My 460 GPU runs with an aftermarket heatsink (Alpenföhn Peter) and 2 500rpm fan with 5 db, so that the card doesn't make a noise even if you game full on. During stresstesting it stays around 80C which is fine for the card, as long as you don't go above midrange cards such as 7850/6850/560. Obviously you'll have to throw away that shitty manufacturer cooling solution, as most of them are unable to lead the heat away sufficiently passive.
Dunno why you all started to talking about GPUs but I don't think that's an issue as long as you don't want the most extreme card and OC.
If you compare what you can get for a 400w fanless PSU, yeah you can get a 800w with silent fan during low loads. You can argue that it's a better solution, but I think it's preferable to have a PSU that outputs 400w if your system load is 200-300w, and the build quality of the top fanless PSUs are as good, if not better since they have to be able to output max power at 50c, maybe even 60c ambient.
The issue with having a PSU fan as I see it, is the fear of it powering on and making it audible if you play games or do something intensive. In my current build, my graphics card is noiseless, my h60 is clearly audible even at idle, and my PSU (thermaltake xt) is pretty noisy. I'm trying to avoid that for my next build.
And as far as I know, fans are the first parts to fail in high quality PSUs, so we get that out of the way for free.
As you said, they still are expensive but what you pay for is an incredible build quality (rivaling many 1000w PSUs), getting it fanless and efficient is just a bonus.