I've been taking my time with the MSQ, running it in tandem with some close friends and I have to say that the healing...is sometimes more than I'm used to, sometimes much less than I'm used to. I came to the game in 3.1, so anything older than that I can't speak for. What I can say is that trash pulls definitely seem more intensive in 4.0 than the dungeon's in 3.X, while bosses feel far less so, instead making use of more mechanics than simply throwing around raw damage; if the party plays the mechs properly, it's a breeze, if they don't...it's pretty inconsequential still in most cases. I've heard that MP management has become more important and a bit harder, but I'm not feeling that at all honestly. I do main WHM though, and their MP management tools feel really powerful, so maybe that has something to do with it.