It seems to me that many programmers don't appreciate that industry practices or regulatory requirements impose quirky requirements on domain specialists that everyone knows are far from optimal but which need to be complied with anyway if the business is to turn a profit or retain its licensure.

Someone mentioned a health insurance example above: there's 50 states, with 50 different sets of insurance regulations, and then some additional territories, federal regulations, and then wird business practices of healthcare providers who are subject to their own 57 varieties of regulation, and there are powerful economic and political interests that get in the way of burning it all down and replacing it with a single system designed by a committee of one patient, one doctor, one nurse, one pharmacist, one lawyer, and one economist.

And even that highly simplistic requirements committee went through 3 versions while I was writing it up.

The domain experts already have lots of complex knowledge and experience they need to automate. They don't want to learn about databases. Unfortunately, the reverse is equally true.