I'm reading a lot of posts asking, "What do hit points really measure?" or something similar. Where hit points seem to jump the shark for people is when a high level character falls 100 feet, gets up, dusts himself off and walks away - or the giant fights with one hit point as effectively as he did with fifty.
D&D seems to me to be about resource management - and hit points are just another resource to manage. Do I have enough to get through another encounter? If not, am I in a safe place to rest? If not... how do I manage my resources?
So here's my proposal for hit points (almost certainly not original of course - but I haven't seen it exactly like this anywhere).
NOTE that this is, of course, an untested work in progress :)
Health, Hit Points, Damage and Recovery
Health Points at 0 Level - all characters roll 1d8 for Life Points, Creatures have their Hit Dice in Life Points
Hit Points are rolled at each successive level according to class and added to the Hit Point Total, as normal. Hit Points represent exhaustion, tenacity, skill, survival instinct, and the blessing (or not!) of the fates and are easily lost and fairly quickly recovered.
Damage in combat and adventuring (with some few exceptions, see below) reduces Hit Points until they are exhausted, then Life Points are reduced accordingly. Additionally, once Hit Points are exhausted, Life Points are drained normally (that is, a 0 level human, or a levelled character who has 0 Hit Points remaining, who is hit for 5 points loses those 5 Life Points) and each point is a wound or scar (see below).
Each time a character takes 10 or more hit points in damage in a single round, regardless of how many total Hit Points the character has, his or her Life Points are reduced, one Life Point per 10 Hit Points of damage, rounded down (1 Life Point for 10-19 Hit Points, 2 Life for 20-29 Hit Points, etc.) with a subsequent Wound or Scar (see below).
Hit Points are recovered with Rest, while Life Points with Recuperation.
Rest: for every 10 minutes of rest, recover one Hit Dice of Hit Points.
Recuperation: for every 2 hours of recuperation, recover all Hit Points and 1 Life Point.
On Death, Dying and Dismemberment
Characters reduced to 0 Life Points are Dying. Dying Characters make a death save every round. A Death Save is a d20 rolled against the PC’s Constitution score, adjusted by his or her Constitution bonus. Two successive failed Death saves and the Character is dead. If a Dying Character is tended to by another Character (or NPC), the Death Save is rolled at Advantage.
Wounds and Scars: When a Life Point is lost, the Character receives a wound or scar appropriate to the situation. Roll on the general wounds and scars table below, adjusted by the number of Health Points lost in a single round and the Character’s Constitution Bonus (adding the Life Points lost, subtracting the Constitution Bonus).
NOTE: While death is generally final, there are some rituals of the Church of the Holy Saints that can potentially resurrect a dead Character. In addition, the clerics of the old gods (Druids) can employ spells like Reincarnation to keep a Character’s Soul from traveling to the great beyond and magic users are able to trap souls in the Mortal Realm (in decaying bodies or as disembodied spirits).