because I ran out of bandages.
I see what you're saying, but that's part of triage too. You can't order surgery for every patient, which is kind of the equivalent of using your largest or fastest heal for every patient, regardless of injury.
The other part of that is if you use your efficient Heal for every single problem, then you'll have tons of mana, but you'll lose people. (In other words, sometimes expensive surgery is exactly the right thing to do.) Mana isn't the entire healing game. It's just one consideration.
As a healer who has played since vanilla, I have to say this whole thread got me quite excited. I remember I once tried to explain to an arena partner how it was that I healed in PvP, and referred to something I called a "mental queue." I said that one thing I do when I enter the arena against a team comp I've never faced before (or alternatively, a new raid I've never played before) is observe the way incoming damage is displayed on a healing bar, and compare it to what is happening in the game world itself. The longer I observe this, the more versed I become in understanding what the upward and downward movement on a player health bar means in a given fight. After a while, I start to know exactly what kind of damage needs to be healed as soon as possible and what can be put off for a second more. My "mental queue" is then derived from that: who needs my attention first, and what kind of attention do they need? This conversation was all an elaborate way of saying "stop calling out for heals" because it risked disrupting my queue by trying to "butt in line." Such an interjection would often undermine everything my experience and intuition was telling me to do, which would lead to confusion and deaths. What I described to my partner then was basically the triage that Ghostcrawler described in this forum thread.
Now obviously, arena is a very stressful environment where one poor choice (like trying to use a Flash Heal for a Penance) can cost an entire game. The majority of raid content isn't like this and shouldn't be like this, simply because the numbers don't call for it. If your 25-man raid wiped every time a single player made one mistake (such as healing with the wrong spell), then it probably wouldn't be fun to the majority of players. (It has the opposite effect on me, personally, as I love when the costs of my mistakes in PvE are on par with arena; but that is another post in itself.) The problem is raid content is a bit unsatisfying on a personal level right now, especially for healers. By introducing the idea of mana management as a more prominent factor, healers will get a taste of punishment and reward without having to endure the
This will make the game a little harder, sure, but believe me when I say the rewards are sweeter when you work for it. Have you ever listened to the audio on a world-first boss kill? The sound of those players always puts a smile on my face. It's what makes me raid in the first place, and this is probably something you've already experienced on your own, regardless of what level you raid at. Triumphing over challenges is rewarding, but look at what we do to raid. Last week, I lamented for the majority of my post about how bubble spam is largely unsatisfying. So, when I look at this new philosophy Blizzard is discussing, I'm pleased that they want to make healing in PvE just as satisfying on a personal level as it is on a group level.
Just think: no more of that trivial whack-a-mole at your local Chuck E. Cheese's; instead, we could be seeing intense, whack-a-mole for adults. I don't even mean that jokingly; I think it's a fun game, especially when it's composed of using the right hammer, on the right mole, at the right time.
So what does this have to do with priests specifically? Well, as your healing guide, I feel like I need to prepare you for triage in the upcoming expansion. Thus I present to you:
Step 1: Go to the auction house.
Step 2: Buy 150-175 item level gear.
Step 3: Queue for random dungeons.
Step 4: Learn how to heal again. (Alternatively: pull out your hair.)
Okay, so that had nothing to do with priests, but the advice is still sound. I would encourage all healers to equip a full set of awful gear (like my 3,390 GearScore set -- something with worse stats than the quest rewards you'd be wearing by the time you hit 80), and go into a random dungeon and get in touch with how difficult healing with no gear is. Your mana regen will be awful, your cast times will be slow, your heals will be weak, and your global cooldown will clock in at a full 1.5 seconds. If you do this, I can guarantee that you will struggle with healing your group in some way shape or form. The goal in all this is to eliminate as many of those struggles as possible NOT by getting better gear, but by making better decisions in what and when you cast.
