| IVOD_ID |
154419 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Clip/1M/154419 |
| 日期 |
2024-07-01 |
| 會議資料.會議代碼 |
委員會-11-1-26-23 |
| 會議資料.會議代碼:str |
第11屆第1會期社會福利及衛生環境委員會第23次全體委員會議 |
| 會議資料.屆 |
11 |
| 會議資料.會期 |
1 |
| 會議資料.會次 |
23 |
| 會議資料.種類 |
委員會 |
| 會議資料.委員會代碼[0] |
26 |
| 會議資料.委員會代碼:str[0] |
社會福利及衛生環境委員會 |
| 會議資料.標題 |
第11屆第1會期社會福利及衛生環境委員會第23次全體委員會議 |
| 影片種類 |
Clip |
| 開始時間 |
2024-07-01T13:24:30+08:00 |
| 結束時間 |
2024-07-01T13:39:28+08:00 |
| 影片長度 |
00:14:58 |
| 支援功能[0] |
ai-transcript |
| 支援功能[1] |
gazette |
| video_url |
https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/1f04b26fe05fa65ad4ce991274d46335fe28e669f0977b5113d733110b52e522b165d9c3a9e3ea845ea18f28b6918d91.mp4/playlist.m3u8 |
| 委員名稱 |
楊曜 |
| 委員發言時間 |
13:24:30 - 13:39:28 |
| 會議時間 |
2024-07-01T09:00:00+08:00 |
| 會議名稱 |
立法院第11屆第1會期社會福利及衛生環境委員會第23次全體委員會議（事由：邀請衛生福利部部長就「有關健保合理支付、保障醫護人員收入、設置百億癌症基金及健康投資等事項」進行專題報告，並備質詢。） |
| gazette.lineno |
1253 |
| gazette.blocks[0][0] |
楊委員曜：（13時24分）謝謝主席。主席，我請一下邱部長。 |
| gazette.blocks[1][0] |
主席：請邱部長。 |
| gazette.blocks[2][0] |
邱部長泰源：委員好。 |
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楊委員曜：部長好。部長，我今天沒有帶任何資料，我們就赤手空拳討論幾個問題。 |
| gazette.blocks[4][0] |
邱部長泰源：好。 |
| gazette.blocks[5][0] |
楊委員曜：今天專案報告的題目開頭第一個就是健保合理支付，也就是健保合理給付。部長本身是一個名醫師、名教授，也曾經是醫師全聯會理事長，也在這個委員會跟我共事了8年，現在是部長，所以由你來認定，我覺得應該還不錯。當然，這個沒有絕對的答案，我第一個問題請教部長，你覺得什麼叫合理？健保怎麼給付叫合理？ |
| gazette.blocks[6][0] |
邱部長泰源：這個要依據每一個國家消費的水準，至少現在比較起來是偏低。 |
| gazette.blocks[7][0] |
楊委員曜：部長覺得現在…… |
| gazette.blocks[8][0] |
邱部長泰源：給付應該是偏低。 |
| gazette.blocks[9][0] |
楊委員曜：是從哪裡看？ |
| gazette.blocks[10][0] |
邱部長泰源：所以可以看到我們…… |
| gazette.blocks[11][0] |
楊委員曜：部長剛剛有講到消費水準也是一個，那就是說，現在健保給醫療院所的給付、讓他們發出去的薪資，是真的有比臺灣一般性的職業低嗎？我現在不是說醫務人員的薪資應該這麼低，我是就部長剛剛講的，就是舉了消費水準，那就跟薪資有關嘛。部長，你覺得太低，我就直接再請教部長，你覺得怎麼做才能夠讓它的給付增加？怎麼做？ |
| gazette.blocks[12][0] |
邱部長泰源：因為如果相比其他國家，我們醫事人員的收入的確是比較低，在開一個刀，譬如開一個盲腸手術，我們這邊可能給付2,000塊好了，可能美國的給付是我們的10倍，難道我們的消費水準差這麼多嗎？這樣是不是將來會擠壓到醫療發展的空間？ |
| gazette.blocks[13][0] |
楊委員曜：不是，其實合不合理，光是我就有兩個答案，所以我們今天就純粹探討它的合理性。假如部長覺得偏低，部長覺得應該用什麼方法讓它比較不低？ |
| gazette.blocks[14][0] |
邱部長泰源：其實我們已經有公告，從113年7月……其實一直在修訂這個支付標準，因為為了臨床的需要，要跟那些專業團體講，所以總共有168次的公告調整、超過3,000次的診察項目在研議…… |
| gazette.blocks[15][0] |
楊委員曜：那個都是在水庫裡面挪動而已，現在是假如給付偏低，就是支出面收到的人覺得太少，表示收入跟支出之間，收入是少於支出的，我這樣子講對不對？有沒有…… |
| gazette.blocks[16][0] |
邱部長泰源：所以收入面也要擴大，收入面擴大才有辦法給付更高一點的給付嘛。 |
| gazette.blocks[17][0] |
楊委員曜：那收入面怎麼擴大？ |
