MSc Dissertation, London School of Economics and Political Science

Completed August 2026

Decentralisation, Regulation, and Regional Inequality in Health Care Systems

Abstract

This essay examines whether health care decentralisation leads to a “race to the bottom” in health care provision and whether it increases regional health care inequality. It argues that decentralisation does not inevitably produce either outcome, but that it frequently intensifies territorial inequality by redistributing responsibility across regions with unequal fiscal and institutional capacity. Drawing on examples from Italy, Spain, the United States, and the United Kingdom, the essay demonstrates how decentralised systems may generate divergence in access, infrastructure, and service quality despite maintaining formal universal entitlements. It further argues that fragmented procurement and weak coordination within decentralised systems can strengthen incumbent firms and reinforce technological inequality, particularly within digital health markets. While decentralisation may improve responsiveness and encourage policy innovation, its benefits depend heavily on strong national standards, redistributive mechanisms, and regulatory coordination. 

Introduction

Universal health systems are meant to guarantee equal access to care regardless of where people live. Practically, though, decentralised systems often produce large regional differences in waiting times, infrastructure, and quality of treatment. The tension between local autonomy and national equality has become one of the central problems in modern health care governance. 

Yet decentralisation also changes the institutional foundations of health care governance. It redistributes fiscal responsibility and regulatory authority across territories with unequal resources and administrative capacity. In doing so, it may weaken coordination, fragment oversight, and intensify regional disparities in access and quality. The central tension is therefore not simply whether decentralisation improves efficiency, but whether it can preserve solidarity and minimum standards across unequal regions. 

Although decentralisation can improve responsiveness to local needs, it also risks deepening inequality between regions with very different resources and administrative capacity. Decentralization rarely produces an explicit “race to the bottom” through formal removal of entitlements. Instead, downward pressure on standards tends to emerge more gradually through fragmented oversight, delayed investment, workforce shortages, and uneven regulatory enforcement. This essay therefore argues that decentralisation is most likely to weaken equity where strong redistributive mechanisms and national guarantees are absent. 

The essay first outlines the theoretical relationship between decentralisation and regulation before examining how decentralised governance can create fiscal and regulatory pressures that gradually weaken service quality. It then explores evidence from Italy, Spain, the United States, and the United Kingdom to demonstrate how decentralisation frequently produces territorial divergence in access, institutional capacity, and infrastructure.  Finally, it argues that decentralisation may also reinforce regional monopolies and digital fragmentation through procurement structures and interoperability barriers. The essay concludes that decentralisation is best understood as a conditional institutional arrangement whose outcomes depend heavily on the strength of national guarantees and redistributive mechanisms. 

Decentralisation and the Governance of Health Care

Decentralisation is not a single institutional reform. It can involve political decentralisation, where elected regional  governments gain authority over health policy; administrative decentralisation, where managerial responsibilities are delegated to local bodies; or fiscal decentralisation, where regions assume greater responsibility for financing and budget allocation. These forms of decentralisation often overlap, although not always in equal measure. 

Health systems are highly regulated institutional environments in which regulation involves rule-setting, monitoring, and enforcement rather than just legislation (Baldwin, Cave, and Lodge, 2012). In health care, regulation includes licensing professionals, setting waiting-time targets, regulating pharmaceuticals, inspecting hospitals, and maintaining patient safety standards. Once these functions are distributed across multiple territorial levels, accountability may become fragmented and enforcement uneven. 

Decentralisation has increasingly been associated with broader shifts toward territorial governance and citizen-centred welfare systems (Costa-Font, 2020) . Essentially, local authorities may possess greater knowledge of regional needs than distant central ministries. Rural regions, for example, often face different workforce and infrastructure challenges from large urban centres. Decentralisation may therefore improve responsiveness and permit policy experimentation. 

However, decentralisation also exposes pre-existing territorial inequalities. Regions differ significantly in wealth, workforce, supply, tax base, and administrative capacity. The performance of decentralised systems depends heavily on the extent to which redistributive and equalisation mechanisms remain strong (Costa-Font and Greer, 2012). In other words, decentralisation itself is not inherently beneficial or harmful. Its effects depend on the institutional conditions surrounding it. 

This distinction is particularly important in health care because health systems are not purely economic institutions. Health care markets differ from standard competitive markets because of uncertainty and information asymmetry (Arrow, 1963). Health systems therefore rely heavily on collective guarantees and regulation. Decentralisation may improve local flexibility, but excessive fragmentation can weaken those guarantees. From a regulatory perspective, it creates a persistent tension between efficiency, local autonomy and substantive equality across territories. 

The result is a tension between territorial autonomy and regulatory coordination. While advocates of decentralised governance often assume that local flexibility improves efficiency and responsiveness, regulatory theory suggests that fragmentation may also weaken accountability by dispersing authority across multiple institutions. The central issue is not simply whether regions possess autonomy, but whether decentralised systems remain mechanisms capable of preserving substantive equality across territories with unequal administrative capacity. 