It may be a little cruel and unusual for the people you queue up with, but everyone could stand to actually earn that "the Patient" title, don't you think? That aside, I'll be honest and tell you right now that this is a very difficult task I'm assigning to you. It will be frustrating and take time to perfect. What I will promise you though, is if you do this, no matter what level of healing you currently play at, it will make you a stronger healer. (If you're going to spend your time doing something, why not do it as best as you possibly can, right?)
So now comes the priest thing. I've said it before, but here it is again: You have more healing abilities than any other class in the game. Each one of those heals is designed to respond to a different kind of damage that your allies will take. Start looking outside your top three spells and try to utilize everything available to you. Think of your heals as keys that unlock specific doors. Let's look at our tool box, or in this case, our keyring:
- Flash Heal Until we get Heal back in Cataclysm, this is arguably the closest we get to a basic heal. We currently use this when one player requires a small or medium amount of healing and can afford the time to wait for a cast. In the future, this spell will cost more mana to make up for its speed.
- Binding Heal If you can spare the time to cast a Flash Heal, but also need to heal yourself up in the process, Binding Heal is your best bet. It costs twice as much as a Flash Heal, but that's due to the fact that you are doing twice the healing. Not a bad deal with all the time you save.
- Greater Heal Use this if your target is missing a large portion of health and won't die without an immediate heal. When dealing with fast-paced damage, this spell is used sparingly.
- Prayer of Mending This spell can be used preemptively on a target you know is going to take damage. The amount healed is low, and so is the mana cost, but it will buy you some extra time to get your next heal to that target. Use it on a tank whenever, or on a target you know will be taking damage in the next few seconds.
- Penance A discipline priest can use Penance in place of Flash Heal or Greater Heal as a large but quick, instant-like heal.
- Circle of Healing When multiple members of your raid need quick attention, a holy priest can use Circle of Healing to deliver a quick burst of healing to those targets. The heal is smaller than a cast Prayer of Healing, but the instant nature of it will buy you more time to get your allies to full.
- Prayer of Healing This long-cast heal will deliver a huge burst of healing to a group. The spell heals for a lot and thus has a long cast time and mana cost. Think of it as a multi-target Greater Heal or Flash Heal. Use it when players low on health are clustered in the same group. If only two players in a group are low, two Flash Heals are sometimes more effective since it will allow you time to move between the two casts.
- Renew Use this spell to grant a target additional healing on top of all your cast spells. This spell works while you're doing other things and can help to stabilize damage which sometimes allows you the freedom to switch targets. If you're a holy priest with Empowered Renew, this becomes a great instant heal for keeping someone (maybe even yourself) alive long enough to cast a heal.
- Power Word: Shield This is an even more powerful form of preemptive healing. A shield can be placed on one or many targets to protect against incoming damage.
- Holy Nova This instant-cast heal is area-based and specific to your party. This makes situations for its maximized use very uncommon. However, if you are stacked up and need a small burst of healing for your group this is perfect. Alternatively, if you're a disc priest who just needs to heal yourself, you can use this spell as filler when you don't have time to cast a spell on yourself and aren't able to use Power Word: Shield yet.
- Divine Hymn Use this spell when many members of your party or raid require fast healing. This spell will automatically heal players of the lowest health for a large amount, so naturally this spell costs a great deal of mana.
One last thing before I leave you to boggle at this week's Spiritual Guidance. Last week I wrote about gems, and Penance Priest conveniently published a great post about improving your performance as a healer through casting more. I thought it was an excellent follow-up read to my gem post, which is why I'm plugging it now. The mentality the article offers may seem to conflict with my anti-meter mentality at first glance, but consider it from the angle of today's article. You should be able to always cast, provided you are casting the right spells. You're already making an effort to maximize the quality of your actions, so the next step is to do it at a pace that lets you maximize every moment you spend in combat.
