What would be big bill in the Congress be without a few extras stuffed into the measure?  Don't worry, the latest health reform bill has a few items surfacing that might raise some eyebrows.

Some of them cropped up yesterday as Sen. Max Baucus issued 36 pages of revisions to his original health reform bill that he unveiled last week.

For example on page 51, the following would be inserted:

"The Chairman's Mark would establish a grant program to be used to fund operating expenses for school-based health centers (as defined in the Children's Health Insurance Program Reauthorization Act of 2009, P.L. 111-3). The Chairman's Mark would appropriate $100 million in FY 2010 and FY 2011, for a total of $200 million, to remain available until expended for such program."

In other words, there is $200 million in spending on school-based health centers.  That was part of an amendment by Sen. Debbie Stabenow (D-MI).

Here is a change that came from Sen. Olympia Snowe (R-ME).

"The Chairman's Mark would establish a three-year, $75 million demonstration project for up to eight states to expand the number of emergency inpatient psychiatric care beds available in communities."

That's $275 million.

Another extra piece of money came from Sen. Tom Carper (D-DE).

"This amendment provides $200 million to the Secretary of Health and Human Services for up to five years to make grants to small businesses with less than 100 employees (full and or part-time workers) to provide access to comprehensive, evidence-based workplace wellness programs."

That's $475 million.

Another plan from Sen. Jeff Bingamann (D-NM) would establish "Teaching Health Centers" that would be eligible for money for medical education expenses.

The money would be funneled to these schools from Medicare.

"A total of $230 million will transferred from the Medicare Part A trust fund for FY2011 to FY2015 using a formula for calculating the direct graduate medical education expenses and the indirect expenses associated with operating approved graduate medical residency training programs established by this Section."

That's $705 million in new spending.

That same Bingamann amendment would also create a new federal grant program to "establish newly accredited or to expand primary care medical residency programs."

"$25 million in FY2010; $50 million in FY2011; $50 million for FY2012 and such subsequent sums as may be necessary to carry out this section."

Wait - wait - "such subsequent sums as may be necessary" - that's basically an open ended appropriation.

That's $830 million (plus).

Another Stabenow amendment would add $200 mllion for "a provision that would appropriate $50 million per year for FY2012 through FY2015 to establish a graduate nurse education demonstration program in Medicare."

That's now $1.23 billion.

I'm not sure I would label any of these as "pork" - but they certainly could be referred to as "sweeteners."

It might be just the start of the Health Care Gravy Train.  Stay tuned.