Here are the results from 32-bit x86 on core2 duo gcc 4.0.1 using 
pydigits_bestof.py 4000:

30-bit digits                     (14):  15719 ms
30-bit digits + optimizations (13+ops):  12490 ms
unpatched py3k                        :  13289 ms

(again, i had to manually add #define PYLONG_DIGIT_SIZE 30 to pyconfig.h 
for the longdigit13+optimizations patch).

and pybench runs on the same builds vs unpatched:

30-bit digits                     (14):  -1.4% (slightly slower)
30-bit digits + optimizations (13+ops):  -0.2% (insignificant)


My votes:

Obviously use the optimized version (but fix the configure stuff).

+0  for enabling it by default on 32bit builds.
+10 for enabling it by default on 64bit builds.