I think you're mixing together things that you don't like with things that are bad. You think that health "adds nothing" to gameplay. I flatly disagree. This is a matter of judgment, not Olympian pronouncement. Complexity is a continuum. I've never liked the specialist aspect of Civ games much, for example; it's simply too micro-management inclined for my tastes. But I understand that they add value that other players enjoy, and there are occasions where I include them in my games.
What I like about health is that it gives me a way to get an edge over computer opponents, much in the same way that I can do so by proper city placement or by intelligent usage of workers and choices of tiles to work. For you it's a detail that you don't care about. There is nothing wrong with your opinion or gamestyle. There is something wrong with assuming that your particular approach is universal.
You're missing my fundamental point - which you effectively state yourself as "is that it gives me a way to get an edge over computer opponents, much in the same way that I can do so by proper city placement or by intelligent usage of workers and choices of tiles to work".
This is the point: it's not "much in the same way", it's *exactly* in the same way. You won't do anything prompted by the health mechanic that you wouldn't do without it in order to gain an edge, for all the reasons given above. There isn't anything in the mechanic that provides any mechanism for giving you an edge you aren't *already getting*. Intelligent city placement automatically gives health advantages; that's not why you settle there, and it's not a component of intelligent placement in itself, it's just an incidental bonus you get *from doing what you would do anyway*.
You would keep cities small anyway to keep costs low - health doesn't factor into it one way or the other, not least because the drawbacks from health don't bite until after you exceed the happiness threshold for growth (which gives you a stronger incentive to constrain city growth).
You're going to settle and improve bonus resources because they give you superior production - it's, again, an incidental bonus that you will also get empire-wide health effects as a result.
And so on and so forth. It's a detail I don't care about *because it doesn't do anything*. I wouldn't settle in a jungle anyway, unless it has bananas/gems etc. If it has bananas/gems etc. I wouldn't chop it down anyway.
You're talking in generalities but haven't given any specific examples of a decision you would make with the health mechanic included that differs from one you would make without it included. In fact I can think of a grand total of two cases:
- Settling a flood plain vs. not settling a flood plain.
- Building a grocer vs. a market, and then this is (1) constrained by the resources you have access to, and (2) not relevant in commerce-specialised cities, where you'd build both.
You could simplify the game by removing tile development too, or workers, or
roads.
Every one of which would have demonstrable effects on play. Taking Civ V's game engine, what decisions would you make now that would not be the same as decisions you'd make if the Civ IV health mechanic were reintroduced, all else being equal?
You'd still have ways to promote growth (by choosing where cities are.)
The issue is that health didn't promote growth, or indeed discourage it. It just meant that cities in places you'd build anyway wouldn't suffer ill-health until you reached a higher threshold than cities in places you wouldn't choose to build. Happiness exerted an influence on growing cities sooner than health, so your decisions about constraining growth were independent of the health mechanic; you'd limit growth purely to limit unhappiness.
There are particular choices which I regard as true design flaws, but there is not a one-to-one match between "bad game design" and "things about Civ 5 that I didn't like".
I can say the same, about both this game and its predecessor. As I've pointed out elsewhere, for instance, fundamental aspects of the religion mechanic were cases of poor game design (and indeed poor simulation, as in my overused example of all those polytheist religions with priesthoods that are unable to build temples because someone else got Hinduism first). At the broadest strategic level, it didn't even add anything much to the game - much like health, in fact, it tended to reward the way you'd play anyway, with the more happiness buildings and the wider your empire, the more reward you'd get. And yet it was a very enjoyable mechanic; nevertheless I've argued strongly elsewhere that if it were to be reintroduced, it would have to be essentially completely redone, for not dissimilar reasons to the above. And it did at least have that key strategic element: decisions you made with it in the game were not exactly the same as decisions you'd have made without it.