"Each year, 18,000 people die in America because they don't have health care. Let me repeat that. Here in America, people are dying because they couldn't get the care they needed when they were sick."
Clinton used the number to dramatize the need for universal coverage.
The number comes from a report called "Care Without Coverage: Too Little, Too Late," produced in 2002 by the National Academy of Science's Institute of Medicine. The National Academy of Science is a private, nonprofit society of scholars. It was granted a charter by Congress in 1863 and has a mandate to advise the federal government on scientific and technical matters.
The report found that people without health care coverage:
• received less frequent or no use of cancer screening tests;
• received inconsistent care for the management of chronic disease;
• received fewer diagnostic and treatment services for trauma or heart attacks, and had an increased risk of death when in the hospital.
The report concluded that "excess deaths among uninsured adults ages 25–64, based on a 25 percent higher mortality risk, can be estimated to be in the range of 18,000 each year."
The report was independently reviewed. Its findings controlled for an individual's health insurance status as an independent variable, ruling out issues of income, for instance.