| gazette.blocks[18][0] |
邱部長泰源：擴大就是我剛剛有做出一些報告，譬如我們要增加公務預算的投資，或者不應該把給健保的費用用其他的補助來填補，其實政府應該給健保36%，這個就差了一百三十幾億了。如果有多這些…… |
| gazette.blocks[19][0] |
楊委員曜：政府法定應該給的，本來就應該給呀。 |
| gazette.blocks[20][0] |
邱部長泰源：對，但是有時候會把補助什麼、補助什麼，都跟健保沒有關的，也算進去這裡面。 |
| gazette.blocks[21][0] |
楊委員曜：我覺得你們行政團隊必須要自己去做處理，就是政府每年應該給健保多少，這個一定要，這個到位了以後，還有沒有給付偏低的問題？ |
| gazette.blocks[22][0] |
邱部長泰源：這個到位以後，應該是還不夠。 |
| gazette.blocks[23][0] |
楊委員曜：還不夠，所以部長剛剛的意思就是還要用公務預算撥補，對不對？ |
| gazette.blocks[24][0] |
邱部長泰源：先把公務預算釐清，比較屬於公共衛生的或者其他不是在健保法裡面可以來支出的，通通把它移出去的話，大概除了36%以外，可以多一百多億，再把原來弄在健保的把它移出去，一年也大概可以再挪出一百多億，這些如果能夠反映在總額的成長，我相信…… |
| gazette.blocks[25][0] |
楊委員曜：點值就會增加？ |
| gazette.blocks[26][0] |
邱部長泰源：給付就會增加，而給付的增加，我相信對於人力的薪資、設備的加強，這個都會有幫助。 |
| gazette.blocks[27][0] |
楊委員曜：對，這個我們都是支持的。 |
| gazette.blocks[28][0] |
邱部長泰源：所以必須要先把水庫做大，然後成長率要談好，談到一定的成長，有合理的成長率，其實健保署才有辦法且有錢去跟人家講支付要合理，沒錢的話也沒辦法說支付要提高嘛！ |
| gazette.blocks[29][0] |
楊委員曜：好，因為現在有很多黨團也好、委員版本也好，都是要保障點值的，這個要從公務預算來撥，對不對？ |
| gazette.blocks[30][0] |
邱部長泰源：對啊，因為你提的太高，第一個也破壞到總額的精神，總額其實就是當時想控制在一定的量，不然一直報、一直報，到最後人民的增加還是多，當然這個總額的控制的確是會擠壓到醫療院所的權益，說實在還是讓他們…… |
| gazette.blocks[31][0] |
楊委員曜：部長，我沒有反對讓醫療院所的收入增加，然後來提高我們今天專案所談醫護人員的待遇，這個我想大家都很贊成，只是用什麼方法來達成這個目的才是重要的。 |
| gazette.blocks[32][0] |
邱部長泰源：是。 |
| gazette.blocks[33][0] |
楊委員曜：像我就比較傾向從整體的保險制度來看，就是說為什麼大家那麼抗拒提高保費，我們現在的的費率也還沒有到達法定，我們提高保費，在六類的被保險對象裡面，政府應該補貼的，我們從這裡來做公務預算的支出，這個我覺得很合理，我一直覺得一個制度要建立很困難，可是要打破卻很容易，因為大家都知道點值保障到1、保障到0.95、保障到0.9，醫界會很歡迎，所以我是很堅持不破壞制度，假如要破壞制度，我的點值保障的主張是1.1到1.2，為什麼呢？因為假如大家提案最高限制保障1.1元，真的要再鼓勵醫療院所投資設備，提高其他的醫事人員的薪資結構，當然必須要超過1.1元，這是我的看法，不過，這個是假如大家已經決議要破壞整個保險制度的前提，可是在還沒有到達那一步之前，我覺得我們是不是再討論看看？我舉一個例子好了，我問部長，台電長期虧損都是由政府的公務預算來補貼，電價明顯低於國際，你覺得這個合理嗎？你覺得這個合理嗎？我講過，今天我們就是沒有任何的對錯，所以我也沒有帶資料，我們就只是看你覺得這個合理嗎？ |
| gazette.blocks[34][0] |
邱部長泰源：這個要在…… |
| gazette.blocks[35][0] |
楊委員曜：假如說這個不合理，其實部長你是不好意思說，那為什麼不合理？因為選票嘛！講最簡單的，就是大家怕漲電價影響選票、失去政權，所以才會一直用政府補貼，我剛才舉台電這個例子，有沒有很像即將要來臨的健保？有啦，很像啦，真的很像啦！我知道我以一己之力並沒有辦法阻擋這個法案的通過，但我要聲明，我並不是不想讓醫界的待遇整體可以提高、醫療的水準可以提高，而我覺得假如有其他的方式，譬如補充保費也是從五千元開始課，後來調高到兩萬，這個也都可以檢討，為什麼大家就是非得要破壞整體的制度，不就真正的問題來做解決？這個我不懂。 |
| gazette.blocks[35][1] |
最後，除了合理的健保以外，我今天剛好看了一則新聞，所以也跟部長講一下，你們是不是從現在開始不要再做醫學中心的醫院評鑑？ |
| gazette.blocks[36][0] |
邱部長泰源：現在還繼續在做啊！ |
| gazette.blocks[37][0] |