Decentralisation, Regulatory Competition, and Territorial Inequality

The ‘race to the bottom” within health care can operate differently from classic models of regulatory competition. Regional governments are rarely competing to attract investment through openly lower welfare standards. Instead, downward pressure emerges more indirectly through fiscal strain, uneven regulatory capacity, and fragmented oversight. Patients may still technically be entitled to treatment, but long waiting lists and staffing shortages can and will make access more difficult. 

Italy illustrates many of these dynamics. Although the Italian National Health Service guarantees universal legal entitlements, regional governments possess significant responsibility over financing and delivery. Research on the Italian health system suggests that regionalisation widened pre-existing north-south inequalities in financing and patient mobility (France, Taroni, and Donatini, 2005). Wealthier northern regions increasingly attracted patients from southern regions for specialist treatment, reflecting differences in institutional capacity and perceived quality. Decentralisation did not create these inequalities, but it embedded them more deeply within the structure of the system. In effect, regional inequality became institutionalised rather than temporary, and this case suggests that decentralisation works far better in wealthier regions than poorer ones. 

Equal expenditure across decentralised regions did not necessarily produce equal satisfaction or perceived access, particularly where governance quality remains uneven (Costa-Font and Turati, 2018). Governance quality and institutional effectiveness remained uneven despite comparable levels of spending. This is particularly important because it demonstrates that decentralisation is not simply a question of funding. Institutional capacity itself becomes unevenly distributed across regions. 

These pressures became more visible after the global financial crisis of 2008. Regions facing fiscal strain frequently delayed infrastructure projects, limited workforce expansion, and restricted service investment. Such measures may appear administratively rational in the short term, yet over time they can contribute to gradual erosion in service quality. The race to the bottom in health care is therefore rarely dramatic or openly ideological. More often, it appears through cumulative deterioration in access and capacity. 

The United States provides another important example of a decentralised divergence. Medicaid is jointly financed by federal and state governments, but states retain considerable discretion over implementation, reimbursement rates, and eligibility criteria. Following the Affordable Care Act (ACA), some states expanded Medicaid coverage while others refused expansion. By 2023, ten states still had not adopted expansion, leaving substantial gaps in coverage for low-income populations (Glied and Weiss, 2023). As a result, low-income populations experienced sharply different levels of access depending on geography. 

This does not represent a classic race to the bottom in every case, since some states pursued more expensive policies than others. Nevertheless, the American system clearly demonstrates how decentralisation permits territorial divergence in access and generosity. In this sense, decentralisation shifts health care access from a universal social guarantee towards a system where the quality of care increasingly depends on geography. States facing political or fiscal pressures may restrict coverage or maintain lower provider payments, which in turn shapes practical access to care. 

Races to the bottom may also emerge through weakened enforcement rather than direct spending reductions. Effective regulation depends not only on formal rules but on monitoring and enforcement capacity (Baldwin, Cave, and Lodge, 2012). National standards lose significance if regional institutions cannot implement them consistently. Abimbola (2020) conceptualises health governance as a triangle of rules, actors, and institutions, highlighting the gap that may emerge between formal policy and institutional reality. National guarantees may remain universal on paper while implementation varies substantially across regions with unequal administrative capacity. 

The Covid-19 pandemic exposed many of these coordination problems. The Covid-19 pandemic exposed problems within fragmented multilevel governance structures, particularly where responsibilities between national and regional authorities were unclear (Angelici et al., 2023). In several decentralised systems, procurement, information-sharing, and crisis management became more difficult because authority was dispersed across multiple levels of government.

Decentralisation, however, can produce genuine benefits. Local authorities may be more responsive to demographic variation, regional disease burden, and patient preferences. Devolved systems can also function as policy laboratories where innovation spreads through imitation. Evidence from the English NHS demonstrates that competition under certain institutional conditions can improve performance. Under some institutional conditions, it has been shown that competition may improve some aspects of public hospital performance in England (Cooper, Gibbons, and Skellern, 2018). This suggests that decentralisation and competition are not inherently damaging. 

These improvements depended heavily on strong national oversight and relatively uniform institutional capacity. The NHS remained centrally financed and nationally regulated despite local variation. Decentralisation therefore appears to function most effectively where strong national guarantees remain intact.

Territorial Inequality and Digital Fragmentation

The evidence that decentralisation increases territorial inequality is stronger and more consistent than the evidence for races to the bottom. Regions differ substantially in wealth, tax capacity, workforce availability, and infrastructure. Once authority is devolved, these differences become more consequential. Wealthier regions are often better positioned to recruit clinicians, finance specialist services, and invest in digital systems. 

Health inequalities are closely tied to broader social determinants such as income, education, and employment (Marmot, 2005). Decentralisation may intensify these inequalities because poorer regions frequently experience both weaker population health and lower institutional capacity simultaneously. Effectively, the territories with the greatest health needs are often least able to sustain high-quality services. 

Italy again provides one of the clearest examples of decentralisation contributing to territorial inequality. Significant north-south differences persist in waiting times, hospital quality, and financial performance despite universal legal entitlements. Patient mobility is especially revealing. Residents of southern regions frequently travel north for specialist treatment, particularly for more complex procedures. While formally compatible with patient choice, this movement reflects unequal confidence in regional systems. 

