Reply to Leaving DC for a lower COL area

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]

A few easy examples:
- With basically one exception (Mayo Clinic), every top hospital in the U.S. is in or adjacent to a major city.
- The vast majority of top research universities are now in major cities (and indeed, they always would have been had it not been for the land grant acts).  This is in large part because urban universities have a dramatically easier time attracting top talent.
- Growth industries and the industries that feed into them (e.g. venture capital) are extraordinarily concentrated.  See e.g. https://www.bloomberg.com/graphics/2018-venture-capital-deals/

Ask basically anyone in any of these industries, and they will tell you that not only are these things true, but they are getting more true over time.  Are there lots of ways to make a living and live a middle class lifestyle in smaller cities in the U.S.?  Sure.  But it's no secret that the top of the food chain is exceedingly concentrated, and only getting more so over time.[/quote]

I’m sorry, did you mean Cleveland Clinic  :wink: [/quote]

Metro Cleveland has over 2 million people, and 3.5 million if you use the Combined Statistical Area definition.  Also, Cleveland used to be one of the richest cities in the U.S., which is why some of its long-established institutions have been able to hang on.  No knocks on Cleveland from me, but that's hardly typical of most smaller cities in the US.[/quote]

I think it would be better to say that all of these places that pp is familiar with are in big cities.

I'm sure pp just define away every exception we come up with, but how about the University of Alabama Birmingham Medical Center?

According to U.S. News and World Report: "The UAB School of Medicine ranks among the nation’s best medical schools, according to the 2019 U.S. News and World Report’s “Best Graduate Schools Rankings.” It ranked No. 37 in medical primary care, No. 32 in medical research, and No. 15 in obstetrics and gynecology."

Or the Andrews Institute for Orthopaedics and Sports Medicine in Gulf Breeze, Florida?  Professional athletes fly in there from all over the country.

Or Baylor Scott and White in Temple, Texas?

There are excellent hospitals all over this country.

And, even if I grant you that most "top research universities" are in cities (which I'm not sure is true), that would be because the cities developed around them.  Even as the Texas Capitol, Austin was, for a very long time, a small town. The area boomed [u]because of [/u]the University.   I also love how you explained away land grant universities as not counting, so you don't have people citing those back at you.  So, Ann Arbor, MI, Gainesville, FL, College Station, TX, Troy, NY, Bloomington, IN, Auburn, AL, South Bend, IN, etc etc don't count?  [/quote]

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