There's certainly far more dynamic, exciting places to live in the US than in countries like the UK or France where the capital hasn't brooked any rivals for centuries and the best any other place can aspire to is regional dominance.

That there's also a lot of quieter, left behind places inbetween - well, yeah, that's pretty unavoidable in a country that size. And yes, modern trends in the job market involve a lot of cluster effects, but in a country as big as the US, you can have lots of bigger and smaller clusters - even the most isolated, thinly populated states will have cities and towns with good or great universities, cutting-edge technology companies and a decent cultural scene.

The federal government suggestion could work but to a fairly limited extent as Douthat admits himself - you could achieve a similar effect in a more efficient way by just empowering the states or local authorities more so that kind of jobs automatically gets spread better across the country. Otherwise, I tend to agree that there's not much need for tinkering wih the 'disease'.