This paper outlines some lessons that policy makers can learn from China and Vietnam. Both countries developed low cost rural health services during the period between the early 1950s and the mid-1970s. Their example strongly influenced international health policy, and lessons from these case studies will have relevance to policy-makers in other low and middle income countries who are asking fundamental questions about how services should be financed, the relationship between service providers and government, and the role of the state in ensuring that health services are cost-effective and equitable [Author's abstact, adapted]