Geographic inequality also overlaps with class inequality. Wealthier patients are often more able to travel for specialist treatment or seek private alternatives. Poorer patients remain far more dependent on local services.

Spain’s health system is similarly decentralised, with autonomous communities exercising major authority over service delivery and planning. Although Spain retains strong universalist commitments, decentralisation has produced visible differences in waiting times, staffing, and organisational performance across regions. The Covid-19 pandemic highlighted many of these disparities. Regional responses varied considerably, revealing tensions between local autonomy and national coordination. While decentralisation allowed flexibility, it also exposed uneven preparedness and fragmented governance structures. 

Territorial inequality is also evident within the United Kingdom. Differences in local commissioning and devolved governance have contributed to what is frequently described as the “postcode lottery,” where access to certain treatments or services varies by region. Some degree of local variation may reflect democratic choice or regional preference. Once differences affect core services such as mental health provision, specialist drugs, or fertility treatment, territorial variation becomes politically contentious. Universal systems are generally expected to provide a minimum standard of care regardless of geography. 

One of the less discussed consequences of decentralisation concerns digital infrastructure and procurement power. Decentralised systems are often justified on the grounds that local procurement encourages competition and innovation. Fragmented purchasing structures may weaken bargaining power and strengthen incumbent firms. Rather than producing genuinely competitive markets, decentralisation can allow dominant vendors to consolidate territorial control incrementally across separate regional systems. 

Electronic health record systems (EHR) provide a useful example. Once a hospital network adopts a dominant platform, switching becomes financially and operationally difficult. As a result, interoperability itself increasingly becomes a regulatory issue rather than simply a technical one. Decentralised procurement allows vendors to establish strong regional positions incrementally, often creating forms of territorial lock-in. 

In effect, procurement processes are frequently shaped less by open competition than by compatibility with incumbent systems already embedded within regional hospital networks. Interoperability concerns and switching costs can narrow the field of competitors before formal procurement begins. Smaller firms may therefore struggle to enter markets that are formally decentralised but practically dominated by established vendors. 

This dynamic has broader implications for inequality. Wealthier systems are often better able to finance technological transitions or negotiate favourable contracts, while poorer regions remain dependent on outdated infrastructure. Decentralisation may therefore contribute not only to service divergence but also to technological fragmentation. Layered governance structures can diffuse accountability across multiple institutions and weaken coordinated oversight (Van de Bovenkamp, Stoopendaal, and Bal, 2017). In fragmented systems, no single authority may possess sufficient leverage to impose interoperability standards or discipline dominant firms effectively. Rather than producing genuinely competitive markets, decentralisation may therefore encourage territorially segmented monopolies alongside uneven digital capacity. 

Conclusion

Overall, the evidence suggests that decentralisation usually increases regional inequality unless strong national safeguards remain in place. The problem is less about decentralisation itself and more about whether poorer regions still receive enough support to maintain comparable standards of care. 

The race to the bottom in health care is rarely explicit. More commonly, it emerges through slower investment, staffing shortages, weaker enforcement, and growing waiting times. Regional inequality, meanwhile, is more visible and more consistently documented. Wealthier or administratively stronger regions tend to provide better infrastructure, stronger digital systems, and faster access to care than weaker territories. 

It has been shown that decentralisation can produce genuine benefits where strong national safeguards remain intact. Local responsiveness and experimentation may improve service delivery under conditions of effective coordination and fiscal equalisation. The problem is therefore not decentralisation alone, but decentralisation without solidarity. The real challenge is deciding how much regional freedom health systems can allow before equal access to care starts breaking down.

Health care systems depend not only on efficiency but on collective guarantees of access and quality. Systems that decentralise authority while maintaining strong national standards and redistributive mechanisms appear to be best positioned to balance flexibility with equity. Without those safeguards, decentralisation risks allowing geography to shape both the quality and accessibility of care. 

Works Cited

Abimbola, S. (2020) ‘Health system governance: a triangle of rules’, BMJ Global Health.

Angelici, M., Berta, P., Costa-Font, J. and Turati, G. (2023) Divided We Survive? Multi-Level Governance during the Covid-19 Pandemic.

Arrow, K.J. (1963) ‘Uncertainty and the welfare economics of medical care’, The American Economic Review.

Baldwin, R., Cave, M. and Lodge, M. (2012) Understanding Regulation: Theory, Strategy and Practice. 2nd edn. Oxford: Oxford University Press.

Cooper, Z., Gibbons, S. and Skellern, M. (2018) ‘Does competition from private surgical centres improve public hospitals’ performance? Evidence from the English National Health Service’, Journal of Public Economics.

Costa-Font, J. (2020) The Political Economy of Health and Healthcare. Cambridge: Cambridge University Press.

Costa-Font, J. and Greer, S.L. (2012) Federalism and Decentralization in European Health and Social Care. 

Costa-Font, J. and Turati, G. (2018) ‘Regional healthcare decentralization in unitary states: equal spending, equal satisfaction?’, Regional Studies.

France, G., Taroni, F. and Donatini, A. (2005) ‘The Italian health-care system’, Health Economics.

