Policy making in the EU has been depicted as starkly fragmented, initiatives are drafted in separate Commission Directorates-Generals, discussed in specific policy communities and decided upon in sectoral European Parliament Committees and Council formations. At the same time we see increasing numbers of complex policy problems demanding cross-sectorally integrated solutions. This paper develops the argument that there are good grounds to expect policy-making in the EU Commission to favour fragmented solutions, while diffuse public interests will push for integrated policies. Yet, only under specific constellations will the EU Commission respond to these interests. The argument will be exemplified against the emergence of three policy instruments adressing the wicked problem of trans-border health care policy. While the Coordination of Social Security Systems Regulation and the Services in the Internal Market Directive favour largely fragmented solutions, Patient Mobility takes a more integrated approach.