| IVOD_ID |
15700 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Full/1M/15700 |
| 日期 |
2024-03-07 |
| 會議資料.會議代碼 |
委員會-11-1-26-4 |
| 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4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 |
4 |
| 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4次全體委員會議 |
| 影片種類 |
Full |
| 開始時間 |
2024-03-07T08:31:26+08:00 |
| 結束時間 |
2024-03-07T13:13:00+08:00 |
| 影片長度 |
04:41:34 |
| 支援功能[0] |
ai-transcript |
| video_url |
https://h264media01.ly.gov.tw:443/vod_1/_definst_/mp4:1M/bfaf9b39ac01a68573b8a2c1b37799c107777c324b69055f3be8d109af184be48831f324297c6f585ea18f28b6918d91.mp4/playlist.m3u8 |
| 會議時間 |
2024-03-07T09:00:00+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4次全體委員會議（事由：邀請衛生福利部部長、中央健康保險署、食品藥物管理署就「健保藥價調整，藥廠停產慢性病用藥之因應作為」進行專題報告，並備質詢。） |
| 委員名稱 |
完整會議 |
| 委員發言時間 |
08:31:26 - 13:13:00 |
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| transcript.whisperx[0].start |
108.353 |
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110.563 |
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MING PAO CANADA 字幕組 |
| transcript.whisperx[1].start |
1716.887 |
| transcript.whisperx[1].end |
1729.598 |
| transcript.whisperx[1].text |
好報告委員會出席委員已經達到法定人數現在開會請議事人員宣讀上次會議議事錄立法院第11屆第1會期社會福利及衛生環境委員會第3次全體委員會議議事錄時間113年3月6日星期三9時1分至13時33分地點群賢樓801會議室出席委員陳金輝等15人 |
| transcript.whisperx[2].start |
1740.467 |
| transcript.whisperx[2].end |
1761.222 |
| transcript.whisperx[2].text |
列席委員洪孟楷等21人．列席官員勞動部部長許明春等相關人員．主席王兆吉委員喻敏．報告事項．宣讀上次會議議事錄．決定確定．邀請勞動部部長．外交部勞動力發展署．衛生福利部．內政部國家安全局就我國開放印度移工．對本國勞工就業市場之衝擊進行專題報告．並備質詢。． |
| transcript.whisperx[3].start |
1765.185 |
| transcript.whisperx[3].end |
1784.795 |
| transcript.whisperx[3].text |
本次會議由勞動部部長報告後．委員蘇清泉等24人提出質詢．均經勞動部部長．外交部亞東太平洋司副司長許書智．及衛生福利部長期照顧司司長祝建方．及各相關主管等及其答覆．委員王洪維及陳冠廷所提書面質詢．列入紀錄刊登公報． |
| transcript.whisperx[4].start |
1785.675 |
| transcript.whisperx[4].end |
1814.737 |
| transcript.whisperx[4].text |
決定一報告及詢答完畢二委員質詢未及答覆或請補充資料者請相關機關於二周內以書面答覆委員令要求期限者從其鎖定通過臨時提案四項宣讀完畢好請問委員會上次議事錄有沒有錯誤或遺漏之處若沒有的話我們議事錄確定那本日會議議程為邀請衛生福利部部長、中央健保署、食品藥物管理署就 |
| transcript.whisperx[5].start |
1816.003 |
| transcript.whisperx[5].end |
1822.127 |
| transcript.whisperx[5].text |
那我們現在介紹今天在場的委員及列席官員陳昭之委員林月琴委員王振旭委員陳金輝委員那我們接下來介紹官員衛福部 |
| transcript.whisperx[6].start |
1844.384 |
| transcript.whisperx[6].end |
1861.059 |
| transcript.whisperx[6].text |
剛進來蘇清泉委員那接下來介紹列席官員衛福部薛瑞元部長中央健保署石崇良署長食藥署吳秀美署長好那接下來我們就請薛部長進行5分鐘的報告 |
| transcript.whisperx[7].start |
1881.341 |
| transcript.whisperx[7].end |
1894.308 |
| transcript.whisperx[7].text |
主席、各位委員、女士先生本部今日受邀到委員會這邊來進行專案報告,個人深感榮幸以下僅就本部執行健保藥價調整及藥品停產的原因作為 |
| transcript.whisperx[8].start |
1896.269 |
| transcript.whisperx[8].end |
1916.591 |
| transcript.whisperx[8].text |
的因應作為提出報告,進行各位委員指教。現行的藥品支付制度是根據《全民健康保險法》規定由特約醫事服務機構根據《全民健康保險藥物及服務項目及支付標準》所規定的價格向本部健保署申請藥費。 |
| transcript.whisperx[9].start |
1918.112 |
| transcript.whisperx[9].end |
1941.1 |
| transcript.whisperx[9].text |
那健保署透過定期調查各個醫事機構的藥品實際的交易價格取得藥品市場的交易價格那並且依據調查的結果將醫藥雙方議價的結果反映在藥品支付價格的調降以控制藥費在合理的範圍來準決健保費用的支出 |
| transcript.whisperx[10].start |
1942.761 |
| transcript.whisperx[10].end |
1968.158 |
| transcript.whisperx[10].text |
從102年起本部每年辦理全民健康保險藥品費用分配比例目標制也就是所謂的第一梯今年第一梯的藥價調整金額是55.3億元調整的時候已經考慮到基本藥物的品項還有條件的幅度、基本價的保障以及 |
| transcript.whisperx[11].start |
1969.079 |
| transcript.whisperx[11].end |
1975.806 |
| transcript.whisperx[11].text |
藥品供應情形等因素檢討的藥品一共有14000項其中有9500項沒有調整只有4500項的藥品調整調整的品項數是從102年來時是第一梯級那是最少的一次近年來因為 |
| transcript.whisperx[12].start |
1991.26 |
| transcript.whisperx[12].end |
2017.431 |
| transcript.whisperx[12].text |
疫情、二污戰爭、鴻海事件、全球藥品短缺等因素．增加藥品穩定供應的不確定性．國內也因應解封、免疫負債等因素．呼吸道跟腸胃道傳染病的病人增加．如流感、COVID-19、腸病毒等．使用藥需求增加．為了保障民眾用藥的權益． |
| transcript.whisperx[13].start |
2018.672 |
| transcript.whisperx[13].end |
2037.243 |
| transcript.whisperx[13].text |
我自101年起逐步健全藥品短缺處理的機制包括完善法規的管理、建立通報案件的評估機制強化短缺資訊的傳遞等等對於個別藥品短缺的事件 |
| transcript.whisperx[14].start |
2039.585 |
| transcript.whisperx[14].end |
2046.853 |
| transcript.whisperx[14].text |
結條供應藥品與通報的機構還有公布替代藥品的資訊公開徵求專案輸入或製造並在112年7月委託藥師公會全面會 |
| transcript.whisperx[15].start |
2055.176 |
| transcript.whisperx[15].end |
2068.394 |
| transcript.whisperx[15].text |
協助藥局間的藥品調度112年8月啟動流行性疾病用藥的準備112年11月公告擴大必要藥品清單 |
| transcript.whisperx[16].start |
2069.335 |
| transcript.whisperx[16].end |
2074.179 |
| transcript.whisperx[16].text |
113年1月建制完成藥品供應監測資訊系統並持續鼓勵藥廠增加原料藥籍來源及儲備並推廣國產學名藥健保署從112年起啟動健保藥價藥品政策改革規劃方向包括藥價不偏離國際提升 |
| transcript.whisperx[17].start |
2100.131 |
| transcript.whisperx[17].end |
2127.084 |
| transcript.whisperx[17].text |
提升學名藥的競爭力鼓勵在台製造新藥學名藥及鼓勵使用生物相似性的藥品以及加強健保新藥的收載提升病人用藥的可進性等等變同修正全民健康保險藥物幾乎項目及支付標準跟全民健康保險藥品價格調整的 |
| transcript.whisperx[18].start |
2129.125 |
| transcript.whisperx[18].end |
2139.489 |
| transcript.whisperx[18].text |
作業辦法,針對外界關心的第一批事辦方案,未來也會邀請相關團體來研議,並凝聚共識之後來做調整。 |
| transcript.whisperx[19].start |
2148.446 |
| transcript.whisperx[19].end |
2166.828 |
| transcript.whisperx[19].text |
隨著醫療科技的進步,健保逐年增加預算來加速引進新藥,提高民眾使用新藥的可進性,並透過藥價調整機制,讓健保有餘力收納新藥,確保健保永續,達到全民健康。 |
| transcript.whisperx[20].start |
2169.918 |
| transcript.whisperx[20].end |
2197.545 |
| transcript.whisperx[20].text |
也另外著手推動健保藥品政策的改革．並嚴厲輔導、獎勵國內藥廠投入或擴充生產的措施．以達到合理調整藥品的價格．那扶植國產的學名藥．那確保民眾用藥權益的三顏．所以請大院各委員持續給我們指教及監督在這裡謝謝 |
| transcript.whisperx[21].start |
2199.005 |
| transcript.whisperx[21].end |
2222.98 |
| transcript.whisperx[21].text |
好 謝謝部長的一個報告有關本次會議各項書面資料均列入紀錄刊登公報那現在開始詢答做以下宣告本會委員會詢答時間6加2分鐘列席委員4分鐘10點30分截止發言登記委員如有書面質詢請於三會前提出預期不受理 |
| transcript.whisperx[22].start |
2223.78 |
| transcript.whisperx[22].end |
2238.511 |
| transcript.whisperx[22].text |
暫定10點30分休息5分鐘原則上11點30分處理臨時提案如有提案請盡早提出以立議事進行現在我們就請登記第一位的委員陳昭之委員進行發言有請薛部長好有請部長委員好 |
| transcript.whisperx[23].start |
2253.547 |
| transcript.whisperx[23].end |
2273.262 |
| transcript.whisperx[23].text |
部長我想請教分級醫療還在嗎?健保開辦29年前就開始規劃分級醫療到今天健保署的網站上還有這些宣傳分級醫療處兵好醫書、社區好便宜 |
| transcript.whisperx[24].start |
2274.642 |
| transcript.whisperx[24].end |
2291.402 |
| transcript.whisperx[24].text |
但是分級醫療離事實越來越遠甚至遙不可及我想部長你也心知肚明只是不知道部長你是無心去改變還是無力去改變這個分級醫療本來就是在就是還在部長我為什麼告訴你它是還在嗎下一張 |
| transcript.whisperx[25].start |
2294.98 |
| transcript.whisperx[25].end |
2313.167 |
| transcript.whisperx[25].text |
部長請你看這個示意圖健保開辦的時候1995年醫學中心13家區醫院48家地區醫院568家這是一個正三角形非常健康的醫療結構25年後醫學中心增加兩倍區醫院增加一倍半地區醫院腰斬了 |
| transcript.whisperx[26].start |
2314.395 |
| transcript.whisperx[26].end |
2316.917 |
| transcript.whisperx[26].text |
這是什麼形狀?好我請部長來預測部長在10年20年後您覺得我們會走向哪一個部分?分級醫療少了最底層的一個基層的診所 |
| transcript.whisperx[27].start |
2327.086 |
| transcript.whisperx[27].end |
2330.207 |
| transcript.whisperx[27].text |
我認為健保制度帶動了造成今天的狀況為什麼呢因為健保制度的設計它會誘引醫療行為也會改變民眾的就醫行為往下 |
| transcript.whisperx[28].start |
2358.083 |
| transcript.whisperx[28].end |
2370.444 |
| transcript.whisperx[28].text |
部長,您選醫學中心還不夠多嗎?這一次你一口氣增加了三家醫學中心,引起很大的爭議加速是不是要限制這個是可以討論的 |
| transcript.whisperx[29].start |
2371.377 |
| transcript.whisperx[29].end |
2377.601 |
| transcript.whisperx[29].text |
部長,您不知道一來往的設計是200萬人一家醫學中心嗎?好,你這次有很多的爭議,這有很多的爭議,請你再關懲署,延宕,這不是理由,延宕公布時間,本來在去年年底應該公布,後來到大選後公布第二個,你改變了遊戲規則,說沒有鑑別度,有差距,你沒考過聯考嗎?聯考同分的時候是比其他各位,你這還有差距欸 |
| transcript.whisperx[30].start |
2396.972 |
| transcript.whisperx[30].end |
2423.844 |
| transcript.whisperx[30].text |
你增加了三家醫學中心你增加三家醫學中心你弱化了分級醫療你讓民眾負擔增加你讓健保點子下降你讓這個已經不足的護理人員重新二項的重新分配健保點子下降不是這個原因啦護理人員的這個缺少也不是這個原因啦部長請幾位系出同門全候任的這個重要人物捫心自問 |
| transcript.whisperx[31].start |
2425.205 |
| transcript.whisperx[31].end |
2438.895 |
| transcript.whisperx[31].text |
究竟受益者是誰?一下子參加三家醫學中心臺灣醫務管理學會紅理事長說外服部此舉是模糊的排名概念是為了某些醫院某些體系的怕他們太沒面子了 |
| transcript.whisperx[32].start |
2443.151 |
| transcript.whisperx[32].end |
2468.216 |
| transcript.whisperx[32].text |
藥價調整是有法源依據的它是應該根據市場的交易情形合理調整但是我要請問交易情形交易情形都是能力都一樣嗎?溢價能力都一樣嗎?臺灣400多家醫院的溢價能力都一樣嗎?當然不一樣大者恆大、強者恆強、弱者恆弱什麼叫合理的調整價格呢?每位醫師要是罹患高血壓都會吃麥優麥優15年來降了實現了兩成的藥價 |
| transcript.whisperx[33].start |
2473.275 |
| transcript.whisperx[33].end |
2483.642 |
| transcript.whisperx[33].text |
萬物皆漲,唯有藥品該疊。各行各業,營業額增加,整個都是喜事。唯有藥費,整體藥費增加,說注定是悲劇。好,我們來看,藥價調整的目的達標了嗎?我們先來看藥價差這個問題。曾經在2016年,8年了。 |
| transcript.whisperx[34].start |
2497.495 |
| transcript.whisperx[34].end |
2522.435 |
| transcript.whisperx[34].text |
監察院有過糾正案藥價差為離地明確的合理藥價差比率藥品核佳機制不足執行全民健保藥價調整機制效能不彰這個造成這個也是監察院的文字以藥養育扭曲了醫療生態你到底是要做這個藥價調漲還是實質組長說過這個藥品供應因素很多這個是矛盾的 |
| transcript.whisperx[35].start |
2523.476 |
| transcript.whisperx[35].end |
2545.433 |
| transcript.whisperx[35].text |
但是我也要告訴你們藥費成長也不能單方面歸功於價格藥費成長至少還有人口老化癌重症病人增加通貨膨脹與物料成本提高研發成本提高研發的規格也提高了所以這幾年的這個藥價調降造成很嚴重的後果當然包括缺藥供藥的這個穩定性換藥第一線不斷的換藥這是不對的說法 |
| transcript.whisperx[36].start |
2548.075 |
| transcript.whisperx[36].end |
2556.843 |
| transcript.whisperx[36].text |
你藥價一直調降,能夠維持品質嗎?你跟我講一下哪一個藥品質看力?我請問你,如果我年年砍你的薪水,你還能維持你原來的生活品質嗎?你跟我講說哪一個藥品質看力?你是專家我們來看藥價調整,下一個我們來看目的,藥價調整的目的有沒有達標第一個,縮小藥價差距部長你知道每年的藥價差有多少錢嗎? |
| transcript.whisperx[37].start |
2575.462 |
| transcript.whisperx[37].end |
2590.523 |
| transcript.whisperx[37].text |
差不多在四五百億左右啦部長不錯你還講出了一個數字我本來想問你是四百億還是五百億還是六百億還是七百億你大概知道我講話不是沒有根據的第一個他達到縮小要加他的目的嗎 |
| transcript.whisperx[38].start |
2591.67 |
| transcript.whisperx[38].end |
2596.451 |
| transcript.whisperx[38].text |
沒有,好,這個沒達標,那個目的有下來,有下來結成了藥費作為給付新藥跟放快藥品給付的裁員抱歉,全台灣只有我有這個完整的數字我們的新藥等待其實越來越長我們的藥品給付是越限越嚴重、越限縮台灣只有台灣發明這個給付方法哎呀,只能用幾個月幾個療程,全世界沒有人這樣做的 |
| transcript.whisperx[39].start |
2614.276 |
| transcript.whisperx[39].end |
2641.414 |
| transcript.whisperx[39].text |
全世界都用到這個要病情惡化為什麼呢?因為錢不夠我知道錢不夠錢不夠那社會委員的主張到底是什麼我實在是聽不出來下一張你是不要調藥價還是要調藥價我在第一張投影片其實有答案了但是來來跑這裡大家都說台灣人愛吃藥我不認為欸大家都在看那個百分比百分之二十五、二十六、二十七、二十八台灣人真的愛吃藥嗎不要比那個好不好整個專業費用服務太低了 |
| transcript.whisperx[40].start |
2642.515 |
| transcript.whisperx[40].end |
2662.639 |
| transcript.whisperx[40].text |
一個扭曲數字翻譜那麼低然後藥品好像佔率很高結果是以藥養醫其實如果我們回到GDP藥品的GDP佔我們才1.1日本1.6南韓1.3如果我再把藥價差再扣掉的話當然實際上不會有這麼理想的狀況只是那0.7以藥養醫部長這個挖東牆補西牆東牆要倒了西牆還能撐住嗎 |
| transcript.whisperx[41].start |
2672.23 |
| transcript.whisperx[41].end |
2672.49 |
| transcript.whisperx[41].text |
這個牆已經快倒了 |
| transcript.whisperx[42].start |
2687.49 |
| transcript.whisperx[42].end |
2696.899 |
| transcript.whisperx[42].text |
這個以藥養醫是過去的這一個部分是比較多的那目前的藥價差是有在下降我已經告訴你藥價差啦你講的414大概是10年前的藥價差是有藥價差,仍然存在是沒有錯這兩張圖我要問衛福部我要問衛福部我一直在追蹤這兩張圖為什麼在去年之前臺灣的醫療衛生支出佔GDP都是6點多 |
| transcript.whisperx[43].start |
2710.971 |
| transcript.whisperx[43].end |
2738.187 |
| transcript.whisperx[43].text |
突然間現在變成7.5這麼巧這麼巧在去年的大選有在野的總統候選人他要求我們把投資健康投資要提高提高到8%剛好你串出來就是7.5這麼多年都是6然後還來一個校正回歸96年到110年全部校正你放了他這麼久你突然間去做修正好一個校正回歸啊 |
| transcript.whisperx[44].start |
2741.92 |
| transcript.whisperx[44].end |
2747.344 |
| transcript.whisperx[44].text |
請問你為什麼在算新藥新科技的財務衝擊時不能夠把這個新藥新科技帶來的可能的長照的費用減少也扣除呢這是兩標標準啊雙標啊請問你這個這兩個你這邊要算這邊就要算部長你不要跟我爭辯我在那個委員會29年好我們看最後一張 |
| transcript.whisperx[45].start |
2773.141 |
| transcript.whisperx[45].end |
2789.929 |
| transcript.whisperx[45].text |
所以要告訴部長有29年錯的都還是錯啦告訴部長齁這個整個醫療支出的占比齁你要算6.1齁你要改成7.5都沒關係我只是要告訴你還是輸人家很多你7.5人家韓南還是9.7你算6.1說韓國是8% |
| transcript.whisperx[46].start |
2795.905 |
| transcript.whisperx[46].end |
2819.592 |
| transcript.whisperx[46].text |
所以這個是健康投資整個不足健康投資不足我知道部長是部長以上都要去負這個責任好嗎健康投資是不足但是政府還不承認健康投資不足好我們再看右邊管理呢管理有沒有適當醫院評鑑內幕重重分級醫療蕩然無存藥價調整慘不忍睹管理的不當這個要指出事實出來部長可能要根據這個診斷去參考未來怎麼治療怎麼進行好 |
| transcript.whisperx[47].start |
2825.973 |
| transcript.whisperx[47].end |
2833.421 |
| transcript.whisperx[47].text |
健康投資不足、醫療管理不當請別把藥品當作祭品好,謝謝部長好,我們謝謝陳昭之委員的發言接下來我們請陳金輝委員進行諮詢 |
| transcript.whisperx[48].start |
2856.084 |
| transcript.whisperx[48].end |
2876.623 |
| transcript.whisperx[48].text |
大家好先邀請部長跟小署署長好請部長跟署長午安好早安大家好今天先問一個全國家長都滿關心的議題啊因為早上家長群組已經爆了 |
| transcript.whisperx[49].start |
2878.022 |
| transcript.whisperx[49].end |
2898.821 |
| transcript.whisperx[49].text |
這個相信大家早上都已經看到新聞了食藥署告訴我們大家說目前蘇丹紅的風暴不保證市場沒問題不保證市場沒問題變成我們的教育局在關心所有的小朋友教育局已經說三個月所以各位覺得三個月這樣子的時間夠嗎 |
| transcript.whisperx[50].start |
2901.142 |
| transcript.whisperx[50].end |
2923.358 |
| transcript.whisperx[50].text |
跟委員報告,蘇丹紅這件事情其實是他本質是辣椒粉辣椒粉因為在國內的話,國人吃辣的習慣是很普遍的所以我沒有辦法說一下子把所有的辣椒粉通通禁掉是不可能,而中國那邊進口的辣椒粉是佔全部的80% |
| transcript.whisperx[51].start |
2925.417 |
| transcript.whisperx[51].end |
2937.87 |
| transcript.whisperx[51].text |
最近這幾家有問題的21家它佔了50%以上所以就必須要很細緻的去查還有5家還沒查到嗎?還沒查完啊?我們都還是繼續往下查 |
| transcript.whisperx[52].start |
2940.453 |
| transcript.whisperx[52].end |
2963.145 |
| transcript.whisperx[52].text |
所以這個是必須要這樣做,因為你必須要確定它合格跟不合格,不合格當然就不准上市把它封存,但是合格你還是要讓它出所以署長會覺得3個月夠嗎?我們保護兒童3個月夠嗎?可以,我們會努力在這段時間完成好,那引起軒然大波,署長會覺得需要稍微跟大家道歉一下嗎? |
| transcript.whisperx[53].start |
2964.953 |
| transcript.whisperx[53].end |
2985.569 |
| transcript.whisperx[53].text |
我想這個跟道歉沒有什麼關係,因為我們都努力,盡力在做這個事情當然這個不完備的地方我們可以再來做修正人力不足,好,了解了解接下來我也滿關心剛剛陳昭芝委員問到的其實今天在這邊跟,署長可以結束了 |
| transcript.whisperx[54].start |
2986.329 |
| transcript.whisperx[54].end |
3014.833 |
| transcript.whisperx[54].text |
今天跟部長在這邊面對面真的很難過因為我跟您跟石三個人長期有這麼多醫護同仁的同學朋友大家都知道問題在哪裡根本不需要講這麼多不管是缺藥五大皆空我們健保就一碗飯你今天兒科的人吃不飽你就給兒科多吃一點別科的人餓得要死現在覺得醫生都好餓喔所以 |
| transcript.whisperx[55].start |
3015.453 |
| transcript.whisperx[55].end |
3034.743 |
| transcript.whisperx[55].text |
剪刀藥價然後這個藥廠吃不飽再來就是護理師吃不飽你就是一樣啊我跟陳昭之委員的想法一樣挖東牆補西牆但是我們三個人其實都完全知道問題在哪裡可是您對於這個有解方嗎 |
| transcript.whisperx[56].start |
3036.837 |
| transcript.whisperx[56].end |
3059.633 |
| transcript.whisperx[56].text |
基本上這是一個必然會存在的一個現象因為如果我們健保收取的這個保費就是固定那一些的話那這個不可避免一定會有互相排擠的現象會出來那現在只是說哪一個部分的話是要讓它比較合理而不是說一定是要把它砍下來 |
| transcript.whisperx[57].start |
3060.934 |
