You'd lose something because those decisions would be impractical for 8-bit and 16-bit targets (which still exist in the world of embedded programming).
My main point is that a C programmer today is forced to learn dozens of rules just to cater for many niche platforms that they will probably never target, so if you were to separate those two use cases you can get a much more neat C that targets modern 64 bit architectures with all the power of traditional C but a bit less portability.
That's a nice theory and is what we've got, but it falls down in a few places.
The first is that the "int" world has got a bit munged - some platforms make some slightly strange choices for long and short and so you can't always rely on it (although int is usually pretty sensible).
The other is that when doing unsigned maths, rollover is silent so generally you really need to know the exact size at coding time so that you can ensure that rollover doesn't happen silently.
Together, these mean that you're generally just better using uint32_t (etc.) all over the place and you get more predictable results.
I am wondering if this complexity exists due to historical reasons, in other words if you were to invent C today you would just define int as always being 32, long as 64 and provide much more sane and well-defined rules on how the various datatypes relate to each other, without losing anything of what makes C a popular low-level language?