Want to find more great tips for carrying out your priestly duties? Spiritual Guidance has you covered with all there is to know. Check out Holy 101 or Disc 101 for an introduction to healing as a priest, or assess yourself for advice on how to improve yourself as a healer and raider. Filed under: Priest, (Priest) Spiritual Guidance
Reader Comments (Page 1 of 3)
venomslife Apr 25th 2010 6:20PM
ironically for about a month to spice up heroics, i've developed what i call the witch costume to heal non LK random heroics with .
this set is highlighted by benediction, features no belt neck or wrist piece.
the helm is the wicked witches hat from kara. i have boots legs rings and trinkets equipped that are 264 items.
benediction has fiery enchant on it btw, for the absolute satisfaction of people telling me how fiery doesn't appear on the staff i'm currently holding.
all told i dont use GS addon so heres an idea of the stats-1400 or so spellpower.
soo many heroics that were released at WOTLK launch are aweome to heal like this.
but one word of warning as a random LFG pro
there are many types of groups but think about these 2 ideas before you do something like gear stripping for fun.
1. is the tank gearing up
2. is the tank showing off
the witch costume does not mix well with the gearing up tank and just be polite and equip your pimp icc gear-
but if you see a druid with 60K hp in violet hold try and heal it with no gear on---you can really do it!
Nazgûl Apr 25th 2010 6:32PM
You went to film school? Kick ass. Which?
Dawn Moore Apr 25th 2010 8:48PM
Chapman University in Orange, California. For one semester I attended their graduate program for producing (business and management side of film to those of you reading who aren't film gurus) but I ended up deciding their program wasn't for me. (I probably would have liked it better at undergrad pacing though!) I did a ton of tv and news in undergrad, but film ended up not being for me. =)
Nazgûl Apr 25th 2010 8:56PM
What a shame. We need more filmmakers, the real talent these days is getting old.
Dawn Moore Apr 26th 2010 5:34AM
I am still undecided about whether I'll return to film, honestly. I would still love to write scripts (my reason for studying producing was to be a writer/producer) but switching to Chapman's graduate scriptwriting program went against my whole idea of going to graduate school to be better prepared to produce my own projects. They have a fantastic scriptwriting program, but you can get a lot of excellent scriptwriting education from reading 'how to' books, analyzing films, and attending cheap weekend seminars - you don't need to go to grad school to be a writer. The reason to go to grad school for producing, and pay the associated price tag, is to learn AND make good contacts. =)
Duckodile Apr 25th 2010 6:34PM
While I hope they aren't bringing back the pain and suffering that was trying to heal while wearing resist gear (NO YOU CAN'T HAVE MY INNERVATE GRRRRRRRR), I AM psyched that they are bringing back some of the BC-ish flavor of healing where it wasn't just about getting your GCD down and spamming your heals as fast as possible (this may or may not be related to the fact I have 300 ms latency on good days). I've never played disc/bubble spam, cause it seems like at that point even doing a rep grind would be more fun (and I don't do those), but yeah, I would love to return to a style of healing where there's decision-making beyond "if more than 1 person is injured, use CoH".
Poonicus Apr 25th 2010 6:48PM
I've been doing this in heroics for a while to at least make them sort of interesting. Of course if the tank is geared to the teeth, they still don't take any damage and you still don't have much to do. Personally, I try to pick gear that looks fashionable for priest, T5 Hood, Shoulders, and Chest, Anathema for weapon, etc. It drops your gear score a ton as well as your SP, haste and regen. What's even more fun is when some punk dps makes a comment about your gearscore when you show up. At the end of the run you put your regular gear on and tell them to shut it. lol.
saregos Apr 25th 2010 6:51PM
Forgot Binding Heal in your list up there... It's rather useful in the right circumstance (i.e. a similar circumstance to what you mentioned about Flash Heal)
Dawn Moore Apr 25th 2010 7:44PM
I did! Thank you, I will go adjust that. =)
Phelps Apr 25th 2010 6:53PM
It's funny -- back in Vanilla, we (my clique) used to say, "a good healer doesn't know who to heal, a good healer knows who to let die." Sounds like we are going to back to that (instead of "find lowest health and heal it in the next 9 ms.")
