It's only limited to the imagination and skill of the cad programmer and machinist.
That's somewhat true. What I find is that all people are creative to some extent, but not all have the skill or talent to fully visualize and create directly from their imagination. That's where designers thrive. How a writer uses words to create a book, a designer uses visual language to create all kinds of things, both real and virtual.
And keep in mind that CAD is a tool, just like a pad and pen is a tool. Some are more prolific than others in the varying skills required to fully utilize all facets of these tools. This is not at all a slight at Aluminati or anyone else. Some people just never fully realize the potential of their tools for various reasons.
For instance, most engineers will scoff at CAD surfacing, because they don't see it's purpose snd they think it is adding complexity for the hell of it. Little do they know how difficult it is to design the curvature of a car door, which can only be done with surfacing and clay modeling. You can't design some of the beautiful objects we have in our daily lives with the limitations of solid modeling. Likewise, designers lack the tecnical know how of engineers. It's a relationship that can be strained sometimes, but the relationship is very necessary for mutual success.