[generalk]

  > CSS to change colours and relative proportions is, I suppose, a concession that had to be made 
  > to 'designers', but when you, as the page author, are having to concern yourself with 
  > typography, then something has gone horribly wrong. 

Have you stopped to consider that some page authors want to concern themselves with typography? Not everyone is aiming to just dump content at a user-agent, and not every message is best delivered that way.

Also: nobody has to concern themselves with design. I'm sure you know that you can put up some semantic markup and expect UAs to figure it out, and they will. If you want to let browsers dictate the layout of your content, that's a doable thing. If you want to put some directives on top and tell the browser what fonts/colors/positioning etc you want, that's doable too. Where's the issue?

  > Did these designers ever stop to think about blind people relying on text-to-speech? It's obvious 
  > how that should render <em> - with emphasis - but what does it do with "letter-
  > spacing:110%;"?

So, you're saying that because some user-agents ignore visual styles, nobody should use visual styles? I mean, a screen-reader is going to ignore things like letter-spacing, font choices, etc, anyway.

  > Fixed-width web pages are _evil_, where by evil I actually mean _stupid_.

Those are some pretty loose/insulting definitions of both "evil" and "stupid."