Health care markets in China and India have expanded rapidly. The regulatory response has lagged behind in both countries and has followed a different pathway in each. Using the examples of front-line health providers and health insurance, this paper discusses how their different approaches have emerged from their own historical and political contexts and have led to different ways to address the main regulatory questions concerning quality of care, value for money, social agreement, and accountability. In both countries, the challenge is to build trust-based institutions that rely less on state-dominated approaches to regulation and involve other key actors.

Regulatory approaches based on functioning local institutions seem to work best in both countries.

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CHINA AND INDIA ARE TWO COUNTRIES WHOSE ECONOMIES are growing rapidly and where governments have found it important to stimulate reforms to strengthen their social sectors. In the 1950s and 1960s, both countries invested in largely public health systems. Yet both health systems have become highly marketized, although they have taken different routes. Both countries are now facing a crisis of trust in the health sector, attributable in part to rising expectations and concomitant failures in their health care markets.1 Each country is tackling the issue of how to regulate its health care market differently