An interesting option could be a "drop side" pickup body. Have the section of the rear body over the wheel well be able to drop down somehow to make bed access easier. What I am thinking of wouldn't make 5wh towing easier, but just getting stuff in and out of the bed.
My 2008 F250, which is 2 wheel drive (I know! horrible!), is pleasantly 6" or more lower than most pickups today it seems.
Ford's tailgate step, which I really wanted, was just being introduced and it would have been an amazingly expensive option. But... the factory installed running board steps alongside the truck are Great! And I highly recommend them.
