VATS accuracy seems fine, but it doesn't seem to account for range at all, anymore. Level 3, 27 small guns, 10mm at about 45% and I was sniping the guys in the pharmacy from just before the cash registers in Super Duper Mart. Of course, after several headshots they do start to close the gap on me and I keep using VATS and the percent to hit is the same at 3 meters as it was at 70ish or so (nearly the span of the building). Would think accuracy would taper down, but the settings are like playing wack-a-mole blindfolded so not sure how it could be achieved with a natural feeling.
I didn't mind how in 4.1.1 with the stats above, I just flat out svcked at shooting and had to actually be careful. The difference is a bit refreshing, but it took a lot of the challenge out.
As far as tactics go... You see a group of raiders? Find a good vantage point with cover and preferrably a predictable path persuers may take, lay out a mine here and there, pop your best chance to kill then take cover and play it safe. Early on (until really 15 or so) it's really really hard to just take on every situation how you want to. If you want to live, you either think outside the box a little, turn down the difficulty or save/load a LOT. Part of the fun is starting as the underdog and growing up to be the big dog.