The guy's Scottish, he thinks it's about San Fran specifically, it's really about AMERICA. Maybe San Fran puts it even more in your face. But compared to most any other country even half as rich as America, the lack of social safety net in the U.S. is kind of shocking. People in Europe don't really realize the extent of it.
For example, Honolulu has a huge homeless population despite the huge tourism industry. The city just pushes homeless towards parts of the island where tourists don't visit and thus aren't aware of the problem.