楊委員曜：不要做了、不要做了！醫學中心不用做，因為醫學中心只升不降的，何必為難大家呢？醫學中心花了那麼多的時間、人力，做書面、寫故事讓這些委員看，看一看，從1988年到現在，沒有任何一家醫學中心是降級的，然後更好笑的是，我們原本是200萬人1間醫學中心，現在我們2,300萬人口已經22家了，我覺得這個可以取消，避免浪費大家的……你們就只要去評，其實醫學中心也額滿了啦，你看喔，再回到我們剛才講的健保支出，一個醫院從區域醫院升級到醫學中心，診察費、住院費、住院護理費都比區域醫院高，我不是說對這種給付的差異有意見，你們有你們的專業，我只是覺得不可思議。陳時中部長任內，我一樣在這個質詢台，四年我問了他不下五次，醫學中心是不是有升有降？他跟我說：是！他走了，薛部長上來，沒有任何一家降的，一下子新增了3間，就剛好勉強快要達到100萬人口1家醫學中心。部長，這樣啦，這件事情不用你回答，但我強烈建議把醫學中心的評鑑取消，讓他們不用再花費那麼多無謂的人力、財力、物力來寫一些書面、說一些故事給你們聽，因為它升上去就不會降了，對不對？部長，我還是回到健保本身，我覺得一個制度的形成真的很不容易，可是要打破、特別是為了選票要打破真的很容易啦！好，謝謝部長、謝謝主席。 |
| gazette.blocks[38][0] |
主席：謝謝楊曜委員的發言。 |
| gazette.blocks[38][1] |
本日會議詢答全部結束，委員林憶君、盧縣一、陳冠廷所提書面質詢列入紀錄，刊登公報。 |
| gazette.blocks[39][0] |
委員林憶君書面質詢： |
| gazette.blocks[39][1] |
一、醫藥分業已經二十餘年，然藥費未有獨立總額之情況下，藥價差即成為醫療院所弭平收入之工具。大型醫院透過大量進藥議價過程得其價差、或是不肖醫療院所浮濫開藥賺取利益。針對藥價差造成之健保財務黑洞，請問部長，我們何時才能夠解決這個問題？我國是否能夠透過訂定藥費獨立總額，藉此來解決上開問題？ |
| gazette.blocks[39][2] |
二、醫藥分業已逾二十年，但我國目前仍然為特殊雙軌制，承上開藥價黑洞問題、及藥師因為與醫療院所為受雇關係而無法監督藥品處方箋之合理性等問題，是否我國能試辦六大公立醫院釋出處方箋（管制藥品除外），藉此解決大型醫院藥價差問題、及對於完全之醫藥分業起示範性效果？ |
| gazette.blocks[40][0] |
委員盧縣一書面質詢： |
| gazette.blocks[40][1] |
質詢提問： |
| gazette.blocks[40][2] |
1.112年健保點值下降其原因為何？未來，114年如何補救改進？ |
| gazette.blocks[40][3] |
2.健保點值保障入法，對健保財務、費率調整及國家 財政的衝擊？未來，如何兼顧保障醫療服務提供者之權益，以及提升其所受僱之醫護人員勞動待遇？ |
| gazette.blocks[40][4] |
3.為使健保藥品有合理的支付價格，如何再次精進健保藥價調整機制？ |
| gazette.blocks[40][5] |
4.食藥署業已建立藥品短缺處理機制，未來改機制如何精進？ |
| gazette.blocks[40][6] |
5.為利醫療機構及藥局於個別廠牌藥品短缺時，可購得替代藥品，食藥署於112年3月建立藥品供應資訊opendata，以利醫療機構及藥局導入藥品管理系統，迄今相關執行成效為何？各地方衛生所，是否亦應用此藥品供應資訊？ |
| gazette.blocks[40][7] |
6.為使有限的健保資源達到有效配置，健保署依健保法第42條規定，辦理醫療科技評估（HTA），衛服部近五年之評估並納入健保給付之成果為何？ |
| gazette.blocks[40][8] |
7.如何藉政策誘因與不利益（如部分負擔或管控措施），於民眾端與醫療端實踐分級醫療措施，以利合理分配醫療資源？「醫療區域輔導與醫療資源整合計畫」相關之執行成果及未來策進措施？ |
| gazette.blocks[41][0] |
委員陳冠廷書面質詢： |
| gazette.blocks[41][1] |
一、永豐化學輸液供應短缺應對現況 |
| gazette.blocks[41][2] |
部長，最近這個永豐化學的輸液供應問題，我想全國民眾都非常關切。我今天想就這個議題和您做些深入的探討，希望能夠讓民眾更加了解目前的情況，也讓大家看到政府的努力和規劃。 |
| gazette.blocks[41][3] |
首先，我們知道目前專案進口預計執行到10月。部長，我想確認，從現在到10月期間，我們是否能夠確保輸液的供應無虞？能不能保證不會出現缺口？如果有的話，我們要如何補足？ |
| gazette.blocks[41][4] |
我希望能夠聽到一個明確的保證，讓全國民眾都能夠安心。特別是對於一些重症患者和他們的家屬來說，這個問題真的非常重要。部長，您能不能給我們一個清楚的時間表，告訴我們什麼時候可以完全恢復正常供應？ |
| gazette.blocks[41][5] |
其次，我們都很關心永豐化學的情況。據我了解，他們可能要到年底都還不一定能夠符合復工條件。部長，我想請教您，對於10月之後的情況，我們有什麼樣的規劃？專案進口會不會延長？還是我們有其他的應對措施？ |
| gazette.blocks[41][6] |
最後，這次的事件讓我們發現到，過去可能過度依賴單一廠商，當出現問題時就會造成全面的供應不足。部長，對於如何健全供應體系，讓風險能夠分散，衛福部有什麼樣的想法嗎？我們是不是有機會看到更多元化的供應商參與進來？有的話，衛福部目前的規劃是什麼？ |
| gazette.blocks[41][7] |
部長，我知道這些都不是簡單的問題，需要長期的規劃和執行。但我們也希望能夠聽到一個長期的戰略，讓民眾看到政府不只是在處理眼前的危機，更是在為未來做準備。 |
