I view the critical updates and security patches as a nusiance more than anything. My home PC is on dial up and so its never connected to the internet for more than 1hr or so at a time. The way I see it is with the dial up connection I don't feel like letting the computer stay connected to microsoft for hours while it installs fixes for their screw ups. As long as I have no problems I just leave it be.
If for some reason my computer is compromised by some outside party big deal. I keep my wanted files backed up regularly and usualy never have more than 6gb on my 40gb hard drive, so if I have to reinstall OH WELL, I do that every 3 or 4 months anyway.