to these new realities. In Germany, where there is currently an oversupply of physicians, a move towards a more global approach to health care delivery, through increased trade agreements, could result in even more German health care professionals' leaving the country. The challenge to be addressed by human resource professionals within the German health care system in this situation would be to prevent, or slow, the loss of the best professionals to other countries. Spending public resources in educating professionals only to have significant numbers of them leave the country is not a financially desirable or sustainable situation for a country. Discussion While examining health care systems in various countries, we have found significant differences pertaining to human resources management and health care practices. It is evident that in Canada, CHA legislation influences human resources management within the health care sector. Furthermore, the result of the debate on Canada's one-tier versus two-tier system may have drastic impacts on the management of human resources in health care. Additionally, due to a lack of Canadian trained health professionals, we have found that Canada and the United States have a tendency to recruit from developing countries such as South Africa and Ghana, in order to meet demand. Examination of the relationship between health care in the United States and human resources management reveals three major problems: rapidly escalating health care costs, a growing number of Americans without health care coverage and an epidemic regarding the standard of care. These problems each have significant