Butte's proud heritage is evident virtually everywhere in the community a visitor might turn — from the grandest courthouse anywhere to the historic neighborhoods and the revitalization occurring in Butte's historic business district. That revitalization, in particular, has been driven to a large extent by entrepreneurship and small business development. Small business and entrepreneurial development hold great hope for Butte and for much of the rest of Montana and the rural Great Plains.

However, Butte's entrepreneurs and small businesses face stern economic challenges. The greatest of these challenges is the skyrocketing cost of adequate health insurance. Rapidly rising health care costs will be the deciding factor in whether many of Butte's entrepreneurs and small business owners — and many of rural Montana's ranchers, farmers and mainstreet business owners — succeed or fail during our nation's economic recovery.

That means all the residents of Butte-Silver Bow and the rural communities in neighboring counties — ranchers, small business owners and entrepreneurs as well as Montana's heavy industry and the men and women who work there — have a vested interest in the health care reform debate in Washington.

As health insurance premiums and out-of-pocket medical expenses rise, more small business owners in Butte and surrounding rural communities will drop unaffordable coverage for themselves and their employees. Moreover, economic development efforts will continue to be hampered by the risk entrepreneurs face in leaving employment with health care benefits to start their own business.

Health care reform is, therefore, crucial to rural economic revitalization. Rural Montana's economy is based on self-employment — owner-operated ranches, farms and rural small businesses — to a far greater extent than large urban centers. As a result, the people living there are more likely to be under-insured, dependent on individual insurance and paying more each year for less coverage.

If Congress and the White House hope to fulfill the promise of making the health care system fair and equitable to all, they must address the unique health care challenges our rural communities face. And the most crucial first step in addressing those challenges will be creating a public health insurance plan that provides individuals, families and businesses affordable coverage by giving them the option of choosing such a plan over private insurance.

The strengths of a public health insurance option are what many rural people and small businesses need —affordability, stability, and the ability to choose their medical provider and control the medical decisions that affect their lives — while providing more affordable health insurance access to vulnerable populations such as low and moderate income families and the self-employed. In particular, small business employers and employees would benefit from having a choice between a public health insurance plan and private insurance.

Montanans have a unique opportunity in the health care debate. Sen. Max Baucus, chairman of the Senate Finance Committee, will play a key role in crafting any health care reform legislation that emerges from Congress. Recently, Baucus' staff held listening sessions across the state to hear what Montanans want and hope for from health care reform legislation.

What Baucus heard from rural Montanans is that the time has come for real, fundamental reform of the American health care system and the time for half-measures has passed. The people of Butte and the rural communities in southwest Montana want, need and deserve a quality, affordable health care system. If they persist in raising up their voices in this debate, they just might get it.