In the first presidential debate, President Barack Obama pointed out that his Obamacare was practically the same health care plan as the one that Gov. Mitt Romney established in Massachusetts. Not only is it the same plan, but it was put together by many of the same advisors.

What did Romneycare in Massachusetts and Obamacare nationwide achieve? As Obama explained, Obamacare wasn't a government takeover of health care. It is a large expansion of private insurance. In other words, Obamacare provided a major boost for the insurance industry. Unfortunately, it falls far short of doing what the American people want and need.

Obama clearly knows that there's a better alternative. He admitted that Medicare is far more efficient than any private insurance company. Romney said that if that is true, then anyone would rather buy Medicare than private insurance. The rub is that most Americans can't choose Medicare. Even the "public option" was taken off the table in the earliest stages of discussion of health care reform in 2009.

If Americans want to be covered by a health insurance plan that is comprehensive, efficient, humane, and fair, we must build a nationwide movement to expand and improve Medicare to cover everything for everyone. We need to pass HR 676, the U.S. National Health Care Act.

Under HR 676, all Americans would be enrolled in Medicare, which would cover all necessary medical care. That means doctors' bills, hospital bills, prescription drugs, mental and dental, eyeglasses, hearing aids, home health care assistants, nursing home care. The whole enchilada.

How can we afford it? Simple. We buy these things through Medicare, which is more efficient than any private insurance company. Not only does Medicare have an extremely low overhead (3 percent versus 30 percent for private insurance), but enrolling everyone in a single plan would streamline billing, eliminating waste and fraud. These efficiencies would save more than enough to cover all of the currently uninsured.

HR 676 would save money for every person, company, nonprofit organization, or government agency that buys health insurance. Instead of paying high premiums to a private health insurance company, workers and employers would pay a modest contribution to Medicare. Retirees, the unemployed, and children would pay nothing. The resulting efficiencies would allow New Jersey to trim its state budget by $2.6 billion per year and to eliminate nearly $60 billion in unfunded liabilities for state retirees' health care.

Plus, Medicare for all would eliminate the threat of medical bankruptcy. Illness and medical debt are currently the biggest contributors to personal bankruptcy in the United States. Many of those who are bankrupted by medical bills had health insurance when they first became sick or injured.

Expanded and improved Medicare for all would put doctors and patients back in control of health care decisions. No longer would bureaucrats in a cubicle somewhere decide what kind of care you can receive. Doctors could spend more time caring for the sick instead of begging some insurance company clerk to cover the care that a patient needs.

Obamacare did not solve our health care woes, but it did delay meaningful reform at the national level. Romney would do no better, and his running mate Paul Ryan wants to cut Medicare and replace it with a voucher system.

In this election year, Americans need to vote for the candidates who have shown the most commitment to preserving the existing Medicare program. Going forward, we need to choose candidates who will expand Medicare to cover everything for everyone.

Ray Stever is president of New Jersey One Plan One Nation, a coalition dedicated to establishing expanded and improved Medicare for all.