Whilst I personally have no issue with the minus health aspect of bleeding out, what I do disagree with is the logic behind it; namely the -10 and dead, bit?
Having thought about it logically, why would a six foot plus warrior bleed out as fast as a scrawny little caster type - races not withstanding, as for this post I shall stick with humans, no offence to the other races.
In these terms what I would prefer is to use the 'bleed out' method based on either a character's Strength statistic, meaning that a warrior with 18 Str would bleed for longer compared to that of a cater with 10 Str, or a combination of stats.
For me this would be a better reflection of a character's physical development in keeping with their chosen profession/lifestyle. Admittedly, this could lead to many caster characters being rolled with greater Str stats than normal, so maybe in that regard maybe the combination of Str + Con = average, would suffice for their 'bleed out' statistic?
It's basically adopting the same principle as gaining bonuses from stats for chosen professions, as casters gain better saving throws vs magic due to increased Intelligence, and for warriors a greater Strength gives a better chance to 'Bend Bars & Lift Gates'. These things, by comparison, never seem to crop up as much as bleeding to death due to massive trauma through combat or falling, etc.
Using this line of thought, take two character sets of stats - one a caster and one a warrior:
Str - 10
Dex - 11
Int - 17
Wis - 15
Cha - 10
Bleed out score = 13 (Str + Con, rounded up)
Str - 17
Dex - 16
Con - 15
Int - 12
Wis - 10
Cha - 8
Bleed out score = 16 (Str + Con)
At least now, the warrior has three rounds of bleeding more than the caster before death claims them. So now the usual '-10 health = death' is removed and replaced by the varying Bleed out score of each character. Racial adjustments, plus or minus, would have to be taken into account, but my feeling is this is a more workable mechanism than the old -10 = death ruling.
Obviously I've used the old D&D aspect of stats and bleeding to death rule, which most likely has changed, and even been scrapped, but not having played the newer D&D rule systems I cannot comment. For this I apologise, in case I'm talking about something already done or scrapped altogether.
Feel free to discuss or comment.