23 What a novel concept: planning health human resources (HHR) to meet popula- tion needs. Tomblin Murphy and MacKenzie (2013)havedescribedtwocasestudies designed to achieve better alignment between what people need and what providers do. The NovaScotiaandVancouverIslandprojectsare in the grand Canadian tradition of incremental change that accommodates the interests of participants. This being Canada, physician engagement has proved a challenge. Likewise, some potentially affected groups have voiced suspicions that the changes are motivated less by patient-centred care than by a desire to save money. Given that Canada is habitu- ally resistant to large-scale change, the projects were sensibly designed to test the waters gingerly. ABSTRACT Contemporary healthcare is a sobering spectacle. It costs a lot and doesn’t deliver much at the margins. But even if deep and open-minded reflection and analysis were to propose a reboot, the odds are very long against it. It is next to impossible to alter deeply entrenched patterns and entitlements. It will take nothing less than a collective commitment on the part of professions, governments, educators, accreditors, employers and a whole host of others to create an agile, responsive and integrated health human resources model for Canada. Is the Deck Stacked against Fundamental Health Human Resources Redesign in Canada? COMMENTARY Steven Lewis President, Access Consulting Ltd. Saskatoon, Saskatchewan Adjunct Professor, Faculty of Health Sciences Simon Fraser University u