Two things became clear in this afternoon’s hearing on the budget needs for prison health care in California: the total cost is still unclear and even then, it’s going to be high.

In the most interesting moments of today’s Senate budget subcommittee hearing, legislators tried to pin down the federal court-appointed receiver, Robert Sillen, on what his reform of the prison medical care system will cost.

Governor Schwarzenegger set aside $150 million in his proposed 2007-2008 budget, but Sillen’s comments made that number seem, at best, optimistic. In fact, Sillen openly speculated that the fixes could be as much as double that amount.

One exchange, in particular, drove the point home.

It began when the subcommittee chair, Sen. Mike Machado (D-Linden), asked if the costs might level off in the near future after the changes have been made.

“Every aspect of the prison medical system is broken,” said Sillen. “It is very, very difficult to project and predict,” he said.

Undaunted, Machado tried again.

“But in your past, you’ve been a very successful administrator of a health care system,” said the senator. “And I can’t imagine you going to that board of directors, and not knowing what you’re going to be spending money on. I would think that you would have some cursory spreadsheet that would give, if nothing else, a number in a ballpark.”

Sillen: “I have never, in my 40 years in health care experience, ever seen anything like this.”

And then, the federal receiver dropped the bomb.

“It is going to cost what it is going to cost,” Sillen said. “And it is going to cost more than the body politic is going to want to spend.”

You can hear the full (longer) exchange here.