> 3. We rely too heavily on the ability to patch after the fact...

I agree on all points and to build up on the last: making a 2.0 or a complete software rewrite is known to be even more hazardous. There are no quarantees the new version is better in any regards. Which makes the expertise to reflect more of other highly complex systems, like medical care.

Which is why we need to understand the patient, develop soft skills, empathy, Agile manifesto and ... the list could go on. Not an easy task when you include you are more likely going to also fight shiny object syndrome of yours execs and all the constant hype surrounding all tech.