Glied, S.A. and Weiss, M.A. (2023) ‘Impact of the Medicaid Coverage Gap: Comparing States That Have and Have Not Expanded Eligibility’. 

Marmot, M. (2005) ‘Social determinants of health inequalities’, The Lancet.

van de Bovenkamp, H.M., Stoopendaal, A. and Bal, R. (2017) ‘Working with layers: the governance and regulation of healthcare quality in an institutionally layered system’, Public Policy and Administration.

Financial Regulators and a Competitiveness Objective

*Shortened from original version 5/20/2026

Introduction

Whether financial regulators should be given a competitiveness objective is a question that has gained increasing attention in recent years, particularly in jurisdictions that seek to maintain their position as global financial centres. Proponents argue that requiring regulators to consider competitiveness would encourage efficient regulation and support innovation in financial markets. However, critics worry that introducing such an objective risks weakening regulators’ primary mandates. This essay argues that although competitiveness may be a relevant contextual consideration, making it a formal objective is unlikely to enhance regulators’ ability to protect consumers, promote prudential resilience, or maintain financial stability. Instead, it risks creating conflicts between regulatory priorities. The essay will first explain why financial regulation prioritises stability and consumer protection, then consider the arguments in favour of a competitiveness objective, before evaluating why these arguments are ultimately unconvincing.

Financial regulation prioritises stability and consumer protection

A starting point for assessing the competitiveness debate is understanding why financial regulation exists in the first place. Financial markets are prone to several types of market failure, including information asymmetries, externalities and systemic risk. Individual financial institutions may take decisions that appear rational from their own perspective but create risks for the wider system. Because financial institutions are highly interconnected, the failure of one firm can spread rapidly through the system. The global financial crisis demonstrated how weaknesses in regulation and risk management can trigger widespread instability and severe economic consequences. For this reason, modern regulatory frameworks focus heavily on prudential supervision, capital requirements and mechanisms for managing failing institutions. These tools are designed primarily to ensure that financial institutions remain resilient and that consumers are protected from harmful practices.

The main argument in favour of a competitiveness objective

Supporters of a competitiveness objective argue that regulators should not focus exclusively on risk reduction without considering the broader economic impact of regulation. Financial services contribute significantly to economic growth, employment and tax revenues in many countries. If regulatory requirements are perceived as excessively burdensome, firms may relocate activities to jurisdictions with more favourable rules. According to this argument, requiring regulators to consider competitiveness could encourage them to design rules that achieve regulatory goals without imposing unnecessary costs. In theory, this might help ensure that regulation remains proportionate while allowing financial markets to continue supporting economic growth.

Competitiveness could encourage more efficient regulation

One potential benefit of a competitiveness objective is that it might encourage regulators to pay greater attention to the efficiency and design of regulatory frameworks. Financial regulation can sometimes become overly complex, with detailed rules that are difficult for both firms and supervisors to implement effectively. Excessive complexity can increase compliance costs without necessarily improving outcomes. If regulators are required to consider competitiveness, they may be more likely to simplify regulatory frameworks or focus on clear and effective principles. In this sense, a competitiveness objective could potentially lead to more proportionate regulation that achieves stability while avoiding unnecessary burdens on firms.

However, competitiveness creates tensions with core regulatory objectives

Despite these potential advantages, introducing a competitiveness objective creates a fundamental tension with regulators’ primary responsibilities. Financial regulators are normally tasked with protecting consumers and ensuring the safety and soundness of financial institutions. If competitiveness becomes part of their mandate, regulators may face situations in which these objectives conflict. For example, stronger capital requirements might improve financial resilience but also make a jurisdiction less attractive to financial firms. In such cases, regulators could come under pressure to prioritise competitiveness over prudential safeguards. This tension is problematic because regulatory decisions should primarily be guided by considerations of systemic risk rather than by concerns about attracting financial activity.

Regulatory competition may increase systemic risk

Historical experience suggests that emphasising competitiveness within financial regulation can create incentives for regulatory competition. Before the global financial crisis, some jurisdictions adopted relatively permissive regulatory approaches in order to attract financial activity. This contributed to a broader “race to the bottom”, where regulators were reluctant to impose stricter requirements for fear of losing business to other jurisdictions. While this strategy may have provided short-term economic benefits, it ultimately allowed risks to accumulate across the financial system. When the crisis occurred, the resulting instability imposed significant costs on economies and societies. This experience highlights the danger of allowing competitiveness considerations to influence regulatory standards.

Competitiveness is not necessarily a regulatory function

Another reason to question a competitiveness objective is that financial regulators may not be the appropriate institutions to pursue this goal. Their expertise lies in supervision, risk assessment and enforcement of financial rules. Promoting economic growth or international competitiveness is generally a broader policy objective that falls within the responsibility of governments rather than regulators. Governments have a range of policy tools available to support competitiveness, including tax policy, infrastructure investment and trade policy. Assigning this responsibility to financial regulators risks blurring institutional roles and potentially compromising regulatory independence.