| gazette.blocks[41][8] |
二、如何提升護病比及護理師合理待遇 |
| gazette.blocks[41][9] |
部長，最近護理人力短缺的問題，我想不只是我們立法院關心，全國民眾都非常在意。 |
| gazette.blocks[41][10] |
首先，我們都知道三班護病比新制已經上路一段時間了。但根據一些民間團體的調查，似乎成效並不如預期。有報告指出有高達9成的醫院未達標，這個數字讓人相當憂心。部長，我想請教您，衛福部對於如何有效提升護病比，讓病患能得到妥善照顧，同時又不會讓護理師過勞難以負擔，有什麼具體的規劃？ |
| gazette.blocks[41][11] |
接著，我想談談護理師的權益問題。長期以來，護理師的辛勞付出與他們所得到的回報似乎並不成正比。部長，現在雖然有針對夜班護理人員的獎勵措施，這當然是好事。但是，我們也聽到了一些聲音，認為這可能會導致同工不同酬的問題，甚至可能造成護理人員之間的矛盾。部長，對於這個問題，衛福部有什麼看法？我們是否有更全面的薪資調整計劃？我想請教您，衛福部有沒有相關機制來提升護理師的實質待遇？ |
| gazette.blocks[41][12] |
另外，除了薪資之外，護理師的職場環境、進修機會、職涯發展等，都是影響他們是否願意長期留任的重要因素。部長，在這些方面，衛福部有什麼具體的措施嗎？ |
| gazette.blocks[42][0] |
主席：現在作以下決定：報告及詢答完畢，委員質詢未及答復或請補充資料者，請相關機關於兩週內以書面答復，委員另要求期限者，從其所定。 |
| gazette.blocks[42][1] |
本日會議到此結束，現在散會。 |
| gazette.blocks[42][2] |
散會（13時39分） |
| gazette.agenda.page_end |
118 |
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委員會-11-1-26-23 |
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黃秀芳 |
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陳昭姿 |
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林月琴 |
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陳菁徽 |
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邱鎮軍 |
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王育敏 |
| gazette.agenda.speakers[6] |
涂權吉 |
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廖偉翔 |
| gazette.agenda.speakers[8] |
蘇清泉 |
| gazette.agenda.speakers[9] |
王正旭 |
| gazette.agenda.speakers[10] |
鄭天財Sra Kacaw |
| gazette.agenda.speakers[11] |
葉元之 |
| gazette.agenda.speakers[12] |
牛煦庭 |
| gazette.agenda.speakers[13] |
林淑芬 |
| gazette.agenda.speakers[14] |
李彥秀 |
| gazette.agenda.speakers[15] |
徐欣瑩 |
| gazette.agenda.speakers[16] |
賴士葆 |
| gazette.agenda.speakers[17] |
陳瑩 |
| gazette.agenda.speakers[18] |
劉建國 |
| gazette.agenda.speakers[19] |
楊曜 |
| gazette.agenda.speakers[20] |
林憶君 |
| gazette.agenda.speakers[21] |
盧縣一 |
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陳冠廷 |
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45 |
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2024-07-01 |
| gazette.agenda.gazette_id |
1136801 |
| gazette.agenda.agenda_lcidc_ids[0] |
1136801_00003 |
| gazette.agenda.meet_name |
立法院第11屆第1會期社會福利及衛生環境委員會第23次全體委員會議紀錄 |
| gazette.agenda.content |
邀請衛生福利部部長就「有關健保合理支付、保障醫護人員收入、設置百億癌症基金及健康投資
等事項」進行專題報告，並備質詢 |
