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Comment by j_m_b | Hacker News Reader

I just got back from a visit with family in Cumberland. It's the epitome of rust belt. What used to be a thriving manufacturing area has become an abandoned service-sector economy with low-wage jobs. Property values are dirt cheap, even for nice houses. There isn't much nearby, you have to travel hours from Pittsburgh to even get there by plane. Tales of theft of items like power tools from relatively remote farms are common. It doesn't look quite as bad as videos I've seen of poorer parts of Appalachia, but it's pretty close. I don't know how they will be able to afford this as the tax base has all but left and Cumberland is trying to pinch every penny they can to afford their over-compensated government staff. It's a pretty sad state of affairs, this seems more like a last-ditch marketing effort.

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Sounds like a place I wouldn't mind working if I can find a remote position again. I'm a big introvert, and I would like to move somewhere more greener (getting tired of living in the middle of a bland hot dessert)

At some point, many people start thinking about things like access to good healthcare, various types of trades, ability to travel without it being a huge hassle, etc. Doesn't mean you need to live right around a big city but I doubt I would want every task or appointment to be a big undertaking.

Healthcare is huge. It's amazing how terrible access to good care is in many rural areas. It's something people often overlook but it's just so important.

Here in Australia people retire ‘down the coast’. For us that’s the stunning south of NSW. Look up Eden (yes, really, Eden).

And then … they come back to the city. Because the older you are the more medical care you need, and there just aren’t enough doctors down there, or in any other regional area.

My parents are going to retire on the Gold coast for this reason. Quieter life but several big hospitals and Brisbane nearby

All the doctors want to live in LA and NY. This problem only gets worse as medical school, etc becomes more competitive and costly.

The problem is a mix of people leaving rural areas which increases per patient overhead at facilities, plus mergers and private equity takeovers.

Hospital chains and healthcare systems have been consolidating like crazy for decades and it's still going strong - 80 or so hospitals merge every year. PE has also been snapping up private practices like crazy, too.

https://www.kff.org/health-costs/issue-brief/ten-things-to-k...

Though the consolidation is something of a mixed bag. My community hospital network had some pretty good docs but lab work, appointments, and so forth was pretty much faxes and phone calls which sometimes worked. Now they're on Mass General Brigham's electronic records system and it's a lot better.

It's not quite that bad. For example, the Boston area is arguably as good or better than those two cities. And some higher-income relatively small town/rural areas are pretty decent. But it definitely becomes a bigger consideration as you get older--although you can of course get unlucky at any time.

(desirable coastal cities with young people and vibrant entertainment)

It's a lot more than that but, as you get away from at least medium-sized cities, things get scantier especially if you need specialized care.

It’s a problem in the medium sized cities too? Because many of the smaller rural facilities are being closed down (often in the wake of for-profit buyouts), and then all those displaced patients overrun the remaining facilities in surrounding towns.

Are we saying anything different?

Have you seen the medical offices in Scottsdale?

Telemedicine / remote surgery should solve this.

I doubt it. Physicians (and nurse practitioners, etc. at urgent care clinics) could arguably do more remotely but I'm not convinced that reducing the involvement of trained humans would be a positive move.

Think you missed the implied /s here :-)

I think a lot of people actually believe that kind of thing.

I was rather impressed with the nurse practitioner at a CVS Instant Clinic a couple of months back. I could have tried to get an appointment with my primary care when I got home. But when I actually saw her a few weeks later for a scheduled appointment, she basically shrugged and said she'd have done exactly the same thing the nurse practitioner did. (Keep taking Tussin and there's a prescription for an inhaler at the pharmacy counter.)

Pre-COVID (and the test I took was negative for what little that was worth), it would have been eh you have a virus. Which ended up basically the diagnosis.

If you’d suggested LLMs in some way I probably would have caught it.

No sarcasm implied. There needs to be programs at medical schools (or ideally, new schools in the first place) that teach robotic surgery only.

Why would you think this is sarcasm? The availability of capable surgeons is already limited; when looking geographically, they are extremely limited.

You would have surgical assistants and nurses on the ground, but the actual expertise for surgery shouldn't be location dependent.

This is actually a very good point. The family I visited travel 1hr+ to get healthcare services because the local ones are pretty bad. They're not elderly per se, only a few years into retirement but they definitely have health issues that come with old age. They're relatively well-off and live in the nicer section of Cumberland where doctors and lawyers lived. I can't imagine how bad it is for people who are just getting by.

Don't fall for it. I had family in Cumberland for 20 years and I know it well. It's a very dark place, most people there barely finished high school and drug abuse is really bad.

