In the end, designing for the web is designing for a lack of control. I can't control your screen geometry, display technology, browser compliance, fonts, and more. There is no fixed canvas like I had in print.
This isn't a limitation, this is simply the medium. Designing for this medium means that you must take your canonical ideal and figure out how it would be transformed under different stresses: tiny screens with partial user attention, big screens viewed from couch distance, monochrome screens which don't refresh quickly, modern browsers with fast javascript, and old broken browsers.
Great design does make things better, but it isn't about pushing the design decisions onto the user. There's no argument that Dustin produces beautiful works of art, but designing with manual layout of the kind he describes is designing against the grain of the medium. CSS has limitations, but so does print. Design is what you accomplish within those limitations, and how you go about accomplishing it in a timeframe that allows you to complete your project and make a living.