The Cross-Border Health Care Directive (CBHD) has the potential to herald a revolution in the ability of EU citizens to access healthcare across European boundaries. The author argues that the CBHD, while activating rights, does too little to operationalize them. The CBHD could function as a major corrective to government failure in the healthcare setting, but critically, its implementation means that information asymmetry and related problems are not tackled systematically. In addition, the calculation of reimbursement tariffs by the Member States is largely un-policed, leading to potential gaming. Nevertheless, very dysfunctional public delivery systems may begin to face material patient out-flows. Although the CBHD makes provision for the Member States to curb reimbursement rights in response, this requires developing a detailed framework for that purpose. The relative priority this framework gives to patient as opposed to provider interests is likely to determine its strictness.