Gothia Apr 26th 2010 2:59AM
Agree, that sounds like the exact model that devs want to bring back because if they limit our mana excessively then only the tank will get heals. This model will not work because they have already pampered Dps to the current attack plan and changing it will P.O. 60% Wow players if they are told to #1 Stop Dps #2 Bandage #3 Start Dps. This will cause a player base uproar unheard of since the great circle of healing cool down nerf of 08.
We will see, but I don't think the company is the same as it was in Vanilla so any changes to the game will benefit their new approach since Activision came on the scene.
Phelps Apr 26th 2010 10:39AM
Well, there were other factors in too. It was 40 man raids, so letting four people die in a 40 man is different than letting four die in a 10 or even 25 man. But yeah, I remember a time when if you were a pure dps class, you didn't get raid heals. You were told to bandage. Locks didn't get heals when they lifetapped. They tapped, then bandaged.
And rogues? They were who the priests flash healed during Nef's class call.
xvkarbear Apr 25th 2010 7:01PM
Hey! I've got a question. One of our ICC10 healers is a Disc/Holy priest. She's rocking one set of t10 gear at the moment.
She's having some difficulties trying to gem/enchant her gear. She's asked me for pointers, because I leveled a Disc priest up to 80. I had scoured the internet of Disc info long ago and came to the conclusion that what I wanted was spell power. The general consensus was to gem for Runed Cardinal Rubies in all slots except where A) I needed a different colored gem for the Meta and B) The socket bonus was worth it.
I passed this info onto her, but she's concerned that is not the correct course of action. She feels that Intellect is the stat to stack. Which do you feel is the better option?
This is also coupled by her desire to use her tier 10 set for both healing specs. Is this viable? Or should she start farming for another tier 10?
Thanks!
Clevins Apr 25th 2010 7:59PM
It depends. Does she need throughput or regen/mana pool? That will be dictated partially by her entire gearset, partly by the encounters, partially by how much time she spends in Holy vs in Disc.
spellpower gems give her throughput in the sense that things hit for more... is that her concern? or does she want to gem for Iny because she has mana issues? There's no one right answer, it's really dependent on what her issues are. If she doesn't run into mana problems at the moment, I'd gem for sp or perhaps sp/haste if she spend a lot of time in Holy and has low haste.
I have to say, too, that it worries me more than a bit that someone can get 2 or 4 pc T10 and not understand how to figure out what stat she needs to improve. Stacking any one stat blindly isn't the answer - you have to figure out what your weak spot is and how gemming can help you with that.
obarthelemy Apr 25th 2010 8:37PM
Very easy:
1- if she needs mana, go Int, which is by far the best regen stat, superior to Spi and MP5, once Kings, ShadowFiend, Replenishment... are taken into account.
Once OOM is no longer a problem, you can start to think of
2- Throughput. Disc this days is mainly a Raid Bubbler. Bubbles can't crit, so Crit is fairly useless (plus all that Int does give you 40-ish % crit, raid-buffed). Haste can be good up to a 1-second GCD including talents, on non-laggy connections, but you reach that GCD fairly easily just with the Haste on the bare gear. Only SpellPo remains as an attractive stat.
Notes:
- the orange gems with Int+SpellPo give more than Yellow + Red. My priest gemmed Orange till he no longer needed mana, then Red. Never Yellow+Red.
- Tank disc healers can use more crit, but not really more haste
- Holy use Crit more , though Renew doesn't really crit, either: Circle, PoM, PoH do. But again, you should be around 40% raid-buffed already. Probably enough.
