I think it matters in terms of creating and maintaining tension, even fear. Of course, in the PnP, with no reload, that fear of character loss is very real, whereas in a videogame...it's so pointless that it should probably be a null factor.
There's something wrong with the design if it drives the player to actively look for an escape from reload instead of caring about what happens on the screen even if the reload is there.
In terms of simple, I'd say simple compared to Panzer General or, I dunno...Jagged Alliance? I'd hope for much, much, MUCH more complicated and rich than Gears of War.
Ok. So having black and white there and the preference being lighter than black, but much much much darker than white, where does that leave you in practice? Somewhere around Wizardry 8 (I actually wouldn't mind a CP game close to that format, though less grindy)? Fallout? Gothic?
I'd also like to see a combat log readout so you can see all these equations play out as you move, aim, shoot, activate Sandevistan, your Smartgun kicks in, etc. You could even plug it into the Biomonitor, a piece of cyberware that typically sits in your wrist and feeds back your status and health parameters to you. Kind of like a built-in PiPboy.
I'd love combat log. But it's a bit confusing; if combat is to be fast and furious with a need for speed, when will you have time to check it and evaluate the information to your benefit or amusement in the situation?