
Politics and architecture. You may not think of those two topics as related, but the reality is that building anything in San Francisco is invariably a political act. And when projects require public funding, they are of necessity a political choice.
Proposition A, the San Francisco General Hospital and Trauma Center Earthquake Safety Bond, is one of those necessary political choices.
State law requires all hospitals to meet seismic safety standards by 2013 or be faced with possible closure. Not surprisingly, SF General is an old facility that doesn't meet those requirements.
SF General Hospital (SFGH) plays an essential role in San Francisco. If you are seriously hurt, say in an auto accident, SFGH is where you want to go. It is the only trauma center in the city; in the event of a major earthquake, SF General will be the place that injured people will go to. SFGH are generally acknowledged as the pros when it comes to trauma medicine.
So what is Prop A about? In a nutshell, it's a revenue bond that would raise $887 million to rebuild SF General by 2015. Since it's a bond issue, a two thirds majority is required for it to pass.
$887 million is a lot of money. And it likely won't completely do the job; big urban hospitals are complex projects and cost overruns are unavoidable. But this project is way to important not to tackle.
There are opponents to this measure, too. Their opposition (at least what they state publicly) is that bond financing is not the way to go. Some opponents have suggested using the money the city receives from the big tobacco settlement (the Master Settlement Agreement, as it is called) to fund rebuilding SFGH. Another objection is that the design of the proposed complex could be simplified and made cheaper.
The problem with the tobacco money, is that it's pretty much already earmarked for other city ventures. Politically, it is all but impossible to get a hold of that money for something new. And the simplified design argument fails because hospitals are expensive projects to do right; SFGH needs to be state of the art when it's completed and that costs big money, plain and simple. Changing the building from the proposed curved facade to a rectangle isn't going to bring any savings; it's the stuff inside the building that drives the cost more than anything. The opponents, I have to say, seem to have little knowledge or experience in constructing modern medical centers.
That brings us back to the one option that makes sense--pass Proposition A and get the new SFGH underway. The city can't survive without it.