Shock therapy

Some California lawmakers and corrections officials are breathing a sigh of relief over the ouster of Robert Sillen, the special administrator charged with repairing the healthcare system in the state’s 33 prisons.

They should know better. Sillen was confrontational -- a bully, even -- but that’s exactly what was called for. California’s prisons are so overcrowded that the failing medical system veered into a continuous violation of the 8th Amendment guarantee against cruel and unusual punishment. Medical care for criminals may not rank high on the agenda of most Californians, who must grapple daily with insufficiently funded highways, schools, water systems and other public services. But if humane treatment of the incarcerated is not a priority, consider this: One looming response of federal authorities to the prison health crisis is to release criminals before their time is served.

Sillen showed little sympathy for the state’s budget problems, and even less for the territorial concerns of prison officials and lawmakers. It was useful for Sacramento to have to defend itself against someone who, pardon the expression, took no prisoners when it came to constitutional absolutes. But Sillen couldn’t get the job done. U.S. District Judge Thelton Henderson, who appointed Sillen as prison medical receiver, wanted standards and benchmarks against which to measure improvements. When Sillen didn’t deliver, Henderson replaced him with a man who has ably ridden to the rescue of various fumbling California government departments: McGeorge School of Law professor J. Clark Kelso.

It’s an inspired choice. Kelso is no shrinking violet, and state officials who have been around for even a few years realize that they will not be permitted to slow their pace or avoid significant spending. But the professor knows state government well, and knows how to work with other officials to get things done in Sacramento. He’s done it before, picking up the pieces at the insurance commissioner’s office when Chuck Quackenbush resigned under fire, guiding the unification of state trial courts and overseeing California’s information technology office.

But bureaucrats and politicians should not forget Sillen. He delivered the shock of reckoning that had until then been sorely lacking. That reckoning may already be at hand for the prisons’ medical system, but judgment day is coming on prison overcrowding. Meanwhile, the state may be facing a calendar filled with days of reckoning, as the failure to invest in vital services -- indigent healthcare, homeless services, foster care -- catches up with us. California has to take such investment seriously, or it might have to deal with a whole platoon of Sillens.