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I see a lot of much more complex macros than what I use.
I have a pally, 2 mages (1 fire and 1 frost), a warlock, and a priest.
99% of the time I simply press "2" or "3".
2 is attack for all but the priest (castsequence macros cycling through dots or offensive spells - there is even the mage elemental summon in there) and the priest castsequence for healing (renew, heal, heal, heal)
3 is attack for all (in fact the warlock, pally, and fire mage just have the same macro in both spots) though the priest attack is only mind blast (long cooldown = less mana blown, but still some DPS)
Pally uses a castsequence for consecrate/holy shield on 2/3
So start the fight by hitting 2 (after the pull) then spam 3 non-stop until I need a heal, then I tap 2 once and go back to hammering my 3 key. For bosses I move the priest attack macro off 3 to an empty spot to conserve mana.
The priest is only healing the tank. Or the whole group (key 5 for me).
The tilde ~ key I bound to strafe on them all - so I tap that to stop follow before most fights.
Oh - and this is obviously for PvE - PvP would require much more complex stuff in terms of heals, etc.
My take on it is to stay simple - be a good tank and it all works.
Just hit 64 and so far I've cleared all the original instances, and Ramps, BF, UB, and SP. I even managed to down Nazan/Vaz in Hellfire Ramparts - that's the toughest fight I've had yet multiboxing.
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All Healing with 5 keys
My team uses a holy pally for heals, my macros goes as follows: (doing this from work, might be some errors)
Numpad 9 (Fire Mage 1) /cast [target=pureundead] [modifier:lalt] Holy Light; [modifier:rctrl] Blessing of Protection; [modifier:rctrl] Clense; Flash of Light
Numpad 6 (Shadow Priest) /cast [target=purehorde] [modifier:lalt] Holy Light; [modifier:rctrl] Blessing of Protection; [modifier:rctrl] Clense; Flash of Light
Numpad 3 (Fire Mage 2) /cast [target=pureforsaken] [modifier:lalt] Holy Light; [modifier:rctrl] Blessing of Protection; [modifier:rctrl] Clense; Flash of Light
Numpad . (period) (Holy Pally) /cast [target=purebubble] [modifier:lalt] Holy Light; [modifier:rctrl] Blessing of Protection; [modifier:rctrl] Clense; Flash of Light
Numpad 0 (Prot Warrior) /cast [target=purezerker] [modifier:lalt] Holy Light; [modifier:rctrl] Blessing of Protection; [modifier:rctrl] Clense; Flash of Light
It's a lil complex, but all the healing uses only 5 keys. Also I have the mages/priest cast remove curse/dispel magic if any along with each heal. This keeps the group pretty clean.
Go Horde, Pure