As someone who did some UX for a touchscreen product in Healthcare, it's 100% just boring old capitalism making real work impossible.

Any time immediate profit is put above the company "Mission Statement" (which is every time) it becomes impossible for designers to do a good job.

I was working with a broken and 90's looking UX/UI and made a modernized Material 3 style redesign that never even got full evaluation because it "wasn't a priority".

They'd regularly recognize UX problems and ask for the best solution. I'd research, test, and design options, explaining how I got there, and then a non-designer from an unrelated department would say some nonsense and we'd scrap the whole thing.