Dawn Moore Apr 25th 2010 8:31PM
There is a strange but common idea that floats around on many servers I've been on (and there are many) that int is -the- thing for disc priests. I think it's perhaps because people think disc priests are just cloth wearing paladins with bubbles. The justification for Int was 'it makes your mana pool so big you don't need regen AND it gives you crit.' If you do the math on how much crit you get from Int though it's pretty awful. In the end it comes down to this: disc priests don't get the same scaling benefits that paladins do from Int, so to us it is strictly a regen stat when it comes to gemming. No mana issues? Don't gem Int.
If you need more mana as disc though, feel free to try int gems or the insightful meta gem with returns mana on proc.
If she has no issues with mana though, then the guide I wrote last week should be plenty for her. http://www.wow.com/2010/04/18/spiritual-guidance-priest-gems-for-raid-roles/
Theresa Apr 26th 2010 12:05AM
My main spec is disc and my off is holy, I do use a single gear set. I gem for throughput - generally the rule by ICC is that you gem for throughput unless you are having running out of mana after using all your regen abilities. So spellpower if mana is fine, int if not.
I do have a couple trinkets I swap around when I need more regen (Solace/Spark/Tears) as needed. The only fight in ICC I have any trouble with in this setup is Dreamwalker as holy when I'm not going into the portals. That is mostly due to the fact that the dps keep killing the thing my shadowfiend is trying to munch on!
My character is Tersa, on Arygos US if you are interested in looking at my gearing choices.
Swifty Apr 25th 2010 7:06PM
I have been playing since late beta on my priest. Went into Beta with her and recreated her at launch. I remember the days of vanilla healing and it was NOT pretty at all. The idea was fine and unfortunately very similar to the idea being passed around now. You have a set of spells for different situations, cast the right ones at the right time on the right people(s) and things are good. Mess up and you go OOM, actually back in vanilla you went OOM regardless and healer rotations were needed. All that for a lack of a better term sucked. I like the idea, it sounds pretty and awesome but if implemented incorrectly could kill priests. All of the healers minus the priest have a small set of spells (compared to the priest). Having a pally decide between flash of light and holy light...not hard or a druid deciding between what HoT...again easy times. Back in vanilla people loathed playing a priest because of the difficulty. If they implement this incorrectly and we priests have to decide which one of myriad of spells to cast every sec on which player(s) it is going to kill the class. I play the game for fun, I enjoy healing but I also enjoy the semi mindlessness of it. The other issue is if healing becomes a great challenge it will drive some players to the less challenging roles of DPS or maybe even tanks depending on how they get worked out.
My suggestion to blizzard is to open the dev testing and ideas to a broader base so it can be implemented correctly and not just make healing hard which could kill priests and healing all together. I fear the days of Vanilla WoW are creeping back.
Dawn Moore Apr 25th 2010 8:38PM
I think it'll be okay. With everything Blizz has been saying it seems like they want to add in a little mana management without the 'you will stand here doing nothing' aspect being added back in. I didn't raid in vanilla, so I take your account and the account of others of it being pretty boring. But in 5-mans during vanilla I had a blast healing all the way up to level cap. In 5-mans it was ALL about picking the right spells for the right applications, and if you did that you'd make it through to the end of every encounter sweating, but still just getting by. I loved that. I don't think it will be that tight again but bringing back that, even in part excites me. All in all, it's all speculation. Like they said - we shouldn't try to make a sandwich out of crumbs.
That doesn't mean I won't put the crumbs under a microscope though. =)
Gothia Apr 26th 2010 4:17AM
I agree and seriously doubt that they will take the Vanilla approach to healing mana regen. Yes, they need to step down regen from where it is now because it is too good, but that is only considering exceptionally geared healers and tuning must be done for healers in quest gear.
Lets face it, Blizzard is not the same as they were in Vanilla Wow and for better or worse I would have a hard time believing that they would return to Elitism with Activision's new standards. Players that raid today have a much different mindset than those that raided in Vanilla. Move forward, not backwards seems to be the trend today and I for one am excited to see what they have cooked up for us in Cataclysm.