What about healthcare?

Insurance seems to cover less and less while premiums rise and rise. It feels like these companies want us all to be sicker so they can make more money. I don't know how people who are in dire need with chronic conditions or cancers manage to deal with them. It is the fifth circle of hell. One is bounced from one group to another to get prior authorizations. If you take the time to google these groups they are all held by private equity. The marginally more user-friendly apps don't make up for the broken process underneath them. On the phone, low-paid employees, if you can even get to them under the AI, read robo-responses to reject your claim and then wish you a nice day and thank you for being part of their insurance company, or add on entity owned by private equity.

It is insane and enraging. Now that I have had just a small interaction with them, I'm amazed we have not had a revolution over this.

I don't know what I am paying for, and I have what is considered good coverage. But I am now forced to pay heavy prices for the first major RX I have really ever needed.

No. But it's the biggest part.

Anonymous wrote:

Anonymous wrote:I mean, is a box of a Cheerios really cheaper in Peoria than NOVA?

How do you expect the grocer to make the extra money to cover the increased rent due to higher property values? And how do you expect the bodega in ny to cover the cost of the tolls and congestion charges just to get into the city? Not to mention spending more on wages because their labor also needs to spend more on rent and their material goods. It’s a complex world out there.

It is complex because people don't buy groceries the same way in NYC and most less dense cities, suburbs, etc. The grocery owner pays high rent for a small space and serves a clientele of people within a walking radius. People aren't paying tolls ans congestion charges to drive to a bodega in Manhattan, the way they drive to a gigantic Costco warehouse in suburban NJ or Super Walmart in rural NY, where price per foot is much lower but overall property size is much bigger. The number of people vs size of transaction is also probably very different in a bodega vs warehouse store. And they don't necessarily need to cover a large staff, many are owner/family operated.

I have shopped in bodegas and produce stands in NY as well as privately owned grocery stores and chains in many other places, and I was actually surprised at first that costs for non-specialty items were the same or lower in NY. There's probably a supply chain/transportation factor too. But I agree that basic food costs don't contribute to higher COL anywhere near the extent that housing does.

The really frustrating part (IMO) is when you live in a smaller actual city, you can organize much of your life to be walkable/bikeable, but there just isn't a density of small or medium size grocery stores near residential areas.

Lower COL areas have cheaper housing, fuel, groceries, prepared food, childcare, insurance, etc.

What doesn’t seem to be cheaper is electricity.

Anonymous wrote:So if your salary in the middle of nowhere, as a nurse (let's say), is 50k a year and your salary as a nurse in NYC is 200k a year, those 150 dollar jeans are going to seem ridiculously expensive on a 50k salary but not so much on a 200k salary. Even if each nurse puts 40% towards housing.... which will of course cost way more in NYC... think of what is leftover for cheerios, clothes, plane tickets, car payments, etc for nurse 1 as opposed to nurse 2.

On $200k, who is buying $150 jeans.

Anonymous wrote:I mean, is a box of a Cheerios really cheaper in Peoria than NOVA?

How do you expect the grocer to make the extra money to cover the increased rent due to higher property values? And how do you expect the bodega in ny to cover the cost of the tolls and congestion charges just to get into the city? Not to mention spending more on wages because their labor also needs to spend more on rent and their material goods. It’s a complex world out there.

I’m not an economist, but I’ve always figured that in addition to housing, child care, etc., it’s also what a large pizza and a 2L of Coke will cost.

So if your salary in the middle of nowhere, as a nurse (let's say), is 50k a year and your salary as a nurse in NYC is 200k a year, those 150 dollar jeans are going to seem ridiculously expensive on a 50k salary but not so much on a 200k salary. Even if each nurse puts 40% towards housing.... which will of course cost way more in NYC... think of what is leftover for cheerios, clothes, plane tickets, car payments, etc for nurse 1 as opposed to nurse 2.

Housing is the biggest ticket item so it's the one that makes the biggest impact, yes. Childcare is also a major expense for families and costs tend to be closely linked to the housing market because the biggest overhead costs for childcare facilities are rent/real estate costs (commercial real estate, obviously, but it tracks with housing costs often) and labor. You have to pay people enough to live, and if housing is expensive, then labor costs go up. Even if there is cheaper housing further away, then you have to compensate people enough to afford to travel to work, and most places in the US don't have adequate public transit for workers, so they need enough for cars and gas. But it's all linked to housing which drives where people live and what they can afford.

But this then impacts most other consumer items, too. Cheerios isn't a good example because people are most likely to buy Cheerios from a chain store (with supply chain efficiencies even in high COL areas) and because as a major brand name, stores are sometimes restricted in how much they can charge -- General Mills might cap a box of cereal at a certain amount as a form of brand protection, and they can enforce it because no one wants to be the grocery store without Cheerios. Issues like this are one reason why grocery stores operate on very thin margins.

But restaurants and entertainment are more reflective of COL issues. It's why even if you are used to DC prices (pretty high) you will still get sticker shock in, say, London or San Francisco.

I believe the COL differences are mainly -
- Housing
- Childcare and other domestic staffing
- Transportation (and distance of home - work - school/daycare)
- Private schools

Household goods and food costs are really not that much. In fact in a diverse metropolitan place, you have more chances of having both Harris Teeter and H Mart. Small towns are mainly ...dollar general.

People get screwed because they have - 1) student debt, 2) no monetary cushion, 3) health issues etc.

I will say that most people can withstand an increase in food prices...but many cannot withstand an increase in gas prices or heating/cooling costs.

Childcare, groceries, and entertainment also cost much more in large cities.

It is state and city tax dependent. Gas is more expensive in CA than other states because there are state taxes that CA attaches to gas that other states don't attach, as just one example.

It’s groceries, gas, restaurants, etc. Also sales tax is different in different counties.

Yes. I have family in the Seattle area and things like chicken thighs are routinely 5$ a lb more than what I pay here in MD…I could go on, but you get the idea.

I mean, is a box of a Cheerios really cheaper in Peoria than NOVA?