Wow that's on-point, agree that in many past projects "inertia to larger changes" is exactly how I would describe so-called Clean Code.
It's that small changes like adding getters and setters give an easy-to-follow PR, a false sense of accomplishment for both the author and the reviewer, and ton of dopamine with that. While important changes, that actually deliver business value or repay technical debt, become increasingly difficult to do without replacing massive amounts of code and redoing the file structure.
Yes that's the theory, yet currently any company with sufficient capital or geopolitical advantage can be an effective market leader, while at the same time operating inefficiently at a loss.