Very few places in the world can feed the labor needs of a fast growing tech company. Even the largest companies in the Bay Area have to go to New York, LA, and elsewhere to hire more people.
What that means is that you are welcome to start a company wherever you like, but when it comes time to hire a lot of people fast, you wouldn't want to be in any other place.
The navel-gazing doesn't really occur outside of that environment, and the "need to scale" is really just a pissing contest that amateurs crow about while the real men and women get shit done by growing organically, turning a solid profit quarter after quarter and not caring what SV hipsters that don't know what the word profit means say they need to do.
I can only speak for DC, but there is a huge labor force here of highly skilled engineers that have been working on (mostly top secret) defense / intel projects at huge government contractors. They know their jobs are there for them again if they leave and decide to come back, and often they are happy to jump ship and work in a startup if the team and product are compelling.
I imagine DC isn't alone in having a niche industry of highly skilled engineers that would be open to startups. Often they're not involved in the startup culture though so it takes some effort to find them.
Isn't this THE problem everyone is complaining about in the Bay Area right now?
but when it comes time to hire a lot of people fast, you wouldn't want to be in any other place.
I can name so many other places in the world that I could hire way more developers elsewhere.
There's different types of technically capably labor supply. The one your talking about is most likely the people who are writing very complex algorithms, NLP, or the "hackers" who are writing rails apps over the weekend. The other 90% is writing Java, .NET, SAP (ABAP), etc for big co. These resources are not in short supply and can be found virtually anywhere in the world.
I know of a few small, profitable companies that acquire talent by luring them away from major metro areas. Also, lots of big companies are attracting talent from people who are not in an urban cluster like SF, NYC, etc. IBM is a great example of that.