First of all, the reason for my recent lack of posts is because I have a seasonal job for the Forest Service, and where I'm living I don't have consistent internet access. Still, I may post something every now and then.
Now on to the subject of the post. I skimmed through the skill powers in the PHB3 and thought "meh." Some looked sort of useful, worth the Skill Power feat but probably not a replacement for a class utility power slot (unless, of course, it's one of the newer classes with fewer power choices, which inevitably leads to levels with no interesting choices). Then I was reading the WotC message board, and someone commented about all the new ways to heal, citing skill powers as one of them. My interest was piqued. I hadn't really read through the powers for Heal, but there are some real gems in there!
Starting as early as level 2, you can get an encounter "let an ally spend a surge" (albeit, a dying ally). At level 6 there's 2 melee range powers, one that lets you or an ally spend a surge, and one that lets an ally second wind without taking an action to do so (the former is a standard action, the latter a minor). At level 10 you can allow an ally to regain second wind. And at level 16 you essentially get the Cleric's CLW (underpowered for its level, but still).
Endurance is even better, at level 10. And immediate reaction to spend a healing surge when you become bloodied! As an encounter power!
So why are these skill powers that facilitate healing so significant? Simply put, it mitigates a role imbalance that has been present in 4e from the outset, namely that the most important role to have in your party is the Leader. Sure, every character has a second wind, but for difficult encounters most parties will need more than that to survive. Now, any character with the Heal (or Endurance) skill can boost the party's (or their own) survivability by trading out their own class Utility powers, or even better, for the price of a feat.
Leaders are still extremely valuable (for buffing, and for easier healing resources), but now most groups will feel less pressured to include a leader in the party just because they feel that they have to (especially since controllers share the responsibility of buffing/debuffing with leaders).
Plus, skill powers obviously make skill choice more meaningful. Heal and Endurance were fairly low priority skills before (at least in my experience), and this makes them more competitive. So in general, while skill powers tend to be slightly underpowered compared to class powers, they can be invaluable in filling gaps in the party, and having the option to either trade out a class Utility or spend a feat (or do both) provides even more options for customization.