You'd want Bob Sillen on your side in a street fight.  His voice is sandpaper. His hair is a five o'clock shadow. His cussing could morph a linebacker into a dwarf.  He's brighter than a super nova.

I've known Sillen for more than 10 years, first as a Fresno Bee reporter getting his take on Fresno County's 1996 contract with Community Medical Centers and then working with him when Community was a member of the California Association of Public Hospitals.

His passion for the disadvantaged was clear in the years he ran Santa Clara County's Valley Medical Center. Last year, a federal judge named him to overhaul medical services in California's prison system where, according to news reports, one inmate dies every six days from poor health care.

Sillen is now squaring off with state lawmakers and regulators. The judge gave him a virtual blank check to do whatever needs doing -- he's already hiked wages for prison medical staff, wants to hire more health professionals, construct new medical facilities and shred existing paperwork logjams.

In a testy exchange Wednesday with a state Senate budget subcommittee, the Sacramento Bee quoted Sillen as saying: "It's going to cost what it's going to cost, and it's going to cost more than the body politic is going to want to spend."

You may not personally care about the health and well-being of prisoners, but you should know two things.

Sillen is wrong on occasion, but he's not much given to self-doubt.  This is a watershed moment for him and for the prison health system that has become his cause.  As long as a federal judge gives him leeway, there will be significant change and harsh exchanges, and large sums of money will be spent.

Which leads to my second and final point. In Washington and in Sacramento, you're hearing phrases like "pay/go" and "zero balance budgets."  Essentially, any new spending must be offset by reductions in existing spending.  So, the unbudgeted millions of dollars spent ensuring the health care rights of prisoners will, in all likelihood, come from cuts in hospital and other California health programs.

A wise person would do well to follow the name Bob Sillen.