Consumer protection could also be weakened

A further concern is the potential impact on consumer protection. Financial products and services are often complex, making it difficult for consumers to fully understand the risks involved. Regulators therefore play an important role in ensuring transparency, preventing misconduct and enforcing standards of fair treatment. Strong consumer protection rules can sometimes increase compliance costs for financial firms, which might appear inconsistent with a competitiveness objective. If regulators are expected to promote competitiveness, they may become more reluctant to impose strict conduct standards. Over time, this could weaken consumer protections and undermine confidence in financial markets.

Stability itself supports competitiveness

It is also important to recognise that financial stability can itself contribute to competitiveness. Financial markets function most effectively when participants trust that institutions are well regulated and that systemic risks are properly managed. A regulatory framework that prioritises stability and integrity can make a financial centre more attractive in the long term. Conversely, a reputation for weak regulation may deter investors and undermine confidence in the financial system. From this perspective, strong regulation and competitiveness are not necessarily in conflict. Ensuring resilience and consumer protection may actually strengthen the long-term competitiveness of a financial sector.

Conclusion

In conclusion, while there are some arguments in favour of giving financial regulators a competitiveness objective, the risks associated with such an approach are significant. Competitiveness considerations may encourage regulators to think about efficiency and proportionality in regulation. However, embedding competitiveness within regulators’ mandates creates potential conflicts with their core responsibilities of protecting consumers and maintaining financial stability. Historical experience also suggests that regulatory competition can contribute to systemic vulnerabilities. For these reasons, competitiveness is better addressed through broader economic policy rather than through the objectives of financial regulators. Maintaining strong and credible regulatory frameworks remains the most reliable way to ensure both stability and the long-term success of financial markets.

Governing Mobility Under Uncertainty: Travel Risk and the Tokyo 2020 Olympic Games

Abstract

The Tokyo 2020 Olympic Games took place under profound uncertainty about international mobility. Rather than treating travel as a technical question of logistics, this paper examines how the International Olympic Committee (IOC) constructed and governed travel as a problem of risk and legitimacy during the COVID-19 pandemic. Drawing on Ulrich Beck’s theory of risk society, the paper analyses how the IOC grappled with manufactured and transboundary risks as it sought to stage a global mega-event amid fractured mobility regimes and domestic opposition in Japan. The study is designed as a master’s-level qualitative document analysis. It proposes a corpus of IOC Playbooks and protocols, Japanese government border and health regulations, and international and Japanese media coverage produced between March 2020 and August 2021. Through thematic coding, the analysis focuses on three dimensions: anticipation of travel risk, concrete mechanisms for governing mobility, and public justifications for exceptional movement. The paper argues that Tokyo 2020 illuminates how a transnational organisation governs by risk, using classifications, exemptions, and surveillance to reconfigure who may move, under what conditions, and with what claims to responsibility and legitimacy.

Introduction

The Olympic Games are often described as one of the most complex recurring events in the world, not only because they gather thousands of athletes and officials from across the globe, but because they rely on a finely tuned system of international mobility. Every edition of the Games depends on predictable flows of people. Athletes, medical staff, journalists, technical personnel, and volunteers all travel along well-established routes and schedules that are rarely questioned. Under normal circumstances, this circulation appears routine. Travel functions as a silent foundation that makes the Games possible rather than a topic that requires sustained organisational attention. The COVID-19 pandemic disrupted this assumption. As borders closed and travel restrictions multiplied in early 2020, mobility became a primary source of uncertainty. Instead of being a background condition, travel became a central site of public health concern, political debate, and organisational negotiation.

The Tokyo 2020 Olympic Games illustrate this transformation vividly. The postponement of the event, the suspension of qualification events, and the fragmentation of global travel infrastructure forced both the International Olympic Committee (IOC) and the Japanese government to reconsider the basic question of how thousands of accredited individuals could enter, move within, and exit Japan safely. These challenges were not only regulatory or logistical. They carried symbolic weight in a period marked by anxiety, heightened sensitivity to infection risks, and widespread debate about appropriate behaviour during a global crisis. Public opposition in Japan was significant. Polling in early 2021 showed that many residents believed the Games should not proceed at all (Kato, 2021). Concerns centred on the possibility that incoming delegations could introduce new infections or variants at a moment when domestic restrictions were still affecting ordinary life. As a result, travel became entangled with judgments about responsibility, legitimacy, and the fairness of exceptional mobility for Olympic personnel.

This paper approaches these developments through Ulrich Beck’s theory of risk society. Beck argues that modern societies generate risks through their own systems of technological and organisational complexity, and that these risks regularly transcend national borders (Beck, 1992). In such circumstances, institutions are compelled to engage in forms of reflexive governance that attempt to anticipate emerging uncertainties and justify decisions to multiple audiences. Travel during the pandemic provides a clear example of what Beck describes as manufactured and transboundary risk. The movement of athletes and staff into Japan created uncertainties that no single organisation could fully control. The IOC therefore had to build regulatory systems that classified individuals, managed exposure, and demonstrated an acceptable level of responsibility. These measures were not only risk-mitigating tools. They were also communicative acts intended to defend the legitimacy of the Games and to reassure the public that the event would not produce unacceptable health consequences.

