CA -Using Muscle To Improve Health Care

Now this is the job you want to get. He makes a half a million dollars a year.

SAN JOSE, Calif. — Last year, shortly after receiving extraordinary powers to overhaul the medical system in California’s prisons, Robert Sillen, armed with a stack of court papers, issued a blunt warning to cabinet officials at the governor’s office in Sacramento.

“Every one of you is subject to being in contempt of court if you thwart my efforts or impede my progress,” said Mr. Sillen, a silver-haired former hospital administrator chosen to carry out the overhaul of the prison medical system as the result of a class-action suit brought by a prison advocacy group.

Backing up his warning, Mr. Sillen handed out copies of a federal court order that named him the health care receiver for the California prison system.

In a subsequent warning, Mr. Sillen threatened to “back up the Brink’s truck” to the state’s treasury, if need be, to finance better medical services for the state’s 173,000 inmates.

State figures show that court-ordered changes to California’s prison system, including those in Mr. Sillen’s health care domain, have cost more than $1.3 billion, and the meter is still running.

For decades, California officials have tried to bring order to the state’s prison system, which is the largest in the nation. There have been lawsuits, special legislative committees and a declaration of a state of emergency by Gov. Arnold Schwarzenegger, but never has one person attacked a problem, piece by piece, with such blunt force and disregard for political convention as Mr. Sillen has the prison system.

Mr. Sillen, whose $500,000 annual salary puts him among California’s highest paid public officials, said he had never visited a prison or thought much about the penal system until a recruiter called last year to persuade him to accept what the recruiter called a “mission impossible.”

Now he has the power to hire, fire, raise salaries, build facilities, waive laws, tap the state treasury and have jailed any bureaucrat who tries to thwart him.NY TIMES