I wasn't born here but my parents came here just after I was born, and they had lived here before that, I did grow up here, I've lived in other (N. Am.) cities, and I've studied a bit about San Francisco's history (Viva Emperor Norton III!) and I've seen more-or-less first hand SF city politics.
This city is nuts.
It's always been nuts. (Since the arrival of the Europeans, I don't know what it was like with the Ohlone https://en.wikipedia.org/wiki/Ohlone )
First it was sort of concentration camps for the Native Americans run by Spanish Catholics.
Then "Commodore John D. Sloat of the United States Navy sailed into Monterey Bay in 1846 and began the U.S. military invasion of California," https://en.wikipedia.org/wiki/California#U.S._Conquest_and_t...
Minutes later gold was discovered at Sutter's Mill and the Gold Rush was on
https://en.wikipedia.org/wiki/California_Gold_Rush
That was a pretty nutty (to put it mildly, very very mildly) time...
Eliding all the craziness between then and the "Bohemia by the Bay" period brings us to the 1950's (https://en.wikipedia.org/wiki/San_Francisco_Renaissance) which then leads directly to the Summer of Love a decade or so later (https://en.wikipedia.org/wiki/Summer_of_Love)
There has always been a dark side to the city, from the tortured and murdered Indians, to the Jonestown Massacre. Sick shit has gone down here. It's not all sunshine and roses.
Last but not least, this city has been the catch-all for all the folks who are too weird or crazy to fir in in the rest of the country. There's even an old joke about it here.
It's only in the last twenty years, since all the tech companies and hype have come, literally since the Dot Com Boom (and bust). Remember that?
Before 2000 nobody but the crazies came here to live. I can't emphasize this enough.
All this "What's up with San Francisco?" is a young person's perspective. It's only by totally ignoring the entire history of the city up to ~2000 A.D. that the current situation seems puzzling or strange.
So anyway, to answer the immediate question: Yes, red tape and bureaucracy are wielded here with a perfection of hypocrisy. If you don't know a "fixer" you can waste hundred of thousands or even millions of dollars and years trying to get projects approved.
We do build things: the new Bay Bridge, and a tunnel under Chinatown, but some of the things we build are crap: The Millennium Tower is sinking, the sidewalks are pulling away from the buildings in Mission Bay (Mission Rock?) The new transbay terminal cracked, etc. https://en.wikipedia.org/wiki/Transbay_Transit_Center#Extend...
Then there's the recent and ongoing FBI probe into corruption, with the arrest of the director of Public Works among other things ( E.g. https://sfist.com/2020/07/15/ongoing-fbi-corruption-probe-hi... )
So yeah we have things like empty "luxury" condos next to folks living in tents in little shanty towns.
(The condos aren't actually lux, they look nice but the construction is crap, the folks in the office are sales not managers or maintenance, to get maintenance you call a call center in another state or country, the owners are a faceless LLC or other corp, etc. These things are all over the place!)
The city does house and feed some homeless people, credit where credit is due. Some folks have been put up in hotel since COVID and some other things have been done.
But we spend $250,000,000 (a quarter of a billion dollars) on less than 10,000 homeless people. As you can imagine most of that money is not just given to the homeless people themselves. Most of it goes to people who are not themselves homeless. Those people don't actually take any homeless people into their own homes and care for them. I'm not sure exactly what they do with all that money, but I'm sure the folks who get paid to "deal with" homelessness in SF are able to pay their rent or mortgage regularly and on time. (I feel a rant coming on, so I'ma stop myself there.)
So yeah, this is a case where the sensationalism is actually warranted in the sense that the situation here is "sensational" (but not in a good way, unless you have lots and lots of money, then you can avoid the worst of the bad stuff by isolating yourself in the nice neighborhoods and taking uber, etc.)
The educational system here is also wildly mismanaged. I could go on but this is already a long post. We recently recalled three school board members for being too nuts and radical for SF! Also the DA got recalled!
(A friend of my sister works for a school, the new principal of which turned out to be so fucking crazy the kids themselves went on strike! They literally walked out! I don't think this made the paper even locally, and I forget the name of the school, if anyone asks me I'll ask my sister about it, okay?)
To sum up: it's nuts here, it's always been nuts, but at least it used to be mostly fun nuts, and now it's more like a 90's cyberpunk dystopia nuts.