The two sides in the battle over Measure F, which would cap how much Palo Alto medical practitioners can charge their patients, have collectively spent more than $7.3 million to spread their messages both here and in Livermore, where a similar measure is also going to the voters, according to campaign-finance documents.

The eye-popping numbers underscore the high-stakes nature of the contest and the regional scope of the measure, which is being spearheaded by the Service Employees International Union-United Health Workers West and which is facing stiff resistance from Stanford Health Care and other area hospitals. As of Oct. 20, the union's campaign committee had spent $2.4 million in support of Measure F and Measure U (the Livermore measure). The hospitals, for their part, have spent $4.9 million as of Oct. 20 to combat the two measures.

Titled the "Palo Alto Accountable and Affordable Health Care Initiative," Measure F would cap how much most local health care providers can charge patients and insurers for medical care. It would limit their charges to no more than 115 percent of the "reasonable cost of direct patient care" and would put the city in charge of regulating the new provisions.

Measure F's sponsor, SEIU-UHW, has argued that the measure is necessary to combat Stanford Health System's high costs and to ensure that Stanford invests money in patient care and addresses its high hospital-infection rate. Measure F, they say, would improve accountability and lower health care costs.

Stanford has argued that the measure would accomplish nothing of that sort. Instead, it would punish medical practitioners by requiring them to meet a narrow definition of "reasonable costs" that does not include necessary components like the salaries of managers and supervisors, audit fees, travel expenses and other expenditures that hospitals need to make.

Opponents also note that while the "Yes on F" campaign focuses on Stanford, the measure would apply to many other medical practitioners, most of whom have no affiliation with Stanford (it does exempt children's hospitals, dialysis clinics, Department of Veterans Affairs clinics and several other categories of medical providers).

As such, several major medical providers have made six-digit contributions to fight the measure. As of Oct. 20, Stanford Health had kicked in $888,474 to oppose the measure; Kaiser Permanente had contributed $381,850; Sutter Health had chipped in $248,000; and John Muir Health, based in Walnut Creek, had contributed $240,000.

The biggest funder of the "No of F" campaign is the California Association of Hospitals and Health Systems, which contributed $3.55 million through the California Hospitals Committee on Issues, which focuses on ballot initiatives that affect area hospitals.

The amount of money being spent by each campaign is highly unusual for local measures, which typically get a few thousand dollars in contributions. Palo Alto's only other measure, Measure E, which would raise the city's hotel-tax rate from 14 percent to 15.5 percent, doesn't have any committees raising money in its support. The "No on E" campaign, meanwhile, has received a single contribution: $5,000 from Cardinal Hotel.

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