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Fixed Maximum Hit Points for PCs

What if you never got more hit points that what you began with at level 1? Think about it. As 4e is set up now most PCs begin with around 20 hit points. This is enough to take a couple of hits but you are by no means invulnerable. As you get more XP and level up you start to improve and one thing that comes with each level bump is more hit points. But lately I’ve been wondering how things would change if your maximum hit points were fixed. How would this change D&D?

In previous editions of D&D PCs could begin with as few as 1 hit point. Some PCs were extremely fragile and a single hit from anything could, and often did, kill them. Knowing that PCs were this vulnerable forced players to play smarter. If your PC was likely to die from a single hit you didn’t run blindly into a group of monsters, even if they were only Kobolds or Goblins. Tactics were important because they often made the difference between living and dying.