I'm pretty much in agreement with everything you wrote here, but I want reply to one thing you mentioned...

You somewhat disagreed with, "we know that most developers do not have great design/refactoring skills", because developers may have little chance to refactor. Totally on board with this; lack of understanding of technical debt and how it impacts a team's achievement is one of the biggest problems with software management.

But my point - which I clearly didn't make well enough - was that refactoring and design skills are really the same thing, and I've seen enough modified code to understand what the design skills of most developers are.