Out-of-pocket medical payments remain a burden for rural households. Financial protection from the NCMS, with an average reimbursement of 17.8%, was modest and should be restructured to provide better benefits that are targeted to those in most need.

Large dams have been an important component of infrastructure development in capitalist and communist countries alike. In 1998, changing world attitudes on large dams led to a two year World Commission on Dams and new global standards may soon insist that future projects pay fair compensation so that resettlement becomes voluntary. Now, 10 years after introduction of economic reforms, China is mobilizing its resources to build the world's largest dam. This fulfils a longstanding ambition to impound the Yangtze River in Central China at the Three Gorges and use the hydropower, improved navigation and flood control to develop the economy. This paper examines the socio-economic impact of Three Gorges Dam on over 1.3 million people to be displaced while China is in transition to a market economy. We consider resettlement in terms of the decision-making structure, property rights and incentives to move, and how the project exacerbates problems created by market reforms, especially rising unemployment and deteriorating public health. We conclude the project is boosting economic expectations while adversely affecting large sections of the population, and this could provoke widespread social unrest and eventual changes in political institutions.

In 2003, China introduced a new community-based rural health insurance called the New Cooperative Medical Scheme (NCMS). In 2005, to assess the NCMS effects on village doctors' prescribing behaviour, we compared an NCMS county and a non-NCMS county in Shandong Province. We collected information from a representative total of 2271 patient visits in 30 village health stations (15 per county). The average number of drugs prescribed (4.6 in the NCMS county vs. 3.1 in the non-NCMS county) and use of antibiotics (72.4% vs. 59.3%) and injections (65.1% vs. 56.3%) were high in both counties, and higher in the NCMS county. Within NCMS villages, prescribing for insured vs. uninsured patients showed a similar pattern with more drugs, antibiotics and injections for those insured. Overall, for NCMS patients, the prescription excess was about equal in value to their 20% fee discount. We conclude that over-prescribing is common in villages and worse with NCMS health insurance, raising concerns for health service quality and drug-use safety. We propose that the NCMS should be redesigned with incentives for service quality improvement. A stricter regulatory environment for doctors' prescriptions is needed in rural China to counter irrational drug use.

Out-of-pocket health payments remain a severe burden for rural households. Financial protection from the NCMS was limited.

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China's health reforms of the 1980s led to privatization of rural health care with adverse impact on farmers. A decade later a new rural co-operative medical scheme (RCMS), was piloted throughout many provinces to promote better equity. Although many schemes later collapsed owing to inadequate funding, some continue to the present. This article compares such a scheme with the out-of-pocket system in Henan province. We study the township hospitals, focusing on cost of services, utilization rates and impact of RCMS on hospitals' financial sustainability. Our results derive from monthly hospital records and a survey of four hospitals in two adjacent counties, one county with low-premium RCMS and the other with the out-of-pocket system.All hospitals charged for preventive activities (such as antenatal care, immunization), an unfortunate consequence of limited government support. It was not clear that on average, the total cost of individual patient visits in RCMS hospitals was lower than non-RCMS hospitals. Farmers were generally unaware of their insurance entitlements, except the catastrophic illnesses for which there was a real benefit from refund of US$100 or more. Although the effect of the RCMS on hospital charges was unclear it was notable that the utilization rates in RCMS areas were twice those in non-RCMS.We conclude that RCMS hospitals were better funded because of re-imbursements from the insurance scheme and therefore were more viable as sources of good health care. Thus, health care could become more equitable under RCMS than the out-ofpocket system. China is now beginning to test a revised form of RCMS with pooling at the county level, increased premiums (10 yuan per person) and increased government funding. However, it must be followed closely to determine the effect on rural services and health care costs for farmers.

We review the debate on the supply of doctors in Australia from an economic perspective. We focus on the supply between urban and rural areas and on Australia’s reliance on foreign-born overseas-trained doctors. Documented evidence shows that doctors are concentrated in cities and rural Australians have relatively poor access; and there is heavy reliance on the recruitment of foreign doctors. We suggest that besides training more local doctors, policy-making should include innovations to resolve the supply imbalance such as physician assistants and community pharmacy care in areas where access to general practitioners is often limited.

This article considers the central dilemmas of wage policies in state socialist economies. It reviews the pre-1978 Chinese low-wage and high employment policy and details the development of Chinese wage policies during the 1980s. The dynamics and contradictions which have resulted in inflation, declining labour productivity, falling real wages and social tensions are analysed.