As U.S. Surgeon General, Koop became increasingly concerned about the escalating cost of health care, the growing disparity in access to health services, the mounting number of Americans without health insurance, and the financial future of Medicare and Medicaid.. After leaving office in 1989, Koop continued to press for health care reform. He participated in a series of public forums with First Lady Hillary Clinton in the fall of 1993 to promote President Clinton's Health Security Act.
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