[Suzerain of Sheol]

Unfortunately, it really does matter. Writing is the combination of ideas and execution, and if you forego execution, you're left with ideas -- which are cheap and easy to come by. So, stuff like formatting and syntax really is important. The bad part, though, is that they don't earn you any points -- being structurally and technically perfect just puts you on a level playing field with your competitors, leaving more abstract things like the successful evocation of mood and emotion, thematic resonance, or (in the context of a narrative piece) strong characterization and engaging dialogue to be the media by which your work is judged.

In fact, I'd say that the technical aspect of writing matters far more than the conceptual aspect, as a skilled writer can make even a dull idea worth reading about, while a good idea on its own can never justify poor writing. It's all about getting those swirling images in your head onto paper in a way that is true to the spirit of the idea, and bringing them to life in a way that other people will empathize with. It's all about execution, and execution is, truly, the hardest part of writing.