As you know if you read “Terminal Sickness,” the much-discussed article by Phillip Longman and Lina Khan in the March-April issue of the Washington Monthly, airline deregulation has proved to be a nightmare for former “hub” cities abandoned due to airline closures and mergers, such as St. Louis, Cincinnati, Memphis and Pittsburgh. But it’s even worse for smaller cities served largely by regional airlines that are struggling to survive.

The New York Times‘ Jad Mouawad provides a depressing but useful overview of the darkening picture for small-city air service, using as his point of departure a 12-hour itinerary for one unlucky traveler trying to get from Mobile, Alabama to Cincinnati over Easter. Such horror stories aren’t so unusual these days.

The major airlines have been paring service for much of the last decade. But their cutbacks accelerated three years ago as carriers merged, fuel prices spiked and the recession reduced demand for seats. Even after the economy started to recover and passengers came back, the big airlines did not restore many of their flights, particularly on routes to small airports, as they sought to bolster their profits.

The strategy has squeezed the regional airlines, whose purpose is to ferry passengers on behalf of the major airlines and provide the backbone of air service to the nation’s small airports. Three regional carriers have filed for bankruptcy protection since 2010, including Pinnacle Airlines in April.

Mergers that reduce hubs, rising fuel costs, airline profit strategies, and a host of competitive (or non-competitive!) factors have hit all airlines and virtually all cities, but it’s the regional carriers and the smaller cities that have seen the most severe cutbacks in service, particularly for nonstop flights, notes Mouawad:

The result is that travelers now face more complicated itineraries, often involving a connection at a big hub airport, and trips that used to take two or three hours can now stretch all day.

Fares in the smaller cities have also risen the most. Ticket prices out of Bellingham, Wash.; Harrisburg, Pa.; and Fort Myers, Fla., for instance, jumped 16 to 18 percent from the third quarter of 2010 to the third quarter of 2011, while the average nationwide increase was 6 percent, according to the latest data compiled by the Bureau of Transportation Statistics.

Higher fares for less service: that’s the general trend in an airline industry where deregulation has not worked out as advertised. Smaller cities are simply on the tip of the spear, and bleeding.

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Ed Kilgore is a political columnist for New York and managing editor at the Democratic Strategist website. He was a contributing writer at the Washington Monthly from January 2012 until November 2015, and was the principal contributor to the Political Animal blog.