Rent is high in New York and Silicon Valley because the markets are warped by regulatory corruption and the extreme illiquidity of the market. Right now, local incomes can support those levels (just barely) but that can change, and when it does, urban decay will set in. Urban decay starts at least a decade before prices start to drop, because people hoard real estate rather than selling it when the market softens.
The problem with real estate markets is that there's extreme demand inelasticity, which means that declining conditions (reduced effective supply) actually cause aggregate prices to go up, in the same way that a hurricane in the Gulf drives up gas prices even though it's not a good thing.
The idea that high rents come from "desirability" is hopelessly naive. Very rich people can live whereever they want, so the difference between a $50-million apartment vs. a $10-million one is driven by those factors: how old the building is, how many third-world despots and celebrities live there there, whether it has a view of The Park. For the rest of us, the rent we pay is dictated by scarcity conditions rooted in regulatory corruption and the slow reaction of new housing construction to economic forces (i.e. that 10 jobs can be created faster than 10 houses)-- not "desirability". Real estate agents want you to believe that the reason The Rent Is Too Damn High is that New York is such an awesome place to live, but economics don't bear them out. Supply-side disruptions and failures push up prices much more than actual value increases or income improvements.
Regarding high-paying jobs outside of those locations, they exist but there aren't as many as there should or could be. The near-impossibility of getting funding for a new technology business away from the coasts is a real problem. Venture capital is ugly and I'd really like to see us, as a society, come up with something better, but it's the only option for a lot of companies in the global marketplace.
As for universal healthcare, we would have had it in 1948 if the Dixiecrat racists (who were afraid that a universal plan would require them to desegregate the hospitals) hadn't threatened to destroy Truman by stonewalling everything he did. Universal healthcare plans have problems-- Canada's system is far from perfect, and the UK's NHS has some serious flaws-- but all of those plans are leagues better than the horrendously shitty system that we have in the U.S.
You make an extremely good point. NYC and SF rents would not be nearly as high if there were more supply, and there isn't more supply because the housing market is so over-regulated. Manhattan is cramped, but outside a few places in the UES and Financial District, it's filled with block after block of low/mid-rise construction, mostly 80+ years old. The reason is that it's extremely difficult to tear down this crap and build new high rises because of regulations.
Also because of our property-tax regime. Tearing down a depreciated/ing low-rise to put up a fresh new high-rise will cause a reassessment of your property value, and because the building is new you'll get hit with a massive tax increase based on your property value shooting up.
The problem being that real-estate property values are only liquidated on selling a building, so you just end up passing the tax on to renters.
A tax on land-value or space usage tends to work better for allowing high-value construction to be done rather than continual depreciation of a whole city.
The problem with real estate markets is that there's extreme demand inelasticity, which means that declining conditions (reduced effective supply) actually cause aggregate prices to go up, in the same way that a hurricane in the Gulf drives up gas prices even though it's not a good thing.
The idea that high rents come from "desirability" is hopelessly naive. Very rich people can live whereever they want, so the difference between a $50-million apartment vs. a $10-million one is driven by those factors: how old the building is, how many third-world despots and celebrities live there there, whether it has a view of The Park. For the rest of us, the rent we pay is dictated by scarcity conditions rooted in regulatory corruption and the slow reaction of new housing construction to economic forces (i.e. that 10 jobs can be created faster than 10 houses)-- not "desirability". Real estate agents want you to believe that the reason The Rent Is Too Damn High is that New York is such an awesome place to live, but economics don't bear them out. Supply-side disruptions and failures push up prices much more than actual value increases or income improvements.
Regarding high-paying jobs outside of those locations, they exist but there aren't as many as there should or could be. The near-impossibility of getting funding for a new technology business away from the coasts is a real problem. Venture capital is ugly and I'd really like to see us, as a society, come up with something better, but it's the only option for a lot of companies in the global marketplace.
As for universal healthcare, we would have had it in 1948 if the Dixiecrat racists (who were afraid that a universal plan would require them to desegregate the hospitals) hadn't threatened to destroy Truman by stonewalling everything he did. Universal healthcare plans have problems-- Canada's system is far from perfect, and the UK's NHS has some serious flaws-- but all of those plans are leagues better than the horrendously shitty system that we have in the U.S.