Vietnam is the country which stands to learn the most by studying developments in health in rural areas of China. In terms of history, culture and recent political and economic reforms, it shares a great deal in common with China, but its reforms have lagged behind, giving it the chance to benefit from positive and negative trends emerging in its bigger neighbour. The Vietnamese will want to consider carefully such issues as the impact of current health financing systems in rural China, and the balance of gains and losses which have resulted from granting wide powers of autonomy to providers to raise funds and manage themselves.