Tokyo 2020 offers a particularly valuable case for studying how a transnational organisation governs risk. Unlike a state, the IOC cannot rely on sovereign authority. Its rules work through coordination with national governments, international federations, and national Olympic committees. This structure becomes especially visible when the organisation is confronted with a crisis. The pandemic exposed both the limits and flexibility of the IOC’s authority. To proceed with the Games, the organisation needed to persuade not only its institutional partners but also the wider public that international travel could be tightly controlled through testing regimes, restricted movement, and detailed behavioural rules. The process produced an extensive archive of protocols, Playbooks, and public statements that together attempted to stabilise a volatile situation.

The central research question guiding this paper is: How did the International Olympic Committee anticipate, govern, and justify travel-related risks during the Tokyo 2020 Olympic Games? This question matters for two reasons. First, it helps reveal how mobility, often taken for granted in global sport, becomes a site of governance during periods of crisis. Second, it allows us to examine how a non-state organisation navigates a form of uncertainty that aligns closely with Beck’s account of risk society. By analysing how the IOC responded to disrupted mobility systems and heightened public scrutiny, the paper seeks to illuminate broader shifts in the governance of transboundary risk.

Empirical and Theoretical Context

Travel Risk at Tokyo 2020

International mobility has long been central to the Olympic Games. Large delegations travel from more than two hundred countries, and this movement usually unfolds through stable and predictable systems of visas, flights, and standardised accreditation. Under ordinary conditions, the IOC and host governments treat travel as a logistical matter rather than a site of governance. The COVID-19 pandemic destabilised this foundation. Once borders closed and global travel patterns fractured, mobility became a central source of uncertainty. What had once been routine now required continuous regulation.

The postponement of the Games in March 2020 reflected the severity of mobility disruption. Even after the new date was set, travel remained unstable. Delegations faced different national restrictions, shifting quarantine requirements, and limited flight availability. To manage these conditions, the IOC and the Tokyo Organising Committee created a series of Playbooks that outlined detailed rules for testing, entry, behaviour, and circulation. These documents introduced categorised mobility. Athletes, officials, and media were subject to different requirements. Delegations were instructed to avoid contact with the public, limit movement to essential venues, and comply with repeated testing. The Games therefore operated within a controlled mobility environment that differed sharply from previous editions.

In Japan, these measures unfolded amid significant domestic scepticism. Polling in 2021 indicated that many residents preferred cancellation or further postponement because they feared imported infections (Asahi Shimbun, 2021; Kato, 2021). The Japanese government created exemptions that allowed accredited individuals to enter the country despite general travel restrictions. These exemptions amplified criticism. Residents who were limiting their own movement questioned the fairness of permitting thousands of visitors to travel for a sporting event.

Concerns emerged among healthcare workers and local officials who worried that the arrival of delegations could strain medical resources or introduce new variants. Internationally, national Olympic committees faced their own challenges navigating inconsistent travel rules. The IOC therefore confronted a situation in which mobility had become a political and symbolic issue as much as a health concern. Reports of rule breaches, even when minor, further intensified scrutiny. These tensions reveal how travel governance at Tokyo 2020 was inseparable from questions of legitimacy. The IOC needed to show not only that it could manage risk technically but also that it understood wider public concerns.

Beck’s Theory of Risk and Its Relevance to Tokyo 2020

Ulrich Beck’s theory of risk society provides a useful lens for understanding these developments. Beck argues that modern societies generate new risks through their own systems of connectivity and technological advancement (Beck, 1992). These risks cross borders, shift rapidly, and require institutions to manage uncertainty in ongoing and reflexive ways. Travel during the pandemic reflects these characteristics clearly. The risk of infection followed global mobility flows, and attempts to govern the Games depended on systems that no single organisation could control.

For Beck, modern institutions must continually adjust their practices to changing risk environments. This reflexivity was visible in the IOC’s repeated revisions of the Playbooks. As global infection rates fluctuated and new variants appeared, the IOC increased testing frequency, adjusted behavioural expectations, and altered movement rules. These revisions reflected attempts to respond to a risk that evolved faster than organisational planning cycles.

Beck also emphasises the political nature of risk governance. Institutions must justify their decisions to a sceptical public whose trust is increasingly fragile (Beck, 2009). This dynamic shaped the IOC’s communication strategy. Public concerns in Japan made it necessary for the IOC to demonstrate that exceptional mobility was justified. The organisation emphasised scientific advice, multi-layered protection, and international coordination in an effort to defend its authority. The Playbooks operated as both operational manuals and symbolic displays of control. Their detailed rules conveyed a message of precision and responsibility that went beyond the technicalities of risk mitigation.

Classifying participants into risk categories and regulating their movement reflects what Beck describes as risk classification systems. These systems create distinctions between safe and unsafe behaviour and establish expectations for compliance. At Tokyo 2020, these classifications shaped not only practical arrangements but also the public meaning of mobility. Athletes and officials were framed as individuals whose movement could be contained and monitored, which was essential to the IOC’s claim that the Games could proceed without endangering the broader public.