| transcript.whisperx[57].end |
3088.799 |
| transcript.whisperx[57].text |
所以剛剛陳教授委員在問的時候我不太同意的地方就是這樣因為你如果單從藥這一件事情去看的話就會以偏看前所以你今天護病比、缺護理師、想要招收護理師又突然突襲我們、突襲全國人民、漲掛號費其實這些全部都是環環相扣的,您覺得呢?漲掛號費是另外一件事情那是另外一件事情我相信這個問題 |
| transcript.whisperx[58].start |
3090.399 |
| transcript.whisperx[58].end |
3106.262 |
| transcript.whisperx[58].text |
所有人、所有記者都已經問過部長了啦你覺得我們113年、112年的目標你會希望我們的醫療支出達到多少嗎?因為這件事看起來十幾年來就是6點多嘛 |
| transcript.whisperx[59].start |
3107.203 |
| transcript.whisperx[59].end |
3133.379 |
| transcript.whisperx[59].text |
我跟委員報告那如果用GDP去算的話是有風險的因為GDP會高會低那不是永遠都是往上走的那所以一般來講用GDP那只是一個參考的指標那如果說我們有沒有一個面向來看的話就是一個目標來做處理的話我們當然是逐步的能夠上漲那我們希望說未來的3、4年能夠拉到8% |
| transcript.whisperx[60].start |
3138.003 |
| transcript.whisperx[60].end |
3157.843 |
| transcript.whisperx[60].text |
臺灣人是非常非常倚重健保我們跟其他國家不一樣其他國家也許一個收入以上一定需要商保你看我們臺灣公部門的醫療支出是3.9%表示說我們這個不管你說6還是7還是8很多都是大家自掏腰包自費出來 |
| transcript.whisperx[61].start |
3159.488 |
| transcript.whisperx[61].end |
3160.108 |
| transcript.whisperx[61].text |
你對這個3.9有印象嗎? |
| transcript.whisperx[62].start |
3187.661 |
| transcript.whisperx[62].end |
3215.988 |
| transcript.whisperx[62].text |
我的印象中現在應該不止3年9所以我們其實不及格只是在比45分還是50分對我們已經從45分不能這樣講因為每一個國家的這個制度不一樣你說像英國這種公益系統他就擺幾乎百分之一百都是公部門的這個是部長您說的你說這個6.6太低了剛剛陳道志有說你後來把它加一加變成7.5然後預計可以到8 |
| transcript.whisperx[63].start |
3217.208 |
| transcript.whisperx[63].end |
3217.228 |
| transcript.whisperx[63].text |
委員會議 |
| transcript.whisperx[64].start |
3228.444 |
| transcript.whisperx[64].end |
3249.977 |
| transcript.whisperx[64].text |
這部分的話,因為我們也正在跟主席總署這邊來做一個調整那另外的話,在今年我們會派一個訪問團到OECD那邊去希望就是說,跟他們的這個數據的來源是可比較性的,能夠比較一致的對,所以您預計要調整到 |
| transcript.whisperx[65].start |
3255.342 |
| transcript.whisperx[65].end |
3283.706 |
| transcript.whisperx[65].text |
就剛那個7.5嘛然後你說年底前完成估算並會推出相關政策過年已經過完年的你的相關政策是就是要成立一個訪問團對我們要先跟OECD因為現在大家在用的都OECD的這一個比較但是OECD跟我們並沒有直接的關係啦所以他所取用的這個data的來源是什麼樣子的話我們並不清楚所以我們必須要跟他能夠接軌接軌才知道 |
| transcript.whisperx[66].start |
3284.686 |
| transcript.whisperx[66].end |
3286.467 |
| transcript.whisperx[66].text |
為何大家不願意用這個資訊平台? |
| transcript.whisperx[67].start |
3308.127 |
| transcript.whisperx[67].end |
3320.759 |
| transcript.whisperx[67].text |
這沒有什麼理由,因為這個如果對一般人來講的話,可能他是一個比較困難去處理,但是你這個專業人員不能講這樣子我有一些藥我已經長期開不出來了,放棄了,第一 |
| transcript.whisperx[68].start |
3325.383 |
| transcript.whisperx[68].end |
3347.843 |
| transcript.whisperx[68].text |
這個平台他告訴你有什麼替代藥這個我們應該都知道我們自己也知道有什麼替代藥第二我們告訴了這個平台以後呢這個平台就是公開徵求願意供應的廠商大家看這個這個頁面上有這麼多廠商但是你跟我們說沒有缺藥那何必要徵求這些供應的廠商呢 |
| transcript.whisperx[69].start |
3348.463 |
| transcript.whisperx[69].end |
3367.914 |
| transcript.whisperx[69].text |
這時候有缺的,有缺的我們就會公開徵求,那大部分都已經徵求的到了,那現在只有一個藥,這個藥是屬於合一的這個診斷用藥,所以只有這個目前還缺,但是在3月過後的話,合原所都就可以來恢復來供應。 |
| transcript.whisperx[70].start |
3369.522 |
| transcript.whisperx[70].end |
3396.911 |
| transcript.whisperx[70].text |
最後沒關係我只剩2分鐘最後我提出來的疑問還是跟許多我們醫藥界的前輩一樣啊我們看醫院他因為收入不穩定嘛他不知道今年的點數是多少藥價差對他來說是最穩定的所以他就簽合約囤藥因此你們都有一個假象我們沒有缺藥因為藥就在大醫院啊就是剛講到的醫學中心區醫院啊 |
| transcript.whisperx[71].start |
3397.751 |
| transcript.whisperx[71].end |
3418.334 |
| transcript.whisperx[71].text |
那健保調整藥價點值下降所以影響的是最左邊最可憐的基層的診所基層的藥局還有一般民眾大家現在他領不到藥好也許關號費又調整了他可能要打電話打個十幾二十通去看住家附近哪一家比較適合他看因為他也不知道也沒有公告 |
| transcript.whisperx[72].start |
3419.295 |
| transcript.whisperx[72].end |
3428.128 |
| transcript.whisperx[72].text |
然後最後呢他開了一個藥他必須要長途跋涉也許到醫學中心去領所以部長這可能是未來您要面對的一個大衝擊 |
| transcript.whisperx[73].start |
3430.229 |
| transcript.whisperx[73].end |
3456.596 |
| transcript.whisperx[73].text |
這個基層的診所藥局的話的缺藥的話其實他們應該要做通報因為通報我們就有辦法去做處理沒有通報我們怎麼會知道那全國有幾萬家 他們已經自求多福了你知道他們已經自己互相在換藥 為了要自求多福所以要通報啊不然你自己又沒有能力來處理那你跟媒體講有什麼用 媒體又不能幫你調藥今天你的喉嚨看起來不是很舒服所以我們就先這樣子 謝謝部長謝謝 謝謝 |
| transcript.whisperx[74].start |
3460.219 |
| transcript.whisperx[74].end |
3469.525 |
| transcript.whisperx[74].text |
好,請部長多喝水,你看起來今天好像身體微恙。好,那謝謝陳金輝委員。接下來我們請林月琴委員進行質詢。好,請部長。委員好。好。 |
| transcript.whisperx[75].start |
3487.352 |
| transcript.whisperx[75].end |
3499.915 |
| transcript.whisperx[75].text |
部長好,剛剛你有提到有4568項藥品要調整可是你沒有提到的是其中3590項的藥品事實上是國內藥廠生產的佔了78.6%可是金額是佔了35%可是輸入藥品也就是進口的藥品978項可是竟然佔了21.4% |
| transcript.whisperx[76].start |
3513.015 |
| transcript.whisperx[76].end |
3539.865 |
| transcript.whisperx[76].text |
可是金額佔了65%那這個調整金額如果比同時就反映了一件事情就是說這樣的一個佔比同時反映一種事情就是我們的學民藥跟我們的原廠藥的市場佔有率可是本席認為進口藥商、國內藥商跟通路本來就不應該是對立的那問題出在我們的健保的那個藥費的制度歐美先進國家那的確他們有專業技術 |
| transcript.whisperx[77].start |
3541.038 |
| transcript.whisperx[77].end |
3554.191 |
| transcript.whisperx[77].text |
然後可是專利期過後國內的藥廠生產的學名藥應該是會有更穩定的供應還有呢藥價是比較低的還有他還有個國安問題如果一旦 |
| transcript.whisperx[78].start |
3555.03 |
| transcript.whisperx[78].end |
3576.873 |
| transcript.whisperx[78].text |
有狀況的時候他可以提供用藥可是現行的我們的藥品費用的支出目標制設定我們的健保費用的支出目標每年壓低藥價然後用量越低藥價越低那造成學名藥根本就沒有利潤最後就是退場退場的結果就是反而我們人民可能會用到的是品質價差的藥所以想問部長 |
| transcript.whisperx[79].start |
3578.362 |
| transcript.whisperx[79].end |
3599.205 |
| transcript.whisperx[79].text |
以藥品費用支出目標制來管制我們的藥費的目的在於我們的控制健保的藥費支出可總不能在缺藥的時候產生危機所以不知道健保署這邊有沒有因應的對策對策是什麼我先跟委員說明我非常贊同委員所說的這個會影響到國安因為一旦是 |
| transcript.whisperx[80].start |
3601.226 |
| transcript.whisperx[80].end |
3624.852 |
| transcript.whisperx[80].text |
如果你完全仰賴原廠藥的話那一旦這個輸入的路徑有受到影響的時候我們馬上就缺藥所以國內的廠商要扶植起來做學名藥那現在剛剛委員提的那個比例是對的因為我們現在是對於原廠藥過專利期的是砍得最多 |
| transcript.whisperx[81].start |
3625.792 |
| transcript.whisperx[81].end |
3643.332 |
| transcript.whisperx[81].text |
因為在專利期他已經受到保障了那所以過了專利期應該就是要大幅的去調降那我們對原廠藥的話如果他在這過專利期之後他可以開始來做學名藥的時候我們給他鼓勵所以在健保的合價我們新的制度就是 |
| transcript.whisperx[82].start |
3644.333 |
| transcript.whisperx[82].end |
3668.062 |
| transcript.whisperx[82].text |
當原廠要過專利期,比如說我們從100塊把它砍到60塊的時候,那我們給學名藥、國產學名藥的是66塊,比那個還高。原因就是本來的market share通通給原廠佔走了,那我們希望在短期之內,你不但是國產的這個學名藥能夠製造出來,而且很快的會有market share。 |
| transcript.whisperx[83].start |
3669.383 |
| transcript.whisperx[83].end |
3687.098 |
| transcript.whisperx[83].text |
會佔Market share是在醫院的醫價所以我們必須要給他好一點的這個健保價才能夠在醫價上面有這個好處所以看起來部長是同意的嘛因為我們現在應該要共同來提升就設法提升我們學民要的那個佔有率 |
| transcript.whisperx[84].start |
3687.694 |
| transcript.whisperx[84].end |
3703.487 |
| transcript.whisperx[84].text |
因為市場現在原廠的銷售額遠高過於相較於學民藥它一直是遙遙領先即便事實上是於專利期5年後還是這樣子的一個問題那我就要問部長說台灣沒有能力自備我們的那個就是原廠 |
| transcript.whisperx[85].start |
3704.367 |
| transcript.whisperx[85].end |
3705.028 |
| transcript.whisperx[85].text |
所以我剛剛跟委員報告就是這個樣子 |
| transcript.whisperx[86].start |
3726.218 |
| transcript.whisperx[86].end |
3742.606 |
| transcript.whisperx[86].text |
國產的原廠的市場佔有率太高所以有一個藥如果說原廠的目前這個很普遍他雖然過專利期但是在過專利期5年之內的話他還在市場的市佔率的話是80% |
| transcript.whisperx[87].start |
3744.307 |
| transcript.whisperx[87].end |
3762.287 |
| transcript.whisperx[87].text |
萬一他就是說沒有辦法供應進來的時候我們國內的廠商縱然有學名藥他只MarketShare只有20%所以他的產線是沒有辦法很快的來補充的這個是真的是一個國安危機所以我們現在正在調整這樣子我們希望說原廠藥 |
| transcript.whisperx[88].start |
3763.408 |
| transcript.whisperx[88].end |
3791.366 |
| transcript.whisperx[88].text |
在過專利期之後馬上就會有國產的藥廠能夠來生產這個學名藥可以來取代而且它的Market share一定要佔一定的規模以上它才能夠有足夠的產線能夠應付臨時的原廠缺藥的時候我們這邊能夠替補上來所以表示是沒問題的嗎不是沒問題現在正在做這個調整因為過去的話並沒有這樣子的一個調整好 |
| transcript.whisperx[89].start |
3794.265 |
| transcript.whisperx[89].end |
3810.682 |
| transcript.whisperx[89].text |
根據健保署這次提供的書面資料那食藥署透過西藥供應平臺網站作為藥品的通路的一個通報機制通報後經調查而提供現有的替代藥品資訊跟公開徵求其他替代藥品 |
| transcript.whisperx[90].start |
3811.503 |
| transcript.whisperx[90].end |
3834.845 |
| transcript.whisperx[90].text |
那替代療法另外一端依我們的法規要求我們的製藥在停或供貨六個月前要告知健保署以提早營業想問的是我們社區藥局依照我們的依令來開藥可是臺灣藥品是用品名來建黨的如果該項缺藥的話那儘管成分相同可是藥局事實上是他不敢使用那怎麼樣解決這個問題 |
| transcript.whisperx[91].start |
3836.155 |
| transcript.whisperx[91].end |
3854.294 |
| transcript.whisperx[91].text |
這部分的話第一個就是我們的規定裡面健保相關規定裡面也說在如果不指定這一個不可替代的話那它藥局是可以把它用同成分的去做直接調劑這是在本來的規定就有 |
| transcript.whisperx[92].start |
3856.476 |
| transcript.whisperx[92].end |
3869.834 |
| transcript.whisperx[92].text |
書面報告也指出未來鼓勵國內藥廠增加除到6個月的用藥意味同時要儲備6個月的一個原料跟藥品的話增加倉儲、溫控這些設施設備 |
| transcript.whisperx[93].start |
3874.181 |
| transcript.whisperx[93].end |
3903.04 |
| transcript.whisperx[93].text |
增加這些設備都是他們的成本喔那他們的成本可是在我們的原廠藥進口的衝擊下如果滯銷就過期銷毀也是風險有沒有一些輔導計畫根本報告這個是所謂的必要藥品的這個品項那我們會要求我們國內的廠商必須原料要儲存是準備6個月啦但是成品就做好的大概2到3個月的這個存量 |
| transcript.whisperx[94].start |
3903.8 |
| transcript.whisperx[94].end |
3930.997 |
| transcript.whisperx[94].text |
因為如果有原料在的話當然隨時他們是可以去做的可是重點是如果今天進口的那個他最後事實上賣不出去那因為國內真的很喜歡是用原廠藥那也不是造成我們國內很大的衝擊嗎這會評估啦這主要是說他如果那個有預期是會就是說短缺的時候他要事先要通報這事先6個月前要通報給我們 |
| transcript.whisperx[95].start |
3933.607 |
| transcript.whisperx[95].end |
3956.755 |
| transcript.whisperx[95].text |
疫情過後我們各國都投入巨資來整對國內的供應鏈韓國五年投資了50億韓元美國花費了26.1億元那法國花了150歐元那臺灣到底有沒有學民藥的產業政策何時制定然後什麼時候公布 |
| transcript.whisperx[96].start |
3958.737 |
| transcript.whisperx[96].end |
3967.652 |
| transcript.whisperx[96].text |
如果說一個整體的所謂的這個政策的話我們目前就並沒有把它彙整但是我們部分已經在進行的 |
| transcript.whisperx[97].start |
3968.969 |
| transcript.whisperx[97].end |
3969.59 |
| transcript.whisperx[97].text |
我們謝謝林月琴委員的質詢 |
| transcript.whisperx[98].start |
3997.486 |
| transcript.whisperx[98].end |
4020.243 |
| transcript.whisperx[98].text |
接下來我們請盧憲一委員進行質詢有請部長好 有請部長委員好部長好 |
| transcript.whisperx[99].start |
4043.757 |
| transcript.whisperx[99].end |
4047.479 |
| transcript.whisperx[99].text |
因為我來自偏鄉,所以我來每次都會提到偏鄉的問題。 |
| transcript.whisperx[100].start |
4049.215 |
| transcript.whisperx[100].end |
4071.423 |
| transcript.whisperx[100].text |
我記得我離開衛生所大概一年多不過屏東一直缺衛生所缺醫師的情況並沒有改善更何況是有些像新竹苗栗比較偏鄉的不是屬於原鄉的也是缺醫師那我希望部長今天能不能給我一個答案或者說你們有沒有再考慮要怎麼樣來我們來招募我們的醫師來進駐我們偏鄉地區 |
| transcript.whisperx[101].start |
4073.904 |
| transcript.whisperx[101].end |
4094.367 |
| transcript.whisperx[101].text |
各位委員報告,大概這樣子以所謂的偏鄉來講,包括像山地原鄉其實我們的調查,山地原鄉現在缺醫師的情況是比較小的最缺的是所謂那種不三不四的,非都會區也不是山區,那些的問題是比較大的 |
| transcript.whisperx[102].start |
4094.687 |
| transcript.whisperx[102].end |
4110.146 |
| transcript.whisperx[102].text |
那我們現在有提出一個偏鄉醫療計畫那已經在行政院那邊應該是快要過了我想知道說他們的薪水有沒有調漲多少就針對不三不四的地區對那這個部分的話我們第一個先要找到人力 |
| transcript.whisperx[103].start |
4111.047 |
| transcript.whisperx[103].end |
4129.586 |
| transcript.whisperx[103].text |
不是你沒有先提供一個待遇讓他們想說他們能不能支撐他們的生活然後去那個地區生活應該是他們最主要的考量是在這裡如果一般市區是7萬多塊的一個本縫的話你是不是用14萬的來招募他們會馬上就很多人來應徵啊不是嗎 |
| transcript.whisperx[104].start |
4130.667 |
| transcript.whisperx[104].end |
4154.068 |
| transcript.whisperx[104].text |
這個部分的話因為委員應該也知道就是說這個衛生所醫師的這個奉給跟他的獎勵金的部分的話其實是在縣市政府的手上沒有錯可是我們是不是可以特別編列預算再從衛福部這裡給他們我們這個是可以來考慮的但是主要還是要看人從哪裡來所以你們可以編預算我們這邊想辦法同意啊 |
| transcript.whisperx[105].start |
4154.648 |
| transcript.whisperx[105].end |
4155.349 |
| transcript.whisperx[105].text |
不然永遠都缺。 |
| transcript.whisperx[106].start |
4177.345 |
| transcript.whisperx[106].end |
4198.535 |
| transcript.whisperx[106].text |
所以我們覺得不能一直把問題放在那裡,要想辦法解決,我再替我們偏鄉的,不是指原鄉,不只原鄉而已,對不對?不過像剛剛委員提到這種像東港啦,或者潮州這一種,大概是因為當地有一些醫療院所,所以衛生所的醫療業務本來就少啦 |
| transcript.whisperx[107].start |
4198.835 |
| transcript.whisperx[107].end |
4199.756 |
| transcript.whisperx[107].text |
我們回到今天的主題 |
| transcript.whisperx[108].start |
4221.127 |
| transcript.whisperx[108].end |
4231.973 |
| transcript.whisperx[108].text |
我們現在的用藥一直在我們的那個保險的比例是從26到現在大概是28左右那我想知道說你們調整這次調整的主要的目的是什麼 |
| transcript.whisperx[109].start |
4233.732 |
| transcript.whisperx[109].end |
4261.408 |
| transcript.whisperx[109].text |
現在在講委員在講的調整應該是第一梯的調整那現在第一梯的調整主要的目的就是讓這個專利剛剛過期的那它的藥價就可以把它壓下來像你常常在遇到我們在偏鄉服務或者是在比較就是老人家比較多的地方其實你在改藥或者是用藥選擇上面如果一改再改的時候你光叫長者來認這個藥就非常的困難 |
| transcript.whisperx[110].start |
4262.268 |
| transcript.whisperx[110].end |
4287.326 |
| transcript.whisperx[110].text |
甚至有些藥廠他也不會考慮說原來的藥是什麼顏色他改顏色他就不敢吃了很多都是因為這樣他說怎麼藥又改了這個醫師本來就有這個我的意思是說頻率不要那麼頻繁尤其是他的慢性病藥但是你說原廠藥通通都保障它的話也不對啦當然我知道我的意思是說盡量如果以後我們國內有生產原廠藥的話盡量它的形狀跟顏色要一樣不然 |
| transcript.whisperx[111].start |
4291.836 |
| transcript.whisperx[111].end |
4320.976 |
| transcript.whisperx[111].text |
幾乎要一致,不然常常會有困難沒有錯,可是盡量因為老人家就是認那個顏色啊認那個大小啊但是藥廠在出製造這個藥的時候我是說那個,我說你要替一些我們老人家在山上但是藥廠在出的時候,他通常都是用他們的同一個系列的會有那有他們的是啦,我說你要普遍請他們略入考量好不好這是有一點困難,要做的話有點困難 |
| transcript.whisperx[112].start |
4323.017 |
| transcript.whisperx[112].end |
4323.037 |
| transcript.whisperx[112].text |
韓國瑜 |
| transcript.whisperx[113].start |
4339.161 |
| transcript.whisperx[113].end |
4353.198 |
| transcript.whisperx[113].text |
正常或是說健康的方向來想嗎?對不對?對,而且公委報告現在有一些新藥是蠻貴的我知道啊,有爭議的我也知道啊那我意思是說我們目前的水準大概是跟土耳其差不多 |
| transcript.whisperx[114].start |
4354.406 |
| transcript.whisperx[114].end |
4375.092 |
| transcript.whisperx[114].text |
現在按照這個他的藥費的比例土耳其然後墨西哥那如果我們跟美國來比是12英國是12韓國是23那我覺得我們的方向是如果以後是越來越低的話你是不是要一個配套措施你要怎麼樣去教育民眾你有一系列的教育的計畫嗎這差異是在母樹 |
| transcript.whisperx[115].start |
4377.053 |
| transcript.whisperx[115].end |
4392.507 |
| transcript.whisperx[115].text |
是嗎?這個不是武術喔?OK,那我們不要看美國,我們就看墨西哥就好啦,或者是說看土耳其是不是?所以我的意思是說,如果以後是越來越低,你要相對花很大的成本在教育民眾 |
| transcript.whisperx[116].start |
4393.468 |
| transcript.whisperx[116].end |
4416.606 |
| transcript.whisperx[116].text |
用這個比例來看的話是不準的,土耳其可能整個醫療費用很少,所以藥費的比例就高了我們是期待是往健康的方向走,而不是支出越來越多的一個方向,不是嗎?所以我的意思是說藥費去佔GDP的這個比例的話,這種比較的話是不很恰當我們的GDP是佔1.1 |
| transcript.whisperx[117].start |
4417.987 |
| transcript.whisperx[117].end |
4434.3 |
| transcript.whisperx[117].text |
我們應該是自己跟自己比啦左手邊是1.1,藥費這樣1.1也就是說我們是在這裡面的倒數第6名沒有,這個比較沒有太大的意義啊我剛剛講嘛,那個base是不一樣,那GDP是不同的你說GDP很少的,那大家藥費就是那麼多那是這樣整體醫療的話這邊就有一個 |
| transcript.whisperx[118].start |
4436.201 |
| transcript.whisperx[118].end |
4465.013 |
| transcript.whisperx[118].text |
右手邊這邊是整體醫療的費用支出這邊是佔GDP的費用支出那我們台灣大概就是倒數第6名那個GDP的比例啊費用的話是在前面就整體醫療費用去佔GDP的比例這個比較有它的基礎但是用醫療費去比的話讓國員理解說目前的狀況是在哪裡那如果國家的政策以後是越來越少的話你們應該要有個想辦法10年的一個計畫怎麼來教育我們全國的民眾好不好 |
| transcript.whisperx[119].start |
4465.533 |
| transcript.whisperx[119].end |
