The United States spends a higher percentage of its income on health care than countries with nationalized health care systems. Some critics contend that Americans are not getting their money's worth in improved health outcomes compared to those other countries.

But using health outcome comparisons is rife with problems. The outcomes can be greatly affected by anything from definitions to demographics. For example, the U.S. infant mortality rate of 9.2 deaths per 1,000 live births ranks it 24th among 39 developed countries. But the way some of the other countries count makes a big difference.

• An infant death is classified as a stillbirth in France if it occurs before the birth is registered - which can take up to two days.

• Japan likewise counts live births as stillbirths if the infant dies before being included in the national family registration system.

• Other countries don't count births between 20 and 27 weeks as live births if the baby dies.

• All these outcomes would be classified as infant deaths in he United States.

Similar problems affect comparisons of life expectancy in the United States with other countries. Males in the U.S. have lower life expectancies at birth than in several nations that guarantee universal health coverage. However:

• The U.S. also suffers from higher rates of social pathologies - crime, poverty, unwed motherhood and the like.

• The U.S. has higher rates of AIDS cases, more drug offenses, more homicides and more serious assaults than almost any other country.

If one measures health care systems in various countries by how the sick are actually treated in various countries, the United States ranks at the top in recovery from specific illnesses. For example, the death rate from heart attacks in the United States is half as high as in England, and that from epilepsy is half as high as in Canada.

Source: John Merline, "Best Health Care in the World," Investor's Business Daily, July 28, 1993.