Beck’s framework also helps explain public resistance. In a risk society, citizens are more aware of institutional limits and are more likely to question official claims. Surveys showing Japanese opposition to the Games suggest that many residents doubted the IOC’s assurances. This scepticism aligns with Beck’s observation that modern risks expose gaps between institutional narratives and public expectations. The controversy surrounding travel exemptions illustrates these tensions. The burden of risk was uneven. Local residents faced potential exposure and healthcare pressures, while accredited personnel were granted special mobility rights. Beck notes that modern risks frequently reveal social inequalities in who bears the consequences of institutional decisions (Beck, 1992).

Contribution to Scholarship

The Tokyo 2020 case contributes to research on mega-events and risk by foregrounding international travel as a domain of governance. Existing Olympic scholarship often focuses on political controversy, media narratives, or long-term impacts (Boykoff, 2013), while studies of mega-event risk tend to examine security and crowd management (Toohey & Taylor, 2008). Far less attention has been paid to how mobility itself becomes a site where uncertainty is produced and regulated. The pandemic created conditions in which travel could not be assumed, which makes Tokyo 2020 a valuable case for analysing how institutions reconstruct mobility in a crisis.

The case also extends Beck’s theory of risk society by applying it to a transnational organisation that lacks sovereign authority. The IOC had to manage manufactured and transboundary risks while persuading both domestic and international audiences that movement could be controlled. This shows how non-state actors use protocols, communication, and symbolic claims to stabilise uncertain conditions. The focus on travel therefore highlights an underexamined aspect of mega-event governance and offers insight into how global institutions defend their legitimacy when foundational systems become unstable.

Methodology

This project is designed as a qualitative document analysis suitable for a master’s-level dissertation. The aim is to examine how the International Olympic Committee (IOC) constructed, governed, and justified travel-related risks in the lead-up to and during the Tokyo 2020 Olympic Games. Because the research question focuses on how the organisation framed uncertainty and defended its authority, the study relies on publicly available documents and media texts through which the IOC communicated its decisions. Qualitative document analysis is well suited to this task, since organisational governance is often expressed through written protocols, guidance materials, statements, and press communication rather than through observable internal processes. Similar document-based approaches have been used in studies of Olympic governance (Boykoff, 2013), analyses of mega-event risk management (Toohey & Taylor, 2008), and research on public risk controversies (Hilgartner, 1992). These precedents provide a strong foundation for adopting a qualitative, text-focused method.

Scope and Data Sources

The project limits the temporal scope to March 2020 through August 2021. This period begins with the postponement of the Games and ends shortly after their completion, which allows for the inclusion of protocol development, rule revisions, and reflections during the event itself. The narrower time frame provides both feasibility and analytical clarity.

The corpus will be composed of three categories of documents. The first category includes IOC and Tokyo 2020 materials that outline mobility protocols, testing rules, behavioural expectations, and logistical arrangements. This includes the full set of Playbooks, updates issued in different months, travel protocols, countermeasure briefings, and press releases. These documents are crucial because they reveal how the organisation sought to shape behaviour, articulate risk management strategies, and publicly justify the continuation of the Games.

The second category consists of Japanese government documents that address border control, quarantine procedures, public health guidelines, and exemptions created for Olympic personnel. Host state rules shaped the IOC’s decisions, which means these documents help illuminate points of alignment and tension between institutional logics. English-language statements from the Ministry of Foreign Affairs, Cabinet Office, and Tokyo Metropolitan Government will be included, as well as selected Japanese-language press releases where relevant.

The third category includes media texts that capture public debate, political criticism, and reactions from international sports bodies. Articles from the Associated Press, Reuters, the BBC, the New York Times, Asahi Shimbun, and Mainichi Shimbun will be used to reflect both international and domestic perspectives. Media coverage will not be treated as factual reporting alone, but as an interpretive site that reveals how legitimacy claims and risk narratives circulated among different audiences.

A corpus of approximately eighty to one hundred documents is expected. This range mirrors the scale commonly used in qualitative studies of international sport and risk governance, where researchers rely on a combination of institutional and media texts to build an interpretive account (Boykoff, 2013; Toohey & Taylor, 2008).

Data Management

All collected documents will be stored in a structured digital archive organised by source category and date. They will be imported into NVivo, which is widely used in qualitative research for coding and document management. Using software provides benefits for transparency and replicability, since coding choices can be traced, adjusted, and compared across the corpus. NVivo also allows for the grouping of documents into sets that represent phases of protocol development, such as early 2021 revisions or the final pre-Games instructions. This temporal organisation is useful given the iterative nature of the IOC’s rule-making process.

Analytical Strategy

The analysis will draw on thematic coding. The approach follows the principles outlined by Braun and Clarke (2006), who emphasise a systematic process of identifying, refining, and interpreting patterns across a body of texts. Coding will proceed in several stages. The first stage involves preliminary reading and memo writing. A sample of documents will be read without coding in order to identify tentative themes, surprising elements, and recurring framing devices. Analytic memos will support early reflections and provide a record of emerging ideas.

The second stage will involve developing a coding frame that blends deductive categories drawn from Beck’s theory with inductive categories that arise from the documents themselves. Deductive codes will include concepts such as transboundary risk, uncertainty, institutional reflexivity, and legitimacy claims. Inductive codes will likely include categories such as arrival protocols, behavioural restrictions, testing layers, and references to scientific advice. The coding frame will remain flexible and open to revision as new themes emerge.

