Eh, I don't think the usable loot issue is that different than D2 in general. It's just that the AH has morphed our perception of what "usable" is since you can find so much better from the AH that potential upgrades are that much rarer. You can basically skip entire tiers of progression with the AH and that's what causes the "so much worthless loot drops" issue really.
But pretty much everyone chugged potions like mad and used town portals to get around the fact that their drops weren't enough for the content. And it was possible to farm your current act to gear up for the next one. Something that will finally be fixed later this month in that patch.