Proponents of the measure have blanketed the state with advertising that describes over-crowded hospitals, long waits in life or death situations, and the closure of 64 emergency hospitals in communities up and down California.

One of those is the Doctors Medical Center emergency room in San Pablo. It is the busiest hospital in West Contra Costa County, and it does not have a trauma center.

Dr. Desmond Carson, a physician on the West Contra Costa County Health Care board, said emergency rooms are often the only source of care for low-income people. “It’s hard when you’re in a poor neighborhood,” he said. “There is a unique burden here because 25 to 30 percent of the patients are uninsured.”

On a recent Thursday afternoon, Johnett Trotter, 32, of Richmond was taken to the Doctor Medical Center emergency room for a bad case of bronchitis. She doesn’t see a doctor regularly, she said. “I have Medi-Cal and I only come [to the emergency room] when I’m really sick.”

By contrast, residents in nearby Walnut Creek represent a different kind of emergency room patient.

“At John Muir, 95 percent of the patients have good insurance; here, people have Medi-Cal and a disproportionate are uninsured,” said Carson.

If Proposition 67 passes, Californians would pay a three percent added fee on residential telephone lines for calls made within the state. The fee would not exceed 50 cents a month on residential land lines but there is no set cap on cellular or business phone lines. Low-income and lifeline plan customers would be exempt. The added fee would raise approximately $500 million a year, according to proponents of the measure.

“It’s like a huge multi-national corporation asking California people to subsidize them even though they’re already making money,” said Ace Smith, campaign manager for No on 67.

However, proponents see the need to fund hospitals that are at risk of closing and to re-open others.

Peter Warren, a spokesman for Proposition 67, said the situation is severe. “Eight emergency rooms have closed this year in California,” he said. “One in six hospitals have disappeared, and 70 are in danger.”

He referred to the “golden hour” – the 60 minute window when emergency treatment is most crucial – as being at risk because fewer facilities are leading to longer drives and less time to care for people and save lives.

“California used to have the best emergency care and that is no longer true,” he said.

According to reports filed with the California Secretary of State, the main contributors against Proposition 67 are SBC Communications, Cingular Telephone Company, T-Mobile USA, Verizon Telecommunications Company, AT&T Wireless, and H.C. Olsen Construction Company.

Those financially supporting Proposition 67 are the California Healthcare Association, American College of Emergency Physicians, ER Physicians Trade Group, California Medical Association, Planned Parenthood, and Community Clinic Association of Los Angeles County.

The campaign against Proposition 67 is overwhelmingly leading in contribution dollars.

Trotter left the ER empty-handed after refusing a prescription for Motrin that would cost her less over-the-counter. She said she could not decide how she would vote.

“Well, I guess if it passes, it passes,” she said. “I would hate to see my phone bill go up, but we need a place like this,” she added, pointing to the hospital as her mother drove her away.