If you can't change design cheaply

If you can’t change design cheaply because refactoring skills are lacking, you’re less likely to end up with a suitable design for a given problem that emerges from insights you get as a byproduct of refactoring.

That’s to say, teams that struggle with refactoring skills are also teams that most likely struggle with design skills, because tapping into a rich pool of domain and design insights generated as you refactor in small, safe steps is out of their reach.