On Nov. 4, Rio Arriba voters flocked to the polls to vote for meaningful health care change. America's system of employer-based private insurance has never worked for us.

According to the Rio Arriba Department of Health and Human Services, more than 50 percent of our local wage economy can be attributed to minimum-wage jobs in the retail and service sectors which do not offer insurance benefits. Many of my own county employees, with wages that are good by Rio Arriba standards and with a generous employer health care contribution, cannot afford to opt in. Because of the rapidly rising costs of insurance, I may soon be forced to choose between laying off employees, or retaining our current level of health care benefits.

I am a county commissioner with my ear to the ground. I know that the high turnout for Democrats in Rio Arriba in November was due in large part to Barack Obama's promise that his health plan will ensure access to quality care for every American, even those of us who live in rural, underserved areas.

Access to care is especially difficult in rural communities where specialists, and even primary-care doctors, are unavailable. Our rural clinics have significant problems retaining dentists, physicians and other professionals. I have heard heart-wrenching stories: a constituent whose birth was unattended; and parents whose son died of a Tylenol overdose en route to the dentist, four hours away.

Parity for mental-health services is an issue particularly close to my heart. It seems as if private insurers have something against the head because they don't cover disorders of the teeth, eyes or brain. The few private insurance plans that serve our residents do not provide adequate coverage for behavioral health. Our jails are packed with individuals suffering from untreated mental illness, substance dependence, traumatic brain injury, developmental delays and learning disabilities.

According to a study by the Kaiser Commission on Medicaid and the Uninsured, "An estimated 22,000 adults (nationwide) between 25 and 64 die prematurely each year from not having access to care because they are uninsured." It is not a coincidence that this age group consists of those who are not covered by government-run health care!

In my opinion, a health care reform plan must include an option from Day One to buy in to a Medicare-like plan directly overseen by the federal government. According to a June 18 NBC/Wall Street Journal poll, more than 75 percent of Americans agree with me.

In Rio Arriba, our county government is forced to care for those citizens who lack access to medical and behavioral-health services in our jails. America is already paying for services. We are paying jailers, ER costs and police, the most expensive and least effective "care" possible. Savings to the health care system from a well-managed public option will reduce the need to spend on jails, indigent hospital care and other high-cost, end-stage care.

I have written several times in the past praising Sen. Jeff Bingaman for his attention to health care access for all New Mexicans. He has been a champion. He is in an excellent position to serve New Mexico because he is a ranking member of the Health, Education, Labor and Pensions Committee. I was therefore stunned to hear him state on KUNM that a public option should not pose any "unfair competition" for private insurers.

I want to remind the senator that we are counting on him to continue his strong record by ignoring lobbyists for corporate health care in favor of New Mexicans.

Alfredo Montoya is a Rio Arriba County commissioner.