4488.591 |
| transcript.whisperx[119].text |
基本上如果我們的base沒有辦法擴大的話那我們這一個藥費所佔的比例會越來越高其實我們在整間其實花最多的時間就是在解釋藥的部分尤其在改藥的時候我曾經在兩年前在訪療的時候他們常常就缺了一個藥叫Adalat或者說氧化酶然後氧化酶甚至缺了半年之久 |
| transcript.whisperx[120].start |
4489.372 |
| transcript.whisperx[120].end |
4518.169 |
| transcript.whisperx[120].text |
那我想知道當初缺藥跟後來進了藥的時候那樣的一個窗口是怎麼樣來運作的?氧化鎂的部分的話事實上是因為的確啦這個健保價是已經殺到很低所以那個廠商要推出啦那後來我們就給他一個保障價地板的保障價那他廠商就恢復供應了所以這是氧化鎂的部分我想知道部長知道怎麼樣來訂價格是最合理的嗎? |
| transcript.whisperx[121].start |
4519.502 |
| transcript.whisperx[121].end |
4520.845 |
| transcript.whisperx[121].text |
下一張再給我一分鐘 |
| transcript.whisperx[122].start |
4530.851 |
| transcript.whisperx[122].end |
4550.156 |
| transcript.whisperx[122].text |
這就Value-Based Pricing也就是說你先教育就是說你先要理解我們消費者這個產品的價值在哪裡這是對這個長期價格的一個取向的一個最好的一個指標希望你能夠上網看一下 謝謝好 謝謝 謝謝委員好 我們謝謝盧憲義委員的質詢接下來我們請邱振軍委員進行質詢 |
| transcript.whisperx[123].start |
4568.41 |
| transcript.whisperx[123].end |
4597.736 |
| transcript.whisperx[123].text |
好我們一樣有請部長好請部長部長請問那個蘇丹紅的事件我想這兩天又上頭版最近又爆出11家的餐飲以及食品業者都中標了這是今天早上的一個兩大報的一個頭版大家可以看一下 |
| transcript.whisperx[124].start |
4601.448 |
| transcript.whisperx[124].end |
4624.204 |
| transcript.whisperx[124].text |
部長有看到嗎?有,我知道我想兩大報我們先談聯合報講的食藥署不保證市場沒有問題這是真的嗎?根本報告目前這會往下再查那因為他這個辣椒粉做成很多成品所以我們現在是你多久可以查? |
| transcript.whisperx[125].start |
4625.377 |
| transcript.whisperx[125].end |
4637.43 |
| transcript.whisperx[125].text |
現在陸陸續續都一直在講你可以給我一個時間嗎?我覺得這樣一直等,拖的時間太久,我們國內的安全誰負責?一個月內應該是可以把這些統統查完 |
| transcript.whisperx[126].start |
4638.736 |
| transcript.whisperx[126].end |
4666.444 |
| transcript.whisperx[126].text |
從今天開始?對,校期之內的這些產品那你查的方式勒?你現在怎麼查?因為現在從原料開始往下第二層加工的然後再第三層的話就是這個零售的這部分因為我覺得啦,我們民眾食安的問題不能拖不能等尤其是在我們16縣市的營養午餐這個部分部長可不可以承諾先可以處理? |
| transcript.whisperx[127].start |
4667.894 |
| transcript.whisperx[127].end |
4697.257 |
| transcript.whisperx[127].text |
營養午餐的部分我們尊重地方的決定因為小孩子吃辣的習慣是比較少的所以營養午餐要去禁這個我覺得營養午餐這部分應該是不是我們這邊要嚴格先禁止先預防性的這些下架因為營養午餐的業務並不是說由衛福部這邊來控制的但你可以通知各縣市吧 |
| transcript.whisperx[128].start |
4698.493 |
| transcript.whisperx[128].end |
4722.45 |
| transcript.whisperx[128].text |
那個辣椒粉這個我們是可以來跟教育部這邊再來討論一下我們這個問題預防性的下架也不敢那暫時下架待檢驗的全部可以因為有問題的是預防性下架本來就要做你上次講的啦你上次講的我們只抽了大概20%、50%我們關心的是那沒有驗的50% |
| transcript.whisperx[129].start |
4724.754 |
| transcript.whisperx[129].end |
4728.517 |
| transcript.whisperx[129].text |
對,所以我們現在就循先在打麥克風所以應該要照著這個部分要盡快,好不好? |
| transcript.whisperx[130].start |
4731.977 |
| transcript.whisperx[130].end |
4757.302 |
| transcript.whisperx[130].text |
另外第二個我們今天談的議題就是藥價的我們今年總共有4568項藥品的價格異動那其中調降了4551項調升17項那當然這是我們2013年以後調整最少的一個紀錄那表示說我們醫界跟藥界的他們的聲音有被聽到那我想請問部長那這次藥價 |
| transcript.whisperx[131].start |
4760.526 |
| transcript.whisperx[131].end |
4789.72 |
| transcript.whisperx[131].text |
被砍最多的前三類藥品是什麼我是不是這個問題我是不是可以請我們健保署長來回答委員好 跟委員報告大概還是以這個慢性病的用藥高血壓還有這個神經用藥還有這個血糖的藥這幾類為主就是心血管藥嘛神經系統的還有全身性抗感染劑用藥那這4000多項裡的調整藥品裡面的慢性病占了多少 |
| transcript.whisperx[132].start |
4790.485 |
| transcript.whisperx[132].end |
4806.769 |
| transcript.whisperx[132].text |
慢性病大概是八成那涉及到這個慢性處方籤的大概是七成我們以聯合報2023年8月有一篇關於慢性病共同防治的報導說2022年我們慢性病就醫人數高達1286萬人超過700萬人罹患兩種以上的慢性病以臺灣的人口結構來看 |
| transcript.whisperx[133].start |
4816.531 |
| transcript.whisperx[133].end |
4819.694 |
| transcript.whisperx[133].text |
跟委員報告目前拿慢性處方籤的人數大概近800萬人 |
| transcript.whisperx[134].start |
4835.187 |
| transcript.whisperx[134].end |
4852.893 |
| transcript.whisperx[134].text |
那我們在這個用藥上呢這一次調降的時候有特別也宣布說如果我們公告之後是4月1號才實施但是在3月8號之前提出那麼如果有不敷成本我們都會重新的調整價格到目前為止提出的只有5項藥對那些藥萬一沒有了怎麼辦 |
| transcript.whisperx[135].start |
4855.775 |
| transcript.whisperx[135].end |
4880.479 |
| transcript.whisperx[135].text |
到目前為止提出不敷成本的有5項的藥而已啦那我們這5項就會暫時不會調降他的這個藥價讓他這個確保能夠繼續供藥好啦因為我據本席了解齁我們慢性病的用藥的習慣齁你如果換藥的話大家都會有抱怨聲啦齁而且對藥會沒有信心好那我希望剛剛呃我們呃次長吶呃署長 |
| transcript.whisperx[136].start |
4885.458 |
| transcript.whisperx[136].end |
4914.383 |
| transcript.whisperx[136].text |
你這邊在這個有這個問題的話請你們就一定要慎重來處理好不好這替代性還是我們必須要有這藥的替代性不然的話這會被原廠把我們的整個的健保掐死當然啦我也不是說你們沒有一定要用一種藥就是說我盡量能夠降低這個我們民眾用的用藥的一個疑慮那再來就是 |
| transcript.whisperx[137].start |
4915.97 |
| transcript.whisperx[137].end |
4939.41 |
| transcript.whisperx[137].text |
我們的醫院的分級我們的醫療落實成相這個醫療差距那麼原本臺灣社區醫院協會在2月21號在國民黨團開記者會說要在3月8日上街遊行表達訴求到3月4號我們行政院才進行溝通那我想知道為什麼每次都要準備抗爭的時候我們才要進行溝通呢 |
| transcript.whisperx[138].start |
4940.351 |
| transcript.whisperx[138].end |
4966.993 |
| transcript.whisperx[138].text |
本來這個溝通就是有的只是說當時他們對於這個結果並不滿意所以才有這樣子的一些舉動我看到3月4號會議裡面達成的一個共識其中一個就是檢討我們健保藥價的政策來協助解決社區醫院用藥的採購困難你們每年說調整藥價是這個例行行業每年都看不到地區醫院的困難 |
| transcript.whisperx[139].start |
4968.803 |
| transcript.whisperx[139].end |
4983.085 |
| transcript.whisperx[139].text |
都要走上街頭才來處理我希望部長這邊能夠認真來看待這個事情第7院經營的一些困難的情形我們有跟他們已經有我們推動醫療分級的時候是從什麼時候開始 |
| transcript.whisperx[140].start |
4984.225 |
| transcript.whisperx[140].end |
5010.846 |
| transcript.whisperx[140].text |
醫療分級是很早,從醫療網計畫在民國差不多74年左右的時候就開始但是時空環境的一些演變,這中間也必須要去做一些調整。我不知道部長有沒有想過,就是說就算是費用高一點,我們像我們苗栗縣,苗栗縣民來講有碰到什麼問題,他還是願意多花一點錢到大醫院跑,你知道這為什麼嗎? |
| transcript.whisperx[141].start |
5012.528 |
| transcript.whisperx[141].end |
5039.257 |
| transcript.whisperx[141].text |
當然有一些是品牌的迷思啦大醫院這醫師是對啦像我們苗栗醫院都是區域醫院跟地區醫院這幾年在醫院縣府我們中央相互的合作做了策略聯盟那當然慢慢的會有提升那我們當然有別的想法就是希望說如果苗栗現有的醫院裡我們就地升級的可能性大不大 |
| transcript.whisperx[142].start |
5040.037 |
| transcript.whisperx[142].end |
5059.815 |
| transcript.whisperx[142].text |
這就是我們鼓勵的方向我們希望說在地的醫院都能夠提升它的品質讓建立這個品牌的形象讓我們的民眾有這個信心像布苗醫院像集中症大樓跟我們的癌症中心兩個大樓沒有辦法主席再給我一分鐘 |
| transcript.whisperx[143].start |
5064.019 |
| transcript.whisperx[143].end |
5088.893 |
| transcript.whisperx[143].text |
因為你知道除了是費用的關係是費用的問題還有沒有其他問題主要還是費用的問題所以我們現在已經工程費用已經有追加了對我這樣講我是有聽到就是說我們的設計跟這個部分我希望部長也能夠去了解一下是不是有一些問題讓廠商不敢去投標 |
| transcript.whisperx[144].start |
5089.833 |
| transcript.whisperx[144].end |
5090.793 |
| transcript.whisperx[144].text |
我們謝謝邱政軍委員的質詢接下來我們請廖偉祥委員進行質詢 |
| transcript.whisperx[145].start |
5129.693 |
| transcript.whisperx[145].end |
5156.349 |
| transcript.whisperx[145].text |
有請部長好部長請委員好部長好部長衛福部在前天突然無預警的宣布掛號費的取消上限請教部長你在做這個行為之前你沒有做所謂的啟動社會溝通以及邀請學者專家研議或評估嗎在做這個政策之前 |
| transcript.whisperx[146].start |
5157.849 |
| transcript.whisperx[146].end |
5183.399 |
| transcript.whisperx[146].text |
倒是沒有說有這樣大規模的去作證如果沒有政策沒有評估就上路完全沒有考慮到取消上限後會造成的任何的影響包含醫療可進性包含醫療階級化或者醫療體系長期上會有發生什麼狀況有沒有可能不利這個醫療分級等等的影響喔我在想這樣子的取消上限我想請問部長你覺得對百姓的醫療負擔會長幾成呢 |
| transcript.whisperx[147].start |
5185.72 |
| transcript.whisperx[147].end |
5208.307 |
| transcript.whisperx[147].text |
以目前來講的話,第一個我要講,我們在做這個公告之前,其實有一些...你知道會長幾層嗎?你們有研究過會長幾層嗎?這個沒有辦法去做這個...所以其實你們沒有審慎的評估研究,也沒有足夠的溝通,對不對?應該不是說這樣,因為...部長,政策是不能隨性的,我覺得很多政策你們必須要經過審慎的評估才可以喔 |
| transcript.whisperx[148].start |
5209.207 |
| transcript.whisperx[148].end |
5227.884 |
| transcript.whisperx[148].text |
尤其是這個對於長期的影響所以你們聽起來就是沒有評估而且看起來的行為就是用甩鍋給地方政府面對這樣的問題你們選擇偏移一下形式的方式我知道學界或者是醫藥界對這件事情普遍是積極的看法可是 |
| transcript.whisperx[149].start |
5228.844 |
| transcript.whisperx[149].end |
5245.622 |
| transcript.whisperx[149].text |
這幾年來對於百姓來講你從去年提高部分的負擔增加醫學中心的名額讓百姓、民眾看病變得更貴之外現在這一次直接拿掉我們所謂的掛號費上限對百姓而言就是漲漲漲所以對於人民而言是被剝了三層皮 |
| transcript.whisperx[150].start |
5246.443 |
| transcript.whisperx[150].end |
5263.209 |
| transcript.whisperx[150].text |
部長我想要請問你這樣拿掉掛號費上線就解決問題了嗎?因為掛號費不是只是行政費用而已嗎?事實上對問題的核心不就是因為健保點值長期的不公而且過低所以才造成這個醫事人員被政府拗作功德 |
| transcript.whisperx[151].start |
5264.149 |
| transcript.whisperx[151].end |
5287.43 |
| transcript.whisperx[151].text |
各位委員報告醫護低薪與過勞並且人力流失所以才造成我們醫療體系可能崩潰所以我覺得你們倉促做這件事情又沒有充分的溝通也沒有充分的去評估你們造成的事情也沒有評估說那這樣對百姓可能造成多少負擔有沒有對於這些比較低薪的百姓或者是比較收入較低的配套方案也沒有做 |
| transcript.whisperx[152].start |
5288.513 |
| transcript.whisperx[152].end |
5307.701 |
| transcript.whisperx[152].text |
我們看起來就是你不去思考怎麼改革健保總額的制度要怎麼改革不去解決問題這樣是一個治標不治本的狀況而且也沒有根治的問題這樣的做法還可能衍生更多的這個對於社會的影響我想這個部分部長你們是不是不夠的嚴謹 |
| transcript.whisperx[153].start |
5309.142 |
| transcript.whisperx[153].end |
5324.184 |
| transcript.whisperx[153].text |
所以看起來你們衛福部的做法就是把這個責任推到推得一乾二淨也把你們對於健保應該改革的問題推得一乾二淨健保的改革是健保的改革這是一樣但是你們現在看起來就是急救張馬 |
| transcript.whisperx[154].start |
5325.816 |
| transcript.whisperx[154].end |
5350.489 |
| transcript.whisperx[154].text |
那個瓜費的這一個部分的話因為瓜費本來就是行政費用那我想請問部長那你健保的總和制度改革你什麼時候要提出現在都逐漸的在進行當中那下次期待你提出一個更完整的方案而不是急救張的方式來做這件事情好嗎跟委員報告因為整個的話是最後健保的改革會在修法的這一個部分真正的問題是健保點值長期不公你認不認同 |
| transcript.whisperx[155].start |
5352.03 |
| transcript.whisperx[155].end |
5357.735 |
| transcript.whisperx[155].text |
你認不認同?你認不認同這件事?這個簡報現在是寫的這樣子所以你認同還不認同?我沒有要你解釋,我問你yes or no |
| transcript.whisperx[156].start |
5367.966 |
| transcript.whisperx[156].end |
5381.959 |
| transcript.whisperx[156].text |
我是認為說這一個沒有去講到核心沒有講到核心那你會改革健保點子的問題嗎那這個是知識體態因為健保所謂的點子是跟量是有關的那如果說好部長 |
| transcript.whisperx[157].start |
5382.68 |
| transcript.whisperx[157].end |
5404.207 |
| transcript.whisperx[157].text |
我們現在進行下一題部長過年前今天的重點過年前這個傳出缺藥時你說堅持品牌迷思堅持原廠藥只能等死喔恕我不能同意你這樣的看法因為官員存在的目的不就是應該解決百姓的問題嗎為什麼可以說只有人民只能等死呢你承不承認這句話是失言 |
| transcript.whisperx[158].start |
5405.587 |
| transcript.whisperx[158].end |
5432.633 |
| transcript.whisperx[158].text |
沒有,因為只有一個病人,如果你堅持這個藥但是缺藥,失明重要的民生一級,攸關人民的健康,可以這樣子講話嗎?因為你可以只講堅持品牌迷失是會造成問題,你不能說民眾只能等死啊,對吧?委員,我想齁,這個遣食用字是沒有好,部長,今天要討論的這個健保藥價調整以及藥廠慢性病用藥的因應作為,我想要請問 |
| transcript.whisperx[159].start |
5433.853 |
| transcript.whisperx[159].end |
5455.858 |
| transcript.whisperx[159].text |
這兩年的缺藥問題很嚴重有些是真的缺藥有些是假的缺藥但是近半年缺藥問題是越來越嚴重包含這個媒體人我們陳文茜女士也在臉書說現在健保制度下卻買不到一粒一元的口服劑型的類固醇所以他還請人從美國代購甚至現在也傳出 |
| transcript.whisperx[160].start |
5457.599 |
| transcript.whisperx[160].end |
5472.332 |
| transcript.whisperx[160].text |
這個藥局為了留住客戶而開始賠錢加價囤一些常用的慢性藥品例如我們調整心跳速率的這個康克我想要請教部長包含著這個我們的 |
| transcript.whisperx[161].start |
5473.846 |
| transcript.whisperx[161].end |
5501.624 |
| transcript.whisperx[161].text |
愛敏氏也已經長期一年多缺藥了我想請問部長喔你有沒有掌握到這樣的狀況這個都有替代的或者是說同成分的一個品牌沒有我剛剛講的事情是現在的藥局為了留住客戶開始賠錢加價存一些常用的慢性藥品你有沒有掌握到這樣的狀況那個委員要不要聽我稍微這一點做一點解釋他現在在抱怨的是我們現在把藥價調下來 |
| transcript.whisperx[162].start |
5502.725 |
| transcript.whisperx[162].end |
5525.588 |
| transcript.whisperx[162].text |
但是當初他禁的藥部長你沒有聽清楚我的問題我剛說你有沒有掌握到這樣的狀況有你不用解釋對好有對不對總是要讓你解釋一下吧那這種類似沒有我只問你有沒有掌握到有我沒有說這個事情發生就是我只想問你有沒有掌握到有所以這類似overbooking的做法是不是只會讓缺藥的問題雪上加霜那我想要請教部長你們衛福部是不是要公開呼籲藥局不要囤貨 |
| transcript.whisperx[163].start |
5528.427 |
| transcript.whisperx[163].end |
5545.713 |
| transcript.whisperx[163].text |
沒有啊,這所謂的囤貨我剛剛...你會公開呼籲嗎?我剛剛解釋,委員就沒有時間給我解釋嘛這個不是囤貨,是他已經買進來了啦但是現在藥局...但是當時的價格是比較高的那所以你是說你不會公開呼籲他們不要囤貨? |
| transcript.whisperx[164].start |
5547.327 |
| transcript.whisperx[164].end |
5549.968 |
| transcript.whisperx[164].text |
我整理出缺藥的原因在供應或是製造端方面有4點 |
| transcript.whisperx[165].start |
5572.572 |
| transcript.whisperx[165].end |
5589.426 |
| transcript.whisperx[165].text |
製造品質或法規要求改變原料藥的供應不及跟物流運送的延遲還有這個藥廠商業考量或是製造排成延遲或停止製造這個預專利很久的藥品而另外在輸入端也就是需求端的部分 |
| transcript.whisperx[166].start |
5590.676 |
| transcript.whisperx[166].end |
5608.874 |
| transcript.whisperx[166].text |
複存量的管理不佳和我們突然增加的需求以及季節需求因素都會造成缺藥我們想請問這些所有可能缺藥的因素我們點出來那食藥署除了建置一個缺藥通報平台之外有沒有針對這些因素預先去因應或是做危機的管控 |
| transcript.whisperx[167].start |
5609.774 |
| transcript.whisperx[167].end |
5630.41 |
| transcript.whisperx[167].text |
如果是在這所謂的必要藥品的項目裡面的話那我們要求是6個月之前若可以是部長我知道藥界都很清楚食藥署只是控藥就是發生缺藥的時候要求這個優先提供給大醫院所以為何食藥署不能夠從製造端或服務端常態性的去了解未來一年未來一年的供應狀況 |
| transcript.whisperx[168].start |
5632.728 |
| transcript.whisperx[168].end |
5654.765 |
| transcript.whisperx[168].text |
好因為時間有限下一題請教部長和我們的健保署的時署長現在缺藥問題涉及的層面很廣所以外界普遍的看法因為藥價不斷被砍鎖導致所以這個藥品的支付改革也是我們缺藥的重要的一環對不對所以請教署長已經開了無數次的這個健保藥品政策改革方案溝通會議何時會定案 |
| transcript.whisperx[169].start |
5656.819 |
| transcript.whisperx[169].end |
5684.705 |
| transcript.whisperx[169].text |
跟委員報告我們近期還會再開一次那包含一些保障的措施還有鼓勵在台製造的政策來確定溝通之後然後接著進行法規的預告好因為已經開了很多次了所以還是請這個我們食藥署的部分還不是請我們健保署的部分可以趕快的進行還有另外因為藥價改革也涉及到修正全民健康保險藥物給付項目跟支付標準我想要請教部長和署長何時會預告何時會公告 |
| transcript.whisperx[170].start |
5686.186 |
| transcript.whisperx[170].end |
5704.726 |
| transcript.whisperx[170].text |
都會在快的話大概在4月份我們就會進行預告了好因為我在面對缺藥問題的時候我一個星期前有公開主張過同時符合三個這個條件我們該的各該品項的藥價就可以排除在每年藥價調整之外或者不受藥價調整的影響 |
| transcript.whisperx[171].start |
5705.447 |
| transcript.whisperx[171].end |
5732.828 |
| transcript.whisperx[171].text |
那這三個條件分別是臨床上有需求臨床上有需求也是也就是要必須經過我們的醫學會的認證第二個是鼓勵在地製造希望可以穩定供應鏈第三個是三張以下的稀缺藥證這三個具體的項目這個提議的背後就是希望尊重各醫學會他們最清楚藥的需求然後第二個是希望鼓勵在地製造希望可以穩定我們的藥品供應 |
| transcript.whisperx[172].start |
5733.809 |
| transcript.whisperx[172].end |
5755.876 |
| transcript.whisperx[172].text |
更加我們的就業機會第三個是希望稀缺藥證就是誠如部長說的替代性的藥品盡量不要調整這三個方案是否可行所以請你們好好的評估根本報告這方向上面我們是贊同但是要醫學會認證這件事情要保留請你們回去好好的評估因為醫學會他們在臨床上有他們的需求這部分請你們相加 |
| transcript.whisperx[173].start |
5758.217 |
| transcript.whisperx[173].end |
5778.036 |
| transcript.whisperx[173].text |
所以我知道你會這樣講沒關係下一題因為時間快到了最後一題我們要回到我們人民最關心的食安問題最近蘇丹紅的事情越演越烈已經是一個系統性的問題而且辣椒原料從禮拜一的時候你們說查出2萬多公斤到今天3天後已經查出6.4萬公斤 |
| transcript.whisperx[174].start |
5780.154 |
| transcript.whisperx[174].end |
5795.468 |
| transcript.whisperx[174].text |
而且我去調了海關進口這個所謂的辣椒製品在2023年也就是112年的時候總共進口了276萬公斤啊部長你知道嗎但是他不是通通都不合格 |
| transcript.whisperx[175].start |
5796.189 |
| transcript.whisperx[175].end |
5813.024 |
| transcript.whisperx[175].text |
不是通通不合格但是我告訴你這276萬公斤進來了對不對你已經查到了6.4萬公斤了你查到了6.4萬公斤了已經2點多趴將近3趴了依照你民進黨陳建仁和你部長的統計學我可不可以說這276萬公斤很多都有問題 |
| transcript.whisperx[176].start |
5814.065 |
| transcript.whisperx[176].end |
5826.554 |
| transcript.whisperx[176].text |
你敢保證都沒問題嗎?我依照你們統計學說的我依照你們統計學說的因為你們上次說這個3%不能夠代表你現在已經驗出了這麼多了你有多少量你還有沒有掌握到? |
| transcript.whisperx[177].start |
5827.253 |
| transcript.whisperx[177].end |
5854.815 |
| transcript.whisperx[177].text |
