European Union health policy has long had two faces. One face was its most visible: its support for data, networks, agencies and research that promoted shared practice and health objectives in fields such as cancer and communicable disease control. The impact the first face was striking mostly because the budget was so small. A second was long its most important: its courts’ application of internal market law and regulation to health care services in pursuit of an integrated European market and freedom of movement of goods, capital, services and people. The impact of this face created EU health care politics, but ultimately had limited effects on health care systems. Since 2010, though, the reaction to financial crisis has given EU health policy a third face: a newly rigorous and intimate fiscal governance model in which member state policies and budgets will be under continuous review, and countries in extreme trouble will face elaborate loan conditions affecting health care in detail. The credibility and wisdom of these new policies is yet to be seen and will be contested, but in principle they commit member states to detailed EU oversight of their health care systems and priorities in pursuit of fiscal rigor.