This game really is not about loot. The random loot in the game is something I personally really like - NOT because it resembles the way loot is handled in loot-centric games (such as Diablo) but because it adds an element of surprise and fun to the game. And, most importantly, depending on how much a player values the quality of loot he gets, it adds greatly to the replayability.
There are various 'Unique' items in the loot tables that will not drop for you on every playthrough. But these items NEVER serve to 'tailor to specific builds' and they never should. For these unique, named drops, the item ITSELF should define the playstyle. That is what itemization is about.
This combination of Unique drops and a random loot table that is almost always spot-on in terms of Item Levels (the most general way to determine loot can be used or not) = creature levels, makes the way loot is handled 'complete' to me. I don't want tailored loot in this game and repeatable encounters would destroy the balance of all content played thereafter (additional XP that was not factored in, combined with perfectly minmaxed characters). The game does not change a whole lot with great gear - the basis and the character development is way too solid for that. It is quite apparent in many aspects of the game that the game is not loot-centric, and even if you don't like the randomness, you can work around that by making a 'loot save' before the last hit on a boss. All you need to do is hit F5.
TL:DR? 'I rest my case' in regards to loot. Things are fine as is and loot tables don't make or break this game, and never will.
