Nudges as an instrumento of external control by the Brazilian Federal Court of Accounts: Na analysis of the application of behavioral economics in public health policies in Brazil
Nudges as an instrumento of external control by the Brazilian Federal Court of Accounts: Na analysis of the application of behavioral economics in public health policies in Brazil
DOI:
https://doi.org/10.51473/rcmos.v1i2.2025.1685Keywords:
Behavioral economics; Nudge; Brazilian Federal Court of Accounts; External control; Public health policies.Abstract
This article analyzes the potential of nudge theory, from behavioral economics, as an instrument for the external oversight exercised by the Brazilian Federal Court of Accounts (Tribunal de Contas da União- TCU) over health policies in Brazil. Through literature and documentary research, it investigates the legal-constitutional foundations that authorize a more preventive role for the TCU, as opposed to the traditional reactive model. The study explores how interventions in choice architecture can enhance the efficiency of the Unified Health System (Sistema único de Saúde- SUS), overcoming cognitive biases in management. It also examines international experiences to extract lessons applicable to Brazil. The article concludes that nudges are promising tools, compatible with the TCU’s powers, capable of modernizing external oversight and generating better outcomes for society.
Downloads
References
BRASIL. Constituição da República Federativa do Brasil de 1988. Brasília, DF: Presidência da República, 1988. Disponível em: https://www.planalto.gov.br/ccivil_03/constituicao/constituicao.htm
. Acesso em: 20 set. 2025.
BRASIL. Lei nº 8.080, de 19 de setembro de 1990. Dispõe sobre as condições para a promoção, proteção e recuperação da saúde, a organização e o funcionamento dos serviços correspondentes e dá outras providências. Brasília, DF: Presidência da República, 1990. Disponível em: https://www.planalto.gov.br/ccivil_03/leis/l8080.htm
. Acesso em: 23 set. 2025.
BRASIL. Lei nº 8.443, de 16 de julho de 1992. Dispõe sobre a Lei Orgânica do Tribunal de Contas da União e dá outras providências. Brasília, DF: Presidência da República, 1992. Disponível em: https://www.planalto.gov.br/ccivil_03/leis/l8443.htm
. Acesso em: 21 set. 2025.
COSTA, N. L. M. “Nudge” como abordagem regulatória de prevenção à corrupção pública no Brasil. Revista de Direito Administrativo, Rio de Janeiro, v. 278, n. 3, p. 123–156, set./dez. 2019.
DI PIETRO, M. S. Z. Direito Administrativo. 36. ed. Rio de Janeiro: Forense, 2023.
HORNE, B. D. et al. Behavioral nudges as patient decision support for medication adherence: the ENCOURAGE randomized controlled trial. American Heart Journal, v. 243, p. 125–134, 2022. DOI: https://doi.org/10.1016/j.ahj.2021.11.001
KAHNEMAN, D. Thinking, Fast and Slow. New York: Farrar, Straus and Giroux, 2011. Disponível em: https://dn790002.ca.archive.org/0/items/DanielKahnemanThinkingFastAndSlow/Daniel%20Kahneman-Thinking%2C%20Fast%20and%20Slow%20%20.pdf
. Acesso em: 21 set. 2025.
KAHNEMAN, D.; TVERSKY, A. Prospect theory: an analysis of decision under risk. Econometrica, v. 47, n. 2, p. 263–291, 1979. Disponível em: https://www.jstor.org/stable/1914185 DOI: https://doi.org/10.2307/1914185
. Acesso em: 16 out. 2025.
LEDDERER, L. et al. Nudging in public health lifestyle interventions: a systematic literature review and metasynthesis. Health Education & Behavior, v. 47, n. 5, p. 749–764, 2020. DOI: https://doi.org/10.1177/1090198120931788
MEIRELLES, H. L. Direito Administrativo Brasileiro. 42. ed. São Paulo: Malheiros, 2016.
MORALES CASTRO, C.; UMAÑA ALVARADO, A.; CERDAS BENAVIDES, V. Beyond compliance: elevating audit impact through behavioral insights. INTOSAI Journal, v. Q3 2024, 2024. Disponível em: https://intosaijournal.org/journal-entry/beyond-compliance-elevating-audit-impact-through-behavioral-insights/
. Acesso em: 11 out. 2025.
MURAYAMA, H.; TAKAGI, Y.; TSUDA, H.; KATO, Y. Applying nudge to public health policy: practical examples and tips for designing nudge interventions. International Journal of Environmental Research and Public Health, v. 20, n. 5, p. 3962, 2023. DOI: https://doi.org/10.3390/ijerph20053962
NWAFOR, O. et al. Effectiveness of nudges as a tool to promote adherence to guidelines: a systematic review. Social Science & Medicine, v. 287, p. 114367, 2021.
