I read in one of the other topics a suggestion that hardcoe mode be modular. I think that is a pretty cool idea. I did play my first character in New Vegas through hardcoe mode. I thought it added something to the game, but the whole Food/Drink thing annoyed me. In Skyrim, I modded the game to do the same sort of thing but I always kept getting rid of the Food/Drink mods because they were very much the busywork mentioned above. I prefer a mod that adds a positive, small incentive for food, like the current one I use in Skyrim that adds small, but extended timeframe, bonuses to Health or Stamina regeneration rates. The weighted ammo and coin mods are essential parts of the game for me now.
In Fallout 4, I am very likely to use a hardcoe mode (if present) or a series of mods that adds that into the game. I may be remembering incorrectly, but I recalled a bit about radioactive storms in Fallout 4? If I am not just senile and that actually was mentioned, what better vehicle to build a Survival/hardcoe mode around? I'm looking forward to seeing how such a thing might be implemented.