And live every day as a mark for a robbery? No thanks.

The area around Cumberland, mostly to the south towards Moorefield and Petersburg, WV, has a somewhat similar climate to the Tokaj region of Hungary, known for growing rare botrytized wines that sell for a fortune. I found this one day when I looked at the map of precipitation activity the US and saw an unexpected dry(ish) spot in northeastern West Virginia.

There's a decently sized saffron industry in that general region of the Appalachia and southern PA for the same reason.

Cumberland is equidistant (~2 hours) between Pittsburgh airport and Dulles.

I think this would be equitemporal rather than equidistant? Maybe isochronic? Isochronal? One of those…

Equidistant in time.

Edit: speak up, annoyant... "Distance" is "standing apart". It is not confined to space - in fact, the original meaning is that of "diverging in stances" (i.e. a quarrel), and the geometric one comes one century later. And there exist languages where speaking of "distance in time" is language in use - so, if in your neighborhood they don't speak this way, it is a problem of your neighborhood.

They sound about the same, but "2 Hours to Dulles" would be the better name for the M Night Shyamalan movie.

2 Hours from Allegheny County would be a David Fincher flic.

2 hours from a central hub I'd actually consider a plus. If you travel for work it's bad, but for any personal trip, skipping a connection is pretty valuable. Not just in time, but generally international / longer flights are higher priority, and are less likely to be randomly delayed or canceled.

I was on the far edge of relatively convenient airport access when I was working and traveling a lot (and, at some point, decided my employer was just going to pay for a private car whether they complained or not, which they didn't). Now I travel somewhat less but take fewer discrete trips so just pay my own transportation out of pocket.

Yeah I’m about 2 hours from the nearest real airport and it’s pretty miserable. Anything I can drive in 8 hours or less is faster to drive.

What you don’t appreciate is that it’s not just the added distance, it’s all the extra uncertainty. Losing an extra hour due to getting stuck on the highway behind an accident is a thing you have to account for.

So in the end you end up having to leave like 4 hours or more before your flight.

I live 400 miles in a straight line and I can drive to downtown Atlanta faster than I can fly to the Atlanta airport.

And, as I say, I get a private car and they do not want to cut things close (understandably). So my not uncommon 6am or 7am flights to either get to Europe without a redeye or to get to the West Coast with the afternoon free end up being 3am pickups.

Not quite true for Dulles. You're looking at 3 hours in good traffic, and it's not a relaxing drive. BWI could be done in 2.5 hours and you don't have to deal with the two way road from Frederick to Leesburg.

Not to mention "incest" is a real word there. It is most definitely Appalachia, part of the dark underbelly.

Drive down any number of the "hollars," and you'll see an active smokehouse, yard litter, and an (often abused) wife sitting on the porch.

There are neighborhood kids endlessly circling the streets. An otherwise innocuous occurrence, however in this case the child is pushing 30 years old.

How good is internet access there?

With Starlink, this question is getting less important. Loads of my family in N. Georgia have started using it and it's crazy how much better it is than the local competition

Starlink still sucks for remote work. Every time the satellites switch there is a slight disconnection, causing interruption to Zoom meetings.

I'm sure but for people who haven't had any better, it's like the second coming of Christ. lol

Yes, it one of the best thing that has happened in many, many years, excluding the birth of kids. It made living where we live viable in an age of remote meetings.

I've been on Starlink since it was first commercially available (I got lucky) so I've seen a lot of changes over the years, and this did used to happen pretty regularly, but it has improved quite a bit. I don't know if Starlink fixed it or if Zoom did, but it's much better. Google Meet has handled these hiccups like a champ for a while and has gotten so good it seems like magic.

I've been using Starlink while RVing around all of North America for four months every summer. This is my third summer doing so. Historically, I've bashed on it a fair bit, because it's not the panacea people think it is for on-the-go Internet.

It's gotten way better, though. The main problem with using it on the go is that campgrounds have trees and Starlink hates trees. If you're in one place, that problem doesn't exist, so long as you have a clear northern sky view.

The disconnection thing is a non-issue. I use it for video meetings every day at work. It never disconnects for more than a second or two, and I almost never notice it. Connections always recover on their own and almost instantly.

I've got a couple people on my team in remote parts of Canada and Chile and they both use Starlink to work remotely with my teams every day (zoom, slack, github, etc.). It's been great for the past year or so. Haven't seen any issues with our Zoom meetings.

I wonder if it's geographically variable. How often do satellites switches happen?

Our company uses it for entire construction job sites, it's perfectly fine.

The brochure says "95% broadband", whatever that means.