The third stage will involve full coding of the corpus. Each document will be read in its entirety, with segments assigned to one or more codes. Coding will focus on three analytic domains that correspond directly to the research question: anticipation of travel risk, mechanisms for governing mobility, and public justifications for the rules. Attention will also be paid to changes across time, particularly as protocols were updated in response to shifting infection rates or public criticism.

The final stage will involve synthesising coded themes into interpretive findings. This will include comparing how the IOC described risk across different audiences, how classifications and exemptions were framed as necessary, and how legitimacy was defended. Triangulation across IOC documents, government materials, and media coverage will help identify points where institutional narratives aligned or diverged. This triangulation is a standard practice in document-based research and strengthens analytical claims (Hilgartner, 1992).

Methodological Challenges

Several methodological challenges are anticipated. The first is the opacity of internal IOC decision-making. Many discussions between the IOC and Japanese authorities occurred behind closed doors. Public documents therefore represent only the finalised or public-facing version of decisions. This limitation is common in organisational research, where internal access is restricted. Triangulation will help mitigate this issue by showing how different actors interpreted and responded to decisions.

A second challenge involves the retrospective rationalisation present in many institutional documents. Playbooks and press releases often present decisions as orderly, even when the actual process may have been more chaotic. To address this, the analysis will examine earlier drafts and track revisions across time in order to identify shifts in framing and tone.

A third challenge concerns media bias. Japanese and international outlets approached the Games from different political and cultural standpoints. Rather than treating media as factual accounts, they will be used as interpretive sources that reflect public sentiment, conflict, and contestation. Comparing multiple outlets will help reduce reliance on any single narrative.

Finally, researcher positionality must be acknowledged. As an external analyst, interpretation is shaped by distance from institutional actors and by reliance on texts produced for public consumption. Maintaining clear analytic memos and reflecting on interpretive decisions throughout the process will increase transparency.

Suitability of the Method

This method is well suited to the research question because the IOC’s governance of risk is primarily expressed through written rules, protocols, and justificatory statements. Document analysis allows for close examination of how risk was constructed, how mobility was categorised, and how legitimacy was defended. The method also aligns with Beck’s theoretical framework, which emphasises the discursive production of risk within institutions. By focusing on the texts through which the IOC sought to stabilise a volatile situation, the study can reveal how a transnational organisation navigated the uncertainties of a global crisis.

Conclusion

This paper has examined how the International Olympic Committee approached the challenge of governing international travel during the Tokyo 2020 Olympic Games. The disruption caused by the COVID-19 pandemic transformed mobility from a routine logistical concern into a central site of public anxiety, political negotiation, and organisational responsibility. The research question guiding the project asked how the IOC anticipated, governed, and justified travel-related risks during a period of heightened uncertainty. By situating the case within Ulrich Beck’s theory of risk society, the analysis highlighted the ways in which mobility became a form of transboundary and manufactured risk that required constant institutional reflexivity (Beck, 1992, 1994).

The empirical and theoretical discussion showed that travel during Tokyo 2020 was managed through layers of rules, testing requirements, behavioural instructions, and controlled movement systems. These measures were not only practical attempts to reduce infection risk. They also served as symbolic tools that aimed to reassure the public that risk had been addressed in a responsible manner. The controversy surrounding the Games illustrated how legitimacy becomes a central concern when institutions operate under uncertain conditions. Public opposition in Japan and international skepticism created pressure on the IOC to justify the exceptional mobility of thousands of accredited individuals. The organisation responded by appealing to scientific advice, demonstrating procedural rigor, and presenting its decisions as the product of extensive coordination.

The methodology proposed in this paper demonstrates how a master’s-level qualitative document analysis could be carried out to examine these dynamics. By constructing a corpus of IOC materials, Japanese government documents, and media texts, and by analysing them through thematic coding, the study would illuminate how the organisation framed uncertainty and defended its authority. The method is grounded in established approaches in risk governance and Olympic research and is well suited to the textual nature of the IOC’s decision-making environment.

Tokyo 2020 offers insight into how global institutions adapt when the foundations of international mobility become unstable. It shows that in times of crisis, travel becomes more than movement. It becomes an arena in which risks are produced, managed, and justified. This project would contribute to understanding these processes and provide a foundation for future research on mobility governance in global sport.

Works Cited

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Beck, U. (1994). Reflexive modernization: Politics, tradition and aesthetics in the modern social order. Stanford University Press.

Beck, U. (2009). World at risk. Polity Press.

Boykoff, J. (2013). Celebration capitalism and the Olympic Games. Routledge.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology.

Hilgartner, S. (1992). The social construction of risk objects: Or, how to pry open networks of risk. In J. Short & L. Clarke (Eds.), Organizations, uncertainties, and risk (pp. 39–53). 

Kato, T. (2021). Opposition in Japan to the Olympics during the COVID-19 pandemic. Humanities and Social Sciences Communications

Toohey, K., & Taylor, T. (2008). Mega events, fear, and risk: Terrorism at the Olympic Games.