Dr Fallout
Centurion
http://www.neogaf.com/forum/showthread.php?t=1083443
Many people in this thread can't even go and play Fallout 3 now, much less 10 years from now. Games like Fallout 1 and 2 have aged much better. This is the kind of audience they cater to though.
I see a trend where a large number of people playing these games don't care about the lore in any way. They don't seem to appreciate world building or any sense of realism. These people don't care about video games actually improving, being more highly regarded as something beyond kids stuff with a nonsensical plot, awful dialog, and no attention to detail. In the comments they speak of NMA. One person mentioned something along the lines of NMA Flamelord. Catchy title.
To add my 5 cents to your nice post, when you say realism I feel it would be more accurate to talk about verisimilitude. A setting like Fallout doesn't necessarily require a lot of realism, outside of the basics, like humans requiring food, water and the like. Even a world or setting that seems highly unrealistic from a scientific standpoint can be believable as long it is consistent within it's own framework. This obviously doesn't apply when you talk about simulations, like a tank-sim where as much as possible should be grounded on the physics in real life, with a few limitations.
Basically the game should make rules... and FOLLOW THEM.
Like Morrowind, the original Fallout games, Lord of the Rings and various other game/book/movie worlds.