I don't considered 200 shots to kill anything is balanced, I'll admit straight away that I am a casual player so I tend to play on easy or normal, but in any mode I find that multiple shots to a vital part like the head for example is unrealistic, find some other way to balance it, because in my opinion that's a poor way to balance, do something like make it more difficult to hit the target, in FO3 it was a little irritating to hit someone in the face with multiple shots only to have them still charge at you, at the very least they should be blind from the blood!,
Thing is, it's just not a "realistic combat sim". It's a goofy, pseudo-science, sci-fi RPG.
I'm not saying make it easy to kill the target, just make it harder to hit them, that would be more realistic.
Actually, the whole "Damage Threshold" thing is more "realistic" than the FO3 version. If you shoot the guy in really heavy armor (high DT) with a lightweight gun, he just stands there and laughs at you.