Presumably the last 5% is the bit that connects to your computer.

That generally means most properties will have decent broadband/>25mbps internet, some will have ADSL <25mbps, and a few won't have internet or you'll have to run it to the property (costs a few thousand USD generally).

The missing 5% was stolen by copper thieves.

70% of households in the county have internet speeds >25 Mbps. Is that metric meaningful to you? What would ideally mean "good internet access?"

I'm working on a project[0] where I sourced this from the FCC Broadband data and am curious about what people are looking for in that respect.

[0] https://www.exoroad.com/us/Maryland/Allegany-County/housing

> What would ideally mean "good internet access?"

For someone who relies on a internet connection for their professional work I'd say 100 Mbps is the floor of "good" in 2024. I think that's what the FCC updated their definition of broadband to earlier this year.

ROFLMAO. I dream of 100Mbps. The only thing my ISP can guarantee is that it will be "at least" 10Mbps.

Unfortunately, knowing that fiber is a mere 0.5 miles from my house doesn't help me in the slightest.

Thank you! Turns out I was missing 'Urban' category, so Cumberland itself still has 99% of households with >100 Mbps available.

Upload, download, latency, and how many options to choose from are what I looked for the last time I bought a house.

I actually asked some of the neighbors about it and called local ISPs.

First, if you aren't already, look into what the FCC is doing with BEAD funding, and consequently what all the states are doing with mapping broadband provision to try and capture some of that money. Tennesee for example.

More generally, there is a little funkiness with the exoroad site. I guess this project is still in the assembly stage?

- When I search for a US county, say Culpeper or Fairfax in Virginia, I get the map and then some very stock images. The images are on things that don't exist in the specific county. E.g. Fairfax doesn't have a cathedral and a giant stately home.

- The crime stats are also a bit weirdly presented. If a county is "9 of 10" for crime that makes it sound terrible...but I think you render it in green to show that it's good? And what does the statistic actually mean? "out of 10 equivalently populated counties?" say, or something else?

Yes it's a scrappy MVP right now.

Images have quality problems, like you described, as I haven't got accuracy figured out across the 3k+ counties.

Crime stat is awkward because everything else 9/10 (schools / snow) sounds like good or a lot. But with crime, it's a feature that people want less of. Since there's so many features I went with 10/10 is consistently good, but I do keep getting feedback about this that maybe I should change it.

Out of 10 is a percentile: 10/10 = top 10%, 9/10 = top 20%, 1/10 = bottom 10%. I'm trying to figure out the right granularity between showing the most important info for quickly figuring out the stat, vs. showing all the details about it, because there's 50 features, with another potential 50, and many have multiple ways of thinking about it. So it can quickly become a deluge of info without the right UI to surface <-> deep.

I really appreciate the feedback and my email is eric@exoroad.com in case this is off topic.

When I looked at the claimed coverage map from providers it was a joke - they just played "color inside the lines" for our region. Ask anyone who has spent more than a couple days here and they can tick off all the areas you don't get any coverage.

Are you in Cumberland? Would you say 99% of households having the possibility of > 100 Mbps is wildly inaccurate?

You can get always get starlink if the fiber/cable is bad.

Sure, if you don't mind regular drops while you're handed off between satellites, and many areas being oversubscribed so badly that people are getting performance worse than DSL.

I only know one person with Starlink, but they seem happy with it. With the previous local provider they paid for 30Mbps, but were getting 15. With Starlink it’s around 230Mbps.

While that’s slower than my cable service in the city, for him, it’s a significant improvement and a big quality of life upgrade.

My brother had it for a while in fairly rural Maine. Eventually got fiber but the Starlink was pretty good if not 100%. I used Starlink on an Atlantic crossing a few months back and it was pretty solid. It's not perfect--or probably as good as my Comcast is these days--but it's pretty good in my experience. But then I'm old enough to remember both pre-broadband and really unreliable broadband.

Stop living in the past. All that is fixed.

No one's getting worse than DSL performance in the US especially not with regards to speeds

If you're in cumberland proper, your main option is cable, which is fine, fast and stable. since the culture is blue collar, their lineman due a perfectionist tier type guys who pride themselves in their craft. they have a guy there who does fibre and is pretty chill but ironically he only runs line rurally (not in the main urban core of cumberland). they have a startup-ish grass roots wireless based internet which is cool but kind of hard to plug into.

