If it's not at least a majority of the time, though, what differs said "damage-based healer" from a healer with some healing-bundled offensive tools (a la Assize)? Else, if I stick Kardia's effect on a cooldown and give also it to SCH, does SCH now become more centrally a "damage-based healer" than a traditional one?
You're insisting that it is possible, that it can handle the given constraints, with enough creativity, but the idea itself is the constraint. Prominently tying damage to healing, and especially healing based on damage, is more restrictive in its kit possibilities and has historically been a nightmare to balance that has left thus designed classes simply less flexible, less dynamic of supports than more traditional modes.
That's not to say elements of that can't be done. But every attempt to have that account for a majority (or even more than some third or so) of a class's healing output has consistently led to that class simply being unable to deal flexibly with higher damage or higher healing needs because they literally cannot significantly sacrifice the one for the other (they are, after all, the same thing for that class).
Compare that, even, against more "traditional" modes of damage-healing synergy, such as each spells of either type empowering or hastening your next (or, next non-filler) spell of the other type. That's standard-fair healer kit stuff, as opposed to vampirism or other forms of damage-based healing, but actually allows the kit to feel slightly more dynamic. Damage-based healing, on the other, in even in more healing-intensive games, tends to lead toThe first tends to be duller even than what we have now if not for the necessitated self-made burst damage windows; the second gives little gameplay not already managed by any other buff-dense healer; the last is a decent way to get DPS to flex into heals but can rarely be used for both slots in any serious content due to its costs for any flexibility.
- most GCDs just being spent on Filler-Attack to simultaneously damage and heal,
- simply cycling GCD-granted buffs just so your damage can heal others (with your "pure damage" state simply forgoing time spent buffing for a modest increase in damage relative to traditional healers),
- or having an otherwise mostly DPS-esque kit but healing someone or those nearby for X% of damage dealt (and therefore needing to hold onto DPS CDs to meet healing checks, causing your combined output to typically fall short of traditional healers unless the fight happens to time out in your favor).
Yes, some damage-based healing is fine. An altogether "damage-based healer," though, is so constrained that it would tend to occupy only specific niches. And they'd make for quite the prog-to-farm balancing headache regardless.



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