Just on an obsessively min/max side note for when people are regemming their gear:

1 [Quick King's Amber] + 1 [Runed Cardinal Ruby] = 23 Spell Power + 20 haste
2 [Reckless Ametrine]= 24 Spell Power + 20 haste

Why is so much itemization being discussed in this thread?

If you're sacrificing 100+ spellpower to regem for 100+ haste in order to avoid CF, it really isn't worth it (Dropping 10 Runed for 10 Reckless, for instance). CF is a gear crutch that is the result of Blizzard telling us to pick up another 500 haste when we were in the middle of accruing crit gear. When you consider you're giving up novelty talents (Revitalize, Emp Touch, Living Seed, etc.) to swap 4 more points into balance, consider the alternative: You're giving up half a trinket for a marginal resto talent(s).

The haste softcap WILL be easy to hit with full access to icecrown gear, as Carebear demonstrated and I've found to be true in my profile making. Patience!

I want to try to tie together some of the thoughts on potential build/gear options in 3.3. We're having a lot of back-and-forth for various talents and spells, and the problem is that, now that we can't have everything we want, we need to look at spell/talent choices somewhat as a whole so there's some efficient synergy. As I see it, there are going to be 2 serious options for ICC hardmode work: 18/0/53 with Regrowth* as the secondary direct heal, and 11/0/60 with Nourish.

*Quick sidebar: I've said a few times that the only buff Regrowth got between 3.2 and 3.3 was the 10% from GOTEM. I only recently realized that that's not true--it also gained all the haste that we're equipping for Rejuv purposes. In 3.2, at the Rejuv haste cap, the cast time of RG was 1.67 (and we never used it). In 3.3, at the Rejuv haste cap, the cast time of RG is 1.33 (1.11 with Nature's Grace). It's much better now.

In a 10- or 25-man raid with a generally balanced healing setup (one or two non-Druid healers in 10-man and at least one of each kind of healer in 25-man), the assumption for now is that Tree that will be first person allocated to cover raid healing needs of which there will probably always be some. So we always want to be set up for Rejuv to be the workhorse, as it always has been so far in WLK. One spell needs to be available for throwing direct heals, and the candidates are Nourish and Regrowth.

All that said, what does Rejuv need for maximum effectiveness? It needs the basic resto skeleton ( Talent Calculator - World of Warcraft ) and 735 haste, plus either:
A) The last 7 points in Balance for CF (picking up NG along the way).
B) 121 more haste. Translating to spellpower, this costs 6 gems worth of spellpower, but you'd pick up a few socket bonuses, so let's say around 110 spellpower.

What does Nourish need in addition to what we already have for Rejuv? Empowered Touch, mainly, and also Living Seed. Nothing for haste (Nourish hits 1s at the same time Rejuv does). Nourish wants option B above, as A adds nothing and doesn't get ET (you can cram ET into option A by giving up 2 points in Nature's Bounty, but this further weakens it compared to RG).

What does Regrowth want? It wants Nature's Grace, mainly, and also Living Seed. Having both requires option B, but it can get its important talent (NG) with A.

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That was a lot of setup, but I wanted to really spell it out so the whole discussion is contained in this post. Here are the important factors weighing one way or another.
1) Rejuv alone prefers option B to the tune of 110 spellpower (less if you're getting significantly over 735 haste without gems. Possible already (I am), but not my much, and once Trauma gets involved, not going to happen for a long time). This matters a lot when you're in a serious Rejuv-heavy situation (like Twins), and not using direct heals anyway.
2) Regrowth completely wrecks Nourish in terms of HPET. An non-Nature's Graced, non-glyphed Regrowth is over 1.5 times the HPET of a Glyphed Nourish on a HoTted target. And in a heavy raid damage situation where you're throwing multiple direct heals and benefitting from NG, and potentially having to hit targets that aren't Rejuv'd, the gap is much wider.
3) If you need to dump heavy HPS into one target, you need Nourish.
4) 2/3 of Regrowth's healing is from the HoT. In a pure direct healing situation, where the HoT will actually not do anything, it's somewhat weaker than Nourish. This is really the same point as (3)--where we simply can't make use of our raid-healing/HoT specialty and are forced to try to be a direct healer, Nourish is the only spell that does it.

