Following accessibility guidelines are important for a bunch of reasons. By following the guide lines you save yourself a bunch of time in debugging sites on various browsers and different medium types. I have found this to be extremely crucial coming from experience in having to relay out an entire older website to confirm with new HTML and CSS standards it can be a very tedious / nightmare of a job. It seems like the majority of accessibility guidelines can be achieved by properly separating your HTML layout from your cascading style sheets.
I have not done too many sites that need to be accessible by blind people but adding title tags and summaries to tables seem simple enough. You just need to be mindful of your audience and your guidelines for the project. Separating your layout from your styles can save make your code easier to read and easier to update. Not to mention you can totally change the looks and feel of your site by simply enabling a alternate style sheet, this can save you a absolute ton of time. One media scenario I have spent some time on it the print ability of web pages. It seems like very few website can be printed out and the printout actually looks like what you have the screen, or even is understandable at all for that matter. Here is an example below I used for my portfolio page so that it can be printed and actually look decent.
Example Alternate Style sheet
HTML Source
<link rel="stylesheet" type="text/css" href="css/main_layout.css" /> <link rel="stylesheet" media="print" type="text/css" href="css/main_layout_print.css" />
CSS Source
/* Normal Nav View */
div#nav { float: right; color: white; margin-top: -.7em; }
/* Print Nav View */ div#nav { display: none; float: right; color: white; margin-top: -.7em; }
For this example the navigation bar on the printed version of the page will not be displayed allowing more room for your actual content to be printed.
to see the effect live you can check out
http://portfolio.totallyworthless.com/course_outcome/cis_215.htm