At least once a day I remember how much I hate the absurdly low word limits in health-related journals. 3,500 (or in today's case, 4,000) is not enough words, and only serves to convey incomplete and misinformative-by-oversimplification publications.
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Agree with your latter absolutely, not so much the former. This may be the problem: 3,500 words is for "communication" to non-researcher decision-makers. But the vast majority of papers aren't even remotely of sufficient quality to be communicated to those decision-makers.
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For those papers that are building evidence but not independently strong enough for direct communication (which is nearly all of them), we need room to explore every nook and cranny, every relevant robustness check, chart, and relevant theoretical concerns.
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