我們現在就是對於那些沒有掌握到的我們足皮的再往下你剛才說一個多月然後現在人民已經暴露在這樣系統性的食安風暴裡面部長我只是把這數據提供給你讓你好好的嚴加嚴加的去查276萬多公斤會影響台灣多少的食品而且你們食藥署也說不保證市場沒有問題所以你這276萬公斤很可怕請你們好好的把皮繃緊一點 |
| transcript.whisperx[178].start |
5857.057 |
| transcript.whisperx[178].end |
5872.952 |
| transcript.whisperx[178].text |
而且現在縣市政府都跟進我們的很多這個團戰包含我們六都裡面全部在野黨執政的縣市地方政府縣市都宣布說不准營養午餐用這個辣椒粉那 |
| transcript.whisperx[179].start |
5874.093 |
| transcript.whisperx[179].end |
5897.604 |
| transcript.whisperx[179].text |
反而是我看到中央好像把關不利變成地方很努力的在為你們擋然後也要求縣市政府說營養午餐、團餐不可以使用可是看起來民進黨執政的縣市沒有跟進我想請問部長有什麼看法我們是不反對說地方政府對於這個小孩子吃辣的習慣是少的 |
| transcript.whisperx[180].start |
5898.084 |
| transcript.whisperx[180].end |
5915.92 |
| transcript.whisperx[180].text |
你不能夠說吃他習慣少那他任何可能知道的風險呢所以那個部分你要你去說禁止我們並不反對你並不反對那為什麼你不可以說你建議你建議這些縣市可以先不要用因為你現在查不到嘛276萬公斤你沒辦法馬上查完嘛那你是不是應該衛福部中央應該要有點尬詞 |
| transcript.whisperx[181].start |
5918.082 |
| transcript.whisperx[181].end |
5930.631 |
| transcript.whisperx[181].text |
擔當起來現在看起來就是現在看起來就是地方為你們把關的很嚴謹中央發生的這個事情好像不管你們是全部推給地方這有前者的分工部長 |
| transcript.whisperx[182].start |
5931.932 |
| transcript.whisperx[182].end |
5956.05 |
| transcript.whisperx[182].text |
食安的預警溯源10年來都沒有進步所以我們星期一的時候也請教你跟徐副主任有關食安匯報的狀況你們本來說今年1月份要召開但是因為選舉因素現在還沒有確定日期大家都說食安不能有假期但是看起來你們民進黨政府選舉最大食安匯報一拖再拖也沒有關係我想問這是你們對食安的態度嗎 |
| transcript.whisperx[183].start |
5958.632 |
| transcript.whisperx[183].end |
5975.206 |
| transcript.whisperx[183].text |
應該我所知道的應該是這一個月會召開那我問部長最後我還是要問你你到底重不重視食安我當然重視你很重視食安對不對你很重視好但是上次我問你的時候你缺席去年食安會報你告訴我說因為你要接受立法院的質詢 |
| transcript.whisperx[184].start |
5976.207 |
| transcript.whisperx[184].end |
5988.834 |
| transcript.whisperx[184].text |
但是我去查了你的食安會報那一次是下午3點召開可是我們的委員會1點22就散會了中間還有一個半小時你說你很重視食安的話你有充分的時間可以去參加食安會報但你卻選擇出席而且面對國會議員的公開質疑你卻選擇說謊不去參加的理由 |
| transcript.whisperx[185].start |
5996.198 |
| transcript.whisperx[185].end |
5996.679 |
| transcript.whisperx[185].text |
我跟委員解釋一下第一個 |
| transcript.whisperx[186].start |
6014.76 |
| transcript.whisperx[186].end |
6025.384 |
| transcript.whisperx[186].text |
當我知道隔天要食安會議報告和解釋不用解釋我沒有要你解釋那件事情我要跟你講的事情是你因為這樣子導致現在臺灣喔不是說你的這個態度喔你這個態度讓現在這個276萬公斤流竄在我們的社會裡面你要不要因為這個系統性的食安問題你要不要因為這個系統性的食安問題跟全國人民道歉 |
| transcript.whisperx[187].start |
6041.189 |
| transcript.whisperx[187].end |
6042.17 |
| transcript.whisperx[187].text |
好 謝謝大家好 謝謝廖偉祥委員的質詢 |
| transcript.whisperx[188].start |
6072.574 |
| transcript.whisperx[188].end |
6081.838 |
| transcript.whisperx[188].text |
那主席在這邊宣告一下等王玉敏委員質詢完之後我們休息5分鐘好接下來我們請黃秀芳委員進行質詢謝謝主席我們請部長好有請部長 |
| transcript.whisperx[189].start |
6096.775 |
| transcript.whisperx[189].end |
6116.793 |
| transcript.whisperx[189].text |
委員好部長好部長我想剛剛那個廖委員質詢的我給你一分鐘的說明時間我看你想要說明可是這個委員不聽所以我一分鐘讓你說明一下兩點第一點的話就是說我們每一次在委員會開完會議之後我會找我 |
| transcript.whisperx[190].start |
6117.614 |
| transcript.whisperx[190].end |
6137.759 |
| transcript.whisperx[190].text |
回到部裡面我會找我們的幕僚討論一下那到底這委員的給我們的一些指教或者我們答應委員要做的事情要怎麼樣進行所以那個時間並不是說我不是在耍花樣我沒有請民意代表要去糟蹋那種行我們很多事情還要去做去做所以 |
| transcript.whisperx[191].start |
6138.419 |
| transcript.whisperx[191].end |
6153.563 |
| transcript.whisperx[191].text |
第二個,就是說當天那個食安會議的時候那因為我預期到有委員會要開,所以一定是預先請教,而且指派代表我沒有辦法去預期說,委員會幾點會結束,因為那個是召委的權責 |
| transcript.whisperx[192].start |
6156.424 |
| transcript.whisperx[192].end |
6179.198 |
| transcript.whisperx[192].text |
這個部分的話我已經請了代理那當然我就照我的schedule講那剛剛也是提到我們委員會開完我不是就沒事了所以我還是必須要回去做一些準備那怎麼樣來處理這些相關的問題那當然國人關心的這個食安的這個議題食品安全那我們希望就是說在這個 |
| transcript.whisperx[193].start |
6180.979 |
| transcript.whisperx[193].end |
6196.421 |
| transcript.whisperx[193].text |
第一線 食藥署這個在第一線就要去把關那後市場後市場的部分我相信你們應該也有通知各個縣市這個所有後市場的部分你們應該也要在短時間內趕快去把它查清楚要不然 |
| transcript.whisperx[194].start |
6197.402 |
| transcript.whisperx[194].end |
6224.567 |
| transcript.whisperx[194].text |
現在大家就疑慮啊各縣市有的縣市會認為就是說在這個時燈平台已經可以很清楚那有的縣市可能會有疑慮那就停了這個營養午餐使用辣椒粉或者是咖哩粉那這樣子會造成很多人就是會恐慌所以我是不是在這邊要要求食藥署針對後市場的部分應該要在短時間內要趕快把它釐清 |
| transcript.whisperx[195].start |
6225.547 |
| transcript.whisperx[195].end |
6244.756 |
| transcript.whisperx[195].text |
根本報告就是第一層進口的廠商那被查到有問題的這個我們已經能夠掌握然後他往下走賣給哪一些廠商這個我們也能夠掌握那第二層的這些加工廠做出來之後的成品賣到哪裡去的話 |
| transcript.whisperx[196].start |
6245.276 |
| transcript.whisperx[196].end |
6271.076 |
| transcript.whisperx[196].text |
在我們的非追系統裡面是沒有辦法完全都查到的所以我們就變成要每一家每一家去查看你賣到哪裡去那賣到哪裡去的時候我們就到那個他所指出來的這個廠商去看他的這些使用這個辣椒粉到底是有哪一些產品那這些我們還要把它抽回來去做檢驗因為如果沒有 |
| transcript.whisperx[197].start |
6271.536 |
| transcript.whisperx[197].end |
6287.428 |
| transcript.whisperx[197].text |
沒有這個違規的我們也不能就把人家禁掉所以還必須要把它抽回來那再做進一步的一個檢驗確定是這個沒有了那我們才能夠把它封存銷毀所以這個事情就是變成是比較細 |
| transcript.whisperx[198].start |
6289.489 |
| transcript.whisperx[198].end |
6313.447 |
| transcript.whisperx[198].text |
當然如果說一個違規的產品如果它的那個風險是非常非常的高我們大概一下子就禁止然後全部都下架但是這個東西的話事實上是致癌致癌物的第三級風險並不如想像那麼高而我們這個整個的民間在使用這種辣椒粉 |
| transcript.whisperx[199].start |
6314.187 |
| transcript.whisperx[199].end |
6336.12 |
| transcript.whisperx[199].text |
又是那麼多我人有這種習慣所以我們沒有辦法說一下子全部通通所有的辣椒粉或者相關製品通通要下架這個我們做不到當然就是說食品安全的這個議題我們希望就是說那個食藥署這邊後市場的部分真的要趕快趕快去積極去查就循線然後積極趕快把它處理掉 |
| transcript.whisperx[200].start |
6339.122 |
| transcript.whisperx[200].end |
6348.971 |
| transcript.whisperx[200].text |
那部長我想說針對這個早產兒育兒津貼養育津貼的這個部分因為在去年我們也有開過記者會就是我幾位委員開過記者會我想說這個兒童節也快到了 |
| transcript.whisperx[201].start |
6356.257 |
| transcript.whisperx[201].end |
6377.851 |
| transcript.whisperx[201].text |
這個早產兒的養育津貼因為家裡面如果有一個早產兒的話在前6個月其實健康照護的這個支出比健康逐月生出來的這個寶寶所支出的可能要多4倍那我想請教就是說我們現在整個少子化在2023年所有新生兒的這個出生率 |
| transcript.whisperx[202].start |
6378.551 |
| transcript.whisperx[202].end |
6396.321 |
| transcript.whisperx[202].text |
出生就只有剩下13萬那一個都不能少那尤其是這個早產兒的養育真的是更辛苦我不知道說部長針對這部分是不是認同或者是未來我們可以怎麼樣來協助家裡面有早產兒的這個家庭 |
| transcript.whisperx[203].start |
6396.823 |
| transcript.whisperx[203].end |
6423.892 |
| transcript.whisperx[203].text |
我們就這一點我們正在找一些相關的團體大家來做討論第一個就是說這個所謂早產的他的這個健康照護的支出是比較高的到底高在哪一些項目上面那如果可能的話我們會用十五幾戶的方式我們比較不想用發現金的方式因為發現金之後父母會拿去做什麼你不知道結果這個小孩子還是沒照顧到這個是我們要避免的 |
| transcript.whisperx[204].start |
6424.992 |
| transcript.whisperx[204].end |
6454.145 |
| transcript.whisperx[204].text |
所以不論是早產的他可能是需要一些營養品或者是眼睛可能會有一些問題或者是肺部會有一些問題那像針對這一部分我剛我也認同部長的這個所說的就是可能用實際的這個補助他需要的這個營養品的一個補助或者是藥品的這個補助我認同那是不是說可以盡速趕快去做一個整理好 謝謝那另外就是說 |
| transcript.whisperx[205].start |
6456.206 |
| transcript.whisperx[205].end |
6481.946 |
| transcript.whisperx[205].text |
這個我們國家挹注的這個兒童專科醫院其實是沒有國家支援挹注的這個兒童的專科醫院像臺大醫院他也算他只是有一個這個兒童醫院他只是有一個建築那很多還是跟成人的一起使用那他也算是只是兒科的一部分就是兒科 |
| transcript.whisperx[206].start |
6483.106 |
| transcript.whisperx[206].end |
6508.163 |
| transcript.whisperx[206].text |
對阿像往南的話就剩下這個還有最南就是彰化基督教醫院有一個兒童醫院嗎應該高雄那邊還有高雄現在有嗎沒有阿目前我們看到是沒有阿高一高一現在是有好那我想請教就是說其實我們看到從這個南部或者是東部其實兒童的這個新生兒的這個死亡率其實一直都沒有 |
| transcript.whisperx[207].start |
6508.863 |
| transcript.whisperx[207].end |
6537.172 |
| transcript.whisperx[207].text |
就是覺得都比例都還是偏高那會不會跟我們沒有這個兒童的這個專科專科的這個醫療會不會是有關跟我們報告就針對這一點的話我們就是也注意到所以這我們推出了一個優化兒童醫療照護的計畫那這個計畫的話在原來的前三年的話是經費是比較少那今年是第四年我們把預算增加了 |
| transcript.whisperx[208].start |
6538.353 |
| transcript.whisperx[208].end |
6563.008 |
| transcript.whisperx[208].text |
明年可能還會繼續再推這第二期這一個部分的話我們會有所謂的核心醫院跟重點醫院另外一個又有專職醫師核心醫院就是比較高的能夠去訓練人力然後來做重男罕症的治療這個部分 |
| transcript.whisperx[209].start |
6564.895 |
| transcript.whisperx[209].end |
6578.049 |
| transcript.whisperx[209].text |
重點醫院的部分就我們希望一個縣市至少要有一家他要做什麼他必須要提供24小時有兒科的專科醫師能夠來看急診或是cover急診 |
| transcript.whisperx[210].start |
6579.881 |
| transcript.whisperx[210].end |
6600.823 |
| transcript.whisperx[210].text |
第二就是他必須要早產能夠做照顧也就是要有新生兒的加護病房當然更好的是說有兒童加護病房會有分級所以這部分的話我們都會給他補助其中對兒科醫師的話大概重點醫院跟核心醫院的部分的話我們會給 |
| transcript.whisperx[211].start |
6602.924 |
| transcript.whisperx[211].end |
6628.83 |
| transcript.whisperx[211].text |
一個月一萬元因為我們看到其實要醫院要招募這個兒科醫師其實也不容易像臺大他連那個兒科醫師的招募都不足所以我覺得說應該要放更多的資源在這個而且這都是公務預算都沒有遲到健保那剛剛最後因為時間的關係最後我想請教就是說很多委員在關心就是我們的這個掛號費 |
| transcript.whisperx[212].start |
6631.731 |
| transcript.whisperx[212].end |
6653.658 |
| transcript.whisperx[212].text |
就是沒有去這個有關這個掛號費這個上限那也沒有去做一個這個備查的這個制度所以我想請教就是說未來如果說是經濟弱勢的民眾那他可能會考慮到這個掛號費真的太貴了那可能會影響到他的整個就醫的這個權利所以我想請教部長就針對這些經濟弱勢的民眾怎麼處理 |
| transcript.whisperx[213].start |
6656.039 |
| transcript.whisperx[213].end |
6676.274 |
| transcript.whisperx[213].text |
跟委員報告,其實經濟弱勢的民眾的話,我們有公財的回饋金是分配給各個縣市政府本來就是公財的回饋金裡面的使用,就有包括這一個經濟弱勢的他就醫的時候的掛號費等等這些,他就可以給他補助 |
| transcript.whisperx[214].start |
6677.535 |
| transcript.whisperx[214].end |
6703.656 |
| transcript.whisperx[214].text |
所以我也想請部長針對目前我們這個公號費的這個上限就是你們沒有特意去就是說要有一個公號費的上限那你們是不是也要有一個一段時間去觀察到底這些診所、診所、醫院、區域醫院、地區醫院或者是醫學中心這個調整之後會有什麼對民眾有什麼樣的影響我覺得你們應該也要有一個配套 |
| transcript.whisperx[215].start |
6704.156 |
| transcript.whisperx[215].end |
6726.495 |
| transcript.whisperx[215].text |
不過可能就是說我們會從那個公立醫院開始公立醫院大概不會去醫院馬上就做調整所以公立醫院應該是暫時不會長所以公立醫院目前這個掛號費應該不會有所調整對那其他的醫院或者診所如果有調整的話如果有聯合行為那就是要交給公平會去 |
| transcript.whisperx[216].start |
6726.735 |
| transcript.whisperx[216].end |
6727.316 |
| transcript.whisperx[216].text |
黃秀芳委員質詢 |
| transcript.whisperx[217].start |
6752.474 |
| transcript.whisperx[217].end |
6761.339 |
| transcript.whisperx[217].text |
謝謝主席。部長,我看到你睡著了。我看你都不醒了。我們請石崇亮署長,還有我們吳署長。好,來請兩位署長。委員長。我將吳署長先回答一個問題。 |
| transcript.whisperx[218].start |
6771.864 |
| transcript.whisperx[218].end |
6785.841 |
| transcript.whisperx[218].text |
這個是媒體要知道的今天早上都談很多了那些蘇丹紅、辣椒粉因為辣椒我們前幾天部長就講說這次出包是辣椒粉蘇丹紅沾在辣椒裡面 對不對 |
| transcript.whisperx[219].start |
6788.364 |
| transcript.whisperx[219].end |
6808.906 |
| transcript.whisperx[219].text |
原頭是大陸嘛所以現在的一級、二級一直分裝一直出去我上次跟部長請教聽說現在十幾萬公斤啊部長又說沒多少你看越拼越多原來三家那我請問今天又查出來幾家 |
| transcript.whisperx[220].start |
6810.097 |
| transcript.whisperx[220].end |
6811.358 |
| transcript.whisperx[220].text |
另外一個有媒體說這個東西已經進來3年了 |
| transcript.whisperx[221].start |
6836.792 |
| transcript.whisperx[221].end |
6863.19 |
| transcript.whisperx[221].text |
三年了?真的有那麼久嗎?還是十年了?因為我們過去一直都有在驗那有一些業者像我們這一次針對的21家全部都禁他的就是只要有不管是農藥啊或者是曾經有驗出蘇丹紅的我們就全部都禁止他再說問題在這裡這一次是雲林查出來嘛雲林是人家檢舉嘛所以你說你邊境你海關要進來你這幾年都有驗嗎?這第一個問題 |
| transcript.whisperx[222].start |
6866.932 |
| transcript.whisperx[222].end |
6884.631 |
| transcript.whisperx[222].text |
第二問題,藥師沒有人檢舉,這件事情又沒人挑起來,就繼續吃?確實是需要全民監督,因為我們的檢驗在邊境不可能百分之百,我們再怎麼做都沒有辦法到百分之百你是不是完全沒有在檢驗?我們每一年都有驗,像去年我們驗的就有87件 |
| transcript.whisperx[223].start |
6886.471 |
| transcript.whisperx[223].end |
6886.611 |
| transcript.whisperx[223].text |
所以你們 |
| transcript.whisperx[224].start |
6905.819 |
| transcript.whisperx[224].end |
6932.902 |
| transcript.whisperx[224].text |
我們美國進,我們就進,但是中央這邊不該積極,那我們現在各縣市政府都非常的努力,小年來的妻兒園大家都很認真,這要敢鼓勵,要敢獎勵啦,要鼓勵,你就是說裝上地方,像部長講的,要合作嘛,所以這個不能有互相在那邊推脫,在那邊塞進去,這完全不行喔, |
| transcript.whisperx[225].start |
6934.301 |
| transcript.whisperx[225].end |
6955.527 |
| transcript.whisperx[225].text |
有嗎有這個 有有齁 是明天是婦女節啦婦女節 三八婦女節這是要很快樂的 孩子要很快樂的這個營養午餐什麼倫巴的 孩子都在吃這些東西部長說的我聽下去他說孩子他就是吃比較辣的東西所以有可能比較沒汙量那但是要還是要小心不要 |
| transcript.whisperx[226].start |
6956.983 |
| transcript.whisperx[226].end |
6972.881 |
| transcript.whisperx[226].text |
婦女節明天就變樣了好不好這個很重要我看食藥署不夠不夠認真好那再來請崇良兄這個第一梯 |
| transcript.whisperx[227].start |
6974.249 |
| transcript.whisperx[227].end |
6991.803 |
| transcript.whisperx[227].text |
就是上次第8屆的時候那個康照桌康照桌這個署長的時候就以前叫做PVS嘛這個是根據健保法46條衍生出來藥價那這個第一批做到現在10年喔差不多喔10年喔 |
| transcript.whisperx[228].start |
6996.241 |
| transcript.whisperx[228].end |
7013.721 |
| transcript.whisperx[228].text |
國產藥藥廠在幹掉進口也沒問題藥借也沒問題衣蓋也沒問題賠償六百萬也沒辦法吃這個方這個辦法是不是該廢止或者是要重新檢討可以玩得差不多了啦 |
| transcript.whisperx[229].start |
7015.525 |
| transcript.whisperx[229].end |
7040.28 |
| transcript.whisperx[229].text |
跟委員報告這個第一梯是從102年開始實施的它最主要當時候提出來是要解決第一個是藥價差當時候初步的剛啟動這個機制的時候一年的藥價差大概有30%為了要解決這個藥價差同時也不要每年的調動的幅度太大所以才訂出一個目標制讓它調整的幅度不要那麼大 |
| transcript.whisperx[230].start |
7041.341 |
| transcript.whisperx[230].end |
7062.954 |
| transcript.whisperx[230].text |
幾年下來大概現在藥價差已經縮小到差不多24、25%那麼也需要到整個要來檢討的時候所以委員的指教我們從去年就開始跟大家在討論應該今年上半年我會提出一些法規的修訂我要這裡要說明一下我是做第一線的重症醫師 |
| transcript.whisperx[231].start |
7065.66 |
| transcript.whisperx[231].end |
7075.133 |
| transcript.whisperx[231].text |
什麼以藥養醫啦什麼藥價差很多啦我跟大家報告我第一線我才做重症我們現在的藥價差搞不好連10%、15%都很難 |
| transcript.whisperx[232].start |
7079.819 |
| transcript.whisperx[232].end |
7103.754 |
| transcript.whisperx[232].text |
現在每年被砍藥一直砍一直砍我們現在根本不會去care藥價差這一塊我想大的醫院或許像長庚體系像北醫體系他的盡量非常大可以用價量來製衡或許他們的藥價才會多一點但是你說基層診所這裡要替他們講講話基層診所要去買藥 |
| transcript.whisperx[233].start |
7107.472 |
| transcript.whisperx[233].end |
7116.98 |
| transcript.whisperx[233].text |
跟健保價的合價是一樣的,甚至於比健保價的合價還高,這樣一個心力不整藥,要健保合價合一點點,然後他們要買要買,比他高。所以不要汙名化我們醫界,這裡我要替他們講話。 |
| transcript.whisperx[234].start |
7130.56 |
| transcript.whisperx[234].end |
7141.781 |
| transcript.whisperx[234].text |
那再來我們一天到晚說停藥啦、COVID的關係啦、打仗的關係所以有些藥都進不來那我要這裡要跟署長講 |
| transcript.whisperx[235].start |
7143.339 |
| transcript.whisperx[235].end |
7163.774 |
| transcript.whisperx[235].text |
我們的用賢明藥的藥我們也同意那賢明藥進來有本國的賢明藥有進口的賢明藥那我們對本國的賢明藥有沒有信心的第一個第二個如果有信心的話要如何保障賢明藥第三個我們的 |
| transcript.whisperx[236].start |
7165.275 |
| transcript.whisperx[236].end |
7178.425 |
| transcript.whisperx[236].text |
學民要的原料台灣有沒有在開發如果開發的話我們真的要保護不然的話真的打起仗來或是封鎖起來我們現在很多原料都從中國大陸跟印度進來的 |
| transcript.whisperx[237].start |
7179.753 |
| transcript.whisperx[237].end |
7207.375 |
| transcript.whisperx[237].text |
所以如果到時候一停那怎麼辦?跟委員報告我們已經在研議中接下來會修訂這個支付標準那在定價的時候如果用到的是臺灣製造的原料藥可以加到20%最高的價格那另外如果是在臺灣製造的學民藥那我們會看他的那個藥證的章數還有他的這個臨床使用缺口最高可以加到15% |
| transcript.whisperx[238].start |
7209.683 |
| transcript.whisperx[238].end |
7209.946 |
| transcript.whisperx[238].text |
主席 |
| transcript.whisperx[239].start |
7211.994 |
| transcript.whisperx[239].end |
7240.593 |
| transcript.whisperx[239].text |
