Lizard said:
3e (and D&D in general) has features which require thought before worldbuilding; 4e adds some new ones, different enough that they haven't had easy 'conventional wisdom' solutions built up over the past 30 years.
While this is undoubtedly true, you are being overly fervent in your efforts to create specific, large differences where there are at best minor ones.
Regarding the overnight healing:
1) D&D does not have a wound system. It didn't have one in 3e, it doesn't have one in 4e. If you want one, make one, or add optional variants in.
2) I see no obligation to use the same overnight healing for npcs, whom I also refer to as "plot points." When a PC is stabbed and nearly dying, and regains his hp overnight, I can describe that as him being bandaged up and ready to fight. When an NPC is stabbed and nearly dying, I don't think I'm cheating to describe him as having a severe, irreparable stomach wound that will keep him off the field for months. If that's what I want, that's what I do. Its only a violation of realism if you believe that "pcs regain hp overnight" is a law of physics instead of a guideline for how to best describe player characters.
3) This whole matter is overblown because in 3e it takes a typical NPC almost no time to regain all their hit points.
You regain your level in hit points per full night's rest. If you do full bed rest all day, you regain twice your level. A healer can double this rate with a skill check for up to six people per day, and still cast all their cure spells. Even without a healer, if your NPCs are getting bed rest, you can expect them back up to full power in very few days. For a 4 HD NPC with a d8 hit die and no constitution bonus, that NPC would probably have 18 hit points, and would heal from 1 hp to 17 hp in two days.
Two days. Now its one day. And with a heal check, its one day in 3e as well for our wounded example NPC.
This is not the immolation of verisimilitude. What's happened is just that an edge rule that already broke verisimilitude and that you probably ignored at times for plot reasons has been highlighted by the edition shift. If you play 4e, feel free to continue to follow or ignore this rule as necessary in exactly the same way that you did before.