Figured I'd toss this bit of advice out for anyone in a similar situation as me.
Apparently the latest update did something funky to the settings in the game - where before I went about 3 days of sweet, smooth playability, today I went to play and BOOM, crash on startup. I cleared my tray folder, still crashed. Uninstalled, redownloaded, and it loaded far enough to ask for the patch. I patched, and again, BAM, crash on launch.
On a whim, I right clicked the icon in my start menu (I'm running Windows 7), and clicked "Run As Administrator" and the game fired right up.
May not be the solution to everyone's problems, but I doubt I was the only one tearing his hair out trying to get the game to actually launch.
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1. Right click the icon for The Sims 4 on your Desktop (not Origin) and select Properties
2. Click the Advanced Button
3. Enable "Run as Administrator"
4. Click "OK"
Once you do this, you can run the game as administrator simply by double clicking the icon on your desktop as normal.
I think the patch has to rewrite some of the game's code (which is a pretty duh statement) so when you launch the first time, the game goes to update itself and can't if its missing the Admin privileges. Since I installed that last patch and spent that day tearing my hair out, the games been launching normally ever since.