那所以你有保護的機制啦不要一天到晚停藥一天到晚沒有藥用這個是很糟糕我去年給大家統計一下我們那個體系的藥就缺了21種21種就真的是藥廠缺藥所以我們對這個非常敏感那這另外一個問題就是以前用PVS就是用Price Volume Survey那你現在用DET這差不多都大同小異啦 |
| transcript.whisperx[240].start |
7242.518 |
| transcript.whisperx[240].end |
7270.353 |
| transcript.whisperx[240].text |
這個還要改變嗎?我今天有一個提案要廢止我們重來不過跟委員報告這個是牽涉到整個健保的總額因為每年的健保的總額有一定的成長那麼第一梯是它的目標藥費支出的成長是跟著總額的成長浮動所以如果說這個藥費的第一梯制度 |
| transcript.whisperx[241].start |
7271.013 |
| transcript.whisperx[241].end |
7296.703 |
| transcript.whisperx[241].text |
目標沒有的時候那怎麼樣去適當的管控這個藥費的成長避免排擠到醫療費用這個也是需要來一併思考的還有這裡我要跟署長報告的就是說我給你請教我們一直講說藥會佔了我們健保費用的25%差不多25、26%如果沒有這個調整前的話是到28% |
| transcript.whisperx[242].start |
7299.241 |
| transcript.whisperx[242].end |
7307.615 |
| transcript.whisperx[242].text |
為什麼我們的藥費的比例佔比會那麼高是因為我們其他的醫療行為的價格太低啦 |
| transcript.whisperx[243].start |
7308.533 |
| transcript.whisperx[243].end |
7329.871 |
| transcript.whisperx[243].text |
就是說點數太低在國外、在美國、在日本他們不太去care藥費所佔的比例那因為台灣便宜啦,大家都很便宜開桌也便宜、醫生也便宜,包括你也很便宜所以這樣是不對的一定要讓這些醫生做醫生要做的有時候做有時候要做的那這樣 |
| transcript.whisperx[244].start |
7330.812 |
| transcript.whisperx[244].end |
7330.832 |
| transcript.whisperx[244].text |
致詢 |
| transcript.whisperx[245].start |
7351.343 |
| transcript.whisperx[245].end |
7356.225 |
| transcript.whisperx[245].text |
所以部長你也是臨床醫師轉過來我們的署長你也是臨床醫師、急診醫師所以要如何讓這個醫界的 |
| transcript.whisperx[246].start |
7381.429 |
| transcript.whisperx[246].end |
7397.798 |
| transcript.whisperx[246].text |
有價量要同等所以這塊要往上加我完全不反對你這個藥品的第一梯什麼要重新檢討但是這個地方的一定要當然volume增加這個很重要不然你當臨床醫師這裡追臨床醫療這樣是 |
| transcript.whisperx[247].start |
7402.215 |
| transcript.whisperx[247].end |
7426.3 |
| transcript.whisperx[247].text |
這目前我們也是在想辦法改善當中那整個健保的基金我們看能不能適度的予以擴充大概是這位不行的就用公務預算來挹注公務預算也是挹注到健保所以我剛剛講是健保基金不夠就是整個volume要增加不用怕大家一起努力好不好謝謝 |
| transcript.whisperx[248].start |
7431.181 |
| transcript.whisperx[248].end |
7434.063 |
| transcript.whisperx[248].text |
好 我們謝謝蘇清泉委員的質詢好 接著我們請王一鳴委員質詢好 謝謝主席那我們請部長跟食藥署署長部長請還有署長 |
| transcript.whisperx[249].start |
7464.466 |
| transcript.whisperx[249].end |
7478.871 |
| transcript.whisperx[249].text |
這次蘇丹紅事件我覺得它不只是一個系統性事件而且還是一個重大實案事件為什麼本席要說它是重大這次整個輻射的範圍坦白講是非常的大 |
| transcript.whisperx[250].start |
7479.611 |
| transcript.whisperx[250].end |
7483.513 |
| transcript.whisperx[250].text |
食藥署本來是預定這個禮拜一你們說你們會查完結果昨天對外說沒有辦法那也告訴大家說不保證市場沒有問題所以本席已經看到這次的蘇丹紅事件他的規模可能會有點像2013年的毒澱粉事件 |
| transcript.whisperx[251].start |
7500.063 |
| transcript.whisperx[251].end |
7519.92 |
| transcript.whisperx[251].text |
就是說所波及的很多的這些食品其實滲透的範圍非常的廣泛所以在這樣的一個情況底下我有兩個具體的建議第一個具體的建議因為是重大食安事件目前我們看到16個縣市是由地方政府他主動發起說這個 |
| transcript.whisperx[252].start |
7522.423 |
| transcript.whisperx[252].end |
7545.737 |
| transcript.whisperx[252].text |
暫時禁用辣椒粉暫時停止辣椒粉進到營養午餐不管他用了多少但是先禁用我覺得這個是一個對的我看到有一些地方政府有點後知後覺包括像嘉義縣政府教育局他說什麼他說我們沒有問題的品項流入嘉義縣所以可以不用 |
| transcript.whisperx[253].start |
7547.109 |
| transcript.whisperx[253].end |
7563.9 |
| transcript.whisperx[253].text |
兩位敢保證嗎沒有問題的品項流入嘉義縣昨天你們公布的就有兩家廠商各有3612公斤跟2439公斤兩家食品廠這個時候誰敢保證沒有蘇丹紅色素流入任何一個縣市部長你敢保證嗎 |
| transcript.whisperx[254].start |
7566.447 |
| transcript.whisperx[254].end |
7584.158 |
| transcript.whisperx[254].text |
當然因為它銷到哪一個縣市去的話,我們還是要循線去追查是啊,還在追查中啊,所以我有點擔心的就是說,各縣市的教育人員他們的判斷有點失準那有的縣市人員竟然說,我們那個有問題的都已經下架了,所以呢我們這個縣市沒問題 |
| transcript.whisperx[255].start |
7586.9 |
| transcript.whisperx[255].end |
7607.901 |
| transcript.whisperx[255].text |
連衛福部都不敢保證現在市場的產品就是不敢保證市場上面沒問題但是有的教育人員竟然說我們這個管制我們沒問題我覺得不可以各行其事所以第一個我具體給部長的建議因為這是重大系統性的食安事件所以有一致性的標準不要讓各個縣市他們各自解讀 |
| transcript.whisperx[256].start |
7608.462 |
| transcript.whisperx[256].end |
7629.204 |
| transcript.whisperx[256].text |
而這件事情更沒有藍綠線式的問題我覺得應該就是一致性的標準就像剛剛部長你講的因為辣椒粉學校營養午餐它不見得使用很大量就是因為這樣子也不會有任何的影響那你直接這一段時間在你們還未查明之前我們就把它禁掉是不是讓所有的家長更安心 |
| transcript.whisperx[257].start |
7630.117 |
| transcript.whisperx[257].end |
7642.04 |
| transcript.whisperx[257].text |
部長你覺得有沒有道理這是可以考慮的因為我剛剛講過嘛因為在血統的部分的話其實吃辣的並不是一個很普遍的習慣對但是他可能還是會誤食所以我覺得啦本期具體件我當然也會有領提我們來討論我主張應該因為它是重大系統性的食安事件暫停一段時間也不會對任何的這個營養午餐供應商產生任何的問題所以我覺得這個是 |
| transcript.whisperx[258].start |
7657.083 |
| transcript.whisperx[258].end |
7673.954 |
| transcript.whisperx[258].text |
讓學童讓家長更安心的一個做法應該全國一致第二個我認為應該比照2013年的這個毒澱粉事件後來衛生署所頒定的這件事情剛剛部長一直說我們是由上而下一直查我們從原料加工到零售 |
| transcript.whisperx[259].start |
7674.574 |
| transcript.whisperx[259].end |
7694.717 |
| transcript.whisperx[259].text |
但是這樣的一個速度坦白講是緩慢的我們到目前查了一個月還有很多的漏網之魚在市面上就是繼續在賣那這件事情我覺得比照2013年毒澱粉事件後來衛生署的處理我覺得很好他就下令要求各個你現在要供應這個辣椒粉 |
| transcript.whisperx[260].start |
7695.197 |
| transcript.whisperx[260].end |
7714.242 |
| transcript.whisperx[260].text |
就是食物的廠商你自行自清就是說本店所使用的辣椒粉不含蘇丹紅色素那業者他可以有兩種做法大型的連鎖店你自己趕快去驗你現在所使用的你要確定你這個本身沒有蘇丹紅色素 |
| transcript.whisperx[261].start |
7714.782 |
| transcript.whisperx[261].end |
7724.473 |
| transcript.whisperx[261].text |
那你透過這種大型的連鎖店他們自己願意自主送驗會加快你的速度昨天本席就接到辦公室就接到這個連鎖的這個早餐店我覺得應該要嘉獎這位人員他說 |
| transcript.whisperx[262].start |
7729.679 |
| transcript.whisperx[262].end |
7755.624 |
| transcript.whisperx[262].text |
他發現他們總公司現在呢就只有告訴他說如果你有用到蘇丹紅就不要用就這樣但是呢他們也沒有一個督導制度也沒有一個強制性的做法那所以他認為現在這樣子只是說用呼籲的這樣子的說法可能會有很多這個食安上面的風險我覺得這一位從業人員真的要獎勵他他自己有這樣的sense |
| transcript.whisperx[263].start |
7756.444 |
| transcript.whisperx[263].end |
7775.029 |
| transcript.whisperx[263].text |
所以他認為說像是這些聯鎖加盟的業者他們應該要發揮業者的這個主動的精神那他現在發現說有的地方政府他反映這件事情他就說那這個就是等上面通知啊他們是等時要數你們公告之後哪些有問題他才可以再往下查 |
| transcript.whisperx[264].start |
7775.609 |
| transcript.whisperx[264].end |
7793.789 |
| transcript.whisperx[264].text |
所以剛剛也有委員在說那我們現在後市場主動去查驗的量夠不夠就現有的產品或者是說它本身是這一種加盟店的店我們主動去查驗看起來沒有現在都是等著食藥署公告上游廠商之後從這邊往下查那所以本期具體建議就是說其實可以比照2013年的這樣的做法 |
| transcript.whisperx[265].start |
7797.593 |
| transcript.whisperx[265].end |
7824.04 |
| transcript.whisperx[265].text |
讓大型的這一些供應的食品廠自主再去加驗然後去貼公告本店就是經過你有拿到那個證書就是說你使用你可以繼續使用你這個含有辣椒的產品但是他不含蘇丹紅我覺得這個是一個加快速度的做法那另外一個也讓下游的這一些廠商他可以往上去要求就是你今天供應商你要供應給我對不對你出去證明 |
| transcript.whisperx[266].start |
7825.24 |
| transcript.whisperx[266].end |
7854.66 |
| transcript.whisperx[266].text |
證明說你的辣椒粉不含蘇丹紅所以他也可以拿著上游的廠商給他這個證明因為他店比較小他不可能自己驗就是說你上面你要供應給我的中韓商你就出去這個證明我就可以貼出來這個在座我不曉得大家有多少人經歷那個當時那個毒澱粉事件後來你去看那個珍珠奶茶那個肉圓店小到小吃攤他都會掛一個公告他在告訴消費者說本店不使用申訂希爾酸 |
| transcript.whisperx[267].start |
7855.22 |
| transcript.whisperx[267].end |
7875.691 |
| transcript.whisperx[267].text |
所以我覺得這個才是一個我們目前可以加快速度的做法我很怕你們繼續這樣由上而下慢慢查坦白講再一個月可能查不完量太大了報告委員其實一開始的時候我們就有這一個措施我們也通知了一些食品業者那我想這我們宣導不夠我們再加強宣導就讓他們自主檢驗 |
| transcript.whisperx[268].start |
7876.431 |
| transcript.whisperx[268].end |
7894.336 |
| transcript.whisperx[268].text |
而且你要要求 而且給他們一段時間當時是加上你們的行政裁罰就是說如果你公告了之後再被驗出來也是有事情的就是說你等於是雙重然後呢 因為這次爆發的我發現業者的自主查驗做得真的很不好幾家大廠 |
| transcript.whisperx[269].start |
7895.296 |
| transcript.whisperx[269].end |
7912.531 |
| transcript.whisperx[269].text |
我就想說如果上面的供應商是有問題的我們不是食安法有規定嗎你達到一定規模的你是要自主去檢驗你這些原料半成品的結果我發現他們都沒有做啊他們都是被動等你們通知那你們通知有的還第一時間否認說沒有我的沒問題然後再突然又改口說我的有問題有的還是上市上櫃 |
| transcript.whisperx[270].start |
7918.737 |
| transcript.whisperx[270].end |
7942.055 |
| transcript.whisperx[270].text |
那個你們回去查你們針對上市上櫃的要求他有的還要自設實驗室就是那個規模結果我覺得現在好像通通都沒有落實所以守護食安政府有絕對的責任但是如果整個食安要做好你必須把業者他的這種自主性也要拉進來而且要求他要到位 |
| transcript.whisperx[271].start |
7942.475 |
| transcript.whisperx[271].end |
7970.811 |
| transcript.whisperx[271].text |
要不然我們的這個食安你看這一次這個系統性的風暴一出現之後你就會發現說食藥署你的人力加上地方的人力你這樣子由上而下一直查那個的速度是不夠的所以由下而上就是在加這一道力量你才可以用最快的時間把這一次的蘇丹紅的風暴就是盡快的收尾要不然你們說這個禮拜我就會查完我敢保證啦 |
| transcript.whisperx[272].start |
7972.092 |
| transcript.whisperx[272].end |
7997.831 |
| transcript.whisperx[272].text |
還沒有啦因為這一次的這個辣椒粉它的特殊性太高了隨隨便便就是大家都會用到它擴散的我們台灣這麼多小吃其實都有可能已經沾染到了那你現在只能就是把它劃一個最後就是處理你所有的邊境已經都禁止了那你現在就是要把已經在市場流竄的這一些趕快透過加入業者的自主檢驗 |
| transcript.whisperx[273].start |
7998.792 |
| transcript.whisperx[273].end |
8007.606 |
| transcript.whisperx[273].text |
然後雙重的讓這一個趕快就是可以順利的收尾部長你同意這我們就來加強這個推動跟宣導 |
| transcript.whisperx[274].start |
8008.612 |
| transcript.whisperx[274].end |
8026.09 |
| transcript.whisperx[274].text |
好,不是宣導喔,還要加上你的行政要求喔,你們回去看一下當時毒澱粉事件,它最後的處理方法本期是覺得這一次的事件跟那個有相近性,當時澱粉也是我們應用性非常廣這一次是辣椒粉,也是使用的非常廣泛,所以當時2013年的這個最後衛生署想出來的這個處理模式 |
| transcript.whisperx[275].start |
8030.755 |
| transcript.whisperx[275].end |
8030.855 |
| transcript.whisperx[275].text |
謝謝王委員、謝謝部長 |
| transcript.whisperx[276].start |
8066.602 |
| transcript.whisperx[276].end |
8067.102 |
| transcript.whisperx[276].text |
法定人數不足 |
| transcript.whisperx[277].start |
8085.544 |
| transcript.whisperx[277].end |
8085.905 |
| transcript.whisperx[277].text |
委員會主席 |
| transcript.whisperx[278].start |
8528.476 |
| transcript.whisperx[278].end |
8552.393 |
| transcript.whisperx[278].text |
好 那我們繼續開會接下來我們請圖全級委員進行諮詢好 那請一下我們薛部長好 有請部長 |
| transcript.whisperx[279].start |
8557.837 |
| transcript.whisperx[279].end |
8584.149 |
| transcript.whisperx[279].text |
委員好部長那今天因為今天我看今天大家也是針對我們蘇丹紅的事件因為媒體一直在報導那記得在那天委員會的時候有詢問就是說這個部分其實在去年我們邊境查驗就已經查獲9件查獲9件那我說為什麼行政院3次的食安匯報還有一次的我們食安專報總檢討都沒有提到這個問題 |
| transcript.whisperx[280].start |
8587.31 |
| transcript.whisperx[280].end |
8607.73 |
| transcript.whisperx[280].text |
那我記得我們部長好像回覆說,你說這個問題是需要累積的,是不是這樣?對,因為其實是七件啦,去年是七件,七件是分布在不同的月份那我們納悶的是,其實他短短不到一年的時間就已經查獲了九件,那九件這樣子累積數量還不夠嗎? |
| transcript.whisperx[281].start |
8609.582 |
| transcript.whisperx[281].end |
8629.507 |
| transcript.whisperx[281].text |
對,所以到後來我們就是變成100%的抽菸的原因就在所以今天我也是提醒一下部長像這個你看即使已經查過那麼多件當下如果我們趕快超前部署趕快處理我覺得這個蘇丹雄事件應該不會爆發到這種程度前面第一時間沒有處理好你看後來到後市場端 |
| transcript.whisperx[282].start |
8630.167 |
| transcript.whisperx[282].end |
8643.741 |
| transcript.whisperx[282].text |
現在到已經一發不可收拾而且到底有多少食品我相信一定是陸陸續續爆發已經變成不是辣椒粉咖哩粉連很多的食品只要有染色顏色的問題我看都有摻這個蘇丹紅 |
| transcript.whisperx[283].start |
8646.183 |
| transcript.whisperx[283].end |
8660.17 |
| transcript.whisperx[283].text |
所以我們現在準備要做的一件事情就是我們會把特點像蘇丹紅這類的不應該出現在食品裡面的這種工業燃料、工業原料的話我們會把它列為所謂的高危的這一個 |
| transcript.whisperx[284].start |
8663.753 |
| transcript.whisperx[284].end |
8669.276 |
| transcript.whisperx[284].text |
那我想請問一下你們民進黨高層有沒有受益說我們520之後我們部長還有我們的食藥署署長有沒有機會繼續留任?署長是事務官那所以520會影響到的是我 |
| transcript.whisperx[285].start |
8689.624 |
| transcript.whisperx[285].end |
8714.896 |
| transcript.whisperx[285].text |
那部長你自己的看法呢?所以部長還是如果有機會還是繼續留任嗎?那署長有沒有意願繼續留任?還是看上面的意思?因為今天國民黨有召開記者會要求我們吳署長應該要下台負責我想了解一下署長對自己這件事情的看法 |
| transcript.whisperx[286].start |
8715.814 |
| transcript.whisperx[286].end |
8716.414 |
| transcript.whisperx[286].text |
圖委員好 |
| transcript.whisperx[287].start |
8744.265 |
| transcript.whisperx[287].end |
8763.352 |
| transcript.whisperx[287].text |
市署長我最近因為針對那個陸配入籍的問題有影響到健保的問題那我想請問一下我們外籍人士在臺灣他來有持居留文件之後他什麼條件下可以參加健保 |
| transcript.whisperx[288].start |
8765.134 |
| transcript.whisperx[288].end |
8786.668 |
| transcript.whisperx[288].text |
我們是根據這個健保法第9條的規定如果有居留證明文件之後那麼分成三種樣態一種是如果是受僱受聘的話那麼立刻就可以加入健保沒關係我們簡單回答那正常有居留文件數滿6個月就可以參加健保如果是受僱的話馬上就可以加入健保 |
| transcript.whisperx[289].start |
8787.108 |
| transcript.whisperx[289].end |
8815.903 |
| transcript.whisperx[289].text |
那如果沒有受雇的情形下的話就要有6個月那我請問一下這些外籍人士他有包含這個入港澳嗎?就是像大陸啊澳門啊香港這些都是履照辦理所以所有的外籍人士包含入配包含入港澳這些都是在外籍人士所以他正常來講規範都是一樣的嘛 |
| transcript.whisperx[290].start |
8816.463 |
| transcript.whisperx[290].end |
8833.952 |
| transcript.whisperx[290].text |
我們是在健保法第8條規定具有中華民國國籍我國國籍第9條是沒有國籍的所以這個參加健保並不會因為他陸配入籍6年或4年其實他的規範是一樣的只要來台居留滿他的規範是一樣的對不對 |
| transcript.whisperx[291].start |
8835.472 |
| transcript.whisperx[291].end |
8863.733 |
| transcript.whisperx[291].text |
這個條件是一個是居留證明文件那這個陸配的並不會因為陸配6年4年的關係影響陸配沒有影響對所以都是一樣的對好那所以我們就說陸港澳及外籍人士只要持有居留文件並在台居留滿6個月他的條件是一樣都可以參加健保而且我們的準總統當選人賴清德之前也有講他說健保牽涉的是我們的健康人權 |
| transcript.whisperx[292].start |
8864.594 |
| transcript.whisperx[292].end |
8893.68 |
| transcript.whisperx[292].text |
所以人權是沒有國界的那當然包含我們的外配陸配等等他居然已經嫁來臺灣我覺得嫁來臺灣他就是我們的家人那居然是我們的家人我們就不應該要有所歧視對不對目前的話外籍配偶的條件都一致沒有錯對嘛所以基本上他這個參加健保還有我們賴清德有講這個人權無國界然後我覺得說嫁來臺灣大家都是平等的對待那所以我們 |
| transcript.whisperx[293].start |
8894.96 |
| transcript.whisperx[293].end |
8922.327 |
| transcript.whisperx[293].text |
針對我們民進黨政府他在兩公約第三次國家報告的時候都會講大陸配偶來台取得身份證的年限調整與外籍配偶一致已經拧聚臺灣地區與大陸地區人民關係條例第17條的新修正草案現在就等立法院完成這個立法的程序所以這個當初就是我們民進黨提出的那我們來講政黨在政策的 |
| transcript.whisperx[294].start |
8923.007 |
| transcript.whisperx[294].end |
8941.404 |
| transcript.whisperx[294].text |
延續上是沒有分政黨的所以當初民進黨提出這個還沒有完成那我請問一下我們國民黨接續完成哪裡有什麼不對不過跟委員報告剛剛講的是在配偶本身那麼權益不論是哪個國籍大家權益相當不過呢是最主要是在 |
| transcript.whisperx[295].start |
8942.385 |
| transcript.whisperx[295].end |
8964.741 |
| transcript.whisperx[295].text |
陸配的依親的規定上呢那麼跟其他是有不一樣那依親的那一塊確實因為年紀都是比較大的那對健保的影響那當然就是會涉及到繳少用多的問題所以我說這個目標其實大家是一致的嘛既然嫁來台灣就是我們家人我們就不應該有所歧視嘛那我請問一下據我們 |
| transcript.whisperx[296].start |
8965.862 |
| transcript.whisperx[296].end |
8972.794 |
| transcript.whisperx[296].text |
署長你這邊來了解一般外籍配偶來台他大部分的年齡 大部分年齡大概在什麼年齡層 |
| transcript.whisperx[297].start |
8975.113 |
| transcript.whisperx[297].end |
8995.032 |
| transcript.whisperx[297].text |
當然都是比較年輕的啦這個根據當然在健保裡面是不會去特別去註記你是外籍配偶啦但是勾結起來當然他的這個對啊所以一般就是比較年輕的嘛那我們以正常常態我們可以知道一般比較年輕力壯其實他看病的機會數是會比年長人少 |
| transcript.whisperx[298].start |
8996.243 |
| transcript.whisperx[298].end |
9008.57 |
| transcript.whisperx[298].text |
比例來講以我們現在就入籍配偶來講他現在的繳的保費跟醫療的支出大概是平衡的對啊所以我的意思是說還有就是說醫輕的問題像我們醫輕 |
| transcript.whisperx[299].start |
9011.551 |
| transcript.whisperx[299].end |
9036.617 |
| transcript.whisperx[299].text |
據我們了解他這來台一清一年的名額也大概只有60個所以我們針對最近有一些很多的問題尤其我們民進黨政府還有我們這個主管單位我們常常針對假新聞假訊息我們都說要澄清要來打擊這假新聞假訊息可是我剛剛問了很多的問題目前這很多的假新聞假訊息都在流竄 |
| transcript.whisperx[300].start |
9037.577 |
| transcript.whisperx[300].end |
9059.717 |
| transcript.whisperx[300].text |
