The first one is a plain unformatted text which you can easily insert into placeholder. You don't need to use wysiwyg tools to enter unformatted text.
First one will look unpredictably in a browser, second one will look exactly how you want it too.
So what's the point of using first one if it has no advantages from the designers point of view?
Now back to the accessibility. Let's take an example.
Here's the site exported with WD without any particular attention to the accessibility by the author:
http://webdesigner.xara.com/
Here's the NVDA, open source, free voice reader software:
http://www.nvda-project.org/
Open this site in Opera for example, and read with NVDA.
Do you hear any influence of the tag mess?
Is this inaccessible site?
Try, and you'll see. Or hear actually.
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