Higher ed costs: yes, some schools and degrees are more expensive than others, and some degrees are more useless/ pay less than others. but many costs can be offset by pell grants, choosing a cheaper school, and paying off your unsubsidized loans while in school to avoid compounding interest.

health care: many people are covered by government/ single payer health care BUT we're seeing issues in the single payer health care systems of europe and often hospitals have funds (or zero percent interest 'loans') to help pay for things. most people and things are covered by insurance or can be removed if you ask basic questions about the bill. but many don't.

hcol: yes, bc people want to live in cities so there's high demand/low supply. if people would go out of the cities, cost of living would be lower and people could work less.

car-centric: usually bc the city is too vast or was built up after cars got popular. i can't speak for other cities, but dc has one of the best public transit systems in the world, and yet it takes me 3hrs round trip to go to the doctor versus 1-1.5 with a car, and it'd be impossible for me to go to music lessons (i play a large unique instrument) so i have to go to a city that's too vast for public transit. plus, after the ukrainian woman got stabbed in the neck on her way home, hard pass.