PINHEIRO, M. M. S. Políticas públicas baseadas em evidências (PPBEs): delimitando o problema conceitual. Texto para Discussão n. 2554. Brasília: Ipea, 2020.
REÑOSA, M. D. C. et al. Nudging toward vaccination: a systematic review. BMJ Global Health, v. 6, n. 9, e006237, 2021. DOI: https://doi.org/10.1136/bmjgh-2021-006237
REINO UNIDO. Behavioural Insights Team. London: Cabinet Office, 2010. Disponível em: https://assets.publishing.service.gov.uk/media/5a79a559ed915d07d35b70f7/Behaviour-Change-Insight-Team-Annual-Update_acc.pdf
. Acesso em: 13 out. 2025.
RIBEIRO, G. M. A. Políticas públicas baseadas em evidências na área da saúde mental: uma releitura das capacidades estatais técnicas, burocráticas e políticas, em especial na região do Amazonas. Belo Horizonte: Editora Expert, 2024. 294 p. ISBN 978-65-6006-146-0.
SAMUELSON, W.; ZECKHOUSER, R. Status quo bias in decision making. Journal of Risk and Uncertainty, v. 1, n. 1, p. 7–59, 1988. DOI: https://doi.org/10.1007/BF00055564 DOI: https://doi.org/10.1007/BF00055564
SUNSTEIN, C. S.; THALER, R. H. O paternalismo libertário não é uma contradição em termos. Civilistica.com, Rio de Janeiro, v. 4, n. 2, p. 1–43, 2015. Disponível em: https://civilistica.emnuvens.com.br/redc/article/view/600
. Acesso em: 12 out. 2025.
TEIXEIRA, L. F. D. A implementação de nudges a políticas públicas: ganhos de bem-estar e riscos à autonomia. Dissertação (Mestrado em Direito) – Universidade Federal de Minas Gerais, Belo Horizonte, 2022. Disponível em: https://repositorio.ufmg.br/handle/1843/44836
. Acesso em: 1 nov. 2025.
THALER, R. H.; SUNSTEIN, C. R. Nudge: como tomar melhores decisões sobre saúde, dinheiro e felicidade. Rio de Janeiro: Objetiva, 2019.
TRIBUNAL DE CONTAS DA UNIÃO. Referencial de Controle de Políticas Públicas. Brasília: TCU, 2020. Disponível em: https://portal.tcu.gov.br/data/files/47/17/2B/CC/50D729104CE08619E18818A8/Referencial%20de%20Controle%20de%20Politicas%20Publicas.pdf
. Acesso em: 27 set. 2025.
TVERSKY, A.; KAHNEMAN, D. Availability: a heuristic for judging frequency and probability. Cognitive Psychology, v. 5, n. 2, p. 207–232, 1973. DOI: https://doi.org/10.1016/0010-0285(73)90033-9 DOI: https://doi.org/10.1016/0010-0285(73)90033-9
.
WEINSTEIN, N. D. Unrealistic optimism about future life events. Journal of Personality and Social Psychology, v. 39, n. 5, p. 806–820, 1980. DOI: https://doi.org/10.1037/0022-3514.39.5.806 DOI: https://doi.org/10.1037//0022-3514.39.5.806
WOLF, A. et al. Using nudges to promote clinical decision making of healthcare professionals: a systematic review. Preventive Medicine, v. 164, p. 107277, 2022. DOI: https://doi.org/10.1016/j.ypmed.2022.107320
ZINGALES, N.; BAKONYI, E. A aceitabilidade do nudging: a necessidade de uma resposta multidimensional. In: FUNDAÇÃO GETULIO VARGAS. Direito e Tecnologia. Rio de Janeiro: FGV Direito Rio, 2021. p. 45–78. DOI: https://doi.org/10.30899/dfj.v16i1.1322
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2025 Luiz Felipe Holanda Menezes, Gláucia Maria de Araújo Ribeiro (Autor)
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This means you are free to:
- Share — copy and redistribute the material in any medium or format.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
The use of this material is conditioned upon proper attribution to the original author(s), providing a link to the license, and indicating if changes were made. The license does not require permission from the author or the publisher as long as these conditions are met.
The Creative Commons license logo is displayed permanently in the footer of the journal.
The copyright of the manuscript can be retained by the authors without restrictions and can be requested at any time, even after publication in the journal.