How do I put all this together?
--In our main familiar role from all prior WLK work (and nothing known about Icecrown is deviating from this), Regrowth is an outstanding complement to Rejuv. It favors the same build, doesn't compromise spellpower stacking, allows use of Nature's Grace, and when we take time out of HoTting to do it, we still get a partial-strength HoT afterwards, so it doesn't compromise HoT coverage around the raid. This is the min/maxy way to optimize your raid healing power.
--In our lesser role, of trying to emulate a direct healer, there's no choice but Nourish.

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Conclusion:

This leaves us with 3 options:
1) Be in the fortunate position of being in a raid group which always has a balanced healing setup with good people covering tanks, so the latter scenario just never comes up in any situation worth speccing for (this is true for me, so my choice is done here, but I know it's not true for everyone).
2) Have 2 builds and 2 gearsets (which is fine unless you, like me, use your second spec for a different role)
3) Compromise your raid healing by not fully utilizing Regrowth. This will probably have to happen for people who can't do 1 or 2. You have to give up CF for ET, and have an uneasy tension between NG and LS.

At this point, balancing these is a personal matter. Hopefully this helps frame your thoughts on what you want to go with.

Thank you very much Arawethion, that is a wonderful post. I have one question though:
Assuming I pick option A, what if the encounter forces me to do direct heals? I'm thinking of Saurfang - we assign marks to individual healers which have to keep that target up and the healing required during his soft enrage is quite substancial. I can only imagine how horrible healing that will be for Druids once we get hard modes ... When specced out of Empowered Touch, which healing strategy would you use?

I also think you missed something (or you found it not worth mentioning):
The Nourish based spec wouldn't need any points in NG which leaves more then enough spare points to pick up Revitalize. I know it's not considered an essential talent but it is a nice bonus that would have to be sacrificed along with ET in order to gain NG and CF.

My guild tried a similar "Heal Agro" strat for the adds. I'm not convinced this is the way to go. We had much greater success once we assigned Ranged DPS specific targets to burn down. With 1-2 ranged DPS assigned per add, it was nothing to kill them before they got to the ranged DPS. This also solved the issue with our Ret/Prot paladins picking up incidental agro with some of their abilities. Overall it seemed to be a more sound strat, minimizing the actual possibility for things to go wrong.

So with the Rejuv/RG build you would value Revitaliz higher than Living Seed?

The problem we had on Saurfang was that if we get like 6 or more marks and Druids "buffer" then healing becomes chaotic, some people start to be overhealed and others die. Assigning fixed targets to individual healers solved that problem for us. Yes, it does not play towards a Druids strength ... but it was the only way to avoid confusion and it worked quite well.

I trimmed this down a bit because it was huge. Thanks as always for your hardwork getting down to the nuts and bolts of things.

I do have a few questions, regarding your points and I'll do my best to be articulate.

First off I do not believe it's so black and white, I think there is a middle ground here that we're not exploring.

- We should not necessarily look at CF as 121 haste. I understand the numerical value is such, but again depending on how an individual's gear works out in terms of the best that they can lay their hands on, they may not be at a deficit of 121 haste. It could be less.
- In the only 264 gear profile I made, unless I've mathed completely wrong I don't see the argument for 100 sp for 100 haste. By my calculations I sacrificed around 60 spellpower (roughly) to hit cap without CF. Again this could change with different gear in different slots and I want to be clear I am not arguing that.
- I agree 100% with you regarding how the different talents support each other but it begs the question why do we have to pick one or the other? We could easily return to a 14/0/57 spec, regaining NG to work alongside RG+LS while mainting ET. Yes, this spec lacks CF and that goes back to what I said above.
- I disagree that things are so cut and dry to say that if you have a competent raid group you should be able to ignore the tank healing talents. I'd like to think my raid group is very capable and made up of some truly amazing healers as well. I do not distrust their ability to execute their tasks for a moment. However, raid content does not exist in a vacuum. During progress, something I learned from many many hours a week with Death and Taxes is that things do not work the way you always expect that they should. I would agree with your assessment for farm content, but progress is another beast. Your victories result not only from your ability to execute your job, but sometimes your ability to do someone else's job, and of course luck.