不知道我們健保署針對這些很多的假新聞假訊息你們看到之後有沒有針對這些做一些調整跟委員報告現在的正義點主要可能在醫輕的部分因為醫輕剛剛也提到他的年齡上是比較高的醫療的使用率是高但是跟國人不同的是他是從加入健保之後才開始繳款 |
| transcript.whisperx[301].start |
9060.317 |
| transcript.whisperx[301].end |
9069.149 |
| transcript.whisperx[301].text |
有關係我希望我們比照辦理來有時候主管單位針對假新聞假訊息我覺得還是要提出嚴正的說明那我們針對現在我們健保砍這個藥價我請問一下我們這個去年也爆發這個缺藥風波 |
| transcript.whisperx[302].start |
9077.66 |
| transcript.whisperx[302].end |
9102.414 |
| transcript.whisperx[302].text |
那現在我們要調降這個藥價那會不會也造成大缺藥之亂跟我們報告這一次調價的時候我們都有通知廠商那麼可以在3月8號之前提出來如果有成本不敷那我們會重新調整到目前為止只有5個藥品提出來而已那我們也會暫時不調整它據我們了解現在好像調降的大部分都是慢性用藥對不對 |
| transcript.whisperx[303].start |
9103.234 |
| transcript.whisperx[303].end |
9103.334 |
| transcript.whisperx[303].text |
好,謝謝委員好,謝謝 |
| transcript.whisperx[304].start |
9130.674 |
| transcript.whisperx[304].end |
9134.256 |
| transcript.whisperx[304].text |
主席好,有請薛部長還有吳署長好,請薛部長、吳署長部長好、署長好 |
| transcript.whisperx[305].start |
9159.244 |
| transcript.whisperx[305].end |
9181.895 |
| transcript.whisperx[305].text |
我們今天要談的就是缺藥問題嘛那我來自醫界所以對於這個缺藥問題也是感同身受不過我想大家更重視的就是如何能夠解決這樣的困境跟問題不過本席也認同也知道說其實健保缺藥的這個問題大家把它歸咎在健保藥價調整 |
| transcript.whisperx[306].start |
9184.216 |
| transcript.whisperx[306].end |
9207.691 |
| transcript.whisperx[306].text |
這個不是唯一的因素這可能是其中一個因素可是並不是唯一的因素那我們也從這個貴組委的報告裡面知道其實缺藥的原因是相當相當的多包括我們目前所能夠了解的生產問題、供應問題還有國內需求增加的部分尤其是在後疫情的時代 |
| transcript.whisperx[307].start |
9208.291 |
| transcript.whisperx[307].end |
9221.909 |
| transcript.whisperx[307].text |
很多的這些民眾尤其是兒童們會因為免疫負債造成某一些藥物的需求增加除了一些慢性病以外那這一部分因為三呼吸道感染所需要的這個藥物 |
| transcript.whisperx[308].start |
9223.629 |
| transcript.whisperx[308].end |
9246.529 |
| transcript.whisperx[308].text |
某些抗生素真的是特別增加包括像這個部長很辛苦受到影響所以我想應該是通盤的來了解那如果針對某一類比較會容易造成這個市場需要而受影響的藥物希望能夠有更有效的方式來做處理所以的確缺藥是我們要非常重視而且要去努力解決的部分 |
| transcript.whisperx[309].start |
9247.691 |
| transcript.whisperx[309].end |
9261.827 |
| transcript.whisperx[309].text |
我們也了解藥品短缺因素是非常非常多元的其中有一項就是會不會藥商有預期的心理希望能夠囤積原料用下一次要做調整的部分 |
| transcript.whisperx[310].start |
9262.427 |
| transcript.whisperx[310].end |
9288.939 |
| transcript.whisperx[310].text |
那我們當然不希望不希望說藥商在這種情形之下他有進口的這個原料或者是生產的原料而不去生產那其實我們很希望說落實藥品的原料的進口管理是要有一個更好的方式請問一下部長或署長針對國內藥商進口原物料的相關數據這邊有沒有適當的掌握尤其是好請 |
| transcript.whisperx[311].start |
9291.664 |
| transcript.whisperx[311].end |
9292.685 |
| transcript.whisperx[311].text |
囤積的可能性大概不大,因為這些都有效期的問題 |
| transcript.whisperx[312].start |
9311.119 |
| transcript.whisperx[312].end |
9337.247 |
| transcript.whisperx[312].text |
是 了解 所以我們也希望這部分不是一個因素之一啦 能夠造成這種不當的影響的因素 盡量把它排除那我們如何針對這個有效解決缺藥的部分本席有下列的一些想法 包括強化藥品的這個供應的主動監控那其實在去年監察院的報告裡面就告訴我們說 |
| transcript.whisperx[313].start |
9338.787 |
| transcript.whisperx[313].end |
9357.034 |
| transcript.whisperx[313].text |
藥商是否能依據必要通報來處置?檢察院發現,欠缺主動監測、查核和管理機制。不知道到目前為止已經半年的時間,有沒有再擬定改善計畫? |
| transcript.whisperx[314].start |
9359.086 |
| transcript.whisperx[314].end |
9374.993 |
| transcript.whisperx[314].text |
這部分的話齁那其實是在必要藥品我們的品齁那個一共是多少的品項?有481 481項的品項這我們有做但是全國在用的藥那幾萬項的話大概沒有辦法全部都去看啦 |
| transcript.whisperx[315].start |
9375.553 |
| transcript.whisperx[315].end |
9391.08 |
| transcript.whisperx[315].text |
是,所以如果已經有一些計畫的話那能不能夠提供免息素面資料以作為後續的追蹤那我們也知道其實推展國產的學民藥是一個未來的期待 |
| transcript.whisperx[316].start |
9391.98 |
| transcript.whisperx[316].end |
9392.16 |
| transcript.whisperx[316].text |
請問目前所謂 |
| transcript.whisperx[317].start |
9409.76 |
| transcript.whisperx[317].end |
9433.233 |
| transcript.whisperx[317].text |
預注適當資源有沒有安排哪一些的適當資源在裡面?該委員報告這有關於我們在鼓勵學民藥的這一個部分的話當然也會牽涉到經濟部經濟部他對於這個比方說CDMO或其他的這個我們國內的藥廠的一些鼓勵的措施在那個 |
| transcript.whisperx[318].start |
9434.474 |
| transcript.whisperx[318].end |
9448.541 |
| transcript.whisperx[318].text |
也相關的法規裡面有那在衛福部這邊的話大概就是用健保的這個方法在健保上面的一些規範來做處理也就是說我們給予這個新發展的學民藥我們會給他這個比較好的一個合價的一個 |
| transcript.whisperx[319].start |
9457.705 |
| transcript.whisperx[319].end |
9458.706 |
| transcript.whisperx[319].text |
再過來就是有關於庫存的部分 |
| transcript.whisperx[320].start |
9480.999 |
| transcript.whisperx[320].end |
9494.838 |
| transcript.whisperx[320].text |
我們也了解建制中盤藥商的藥品監測機制是有他主動監測的部分請問除了主動監測以外我們還有沒有其他可以主動的作為 |
| transcript.whisperx[321].start |
9496.48 |
| transcript.whisperx[321].end |
9517.922 |
| transcript.whisperx[321].text |
這部分是一個我們新的措施,那要處理的對象主要是社區的藥局還有我們一些診所因為這些診所和社區藥局大概很少能夠直接跟廠商直接訂貨,因為量不夠大 |
| transcript.whisperx[322].start |
9518.442 |
| transcript.whisperx[322].end |
9538.31 |
| transcript.whisperx[322].text |
所以很多都是透由中盤商來做處理所以中盤商他就會有調度的這種可能性所以在這裡的話我們新的措施裡面就是我們去監測中盤商那哪一些藥如果被通報這一個有缺藥的時候我們就去看中盤商的 |
| transcript.whisperx[323].start |
9541.155 |
| transcript.whisperx[323].end |
9548.892 |
| transcript.whisperx[323].text |
中環商進出狀況沒有異常的話,我們會請中環商就直接去分配,因為大概就會分配出問題 |
| transcript.whisperx[324].start |
9550.066 |
| transcript.whisperx[324].end |
9569.714 |
| transcript.whisperx[324].text |
OK 好 謝謝部長的說明和這方面的努力那我們再過來可以瞭解藥品供應通報處理中心那這一部分不知道這個中心有沒有被賦予什麼樣的具體任務因為去年就是2023年4月11號貴單位為了要因應全球性缺藥問題而啟動了這個通報中心 |
| transcript.whisperx[325].start |
9572.815 |
| transcript.whisperx[325].end |
9599.233 |
| transcript.whisperx[325].text |
所以這個中心我們所看到的就是這是一個平台那把五個平台的這個網路連結在這個我們的網路上面我們看到的就是包括有西藥供應平台、中藥還有公費傳染疫苗、兒童困難取得、罕病等等那這部分不曉得有沒有具體任務要透過這個處理中心來處理哪一些的事情 |
| transcript.whisperx[326].start |
9600.827 |
| transcript.whisperx[326].end |
9621.092 |
| transcript.whisperx[326].text |
這部分的話那每一個這五大類的話都有一些特殊性的比方說那個罕見疾病的這個部分的話這物流中心他會去監測到底我們整個國內的剩下存量是不是對於這罕病所需要的是夠不夠如果不夠的話就要去採購那 |
| transcript.whisperx[327].start |
9626.819 |
| transcript.whisperx[327].end |
9640.771 |
| transcript.whisperx[327].text |
業務比較大的應該是在西藥的這個部分是的確那我們可以往下看可以瞭解說目前這個平臺的運作狀況西藥供應平臺的確是隨時在滾動對不起我再多兩分 |
| transcript.whisperx[328].start |
9642.208 |
| transcript.whisperx[328].end |
9664.344 |
| transcript.whisperx[328].text |
有在做這個即時更新可是中藥到目前一年都沒有更新還有其他的部分所以我們很期待這個運作還可以能夠更及時去反映出這個供應的這些問題我們可以往下看就知道說依照這個西藥供應平台他已經很努力的在作業那也透過這個通 |
| transcript.whisperx[329].start |
9665.825 |
| transcript.whisperx[329].end |
9679.291 |
| transcript.whisperx[329].text |
包括缺藥來執行相關透過食藥署的評估進入到有替代方案、無替代方案還有其他廠商的這個輸入來辦理如果有缺藥的時候可以作業的模式那我們可以再往下看 |
| transcript.whisperx[330].start |
9680.575 |
| transcript.whisperx[330].end |
9702.848 |
| transcript.whisperx[330].text |
那其中有一個問題,一個實務的困境就是當藥品短缺現象透過這個平台去緩解以後那曾經為了要緩解幫助緩解的這個廠商他如果提供了藥物那這種狀況造成說新的要來幫助緩解這個藥物不足的部分結果他進來了 |
| transcript.whisperx[331].start |
9704.249 |
| transcript.whisperx[331].end |
9704.689 |
| transcript.whisperx[331].text |
我是請食藥署署長來回答 |
| transcript.whisperx[332].start |
9728.066 |
| transcript.whisperx[332].end |
9755.893 |
| transcript.whisperx[332].text |
因為通報的業者其實都會跟我們說他大概是有多少時間他需要等於是有一些藥品的短缺所以我們在徵求專案製造或專案輸入的時候也會保障這一些來協助我們的業者他們不至於做了以後結果本來在賣那個藥品進來了就沒有人要買他的所以我們有這樣的時間之內不會讓那個藥品再輸入就是你已經跟我說不能輸入了所以已經有其他出來要做專案輸入的 |
| transcript.whisperx[333].start |
9756.673 |
| transcript.whisperx[333].end |
9757.293 |
| transcript.whisperx[333].text |
好,那了解了,謝謝 |
| transcript.whisperx[334].start |
9784.056 |
| transcript.whisperx[334].end |
9791.521 |
| transcript.whisperx[334].text |
好,我們謝謝王振旭委員的質詢接下來我們請林德福委員質詢謝謝主席,是不是請薛部長好,有請部長 |
| transcript.whisperx[335].start |
9811.397 |
| transcript.whisperx[335].end |
9835.356 |
| transcript.whisperx[335].text |
委員好部長你好部長因為麻疹傳染力高那被我國歸類在第二類的傳染病可藉由空氣包括灰末傳染那根據媒體的報導世界衛生組織這個在今年2月示警除非採取緊急防範的措施否則到了今年年底 |
| transcript.whisperx[336].start |
9836.337 |
| transcript.whisperx[336].end |
9853.912 |
| transcript.whisperx[336].text |
全球有差不多超過半數的國家會面臨麻疹的疫情那爆發的風險將達到高或非常高的程度那請問薛部長我國今年面臨麻疹疫情爆發的風險比例 |
| transcript.whisperx[337].start |
9855.316 |
| transcript.whisperx[337].end |
9856.837 |
| transcript.whisperx[337].text |
所以說我希望說衛福部要有所準備去因應 |
| transcript.whisperx[338].start |
9879.957 |
| transcript.whisperx[338].end |
9907.217 |
| transcript.whisperx[338].text |
所以在這個部分我們主要的是疫苗要開疫苗來去做阻擋那目前的公費疫苗大概庫存還有5萬支那我們優先是會打在醫護人員因為我知道那個當然是應該優先因為最近本席的選區裡面包括中和永和有病例發生那曾有專家建立1981年後出生的 |
| transcript.whisperx[339].start |
9908.118 |
| transcript.whisperx[339].end |
9911.081 |
| transcript.whisperx[339].text |
請問衛福部目前麻疹疫苗供應北北基桃醫療單位的情況 |
| transcript.whisperx[340].start |
9929.679 |
| transcript.whisperx[340].end |
9943.146 |
| transcript.whisperx[340].text |
目前如何目前的話我剛剛報告過目前的公費疫苗大概庫存還有5萬支只有5萬支而已但是在封建檢驗中的有6萬所以加起來會有11萬那以北北基島應該的這個醫護人員的使用 |
| transcript.whisperx[341].start |
9946.167 |
| transcript.whisperx[341].end |
9958.784 |
| transcript.whisperx[341].text |
議務人員對那未來是否會有缺貨的問題呢?你們有沒有去規劃?所以我們現在正在爭取那國際的這個疫苗廠商那我希望他們要及早供應給我們這個我們正在跟他們洽談 |
| transcript.whisperx[342].start |
9961.468 |
| transcript.whisperx[342].end |
9980.689 |
| transcript.whisperx[342].text |
因為這個我是擔心說會不會排擠一些新生兒接種這個麻疹的疫苗因為你用在醫護人員身上那當然還有一些必要的那這個新生兒有時候需要接種這些麻疹疫苗的時候他等於是會排擠到他們本來可以用的 |
| transcript.whisperx[343].start |
9981.129 |
| transcript.whisperx[343].end |
9983.37 |
| transcript.whisperx[343].text |
若民眾要是有感染麻疹,依目前整個治療方式以支持 |
| transcript.whisperx[344].start |
10009.636 |
| transcript.whisperx[344].end |
10010.096 |
| transcript.whisperx[344].text |
這部分的話是 |
| transcript.whisperx[345].start |
10026.543 |
| transcript.whisperx[345].end |
10052.698 |
| transcript.whisperx[345].text |
因為本期以公會流感疫苗為例去年採購數量為698萬劑但是病毒株不同所以WHO建議每年都要施打一次反觀麻疹疫苗的效率注射是15年後才開始下降 |
| transcript.whisperx[346].start |
10053.618 |
| transcript.whisperx[346].end |
10069.721 |
| transcript.whisperx[346].text |
接種一次它的保護力可以有這個好多好多年不需要每年環顧的去施打那請問衛福部有沒有考量要以專案的方式來處理全民啊補接種這些麻疹疫苗有沒有 |
| transcript.whisperx[347].start |
10070.982 |
| transcript.whisperx[347].end |
10093.05 |
| transcript.whisperx[347].text |
目前的話全民去補接種的話是比較不切實際的因為這還是有疫情的高低起伏的一個問題但是現在的小孩子他的常規疫苗的施打裡面其實麻疹疫苗這個是算在裡面的我希望衛福部在這方面要及早的去因應去規劃好不好好謝謝 |
| transcript.whisperx[348].start |
10094.854 |
| transcript.whisperx[348].end |
10106.777 |
| transcript.whisperx[348].text |
好 謝謝林德福委員的質詢那等一下委員會等林淑芬委員質詢完畢之後我們處理臨時提案麻煩通知各位委員接下來我們請王紅薇委員進行質詢好 謝謝主席我請薛部長好 請部長 |
| transcript.whisperx[349].start |
10124.613 |
| transcript.whisperx[349].end |
10129.294 |
| transcript.whisperx[349].text |
今天在經濟委員會有關電價上漲的專案報告大家都非常非常關心電價上漲會引發通膨、物價上漲 |
| transcript.whisperx[350].start |
10148.678 |
| transcript.whisperx[350].end |
10165.943 |
| transcript.whisperx[350].text |
那我想請教部長你知不知道在我們各類消費物價上漲大家都知道食物類是上漲最多的食物類以外排名第二的類別您知道嗎這我倒是不清楚你不知道 |
| transcript.whisperx[351].start |
10167.671 |
| transcript.whisperx[351].end |
10179.101 |
| transcript.whisperx[351].text |
所以我說現在整個的行政院對於未來可能物價上漲尤其電價帶動的通膨的壓力跟危機現在是麻木不仁的狀態好我給你看一個圖片 |
| transcript.whisperx[352].start |
10182.616 |
| transcript.whisperx[352].end |
10208.05 |
| transcript.whisperx[352].text |
這個圖片不是我做的是我們國發會這兩天他也來這個立法院報告可以看到一月份CPI各類指數年增率食物類上漲最多排名第二的就是醫藥保健類了所以就是說在民眾整個的對於物價上漲的壓力裡面醫藥保健類是其中非常重要的一環可是啊部長 |
| transcript.whisperx[353].start |
10209.051 |
| transcript.whisperx[353].end |
10230.752 |
| transcript.whisperx[353].text |
你們卻非常天才地選在這個時候要取消掛號費的上限我真的要請問你們到底要逼死誰啊怎麼會在這個時候這個節骨眼去取消掛號費上限然後說沒有關係啊你們各縣市啊自己去決定啊 |
| transcript.whisperx[354].start |
10232.613 |
| transcript.whisperx[354].end |
10255.191 |
| transcript.whisperx[354].text |
部長,請問這個決策你有跟院長報告過嗎?這是我們本來做的所以不用跟部長報告那我們物價督導匯報的主持人應該是副院長因為這個取消上限也都不用跟副院長報告並不一定就是會漲價這要把它認出來什麼叫不會漲價?現在都已經在漲價了你到底在說什麼?來我們看 |
| transcript.whisperx[355].start |
10256.732 |
| transcript.whisperx[355].end |
10258.054 |
| transcript.whisperx[355].text |
現在不都在漲價嗎?為什麼這些醫師一直不停的遊說呢?說我們成本升高了,不可以再管我們的掛號費了 |
| transcript.whisperx[356].start |
10269.795 |
| transcript.whisperx[356].end |
10293.375 |
| transcript.whisperx[356].text |
你看現在包含民間監督、健保聯盟說未來可能連掛澳費都繳不出來沒有生命的權利然後蘇伊鳳醫師說快倒閉的醫生診所不可能漲價自救沒人選的賠錢科也不可能因此熱門只是打假球然後很多民眾說你主動去吃飯去政府化嗎這邊還沒有什麼消極會消極會也說他 |
| transcript.whisperx[357].start |
10295.917 |
| transcript.whisperx[357].end |
10318.277 |
| transcript.whisperx[357].text |
一般來講當醫院或診所你的行政成本升高可以容許你可以提高但是你現在完全取消上限是什麼意思我們現在有一些私人的醫院這個掛號費是上千兩千多塊所以老實講我為什麼今天一定要來我是覺得我們今天政府是怎麼回事啊 |
| transcript.whisperx[358].start |
10320.8 |
| transcript.whisperx[358].end |
10331.895 |
| transcript.whisperx[358].text |
經濟部要漲電價然後這個國發會已經告訴你了我們現在呢今年的這個CPI一定會超過2%2%是全世界認為一個物價通膨的一個指數超過就是物價通膨了 |
| transcript.whisperx[359].start |
10338.264 |
| transcript.whisperx[359].end |
10356.174 |
| transcript.whisperx[359].text |
1.8再加上物價上漲然後你現在醫藥保健類已經是排名第二了這個時候你給我在那邊說漲就漲部長部長我要求我要求你收回成命啊你為一些廣大的這些消費者好好想一想好不好 |
| transcript.whisperx[360].start |
10357.284 |
| transcript.whisperx[360].end |
10383.93 |
| transcript.whisperx[360].text |
他們面臨有一些他們是長期在那邊看病的你以為他們可以轉來轉去啊?我們沒有政府了嗎?我們是完全資本主義了嗎?我們對於物價上漲一點感覺都沒有嗎?我們這個政府麻木不仁嗎?認為這個物價上漲沒有關係嗎?然後你們自己衛福部自己做決定我今天會覺得奇怪,院長現在你們是整個整個的看守內閣然後是怎麼樣?想去 |
| transcript.whisperx[361].start |
10384.79 |
| transcript.whisperx[361].end |
10405.239 |
| transcript.whisperx[361].text |
想去數饅頭的數饅頭想要去求官的求官怎麼會對一個醫藥保健類上長如此無感你無感民眾很有感啊民眾很痛苦所以部長我在這邊正式要求你們要收回成名你可以去研究怎麼樣比較合理而不是說我通通不管了我殺手不管了我要政府幹什麼啊 |
| transcript.whisperx[362].start |
10411.321 |
| transcript.whisperx[362].end |
10414.703 |
| transcript.whisperx[362].text |
不能這樣講那你為什麼要取消三線有這樣子取消三線嗎你除了跟診所醫院去討論你有跟消費者討論過嗎你跟哪一個民間團體討論過 |
| transcript.whisperx[363].start |
10427.231 |
| transcript.whisperx[363].end |
10431.857 |
| transcript.whisperx[363].text |
有跟看病的病人討論過嗎?你是醫生診所的醫院的衛福部嗎?怎麼會到這種地步?所以我這兩天看到這個覺得太莫名其妙了所以請你去跟陳介仁院長報告 |
| transcript.whisperx[364].start |
10445.672 |
| transcript.whisperx[364].end |
10474.548 |
| transcript.whisperx[364].text |
你們把國發會找來你們把鄭文燦找來你們把所有跟物價相關經濟部找來說如果這個會造成物價更加上漲的話我們是不是應該改變我們是不是應該收回成命怎麼會政府這麼麻木到時候一定大亂哪有這個樣子我們不要政府啊政府該做的事情就應該要做我們會監測啦這一個瓜匯的情形我跟你講你不做你可能覺得現在沒有選舉你選選你敢做看 |
| transcript.whisperx[365].start |
10475.35 |
| transcript.whisperx[365].end |
10476.271 |
| transcript.whisperx[365].text |
謝謝主席,有請衛福部部長 |
| transcript.whisperx[366].start |
10504.929 |
| transcript.whisperx[366].end |
10527.97 |
