SF suffers from many of the same problems that other much-more-conservative cities suffer from, but you don’t hear about them as much because it doesn’t fit a narrative.
I live in NYC, and visit SF often for work. I’m fascinated in the similarities and difference between the cities.
For example, pre-pandemic SF public transport had half the daily ridership per capita that NYC had, implying workers there were much more dependent on cars. That, combined with the much lower housing density, meant that white-collar workers were much less interested in returning to the office.
NYC and SF have a similar unhoused percentage, yet one seems worse. Maybe a bunch of that is due to laissez-faire policing? But it could also be due to SF’s climate that makes being out on the street year-round slightly more doable.
Downtown has particularly low housing density. How much of that is due to SF government, and how much is due to big tech paying ridiculously high rents for buildings?
SF has much more property crime than Los Angeles, but lower violent crime than Los Angeles (and most other big cities).
SF was a place to cosplay city life for people who commuted into Silicon Valley. Recently the VC network seemed to claim it but that's by definition small numbers.
I think it's a hard problem to solve.
AFAICT, it's a topic where different political ideologies suggest very different (and largely incompatible) solutions.