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謝謝主席。主席我請一下邱部長。請邱部長。委員好。部長好。部長我今天沒有帶任何資料齁。我們就...就是...欸...赤手空拳齁,討論幾個問題。今天的...的... |
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29.612 |
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這專案報告的題目呢就是開頭第一個就是健保合理支付也就是健保合理給付那部長本身是一個名醫師、名教授也曾經是醫師前年會理事長也在這個委員會跟我共事了8年現在是部長所以由你來 |
| transcript.whisperx[2].start |
57.546 |
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來認定我覺得應該還不錯那當然這個沒有絕對的答案我第一個問題請教部長你覺得什麼叫合理健保怎麼給付叫合理 |
| transcript.whisperx[3].start |
76.674 |
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92.983 |
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這個是因為要依據每一個國家的消費水準至少現在比較起來是偏低部長覺得現在是偏低應該是偏低是從哪裡看 |
| transcript.whisperx[4].start |
102.271 |
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122.117 |
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就是部長剛剛有講到消費水準也是一個那就是說現在健保給醫療院所的讓他們發出去的薪資是真的有比台灣一般性的職業低嗎? |
| transcript.whisperx[5].start |
124.175 |
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我現在不是說醫護人員的薪資應該這麼低,我是就部長剛剛講的就是舉了一個消費水準,那就跟薪資有關嗎?保障你覺得太低啦,好,那我就直接再請教部長,你覺得 |
| transcript.whisperx[6].start |
153.154 |
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178.083 |
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怎麼做才能夠讓他的給付增加?因為我們如果比其他國家的醫事人員的收入的確是比較低然後來使用開一個刀比如說開個房廠我們這邊可能給付兩千塊好了那可能美國就給付那個多少可能是有十倍 |
| transcript.whisperx[7].start |
179.421 |
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202.283 |
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難道我們的消費水準差這麼多嗎?那個是不是這樣將來會擠壓到醫療發展的空間?不是我現在其實合不合理呢?光是我就有兩個答案所以這個我們今天就是純粹探討探討他的合理性假如說部長覺得偏低 |
| transcript.whisperx[8].start |
203.513 |
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那部長覺得應該用什麼方法讓它比較不低?所以我們其實我們已經有公告從113年7月其實一直在修訂這個支付標準因為有臨床的需要要去專業團體說所以總共有168次的公告調整超過3000次的診察項目 |
| transcript.whisperx[9].start |
233.496 |
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257.442 |
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不是,那個都是在水庫裡面挪動而已嘛。現在是說,你假如說給付偏低,就是你支出面覺得收到的人太少表示支出、收入跟支出之間,收入是少於支出的嘛。我這樣子講對不對? |
| transcript.whisperx[10].start |
259.301 |
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280.873 |
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所以收入面你要擴大啦收入面擴大你才有辦法給付比更高一點的給付嘛那收入面怎麼擴大擴大就是我剛剛有做一些報告比如說我們要增加公務預算的投資或者是說不應該把給健保的一個費用 |
| transcript.whisperx[11].start |
284.955 |
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309.826 |