| transcript.whisperx[366].text |
好 部長請 水帶著委員好部長你好 我想我本身也是接獲到選情許多的電話一直在跟我們抗議這件事情衛福部你取消掛號費上限這件事情對我們來說基層影響非常深那剛剛聽到部長你一直咳嗽 最近有去看醫生嗎還是看診所沒有 我自己處理 |
| transcript.whisperx[367].start |
10529.051 |
| transcript.whisperx[367].end |
10556.338 |
| transcript.whisperx[367].text |
自己就處理了我想那我要跟你科普一下基本上台中我們的診所掛號費大概150甚至有的會部分減免50那台北就所調查大概250左右那我想就這樣子的掛號費來說我想民間都非常非常的希望衛福部應該重新思考審視廢除這樣子的規定我想政策政府的政策不應該是有錢人才有資格生病雖然這不是本席 |
| transcript.whisperx[368].start |
10556.718 |
| transcript.whisperx[368].end |
10577.873 |
| transcript.whisperx[368].text |
今天總要質詢的一個內容範圍但是我要表達我的抗議那另外呢我想跟本席有一個重要議題想跟你探討一下部長第一梯事辦超過10年遇到缺藥就說要檢討第一梯請問過去10年是否跟藥界討論第一梯的一個檢討事項若有跟誰討論能不能跟現場每位委員來說 |
| transcript.whisperx[369].start |
10580.16 |
| transcript.whisperx[369].end |
10601.149 |
| transcript.whisperx[369].text |
這都每年都有跟這一些藥界在做討論那至於對象是誰我是不是請我們署長來回答好是委員好跟委員報告那麼我們從去年開始就在討論這個第一梯的修正那跟這個九大工協會九大工協會包含進口商的還有在台學民要的大概都有在討論 |
| transcript.whisperx[370].start |
10601.789 |
| transcript.whisperx[370].end |
10628.562 |
| transcript.whisperx[370].text |
那會後是不是可以提供會議紀錄呢?可以可以那我還是要跟您分享我所了解到的一些相關資訊跟你分享那我有幾個時間走想跟你分享106年3月劉建國委員受藥界八大工協會請理事長請託邀集健保署召開協調會我想原本答應但最後會後健保署是反悔那建國委員只好請陳時中部長自己向藥界八大工協會理事長來解釋 |
| transcript.whisperx[371].start |
10631.123 |
| transcript.whisperx[371].end |
10645.591 |
| transcript.whisperx[371].text |
106年4月10日陳時中部長特別宴請八大工協會在北海漁村參宴我想當時參宴就有跟陳時中部長就有說明同意藥界要求近期召開修正的第一批會議 |
| transcript.whisperx[372].start |
10646.631 |
| transcript.whisperx[372].end |
10668.538 |
| transcript.whisperx[372].text |
那108年3月我們也看到有這樣的新聞稿建保署發佈建保署依法調整藥價願積極與藥界檢討第一梯的計算公式我想112年2月27日我們也看到缺藥潮的一直在延燒衛福部又提出短中長期的因應策略在中期的部分食藥署跟健保署也都說要第一梯的檢討 |
| transcript.whisperx[373].start |
10669.778 |
| transcript.whisperx[373].end |
10693.104 |
| transcript.whisperx[373].text |
我想這樣子一連串一直都說要檢討檢討到113年2月27日中國時報的報導健保砍藥價半年後恐缺藥草我想本席就自己本身有去請教過幾位藥界的大佬他們一致的都跟我說DET的事辦至今超過10年從來都沒有正式的跟開會跟藥界討論也沒有調整過我想部長我想請 |
| transcript.whisperx[374].start |
10697.465 |
| transcript.whisperx[374].end |
10710.935 |
| transcript.whisperx[374].text |
聽清楚他們所說的是他們認為從來都沒有跟藥界討論過因此本席不僅要問106年陳時中部長近期所召開的修正研討第一題的會議何時會開會108年積極討論計算公式何時會開會112年食藥署健保署檢討的第一題制度什麼時候會開會 |
| transcript.whisperx[375].start |
10720.121 |
| transcript.whisperx[375].end |
10738.686 |
| transcript.whisperx[375].text |
顯然我個人認為在我所探討的這些藥界大佬他們沒有覺得有一個固定的確定時間僅僅只是官方的一個美化我想這個部分本席希望主席能夠才是請衛福部確定究竟是一個月兩個月三個月還是半年一年還是四年兩年 |
| transcript.whisperx[376].start |
10740.926 |
| transcript.whisperx[376].end |
10765.733 |
| transcript.whisperx[376].text |
來檢討召開這個第一梯的一個會議是不是能夠有一個確切的一個時間能夠建議邀請醫藥界的消費者代表還有相關的團體就召開第一梯的檢討會議創造三贏的第一梯會議讓藥價回到正常的醫療經濟學讓民眾可以用到高品質的藥物最後我想為免除民眾的恐慌請衛夫允諾 |
| transcript.whisperx[377].start |
10767.073 |
| transcript.whisperx[377].end |
10767.553 |
| transcript.whisperx[377].text |
委員我可以回答嗎? |
| transcript.whisperx[378].start |
10796.216 |
| transcript.whisperx[378].end |
10819.441 |
| transcript.whisperx[378].text |
我稍微說明一下因為剛剛有講到那其實去年有關於第一批的會議已經開了5、6次那最近一次會在1月13日3月13日召開啦所以說有關於會議紀錄我們都可以來做提供至於說開會的時候立委是不是可以參加我想這我們再研議看看 |
| transcript.whisperx[379].start |
10820.936 |
| transcript.whisperx[379].end |
10823.558 |
| transcript.whisperx[379].text |
我可不可以邀請部長跟時署長好請部長跟時署長 |
| transcript.whisperx[380].start |
10852.374 |
| transcript.whisperx[380].end |
10865.339 |
| transcript.whisperx[380].text |
部長辛苦了我們2月26號上個月開的那個藥價的那個調整會議的結果我們新的藥價是什麼時候生效?4月1號 |
| transcript.whisperx[381].start |
10867.901 |
| transcript.whisperx[381].end |
10893.594 |
| transcript.whisperx[381].text |
當然今天召委特別排這個專案報告其實一定有它的意義在我們從各層面聽到各種不同的聲音包括藥師全聯會的黃金順理事長說預估半年後有可能發生缺藥潮也就是我看到媒體媒體在問你說會不會有缺藥的狀況發生部長你的回應說至今還沒接受到任何的資訊 |
| transcript.whisperx[382].start |
10895.035 |
| transcript.whisperx[382].end |
10911.847 |
| transcript.whisperx[382].text |
今天沒有收到任何資訊不代表你藥價調整之後半年不會有問題我這樣講對不對這應該是說因為我們有這樣子一個通報的機制在那裡所以6個月前就必須必要藥品就是要做缺藥的一個通報所以 |
| transcript.whisperx[383].start |
10912.688 |
| transcript.whisperx[383].end |
10936.74 |
| transcript.whisperx[383].text |
我們可以說那些必要的藥品有400多個部長今天專委排這個專案報告也就代表著你過去因為我們每一年都是二月份開藥價調整會議那也差不多如果有調整的話也差不多是類似像4月1號我們為什麼會排這樣的專案會議也就是說過去我們衛福部這個後面缺藥的處理的機制 |
| transcript.whisperx[384].start |
10938.301 |
| transcript.whisperx[384].end |
10959.91 |
| transcript.whisperx[384].text |
顯然是有問題的我為什麼會這樣子說監察院在去年11月份的調查報告也有講啊就是說你的食藥署是勸缺主動稽查的管理機制不只是地區醫院社區醫院還有包括我們社區藥局事實上是有嚴重的缺藥問題這件事情以前沒有發生過 |
| transcript.whisperx[385].start |
10963.251 |
| transcript.whisperx[385].end |
10965.552 |
| transcript.whisperx[385].text |
社區藥局剛好沒有這個藥不叫缺藥社區藥局就沒有買這個我能夠逼他買嗎? |
| transcript.whisperx[386].start |
10982.761 |
| transcript.whisperx[386].end |
10988.163 |
| transcript.whisperx[386].text |
這個部長你不應該這樣跟我講那我覺得 因為跟地區醫院跟社區醫院溝通部長是你的責任喔施出處方簽之後民眾拿個處方簽到藥局去做調查部長那我就要說你大數據的管理要做得更好啊你應該跟教學醫院、社區醫院、地區醫院所有社區藥局你應該有一個雲端的管理部長 |
| transcript.whisperx[387].start |
11008.21 |
| transcript.whisperx[387].end |
11009.351 |
| transcript.whisperx[387].text |
部長今天身體微漾,你先聽一下委員講 |
| transcript.whisperx[388].start |
11025.222 |
| transcript.whisperx[388].end |
11041.936 |
| transcript.whisperx[388].text |
我覺得在管理系統顯然出現問題不管是社區醫院、社區藥局顯然大家都有可以調整的一個SOP的空間民眾買不到藥是會憤怒的這個憤怒端後面是你要去做承擔我這樣講沒錯吧 |
| transcript.whisperx[389].start |
11043.597 |
| transcript.whisperx[389].end |
11063.248 |
| transcript.whisperx[389].text |
所以我覺得應該有一套更好的管理系統所以去年10月份監察院也提出報告就是說你應該在某一塊某幾塊你要去盡速的去做調整當然去年我也關注到你說有一定的比例要留給社區醫院因為他們採購會有問題那一定的比例包括你在2月24號在媒體採訪的時候你也提出來說我們要統一採購 |
| transcript.whisperx[390].start |
11067.33 |
| transcript.whisperx[390].end |
11092.768 |
| transcript.whisperx[390].text |
那後來又說統一採購可能不是最好的方法這是你去年跟今年講的都不一樣的版本那現在解決的具體做法你可不可以告訴我是什麼本來統一採購就不是一個辦法本來要統一採購去年是你說的啊你去年的你今年的部長打去年的部長都是你說的我沒有要責罵你你可不可以告訴我你具體的解決方案是什麼 |
| transcript.whisperx[391].start |
11094.957 |
| transcript.whisperx[391].end |
11100.442 |
| transcript.whisperx[391].text |
這個所謂的缺藥的話是主要有兩種情形一個是真正缺藥一個是調度的問題 |
| transcript.whisperx[392].start |
11101.314 |
| transcript.whisperx[392].end |
11125.794 |
| transcript.whisperx[392].text |
那在調度的問題我同意有調度的問題所以調度的問題你要怎麼處理調度的問題我們現在是對於基層的這些社區藥局還有這個診所的部分我們藉由去監測中盤商那他的這個藥的進出的情況如果說有這種所謂的通報缺藥過來的話我們就會去檢測這個中盤商部長你後面要書面回答我 |
| transcript.whisperx[393].start |
11128.516 |
| transcript.whisperx[393].end |
11145.617 |
| transcript.whisperx[393].text |
因為我覺得可以用大數據的分析包括近三年疾病跟用藥的趨勢然後未來推估接下來兩年可能熱門用藥的品項你怎麼樣去跟他們互動把大數據管理好那我覺得這是你未來要做的工作我希望可以做得好然後我快速的 |
| transcript.whisperx[394].start |
11146.658 |
| transcript.whisperx[394].end |
11166.154 |
| transcript.whisperx[394].text |
馬整的疫情升溫我們當然我們現在優先因為你現在是控管這些所有可以施打的因為民間想自費買也買不到我尊重你我們現在有123項我們公費接種的對象那MMR的疫苗現在廠商控貨那要優先他優先供貨也會優先供貨給我們機關署 |
| transcript.whisperx[395].start |
11169.036 |
| transcript.whisperx[395].end |
11194.544 |
| transcript.whisperx[395].text |
但是國際藥廠他現在跟我們回答的是說如果要買也排單也要半年後才有貨是典型的有藥但是民間是買不到甚至診所我為什麼這麼說有一些高風險群譬如說他必須常出國或必須跟外國人長期接觸的我們也希望這一類的高風險群有機會我不要說排在公費裡面他們自費但是他們有機會注射到 |
| transcript.whisperx[396].start |
11195.584 |
| transcript.whisperx[396].end |
11199.588 |
| transcript.whisperx[396].text |
這部分的話在智慧疫苗的部分本來就還有一些庫存兩萬多那封面檢驗中的還有兩萬多支那四萬多支如果對這些經常要出國的他是夠啦 |
| transcript.whisperx[397].start |
11214.202 |
| transcript.whisperx[397].end |
11237.302 |
| transcript.whisperx[397].text |
沒關係部長我只是提醒你有這一塊我接受到陳情有這一塊自費那他們也希望有機會他們常出國常接觸外國人去高風險群的國家感染者的國家我希望這一塊他們有機會注射到那這一塊怎麼處理給我一個書面更明確的答覆可能我們會藉由這一些所謂的理由醫院來處理這一塊好的謝謝謝謝部長好謝謝李燕秀委員的資訊 |
| transcript.whisperx[398].start |
11243.342 |
| transcript.whisperx[398].end |
11261.914 |
| transcript.whisperx[398].text |
接下來我們請林淑芬委員進行質詢林委員質詢結束我們處理臨時題案主席各位大家午安了是不是還是請我們薛部長好部長請 |
| transcript.whisperx[399].start |
11266.335 |
| transcript.whisperx[399].end |
11294.468 |
| transcript.whisperx[399].text |
委員好部長其實我還有那個蘇丹紅事件要跟你就教但是因為藥價的問題我跟我們新北市工會也稍微溝通了一下所以有幾個幾個簡單的問題也先再一次的這個反應我必須要說如果幾種藥品缺貨去換藥我覺得對市場或對用藥人來講這個影響這是無法避免的就沒有如果是幾種而已可是如果 |
| transcript.whisperx[400].start |
11295.809 |
| transcript.whisperx[400].end |
11319.297 |
| transcript.whisperx[400].text |
在藥局看到的現象是缺藥而民眾退單的比例高達30%以上那它可能就不是這簡單的幾個問題所以變成換藥草的話那我們的確是要正視這個問題但你們一直講說是缺貨而不是缺藥或者是你們在談說三同等同的狀況就可以治療可是第一線的藥局的確發現 |
| transcript.whisperx[401].start |
11323.14 |
| transcript.whisperx[401].end |
11338.014 |
| transcript.whisperx[401].text |
換藥時,比如說這個血壓藥為例,他們發現患者會反應說用以前的藥大概可以血壓控制維持在110可是你換了藥以後,他總是在怎麼控制都是180所以他只能夠回到大醫院裡面去領原廠藥或是原來的藥,他們的確是觀察到這個現象 |
| transcript.whisperx[402].start |
11344.761 |
| transcript.whisperx[402].end |
11365.274 |
| transcript.whisperx[402].text |
另外一種就是管制性的藥品那因為管制性藥品的用藥人他本身就是很敏感的那你換藥的時候他的確就更敏感有可能是這樣子那特別排斥所以的確我們也有一些藥廠過去做了很多不應該做的事比如說很多年以前我揭發過的 |
| transcript.whisperx[403].start |
11367.475 |
| transcript.whisperx[403].end |
11367.996 |
| transcript.whisperx[403].text |
所以我今天是希望說 |
| transcript.whisperx[404].start |
11392.618 |
| transcript.whisperx[404].end |
11411.032 |
| transcript.whisperx[404].text |
這個部長這個你說三童三童這個東西要宣傳啊然後另外就藥局也一直老是講說因為社區藥局是我們分級醫療然後醫藥分業要專業化那我們也鼓勵嘉醫也鼓勵社區藥局 |
| transcript.whisperx[405].start |
11412.173 |
| transcript.whisperx[405].end |
11426.779 |
| transcript.whisperx[405].text |
可是藥局面臨大很大的這個困難我們也是要想到比如說分配不均有藥的先分配大院他們就一定沒有嘛那再來他們都是跟盤商要的可是盤商因為這個很多種種因素他不供藥了或是最小出貨量你在藥廠裡面某些藥物是1000粒為一瓶的基本包裝他就沒用得多你怎麼所以這個都是可解決的啊 |
| transcript.whisperx[406].start |
11438.604 |
| transcript.whisperx[406].end |
11438.884 |
| transcript.whisperx[406].text |
保定對不對 |
| transcript.whisperx[407].start |
11457.02 |
| transcript.whisperx[407].end |
11471.836 |
| transcript.whisperx[407].text |
我們剛剛有提到的幾個我們都非常的贊同,比方說山桐這一個學名要需要去做promote,讓民眾比較能夠接花很多錢在宣導,但這種東西都沒看到你們的宣導 |
| transcript.whisperx[408].start |
11473.853 |
| transcript.whisperx[408].end |
11499.034 |
| transcript.whisperx[408].text |
這我們會持續而且會加強去做因為這個會關係到國內的一些命脈那第二個部分的話那剛剛委員有提到那這個藥物調度的問題比如說社區藥局他要調度跟盤商那這個部分的話因為新的制度我們剛剛才建立起來對盤商的一個監測那幸好這個國內的大的盤商他們都願意來做配合 |
| transcript.whisperx[409].start |
11499.694 |
| transcript.whisperx[409].end |
11521.689 |
| transcript.whisperx[409].text |
所以這個部分的話我們就可以來監測在社區藥局這邊如果是缺貨的時候我們到底是不是可以來請盤商來做調度那如果說中盤商沒有辦法調度的話那我們就找藥商中盤商不能調度的理由和原因很多啦所以你們也是要去了解合不合理嘛因為這個部分的話其實是他們最常講的一個理由是說現在進貨的藥價到未來賣的時候都賠本 |
| transcript.whisperx[410].start |
11525.231 |
| transcript.whisperx[410].end |
11542.024 |
| transcript.whisperx[410].text |
我的意思是說這是其中一個理由我知道但是那個是在這種藥價調漲的這個時間當然中環社會的大理由就是因為我們的PIX GMP裡面還包含這個冷鏈的系統所以他們冷鏈不合格是不是也應該繼續輔導趕快輔導好這部分我會理解 |
| transcript.whisperx[411].start |
11546.087 |
| transcript.whisperx[411].end |
11559.181 |
| transcript.whisperx[411].text |
那我還是要談蘇丹紅事件蘇丹紅事件很嚴重是因為你說你不能保證在架上的都是安全的沒有漏網之魚我現在看一下第8章這個產品而且這個海順公司的產品 |
| transcript.whisperx[412].start |
11566.26 |
| transcript.whisperx[412].end |
11594.108 |
| transcript.whisperx[412].text |
然後你看他的下一頁香麻辣粉現在大家上Google到MOMO網站現在還在架上3月7號現在還在架上初一十五海順而你們知道嗎衛生局也知道海順署長他為什麼還在架上你們的所謂的檢出辣椒粉含蘇丹紅的專區裡面也沒有這種產品 |
| transcript.whisperx[413].start |
11596.173 |
| transcript.whisperx[413].end |
11619.621 |
| transcript.whisperx[413].text |
這個部分我們會查它的批次到底現在的狀況是什麼海順公司是一個算是進口不要講批次的問題這個部長我就回到我們的第二頁第三頁的故事說給你聽一下批次我們什麼時候100%逐批查驗應該是去年的12月12月之後還有沒有人繼續進含有蘇丹紅產品的 |
| transcript.whisperx[414].start |
11624.022 |
| transcript.whisperx[414].end |
11634.611 |
| transcript.whisperx[414].text |
這個辣椒粉,馬上給你看,這個馬上給你看,部長,這是你們自己說的,我這一份拿錯了,你看它,編進受理時間1月6號,今年的,我們本來是 |
| transcript.whisperx[415].start |
11645.742 |
| transcript.whisperx[415].end |
11650.144 |
| transcript.whisperx[415].text |
我再問你,去年12月11號已經百分之100的在查驗了為什麼這些廠商仍然有恃無恐繼續進口大量含蘇丹紅的辣椒粉?我不在講查到被退,他當然沒有成...我上禮拜就跟你講啊查到沒關係,沒死也沒了結你就叫他退官,退回去中共而已沒有啦,那退就已經是了結了 |
| transcript.whisperx[416].start |
11674.694 |
| transcript.whisperx[416].end |
11676.738 |
| transcript.whisperx[416].text |
後來我還沒再跟你說為什麼這間家館都所有這幾天都跟這個公司他百分之一百逐批查驗了他在1月6號 |
| transcript.whisperx[417].start |
11690.27 |
| transcript.whisperx[417].end |
11698.419 |
| transcript.whisperx[417].text |
仍然在繼續進口,而且進口量有多高呢?據我所知,好像是1月6號的是13696公斤。好,來第二張。但不是1月6號,它被退了!如你們所說,被退了! |
| transcript.whisperx[418].start |
11711.943 |
| transcript.whisperx[418].end |
11729.609 |
| transcript.whisperx[418].text |
1月30查出不額個備退要求他退他1月30之後仍然還繼續進1月28OK沒關係他在你們百分之一百去年12月11就發布百分之一百逐批查驗的時候他仍然進我都中三張了 |
| transcript.whisperx[419].start |
11731.469 |
| transcript.whisperx[419].end |
11736.953 |
| transcript.whisperx[419].text |
因為他的出口商不是Kevin Shipping,是這間啦你們沒有在調查,我都幫你們查好了,其實你們都知道 |
| transcript.whisperx[420].start |
11760.871 |
| transcript.whisperx[420].end |
11771.814 |
| transcript.whisperx[420].text |
她的出口商從中國出來荷蘭的,是龍海銅製你別以為這是中國廠商,這是他們自己因為台灣李彥廷也有登記一家龍海銅製他們自己,剛才那些是中國人,你看中國登記的他1997年就成立了 |
| transcript.whisperx[421].start |
11783.848 |
| transcript.whisperx[421].end |
11808.84 |
| transcript.whisperx[421].text |
他1997年就食品原料、食品加工然後為什麼他在溯源追蹤系統他會登記的是什麼Kevin Shipping因為他的裡面的真正的出口商是龍海同志你退關退回去也是他們自己的公司啦退回去他們中國也是他們自己的公司啦 |
| transcript.whisperx[422].start |
11810.734 |
| transcript.whisperx[422].end |
11820.142 |
| transcript.whisperx[422].text |
所以你看這個葉澤,我們看他有幾家公司啊?沒錯,我剛才說的那個初一十五是哪一家公司?是海順我拜他就說他有四間啊,現在再多一個海順 |
| transcript.whisperx[423].start |
11828.126 |
| transcript.whisperx[423].end |
11845.936 |
| transcript.whisperx[423].text |
事實上他不是啦 你看他多少金湛、釜山、廣源、龍海、節展、加廣、初一、十五、食品有限公司、素食業、淪陷、頂紀、海順、國際我剛才講了這個龍海同紀他台灣也有登記第一次看起來 整間 九間 |
| transcript.whisperx[424].start |
11855.831 |
| transcript.whisperx[424].end |
11871.242 |
| transcript.whisperx[424].text |
已經出包了,你9家有沒有全部都查?食藥署署長,你有沒有全部都查?我想這部分的話,對於個別的這些廠商如果是有輸入到違規的,我們就進行進口沒有啦,保證我不是在說如果的問題啦 |
| transcript.whisperx[425].start |
11874.423 |
| transcript.whisperx[425].end |
11893.262 |
| transcript.whisperx[425].text |
至少經戰加廣都已經爆發食安事件了至少我禮拜一都已經跟你們說過他們的人頭公司很多這個經營者他們至少有很多家的經營者有很多家的公司的時候 |
| transcript.whisperx[426].start |
11894.48 |
| transcript.whisperx[426].end |
11897.483 |
| transcript.whisperx[426].text |
因為它是個別登記的公司所以我們還是必須要掌握那為什麼立委Google就有了 |
| transcript.whisperx[427].start |
11914.318 |
