Yeah, I get the level of abstraction of HP and all that. That's just the example.
I want to talk about the effects that abstraction in 4E - hp or healing surges or skill challenges or power sources - has on player choice.
Lostsoul, I think I undeerstand what you're getting at with this question and if so I believe it is definitely an interesting conundrum to explore, so let me try to answer from my own experiences in 4e...
The greater abstraction, IMO, of 4e leads to a process that is mostly non-narrativist and non-simulationist in nature when the game is being played. To expound on that a little...
I have found, IME, that when making a decision (especially in combat but outside as well in such matters as skill challenges) are actually making decisions based on gamist (as in the behind the scenes mechanics) as opposed to what best fits a believable world or best suits the narrative. To further expound here's some examples...
In a skill challenge a simulationist approach would be to use a skill that interacts with the "reality" rules of the simulated world in a believable manner as to arrive at the result one wants. So you would not use your History score to recall knowledge of rock formations in order to help you climb a sheer cliff face, it's (from most perspectives anyway) unbelievable to think that reading about rocks in some way taught or helped you climb cliffs. However Athletics to actually climb would be totally acceptable to players and GM's in a simulationist game.
A narrative approach would be to use whatever skill is best suited to the story, whether they are good, bad or irrelevant in order to achieve the desired narrative flow of the story. In fact you would actually choose to use a bad skill on purpose if a failure would be more to the liking of everyone's sense of the "story", of course many narrative based games will reward the choice to fail with a special type of reward, meta-mechanic, or beenie... since the most important thing in a narrative game is sustaining the narrative flow, theme, etc. that the players want... not competing and succeeding against mechanical challenges.
Finally the gamist approach, and what I see in majority of D&D 4e games is to select the skill you have the highest score in and then try and justify it's use... not because it is appropriate narratively or because it interacts with the world in a way that it believably simulates a coherent reality... but because mechanically it is the optimal choice.
You can also apply these things to combat as well (and honestly I believe it is why the majority of players in 4e choose to only use powers as opposed to ad-hoc moves and stunts. If I'm an avenger who pumped up Wis because my powers are based on it... why would I ever try a maneuver that relies on Strength or Dexterity (unless I'm a Pursuing Avenger) and risk a way bigger failure chance? It's a mechanics first way of thinking.
I think both D&D 4e's abstraction and it's decidely gamist bent encourage and even reward this behavior as opposeed to the other two (and of course you can consciously choose to play it in a different style, but I am talking about what the default suggests), and thus your players, when making decisions, will either embrace "choose a superior mechanic first, and everything else later" attitude... or will eventually come around to this way of thinking as the game progresses and this way of play is enforced and rewarded more and more.