Despite its good intentions, San Francisco is not leading the country in gay marriage. Despite its good intentions, it is not stopping wars. Despite its spending more money per capita on homelessness than any comparable city, its homeless problem is worse than any comparable city's. Despite its spending more money per capita, period, than almost any city in the nation, San Francisco has poorly managed, budget-busting capital projects, overlapping social programs no one is certain are working, and a transportation system where the only thing running ahead of schedule is the size of its deficit.
...Amazingly, this gets worse. After securing the bond funding to save Laguna Honda as a hospital for the elderly, the Department of Public Health began transferring younger, often dangerous and mentally ill patients there and mixing them among the old people. This went about as well as you'd think: A 2006 state and federal licensing survey noted numerous instances of elder abuse, staff abuse, and patients toting drugs, alcohol, and even loaded weapons. One patient was assaulted four times in four months; to address this problem, staff erected signs reading "No Hitting." (That didn't work.) To cap it off, elder activists now worry that a 2009 Department of Public Health–commissioned report will pave the way for even more relatively young, mentally ill patients heading to Laguna Honda. The massively overbudget, behind-schedule hospital may not even end up primarily serving the elderly population that voters were promised it would.
Read the whole thing. San Francisco municipal government makes the DC municipal government look competent.