Rising healthcare costs in Europe represent a daunting challenge for the coming decades. The demographic outlook of Europe is such that the continent’s population is destined to age significantly based on declining fertility rates and increasing levels of life expectancy. Growing elderly populations will inevitably lead to higher demand of healthcare goods and services, and thus to more spending, putting further pressure on already fragile national budgets. At the same time, rising R&D costs for medical innovation are expected, which will also confront governments with further fiscal challenges and dilemmas. Finally, it is argued that the incentives shaping the behaviour of patients, providers and payers in the present state-dominated system are distorted, and that a more market-oriented system could provide better healthcare services at lower costs. Our discussion will try to offer an unconventional treatment of healthcare challenges in Europe and it will consider the potential impact of a radical liberalisation of healthcare services within the EU single market. It will also consider whether the proposed Transatlantic Trade and Investment Partnership (TTIP) offers opportunities to improve services and reduce costs.