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Tucked within is a provision that could provide billions of dollars for walking paths, streetlights, jungle gyms, and even farmers' markets. The add-ons - characterized as part of a broad effort to improve the nation's health "infrastructure'' - appear in House and Senate versions of the bill.
Critics argue the provision is a thinly disguised effort to insert pork-barrel spending into a bill that has been widely portrayed to the public as dealing with expanding health coverage and cutting medical costs. A leading critic, Senator Mike Enzi, a Wyoming Republican, ridicules the local projects, asking: "How can Democrats justify the wasteful spending in this bill?''
But advocates, including Senator Edward M. Kennedy of Massachusetts, defend the proposed spending as a necessary way to promote healthier lives and, in the long run, cut medical costs. "These are not public works grants; they are community transformation grants,'' said Anthony Coley, a spokesman for Kennedy, chairman of the Senate health committee whose healthcare bill includes the projects.
"If improving the lighting in a playground or clearing a walking path or a bike path or restoring a park are determined as needed by a community to create more opportunities for physical activity, we should not prohibit this from happening,'' Coley said in a statement.