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用其他的補助來填補這個其實政府應該給健保的36%這個就差了一百三十幾億了政府政府應該給的就是法定應該給的本來就應該給啊對但是他有時候會會把算說他補助什麼補助什麼都跟健保沒有關也算進去這裡面 |
| transcript.whisperx[12].start |
311.207 |
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327.998 |
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這個我覺得你們行政團隊必須要自己去做處理是就是政府應該每年應該給健保多少這個一定要這個到位了以後還有沒有給付偏低的問題這個到位了應該是還不夠還不夠所以 |
| transcript.whisperx[13].start |
332.557 |
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358.095 |
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部長剛剛的意思就是還是要用公務預算駁補對不對先把公務預算釐清就是比較屬於公共衛生的或者是其他不是在健保法裡面可以來支出的統統把它移出去的話那大概除了說36%以外可以多100億多億那其實再把 |
| transcript.whisperx[14].start |
359.403 |
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360.123 |
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所以必須要先水庫做大嗎? |
| transcript.whisperx[15].start |
388.3 |
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391.122 |
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因為現在有很多黨團也好委員版本也好都是要保障點子的這個是要從公務預算來撥對不對 |
| transcript.whisperx[16].start |
419.003 |
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442.357 |
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因為你提的太高,第一個也破壞到總和的精神,總和其實就是當時想控制啦控制在一定的,不然一直報一直報到最後人民的增加還是多嘛那當然這個總和的控制會的確是會擠壓到醫療院所的權益啦,說實在還是讓他們還是會比較幸福不然我沒有反對 |
| transcript.whisperx[17].start |
447.525 |
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472.415 |
| transcript.whisperx[17].text |
讓醫療院所的收入增加然後來提高我們今天專案裡面提高醫護人員的待遇這個我想大家都很贊成的只是說用什麼方法來達成這個目的才是重要的像我我就比較傾向從整體的保險制度來看 |
| transcript.whisperx[18].start |
473.703 |
| transcript.whisperx[18].end |
477.918 |
| transcript.whisperx[18].text |
就是說為什麼為什麼大家那麼抗拒抗拒 |
| transcript.whisperx[19].start |
480.529 |
| transcript.whisperx[19].end |
504.88 |
| transcript.whisperx[19].text |
提高保費我們現在的費率也還沒有到法定我們提高然後在六類的被保險對象裡面政府應該補貼的我們從這裡來做公務預算的支出這個我覺得很合理因為我一直覺得一個制度要建立很困難 |
| transcript.whisperx[20].start |
506.274 |
| transcript.whisperx[20].end |
533.964 |
| transcript.whisperx[20].text |
可是要打破呢很容易因為大家大家都知道點子保障到1保障到0.95保障到0.9一屆會很歡迎所以我呢我是很堅持不破壞制度那假如要破壞制度呢 |
| transcript.whisperx[21].start |
535.049 |
| transcript.whisperx[21].end |
561.045 |
| transcript.whisperx[21].text |
我的點子保障我的主張是1.1到1.2為什麼呢因為假如說大家提案最高限制保障1.1元那真的要再鼓勵醫療院所投資設備然後提高其他的醫事人員的薪資結構那當然必須要超過 |
| transcript.whisperx[22].start |
563.038 |
| transcript.whisperx[22].end |
563.058 |
| transcript.whisperx[22].text |
