"The European Union and the United States of America have experienced some of the most concerning outbreaks of COVID-19. This paper investigates the division of power in the EU and the USA, suggesting the radical uncertainty created by the COVID-19 pandemic means that states' procurement and distribution of the materials they need for testing and the obtaining of medical supplies to treat the seriously ill might best be centrally administered. The centralised procurement and distribution of essential medical goods can resolve the problems arising from harmful competition between states to procure them and allow states to exercise their buying power. Moreover, it might solve the moral hazard problem, which leads to the hoarding of necessary medical goods, thereby creating a cross-border externality when other states within the federal system do not have enough of the medical items needed. However, the paper argues that the importance of local information suggests that organising the provision of testing programmes is optimally done as part of a decentralised process. Finally, to enable the most effective health responses for future pandemics and achieve the most effective integration of EU Member States, the current regulatory and legal adaptations and allocation of competences should also become permanent features in the EU's constitutional landscape."

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