SF might be great for some, but it's not for me. Unfortunately, SF, Seattle, and Vancouver always top the lists and they're all places I wouldn't dream of living in any time soon. If I'm moving, I don't want to take a pay cut. I wouldn't trade a $50,000/yr job in the midwest for a $100,000/yr job in SF, because I'd actually have less money than I do now.
I'd rather be rich in a swamp than poor in a city. I just really wish there was a list of great cities like Grand Rapids, Pittsburgh, or Kansas City where you don't have to fight traffic for hours a day, you can actually buy a house somewhere close to work, but you can also work for a great company doing something exciting and make a livable wage doing so. As you allude to, most lists of "best mid size cities" point to retirement-age people.