Take for instance, drinking water. How many of you have stood in some water and leaning down, cupped your hand and drank by pressing a button. It's actually really cool. The load screen actually say 'drinking water in the wasteland is a tactical consideration, it can offer health replenishment, but it will cause radiation poisoning' or something like this.
The point is, that I think there are so many cool little features in this game that are wasted, because they are simply superfluous. The game is pretty easy, even on Survival difficulty -- so that you rarely need to make careful tactical considerations like 'should I drink radiated water or not?'. Because the game makes it unnecessary.
Even on Survival the game offers sooo much loot and an abundance of items like Stimpaks. It effects other things like cooking... I mean cooking apart from some of the weird buff you get from cooking, using it as an alternative to Stimpaks is simply not needed, given the abundance of Stimpaks even on the hardest difficulty. You should have to hunt and cook, to replenish health...
I find when games are hard, it changes the experience, forces the player to use all the resources available to them, and also play more strategically....