They also have various speakeasies fully in the classic unlicensed since but for obvious reasons I won't say where. I would call it a "deregulated" region. Whereas in most of MD you have vehicle emissions and all that redtape, none of it in cumberland.

there are methheads about but police force and community are hand in hand and highly functional

if you're in cumberland proper all you could want is walkable, including an amtrak station that links you directly to DC and chicago, walking distance

there is an aspect of xenophobia but generally if you live there a while, well, if you're willing to live in cumberland that's good enough for most people to welcome you. it does have a small town vibe as far as saying hello to everyone on the sidewalk as such

the other point people who visit may miss about appalachian culture (it is appalachian culture very much so, not maryland culture) is everyone dresses like a methhead, even people who aren't methheads, so take appearences softly.

When the railroad was the internet, it was really the Silicon Valley of its day. Really makes you think.

Maybe youre not familiar with Qwest Communications?

Man does SV have stories to tell that will be lost to us old BOFH ilk:

Qwest communications came about when the railroad realized they had rights to the easement lanes on either side of ALL their train tracks, that allowed them to basically do anything they wanted with that strip of land.

So Qwest Communications was born to run fiber along all the tracks and built a huge fiber infra.

There was a huge scandal with the telecom giants, and Qwest's CEO was convicted:

---

Dossier: Qwest Communications

Creation and Early Years

- Qwest Communications was formed in 1996 as a spin-off from the Southern Pacific Railroad Company. The railroad company had been granted easement rights to lay fiber-optic cables along their tracks, which Qwest leveraged to build a massive fiber-optic network.

Fiber-Optic Network Expansion

- Qwest used the easement rights to lay fiber-optic cables along the railroad tracks, expanding their network across the western United States. This strategic move allowed Qwest to:

- Reduce costs: By utilizing existing railroad easements, Qwest avoided the need to purchase or lease land for their fiber-optic cables.

- Increase efficiency: The railroad tracks provided a direct route for fiber-optic cables, reducing the need for detours and minimizing signal degradation.

Scandal and Conviction of CEO Joseph Nacchio

- In 2005, Qwest CEO Joseph Nacchio was convicted of insider trading and sentenced to six years in prison. The scandal involved Nacchio selling millions of dollars' worth of Qwest stock while aware of the company's financial struggles.

Scale of Fiber Plant

- Qwest built an extensive fiber-optic network, spanning over 190,000 miles across the United States. This massive infrastructure enabled Qwest to offer high-speed data and voice services to customers.

You missed the part where the Qwest refused to participate in illegal surveillance and the NSA destroyed the company for it.

https://www.eff.org/deeplinks/2007/10/qwest-ceo-nsa-punished...

Sorry - Yeah - actually I regret that as I have a humongous amount of /r/conspiracy history in my head - and I forgot that was the real reason.

This sounds a lot like the story of Sprint (Southern Pacific Railroad INTernet?). If I were less lazy I bet I could find the story where this part of Sprint morphed into Qwest.

Reply to mgerdts: The acronym is actually Southern Pacific Railroad Internal Network Telecommunications according to NPR.

https://www.npr.org/2012/10/15/162963607/sprint-born-from-ra...

I had been thinking about looking at history from the lens of information technology.

China is an interesting example, in that it was so well ahead of the curve until around 1700s. In the 1800s, when telegraphs were connecting the Western world together, the Qing dynasty China would not have been able to participate unless pictographs could be encoded as easily as letters (let alone the century of uprisings, rebellions, and civil war).

But look at Tang Dynasty China. The Silk Road was a part of a global trade network reaching through the Middle East, and into Africa, along with maritime routes from India.

It wasn’t just trade goods that travelled. Ideas — religious, cultural, technological, flowed along the network. But they travelled only as fast as trade goods.

I think it is when information is able to flow faster than the physical items that, we might find some insights about what is going on now.

I have good news re: information flow rates

Categorical mistake.

A rural community based on a single industry is always high risk for economic sustainability.

Silicon Valley is has cities older than the USA, was grown by the gold rush, the early movie studios, the defense industry (plus some world class universities), NASA contractors, microelectronics, etc. The most recent iteration is software startups.

Cities are always more resilient than isolated rural communities because they are inherently more diversified in both economy and workforce.

Excellent point.

Longnow.org has a lot of material about the resilience of cities over very long time scales (like, millennia).

Here’s an example on the resilience of cities versus corporations: https://longnow.org/seminars/02011/jul/25/why-cities-keep-gr...

Another example, from a longnow podcast, is the tendency of people to think of themselves as citizens of a particular city (I’m from San Francisco, I’m from Venice, I’m from Helsinki), perhaps even more so than a state/province or a nationality in some cases.

And makes you humble.

Seems like its 2hrs drive from Pittsburg and IAD airports?

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