3catcircus
Adventurer
I think it would depend on the nature of the thing that's being simulated and how well the game does it.
This.
Game mechanics should "feel" like they are simulating something. It doesn't have to be a perfect simulation or even a realistic one, so long as it "feels" like it is.
Hit points are a perfect example of why gamist mechanics don't "feel" right. Originally, in OD&D, they worked, because the entire framework of the mechanics supported hit points - first level fighters got one hit dice, heroes got 4 - they maxed out at 61 hit points. That's it - 61 hp at 10th level. As things progressed, the framework changed, but hit points continued to be accrued in a similar manner, but with different dice used and additional modifiers. Now, we've got PCs and monsters with 3-digit hit point totals.
Compare that to a game like Twilight:2013 (my favorite non-D&D game). All creatures (human and animal) have a base hit point total that is solely due to a combination of strength and constitution (or that game's equivalent) - their base hit points are [10 + Muscle + 2 x Fitness]/4. That's it.
They then use multiples of the base as trip points for injury. (1 hp = a slight wound - a scratch, 2x base hp = serious wound, etc.) At each of these trip points, more serious penalties occur (reflected in the form of modifiers to dice rolls) as well as the possibility of going into shock or starting to bleed out. A critical head wound, for example, renders you unconscious and taking more than 2x your critical hp to a limb has a chance of catastrophically amputating it. If you are in shock, any additional effect that would cause you to go into shock instead makes you unstable. When you are unstable, at the end of each round, each of your hit locations that have a wound level increase that level by one until one location exceeds critical at which point you die of blood loss - unless someone gives you first aid to make you stable.
Compare these two examples: a giant box of hit points during which you are fully capable until you hit zero, or a system where the seriousness of the injury depends upon the amount of damage, resulting in degradation of capability.
Which one is more "realistic" in terms of "feeling" like that is how it could work based on "real life" (where most people equate tv shows and movies with real life, having never seen actual combat or injury impacts on human performance)? Does the TW:2013 system simulate how it really happens when someone gets stabbed with a dagger or shot with a rifle? No, but it is certainly closer than D&D's hit points.
And that is what matters - does it feel right?