臺電長期虧損 |
| transcript.whisperx[23].start |
593.322 |
| transcript.whisperx[23].end |
617.164 |
| transcript.whisperx[23].text |
都是由政府的公務預算來補貼然後電價明顯低於國際你覺得這個合理嗎?沒有,你覺得這個合理嗎?我講過今天我們就是沒有任何的對錯所以我也沒有帶資料我們就只是看你覺得這個合理嗎? |
| transcript.whisperx[24].start |
619.115 |
| transcript.whisperx[24].end |
646.956 |
| transcript.whisperx[24].text |
那假如說這個不合理,其實,不好意思說,假如說這個不合理,那為什麼不合理?因為選票嘛。講到最簡單的就是,就是大家怕漲電價,影響選票,失去政權嘛。所以才會一直用政府補貼嘛。我剛才舉台電這個例子,有沒有很像即將要來臨的健保? |
| transcript.whisperx[25].start |
648.752 |
| transcript.whisperx[25].end |
663.191 |
| transcript.whisperx[25].text |
有啦!很像啦!真的很像啦!我知道我以一己之力並沒有辦法阻擋這個法案的通過那我要聲明 |
| transcript.whisperx[26].start |
664.636 |
| transcript.whisperx[26].end |
682.805 |
| transcript.whisperx[26].text |
我並不是不想讓醫界的待遇整體可以提高醫療的水準可以提高而我覺得假如有其他的方式譬如說我們補充保費也是從五千元就課後來提高調高到兩萬這個也都可以檢討 |
| transcript.whisperx[27].start |
685.706 |
| transcript.whisperx[27].end |
712.021 |
| transcript.whisperx[27].text |
為什麼大家就是非得要破壞整體的制度然後不就真正的問題來做解決這個我不懂那我最後除了合理的健保以外我今天剛好看了一則新聞所以也跟部長講一下是不是你們從現在開始 |
| transcript.whisperx[28].start |
715.54 |
| transcript.whisperx[28].end |
737.97 |
| transcript.whisperx[28].text |
不要再做醫學中心的醫院評鑑因為醫學中心不用做啊醫學中心只升不降的啊何必為難大家呢醫學中心花了那麼多的時間、人力然後做書面、寫故事 |
| transcript.whisperx[29].start |
745.031 |
| transcript.whisperx[29].end |
767.639 |
| transcript.whisperx[29].text |
然後讓這些委員看啊看一看呢從1988年到現在沒有任何一家醫學中心是降級的然後更好笑的是我們原本是200萬人一間醫學中心現在我們2300萬人口已經22家了 |
| transcript.whisperx[30].start |
774.059 |
| transcript.whisperx[30].end |
797.134 |
| transcript.whisperx[30].text |
我 我 我覺得這個可以取消避免浪費大家的 你們就只要去評阿其實 欸 也額滿了啦醫學中心在 你看喔 在回到我們剛才講的健保支出一個 一個醫院 從7億醫院升級到 到醫學中心 |
| transcript.whisperx[31].start |
798.451 |
| transcript.whisperx[31].end |
827.349 |
| transcript.whisperx[31].text |
檢查費、住院費、住院婦理費都比區醫院高那我不是說我不是對這種給付因為這個你們的專業我不是說對這種給付的差異有意見我只是覺得不可思議陳時中部長任內我一樣在這個執行台四年我問了他不下五次 |
| transcript.whisperx[32].start |
828.73 |
| transcript.whisperx[32].end |
849.699 |
| transcript.whisperx[32].text |
醫學中心是不是有升有降?他跟我出了事,他走了薛部長上來,一下子沒有任何一家降的,一下子新增了三間,就剛好勉強快要達到一百萬人口一家醫學中心。 |
| transcript.whisperx[33].start |
851.581 |
| transcript.whisperx[33].end |
873.536 |
| transcript.whisperx[33].text |
部長這樣啦!這件不要給你回答啦!但是我強烈建議把醫學中心的評鑑取消啦!讓他們不用再花費那麼多無謂的人力、財力、物力來寫一些書面說一些故事給你們聽啦!因為他升上去的就不會降了嘛!對不對? |
| transcript.whisperx[34].start |
876.223 |
| transcript.whisperx[34].end |
876.984 |
| transcript.whisperx[34].text |
好 謝謝楊曜 |