David McElroy

About six or seven years ago, I got a late-night phone call from a woman I know. She was really upset and on the verge of crying when I answered. I remember the feelings associated with the conversation far more than I do the details, but I’ll never forget the emotions because I’ve thought about it over and over since then.

The woman was a teacher who hadn’t been teaching long. I don’t recall whether it was her first or second year, but I know she loved her middle school students very much. She was a very good and caring teacher — with a brilliant mind and flair for communicating effectively — the prototype of the rare sort of teacher who anyone would gladly trust his own children with. But on this night, she was upset and confused.

She was on a school trip with her students to Washington, D.C. At some point along the trip, some sort of bullying or rivalry started among her girls. I don’t remember if there was just one victim or if it was a conflict between groups. But whatever it was, it was the sort of ugly, mean, nasty thing that only kids of that age can do to one another. For this kind and loving teacher, it was enough to break her heart — partly because of the pain it was causing for students she loved and partly because it was reminding her of her own miserable school years at that age.

As we talked that night, I sat in a parking lot and listened, but I didn’t have any useful advice to offer. For all these years, I’ve been wondering about it. What causes kids to act this way to each other? And what can we do about it?

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We’ve been told over and over that problems with health care in this country prove that the free market has failed. But what if the medical industry is already so regulated that its problems have nothing to do with the free market?

There hasn’t been a free market in health care for a long time, certainly not in my lifetime. Probably not since sometime in the 19th century. An item in the local news this week is a stark reminder of that to me.

In 2008, Trinity Medical Center in Birmingham proposed relocating from an older part of town to a fast-growing area along U.S. 280, very close to affluent southern suburbs. A major hospital company (HealthSouth) had built a state-of-the-art building already, but the company was hit hard in an accounting scandal involving the company’s founder and former CEO. The company unloaded various properties around the country just to survive, including this hospital which was about 90 percent complete. (That’s the new building above, framed by a nice sunset I shot last year.)

Trinity is currently in an older part of Birmingham near downtown that’s declining. The hospital was founded as Baptist Medical Center-Montclair many decades ago, but the Baptist system sold that hospital to a private company a decade or more ago. Before too long, the new management was looking to relocate to a newer facility closer to a suburban population that didn’t have a hospital close by.

In the current location, the hospital competes with various huge hospitals downtown. Although most people don’t realize it, Birmingham is a major center for medical research and health care. The medical industry — clinical and research combined — is the biggest in the area by far.

After an aborted plan to move to the suburb of Irondale, Trinity decided that moving to the unused HealthSouth building was more economical and would provide access to a better market. There was only one problem.

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Why would someone tear down a $4.5 million building that’s only 13 years old? If you’re a government agency, you do it because you simply want to build something else. After all, you’re not spending your own money.

In Birmingham, the local mass transit agency built a fancy new central terminal for buses in 1999. It’s across the street from the Amtrak station, and the Greyhound bus station is a few blocks away, in a location where it’s been for many decades. When the new terminal, shown above, was built, it was supposed to be the first phase of a larger project that would combine a terminal for Amtrak, Greyhound and local transit buses. The agency has been talking about an “intermodal facility” for years.

The Birmingham-Jefferson County Transit Authority is a county-wide, inter-government agency, but it’s the Birmingham city government that drives the bus, so to speak. Mass transit is important to a substantial number of people who live in the inner city, but it’s irrelevant to almost everybody who lives in the suburbs. (I’ve never been on one of the buses and I see many of those big buses riding around the area virtually empty.)

So why is this very expensive new building being torn down this summer? That’s not clear. Nobody seems to ask hard questions — and make them stick — when it’s “government money” involved.

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