The way I see it, the main way in which the citizens of SF can fix it is by voting for something different, but they don't. So it certainly does seem like they find the status quo preferable to alternatives.
Before you jump to that conclusion you have to be sure that:
- such politician exist (politician is not where we humans shine)
- you believe the ones who claim they will fix it
- the one that you believe can fix it don’t come with values that you cannot accept (extreme example: “I’ll kill all homeless people. vote me!”
Given there are/were cities that are not in such decline and such a state, including SF itself, it definitely seems like there are politicians that can fix it.
The values conflict may be relevant. If, for example, you think it's critical to allow and facilitate your fellow man to become total enslavement to drugs that destroy their lives and health and eventually kill them, then I can get that you won't want to do anything to stop it, even if you have to live in squalor for that to be the case.
Not really. People have just deluded themselves into thinking that the current situation is somehow more humane than mandatory rehab and institutionalization.