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Anyone who has ever had the book of someone with no design background in their hands will be able to testify that there is a huge difference between books done by a professional typesetter and an amateur (if that amateur isn't self-taught and doesn't otherwise care about design).I've read books double spaced with monospaced fonts on shitty LCD monitors - I was able to ignore the terrible presentation because the content was amazing. I've read books where there was a lot of attention paid to design. The paper was nice, the font was carefully chosen, the drop caps were just right, the chapter bullets were spot on, and the cover art was exquisite. The content was awful. The great design did not make me think I'd spent the money well. The great design did not make me rate the book higher on Amazon.
I never recommend a book because of the nice typeface, or the lack of rivers. I only ever recommend a book because of the plotting or characters or writing.
I have not said (but some people seem to think I have) that design is a pointless waste of time. I have said that given the choice between great content or great presentation that I'd much rather have great content.
These are all visual examples. I want to try and avoid analogy (because I usually pick poor choices) but the same is sometimes true for sound. Some early Beatles[1] records are, technically, decidedly sub-optimal compared to today's technology. But that's okay, because they're still amazing. Some awful dull band recorded with 128 track and a bunch of processing and a great engineer is still going to be bad and bland because, well, just because.
[1] I say Beatles but better examples would be all the music on Trojan records, which are pretty lo-fi. (http://www.youtube.com/watch?v=e3AbgBOcYHg&feature=fvwre...)