Mayor Daniel Lurie promised to run San Francisco like it actually has a bottom line. Now the bills are coming due — and some of the line items getting zeroed out are going to sting.

The city is closing three health clinics, including longtime youth centers, as part of a sweeping effort to close an approximately $400 million budget deficit. Layoffs are already underway across city departments, and insiders say more cuts are on the horizon. This is the unglamorous reality of fiscal correction: somebody's program gets defunded, and somebody's job disappears.

Let's be honest about the situation. San Francisco didn't stumble into a $400 million hole overnight. This is the cumulative result of years of ballooning budgets, duplicative nonprofit contracts, and a political culture that treated spending increases as a moral imperative regardless of outcomes. As one Bay Area resident put it bluntly: "The city has a massive deficit, of course there will be cuts."

And some of those cuts should force a harder conversation about where the money's actually been going. Consider the city's homelessness department, which commands roughly $785 million in the current fiscal year to provide shelter to fewer than 4,000 people and some services to another 4,000. As one local noted, that's an extraordinary amount of money producing modest results — and much of it flows to a web of contracted nonprofits with limited accountability. When you're spending nearly $200,000 per sheltered person per year and the crisis isn't improving, the problem isn't underfunding.

That said, closing youth health clinics isn't nothing. These are real services that real families depend on, and the optics of cutting clinics while the bureaucratic middle remains largely intact will — and should — invite scrutiny. If Lurie wants credibility as a reformer, the cuts need to be strategic, not just easy. Trim the administrative bloat. Renegotiate the contracts that deliver overhead instead of outcomes. Don't just slash the stuff that serves actual people because it's politically simpler.

The predictable chorus is already calling for higher taxes on billionaires. But San Francisco already taxes and spends at levels most American cities would find surreal. The issue was never revenue — it was discipline. Lurie's budget ax is overdue. The question is whether he swings it with precision or just flails.