I prefer the ability to step up and tank heal depending on the situation. And I know in a bad situation it's pulled me through what looked like a complete loss. I will not sacrifice those talents if there is a compromise which avoids it. I obviously am running CF now in current gear and will continue to do so until I can make the switch reasonably without sacrificing a ton of spellpower. I will however, make the switch when I feel the gap is close enough. Raid healing is obviously a very important role, but tank deaths particularly on progress are far more concerning than a random dps.

Maybe I should have more considered dropping Living Spirit; it actually adds a lot less than I think people realize. That might be a very good compromise to pick up ET. More detail later.

Yep, also overlooked Living Spirit as a viable choice for making it work. I just am definitely a fan of the middle road spec because of my healing style and also because it's really not feasible for me to run 2x resto specs.

I have been running with 2/3 Living Spirit for a while now, I agree that it's the best place to get a point in a balanced spec. Of course I run two resto specs, and the 'balanced spec' has rapid rejuv (it's good for tank healing after all), while the 'raid spec' optimizes ght. I feel ght's speed and worst case performance is undervalued, it's very helpful on FC/Anub (of course it's farm content for most people now).

My problem with direct healing with nourish has always been the variance. I feel that with direct healing worst case performance is much more important than average case performance. This is because druids direct heal to deal with burst, and burst is about the worst case (as any tank gearing for effective health will tell you). Nourish worst case performance isn't very good (on the raid, on the tank it's great because of all the hots).

Ok responding in more detail (yay for free airport wi-fi). Trying to keep everything separate:

--Value of CF. I don't want to get into minutiae of gearing too much, but best I can tell, if you want to use 4T10 and Trauma, you need very good ICC gear to push far above 735 without gems. Now, a lot of people are going to get a bunch of ICC gear but not Trauma (so they'll have a haste weapon), and get to around 800 haste without gems, which would make CF less valuable. Let's say for now that if you're gemming for haste at all, which most people still will be for a while, giving up CF will cost a little over 100 spellpower.

--Various raid healing solutions. Again, too big a topic to get into fully now. I'll still make a case for people in situations similar to mine not needing to use Nourish very often, and therefore not wanting to spend talent points on it, but I think we can put that aside for now anyway. Lots of people will need or want a strong talented Nourish available, so we should figure out how to fit it in.

Exploring the options for picking up ET, starting from my build (Armory):
1) Give up CF. This is what I talked about already. I'm not planning to doing so right now, but I might with better gear. Just for reference, the haste caps with 1/3 and 2/3 CF are 775 and 815.
2) Give up 2 points from Nature's Bounty. I don't really like this one either. It's a pretty significant hit to your Regrowth. And I think I've made the case above that, even you find it valuable to keep a strong Nourish at your disposal, you'll largely be tossing Regrowth more often in ordinary use, and don't want to heavily weaken it.
3) Give up 2 points from Living Spirit. I left this out of my big post, but I think it might be the best option. 2 points of LS adds maybe 20 spellpower at most, so by anyone's accounting is less valuable than CF. It adds a decent (but not enormous) amount of regen as well--given the ease with which most of us are sacrificing Regen for stronger heals, I don't think that's going to bother anyone too much.

So perhaps, 18/0/53 with ET and only 1/3 LSpirit is what I would recommend as a standard general-use build.