Yeah. My main gripe with art is that if you're not capable of having good art, you often wind up with zero-sum art; what the art adds is taken away by its lack of coherence with your material or a lack of quality; I'd take a black-and-white line art image similar to those in Shadowrun 3rd over any number of low-budget Photoshop filtered public domain images that I've seen in other works.
It's not just layout. That is a major concern, especially when you have people who don't follow basic typographic principles (as many one-man productions do), but it's also about the quality. I believe it was in Transhuman that Posthuman Studios included several images that had so poorly drawn facial proportions throughout that it was hard to take them seriously. In this case, adding more images actually detracted from the art; even if they didn't have images Eclipse Phase's typesetting and layout could have carried it, but by using those images it came across as more amateurish than it should have.
For most medieval and fantasy stuff, there's no excuse not to have art, and places like OpenGameArt make it increasingly possible to find good openly licensed art for genres which don't have existing public domain works (speaking of which, are there any alternatives to OGA? I know Deviant Art, but it is incredibly hard to find CC-licensed stuff on there of any quality in part due to its really obtuse licensing).