As for the getting it right at the design stage I agree, but it is not always possible or even desirable. I happen to have very few changes to make but a change is a change and requires respect - hence the OP.

Changes can occur for lots of reasons, usually they are used to add features. For example say I am ( and I really am ) designing a small simple web shop. After a few months of trading it turns out that discounts would be a good thing for customers spending over a certain amount. To accomodate this the database (and code) needs to be changed. This sort of thing cannot always be spotted at the initial design stage and it would be impossible to take into account all the possible future features that are needed.

In summary: Yes, getting it right at the start is a good thing, but so is making changes based on lessons learnt.