Now, think about this for a second. What is the fundamental difference between skills and perks? There isn't one, really. Every time you level up, you get a (perkpoint/skillpoint) that you put in a (perk/skill), and it makes you better at (science/medicine/guns/talking etc...). The way I see it, the perks in Fallout 4 are the skills, just a bit confusingly laid out. If you invest, say, 100 points in Guns in New Vegas, you will do a lot more damage with guns. This is the equivalent of spending 5 perk points on gun-related perks in Fallout 4, in which case you will also do a lot more damage with guns, but it will be the guns that you chose to spend perks for, like say if you invested 3 of them in the Sniper perk, one in the no-scope accuracy perk and one in the non-automatic Rifles perk, you would have a completely different build than one who spent all of them on pistols. Furthermore, the benefits you would gain from the perks are much more diverse than just a flat hit bonus or damage. They range from armor piercing, knockdowns, ammo use, accuracy, pretty much anything you could think of regarding the "skill" that they're related to. So in conclusion, the skills are an unnecessary abstraction that don't help to define your character any further than what can be achieved with perks. Saying that a character can heal crippled limbs with stimpaks and has 20% armor penetration with revolvers is more describing than saying he has 25 Medic skill and 50 Guns skill.