The patches fixed things up quite well. I still have glitches from time to time, and my current game has some missing sounds(?). But the glitches do not detract from what is an excellent game like they did right after release.
I'd count myself in that lazy-RPG crowd, and I love NV, as I did FO3. It does require a little bit of effort to get going, and you have want to explore. Once you've come across a few people with their own quests, things begin to pick up and get really fun. The more 'immersive' elements like crafting ammo and campfire cooking/chem-creation can all be bypassed with no real penalty, given that ammo/health items are often cheap, and plentiful.
For $12.50, you're getting a heckuva bargain.