| transcript.whisperx[427].end |
11931.712 |
| transcript.whisperx[427].text |
你整個食藥署專業的人力咧一千多人欸那你只是負責你政策責付出去地方政府也有人力欸那今天在這裡我覺得行政部門有道德風險啊你們食藥署的人有一種道德風險是什麼你知道嗎你們有辦法查好查滿嗎你查好查滿會不會像滾雪球一樣越滾越大 |
| transcript.whisperx[428].start |
11942.063 |
| transcript.whisperx[428].end |
11957.242 |
| transcript.whisperx[428].text |
當你們為了避免越滾越大的時候是不是就不能太認真所以不做不做多做多錯我現在看到的就是這樣子啊我Google就可以知道他有9家公司你知道他還有1家 |
| transcript.whisperx[429].start |
11961.061 |
| transcript.whisperx[429].end |
11972.711 |
| transcript.whisperx[429].text |
那個工廠登記嗎?來看一個工廠登記我...我...這個來鐵皮屋工廠來我會講公司登記喔工廠登記你們有去查過廠嗎?這個地方有去查過廠嗎? |
| transcript.whisperx[430].start |
11975.543 |
| transcript.whisperx[430].end |
11994.432 |
| transcript.whisperx[430].text |
因為所有要餐蘇丹紅都是辣椒要磨成粉以外是要加工餐入的加工過程才餐入的他現在有一種是邊境就餐入那還有加工廠這個我跟他簡單問你這間工廠登記證他名字他是哪一家工廠工廠登記證嗎名字叫什麼FDA知道嗎你不知道他有高經公司你也不知道 |
| transcript.whisperx[431].start |
12005.876 |
| transcript.whisperx[431].end |
12023.545 |
| transcript.whisperx[431].text |
從委員的資料裡面看的話,一看就是用那個地址去查的吧,就同指的...沒有啊,我們的公司登記毛那個吳克民三年也可以的啊我沒有辦法用這樣去查啦你為...我不用去查耶,我只是Google就有了耶 |
| transcript.whisperx[432].start |
12025.182 |
| transcript.whisperx[432].end |
12043.508 |
| transcript.whisperx[432].text |
Google台灣公司網就有阿你Google一個加廣金站Google一個加廣他就告訴你加廣還有其他的這個分公司有沒有你Google這個加廣兩個字就全部找到連他的工廠登記都有我這就是工廠登記來的 |
| transcript.whisperx[433].start |
12045.068 |
| transcript.whisperx[433].end |
12053.496 |
| transcript.whisperx[433].text |
不過因為行政機關在做事情的時候,它還是一個一個的公式要去做處理我現在說行政機關入圍谷歌就有了,你們沒辦法做,那就是你們的道德風險嘛你如果怕差太多,滾雪球啦 |
| transcript.whisperx[434].start |
12060.463 |
| transcript.whisperx[434].end |
12076.82 |
| transcript.whisperx[434].text |
這個會報的一定會報啦尤其是這種那我現在再告訴你不是會報的就會報都沒有報啊林淑芬今天沒有講這9家公司你會去查9家嗎沒有我今天講初一15素食食品公司3月7號現在MOMO網站上還有 |
| transcript.whisperx[435].start |
12077.921 |
| transcript.whisperx[435].end |
12095.846 |
| transcript.whisperx[435].text |
現在大家Google進去都還有3月他還有特價3月1號到3月7號想最低價格八三折好我現在要再講喔我我覺得你們這個東西很離譜以外我們整個事件喔我覺得查到最後非常可惡的是因為 |
| transcript.whisperx[436].start |
12097.026 |
| transcript.whisperx[436].end |
12116.689 |
| transcript.whisperx[436].text |
如果我們整個食品安全的管理是仰賴業者自律,然後當初我們建置一個食品溯源系統,追蹤追溯系統,我們都這麼講,我們政府不斷跟大家講,你要來登錄,然後你要自律,如果你被我查到了,我要重罰。 |
| transcript.whisperx[437].start |
12118.53 |
| transcript.whisperx[437].end |
12139.306 |
| transcript.whisperx[437].text |
今天查到了你也說重罰但是我現在問你業者查到要重罰但是如果政府被人民查到政府被立委查到你們就沒有在管要不要重罰因為現在上游的廠商登錄的是虛偽下游的廠商把青菜蝦蝦蝦沒多轉 |
| transcript.whisperx[438].start |
12141.485 |
| transcript.whisperx[438].end |
12164.095 |
| transcript.whisperx[438].text |
你這樣,你根本就都沒在查,所以讓那個溯源追蹤追溯制度,淪於假的形式,讓我們食安五環破功,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講,不能這樣講 |
| transcript.whisperx[439].start |
12174.239 |
| transcript.whisperx[439].end |
12196.825 |
| transcript.whisperx[439].text |
他在測試你政府的底線啊他在測試你政府可以容許會不會查嘛然後你的下游高雄市政府說他提供不出完整的下游名單他也沒有嘛我現在再問你在幾天拜議的時候食藥署署長說他們都有登錄他們是登錄第23類 |
| transcript.whisperx[440].start |
12198.525 |
| transcript.whisperx[440].end |
12212.654 |
| transcript.whisperx[440].text |
署長我現在跟問你啦我們是7萬家的公司需要強制登錄的只有一萬家這一萬家裡面是在25個品項裡面他到底是基於哪一個品項所以必須要強登 |
| transcript.whisperx[441].start |
12215.932 |
| transcript.whisperx[441].end |
12228.379 |
| transcript.whisperx[441].text |
因為25項大多數都是鎖定在3000萬以上的食品公司、食品工廠才必須啊我現在這樣問你,他是多一項,你告訴我他必須強登的規定是第幾個品項23萬 |
| transcript.whisperx[442].start |
12232.284 |
| transcript.whisperx[442].end |
12237.987 |
| transcript.whisperx[442].text |
我現在要說的是你們的科長告訴我們登載不實他要登錄一個登了原因是他是第24類不是23類 |
| transcript.whisperx[443].start |
12260.979 |
| transcript.whisperx[443].end |
12279.235 |
| transcript.whisperx[443].text |
到底23還是24 您課長說的跟您書長說的不一樣再來 再來說以這種業者自律嚴重的被查到我要重罰那政府現在發現政府就不在管啊這樣人民發現你嚴重的疏失不在管要不要重罰事務官、公務員要懲處啊 |
| transcript.whisperx[444].start |
12284.093 |
| transcript.whisperx[444].end |
12284.854 |
| transcript.whisperx[444].text |
所以由此可知啊,瀆職的很嚴重 |
| transcript.whisperx[445].start |
12309.999 |
| transcript.whisperx[445].end |
12320.03 |
| transcript.whisperx[445].text |
這個指控的話需要有一些證據的沒有證據嗎?他登錄了凱文需品作為上游公司這不是證據嗎?我現在在說的是你們沒有在查 |
| transcript.whisperx[446].start |
12324.935 |
| transcript.whisperx[446].end |
12330.279 |
| transcript.whisperx[446].text |
你們有沒有一個定期檢視?112年逐批拖延到100%了,你可以不用查嗎?如果他過去的紀錄在邊境都查到,還有蘇丹紅而且屢次的被發現,你不用去食品雲查嗎? |
| transcript.whisperx[447].start |
12350.069 |
| transcript.whisperx[447].end |
12366.46 |
| transcript.whisperx[447].text |
你不用去食品雲茶嗎?如果他是累犯,如果是鋁鋁,如果他是這樣子,我現在講說這一群人喔這一群人是不是故意的、組織性的在做啊?你看,他根本就是...我只要跟你講,他在台灣也有工廠登記也有公司高競,然後在中國也有,你如果他輸出 |
| transcript.whisperx[448].start |
12377.667 |
| transcript.whisperx[448].end |
12404.028 |
| transcript.whisperx[448].text |
中國輸出廠商寫龍海同濟,他如果去抓到禁止輸入,這樣他這間就破錢了,就沒好啊,但是他都把你用Kevin Shipping所以你還敢說我禁止了21家中國廠商,你禁止的是Kevin Shipping你禁止的不是吳彥廷、吳克敏他們的龍海同濟,叫Eastrong |
| transcript.whisperx[449].start |
12406.704 |
| transcript.whisperx[449].end |
12431.677 |
| transcript.whisperx[449].text |
而且你們還有一個我搞不懂的你們的新聞稿專區裡面這21家被中國中國被禁的廠商名稱21家在你們的新聞稿裡面沒有放上來沒有放21家的名稱而是隱藏在一個大家都看不到的地方苦心的一直問的去查才查得到這21家所以我很懷疑的 |
| transcript.whisperx[450].start |
12432.777 |
| transcript.whisperx[450].end |
12455.3 |
| transcript.whisperx[450].text |
您為什麼都不公布在您的新聞稿專區新聞稿專區沒有放上去過這是不是有貓膩我們就不得而知了好謝謝林委員的質詢那請這個衛福部要積極的去查緝剛剛委員提供這麼多的資料積極去查接下來我們就處理臨時提案那現在臨時提案總共有6案請一併宣讀 |
| transcript.whisperx[451].start |
12456.859 |
| transcript.whisperx[451].end |
12473.673 |
| transcript.whisperx[451].text |
臨時提案第一案衛生福利部為因應日益嚴重之藥品短缺問題於112年成立跨部門藥品供應通報處理中心為目前作法人偏向個案危機處理模式使藥署對於嚴重缺藥時的藥品分配或調度機制為制度化 |
| transcript.whisperx[452].start |
12474.573 |
| transcript.whisperx[452].end |
12500.591 |
| transcript.whisperx[452].text |
針對健保藥價調整等重大政策可能影響藥品供應狀況亦缺乏風險管理及資訊透明原要求衛福部食藥署應就各項藥品缺藥風險及對疾病治療影響程度建立完整缺藥預防和藥品調度機制並以數據化和透明化方式防止缺藥引發民眾恐慌提案人委員王育敏、陳金輝、蘇清泉 |
| transcript.whisperx[453].start |
12504.974 |
| transcript.whisperx[453].end |
12521.606 |
| transcript.whisperx[453].text |
第二案經查社區藥局目前佔整體藥品市場比例約一成市佔率偏低導致藥品供應與社區藥局難以簽訂藥品穩定供應契約一旦發生缺藥狀況或是健保藥價調整時社區藥局藥品缺 |
| transcript.whisperx[454].start |
12524.568 |
| transcript.whisperx[454].end |
12525.209 |
| transcript.whisperx[454].text |
第三案有鑑於臺灣當前的 |
| transcript.whisperx[455].start |
12554.752 |
| transcript.whisperx[455].end |
12582.064 |
| transcript.whisperx[455].text |
藥品費用分配比率目標制第一梯實施過程中第一大類藥品新藥專利期內藥品費用成長幅度較高但藥價削減的重點卻落在第三大類藥品上這種不平衡的做法不僅對學民藥市場造成不利影響也可能阻礙整體藥品市場的健康發展藥品第一梯辦法已經實施10年這個制度要重新檢討或者是廢止另提辦法 |
| transcript.whisperx[456].start |
12582.904 |
| transcript.whisperx[456].end |
12595.357 |
| transcript.whisperx[456].text |
原要求衛福部於一個月內研擬改善方案．並向立法院社會福利及衛生環境委員會提出解決辦法提案人委員蘇清泉聯署人委員廖偉祥、王育敏第4案 |
| transcript.whisperx[457].start |
12596.516 |
| transcript.whisperx[457].end |
12615.688 |
| transcript.whisperx[457].text |
要徹底解決缺藥困境需同時以滿足醫師最佳處方選擇及照顧病患用藥權益的為基礎另外避免全球性藥品供應不穩定或兩岸關係影響導致救命藥品無法順利進口強化臨床需求必要性藥品在地生產能力 |
| transcript.whisperx[458].start |
12616.228 |
| transcript.whisperx[458].end |
12633.341 |
| transcript.whisperx[458].text |
確保所有疾病患者有藥可用．以維護民眾生命權．原要求衛福部在同時符合以下三項要件．各該品項之藥價不受藥價調整影響．或排除在每年藥價調整之外．一、臨床上有需求醫學會認證．二、鼓勵在地製造 |
| transcript.whisperx[459].start |
12636.483 |
| transcript.whisperx[459].end |
12655.089 |
| transcript.whisperx[459].text |
領有食藥署合發臺灣製造藥品許可證、三、三章以下的稀缺藥證提案人委員廖偉祥、聯署人委員陳金輝、王育敏、邱振軍、蘇清泉、盧憲一。第五案長期以來健保費率調漲相當困難在先節流後開源的要求下 |
| transcript.whisperx[460].start |
12656.977 |
| transcript.whisperx[460].end |
12681.878 |
| transcript.whisperx[460].text |
忽視醫療人員的服務價值另外在總額制度控管之下醫治機構應得的給付長期被打9折甚至8折長期管控與節流也讓醫療能力與資源只能勉強維持堪用的狀態建請政府撥補裁員以合理之意補充我國醫療品質一、西醫、牙醫及中醫基層浮動點值保障一點0.95元 |
| transcript.whisperx[461].start |
12684.601 |
| transcript.whisperx[461].end |
12700.934 |
| transcript.whisperx[461].text |
2.醫院浮動點值保障1.0.9元提案人委員黃秀芳、林俊憲連署人委員林月琴、王振旭第6案113年食品藥物管理署查獲大量進口中國製辣椒粉含致癌物蘇丹色素3號 |
| transcript.whisperx[462].start |
12701.795 |
| transcript.whisperx[462].end |
12729.022 |
| transcript.whisperx[462].text |
目前中國製辣椒粉已進入市場並大規模利用於加工食品危害國人食安甚具食藥署也無法保證市場完全沒有問題經查我國國中小學約165萬名學生食用營養午餐若含蘇丹紅辣椒粉用於營養午餐恐危害多數孩童健康原要求衛福部於市場內蘇丹紅辣椒粉清查完畢前應限制全國學校營養午餐食材添加辣椒粉 |
| transcript.whisperx[463].start |
12730.114 |
| transcript.whisperx[463].end |
12737.199 |
| transcript.whisperx[463].text |
提案人委員王育敏、蘇清泉、屠權吉宣讀完畢好 謝謝來請問第一案行政單位有沒有意見主席有關第一案的部分有文字的修正那修正的是在第二行還有第三行有這個部分我們是建議要刪掉然後更換文字由中盤藥商這裡到第三行的 |
| transcript.whisperx[464].start |
12758.769 |
| transcript.whisperx[464].end |
12760.57 |
| transcript.whisperx[464].text |
並以建立藥品短缺通報及評估處理程序 |
| transcript.whisperx[465].start |
12770.97 |
| transcript.whisperx[465].end |
12800.559 |
| transcript.whisperx[465].text |
那到第二段的部分有幾個很簡單的一些字要希望可以劃掉的就是在我們第一句話之後竇點那裡可以劃掉對疾病治療影響程度這句話希望可以劃掉然後在後面的部分並以數據化的這個這個我們要劃掉是並以透明化方式防止缺藥引發民眾恐慌 |
| transcript.whisperx[466].start |
12801.823 |
| transcript.whisperx[466].end |
12824.46 |
| transcript.whisperx[466].text |
好 那就按照修正後通過來 謝謝好 那第二案也是有文字的修正那在第二段第二段這裡第二段倒數第二行就是我們是倒數第三行那裡寫研擬社區藥局然後開始是與物流業合作方式這裡我們劃掉還有下一句話 |
| transcript.whisperx[467].start |
12824.94 |
| transcript.whisperx[467].end |
12825.22 |
| transcript.whisperx[467].text |
好,好,謝謝 |
| transcript.whisperx[468].start |
12844.54 |
| transcript.whisperx[468].end |
12861.888 |
| transcript.whisperx[468].text |
主席跟各位報告有關第三案檢討第一梯的提案我們會積極來進行不過因為還需要有一些法規預告等等是不是可以從一個月延長成三個月內研擬改善的方案提出解決辦法 |
| transcript.whisperx[469].start |
12864.4 |
| transcript.whisperx[469].end |
12884.231 |
| transcript.whisperx[469].text |
那另外那個剛剛有委員提到說你們開相關會議的時候希望委員可以參與這個部分可以嗎?可以可以沒問題那就拜託你們開相關檢討會議的時候同時通知立法院關心的委員通知委員辦公室關心的委員他就可以去列席好謝謝好來第四案 |
| transcript.whisperx[470].start |
12893.074 |
| transcript.whisperx[470].end |
12908.249 |
| transcript.whisperx[470].text |
有關第4案提到對於一些稀缺藥證的藥品在調藥價的時候能夠予以排除這個精神上我們都支持不過就是說我們略做一些文字的調整 |
| transcript.whisperx[471].start |
12910.813 |
| transcript.whisperx[471].end |
12934.504 |
| transcript.whisperx[471].text |
這個原要求衛福部於本次修法時必須參裁同時符合以下三項要件各該品項之藥價不受藥價調整影響或排除在每年藥價調整之外一、臨床上有需求醫醫學會認證或我們後面加一個另外一個同時可以考量的 |
| transcript.whisperx[472].start |
12934.744 |
| transcript.whisperx[472].end |
12947.575 |
| transcript.whisperx[472].text |
或依要釋法第27之2條必要藥品清單那以下都是照列好請問廖委員可以嗎好來那就按修正通過來第五案 |
| transcript.whisperx[473].start |
12951.02 |
| transcript.whisperx[473].end |
12974.777 |
| transcript.whisperx[473].text |
第5案是林俊憲黃秀芳委員提案有關於要政府撥補裁員那因為這個還有很多的層級要討論所以建議加兩個字就建請政府研議撥補裁員黃秀芳委員可以嗎?可以齁,好來修正通過第6案 |
| transcript.whisperx[474].start |
12977.257 |
| transcript.whisperx[474].end |
12990.037 |
| transcript.whisperx[474].text |
報告委員第6案有修正文字那在第一行的部分最後那邊寫含致癌物這裡我們建請可以修改為含具有潛在致癌性 |
| transcript.whisperx[475].start |
12992.854 |
| transcript.whisperx[475].end |
13013.331 |
| transcript.whisperx[475].text |
第二段的第二行是原要求衛福部我們希望可以增加原要求衛福部協調教育部於市場內蘇丹紅辣椒粉為這個地方改成為為清茶上位那個為為清茶完畢前 |
| transcript.whisperx[476].start |
13015.008 |
| transcript.whisperx[476].end |
13022.711 |
| transcript.whisperx[476].text |
應通知團散業者暫停使用加辣椒粉應通知營養午餐業者暫停使用加辣椒粉 |
| transcript.whisperx[477].start |
13045.154 |
| transcript.whisperx[477].end |
13048.376 |
| transcript.whisperx[477].text |
因通知全國營養午餐業者。 |
| transcript.whisperx[478].start |
13069.258 |
| transcript.whisperx[478].end |
13070.599 |
| transcript.whisperx[478].text |
黃健豪委員 |
| transcript.whisperx[479].start |
13104.229 |
| transcript.whisperx[479].end |
13107.945 |
| transcript.whisperx[479].text |
好,謝謝主席,那我們是請薛部長好,有請部長 |
| transcript.whisperx[480].start |
13114.81 |
| transcript.whisperx[480].end |
13140.949 |
| transcript.whisperx[480].text |
委員好部長好部長今天我想當然大家主要討論到這個健保藥價的部分那其實我想這個健保涉及到我們這個醫療機構相關這個營收一般來講就所知一般的醫療機構不管大的小的它的這個收入來源一方面是這個健保的這個給付另外一個很重要當然就是所謂的門診的這個掛號費的收入所以說其實我剛剛看到這個報告的第一頁就提到說 |
| transcript.whisperx[481].start |
13142.25 |
| transcript.whisperx[481].end |
13168.461 |
| transcript.whisperx[481].text |
主要是希望說能夠來這個反映藥品支付的價格調降來控制藥費在合理範圍裡面來尊潔健保的支出那包含剛剛的委員的臨時提案裡面也提到這個健保的支出當然健保可能現在入不敷出所以是不是有可能考慮用這個公務預算來撥補因為像其他的這個其他像比如說勞保或其他的這些保險的這個公務的保險如果他在保險的經費不夠的時候都會使用這個公務預算來撥補來擬貧這個可能虧損的部分 |
| transcript.whisperx[482].start |
13171.143 |
| transcript.whisperx[482].end |
13172.046 |
| transcript.whisperx[482].text |
那在健保這部分 |
| transcript.whisperx[483].start |
13173.442 |
| transcript.whisperx[483].end |
13199.799 |
| transcript.whisperx[483].text |
當然健保要不要勃勃這部分我們未來再討論那我今天想要講的是這個提到這個那個什麼掛號費提升的問題解開解封的問題其實我想跟這個部長來討論就是說部長說這個是市場機制但是我想這個醫療行為很難用這個市場機制來認定如果今天醫療行為要用市場機制來認定的話那我想醫院他的管理單位就不是衛福部可以把它移去經濟部了所以我想這個部長 |
| transcript.whisperx[484].start |
13201.44 |
| transcript.whisperx[484].end |
13226.89 |
| transcript.whisperx[484].text |
我還是希望說這個在調整因為你今天受訪的時候也是很肯定的說這件事情一定會執行但在執行之前我想問部長有沒有可能至少你要召開一個公聽會來瞭解除了醫界的意見之外我想使用者、各民間團體、民眾的意見也很重要就是我願意能夠花多少錢來看一般的診所那願意花多少錢去掛特別的門診的這個健保這個購入費我想這是不一樣的這個結構 |
| transcript.whisperx[485].start |
13228.93 |
| transcript.whisperx[485].end |
13247.237 |
| transcript.whisperx[485].text |
一刀切的說啊,全面性的都可以去調整,都可以去調漲,我想對這個名稱衝擊會非常大,尤其現在這幾年啊,這幾個月來我想很多的這個費用都在調漲,不管是物價也好,電費也好,如果連現在這個掛號費也要調漲的話,我想對一般的民眾的衝擊會非常大。部長對這件事有什麼看法?有沒有 |
| transcript.whisperx[486].start |
13248.237 |
| transcript.whisperx[486].end |
13270.212 |
| transcript.whisperx[486].text |
延後實施的可能性有沒有可能再徵詢更多的意見再去執行這件事情首先跟我們報告其實對於掛號費這種行政費用的管制法律上是沒有根據的我知道那所以這一個解既然說醫界有這樣子的提出來這樣的質疑的時候我們就必須要去做處理 |
| transcript.whisperx[487].start |
13270.712 |
| transcript.whisperx[487].end |
13296.826 |
| transcript.whisperx[487].text |
我想醫界在質疑當然主要還是因為說這個收入的問題啦所以要提到說這健保的幾負點是不是也是很重要的一個環節那健保的部分是另外一件事情那健保事實上對於所謂的這一些營運成本包括說租金、水電等等這些還有人員薪資的上漲的壓力的話健保沒有辦法完全去cover但是那個是行政成本 |
| transcript.whisperx[488].start |
13297.746 |
| transcript.whisperx[488].end |
13312.18 |
| transcript.whisperx[488].text |
所以我們其實是解開那個管制並不是說他一定就會調整比如說我們現在對於我們可以掌握的公立醫院的話我們可能就是讓他先不掌公立醫院先不掌對 |
| transcript.whisperx[489].start |
13312.901 |
| transcript.whisperx[489].end |
13338.004 |
| transcript.whisperx[489].text |
好部長謝謝喔晚上就是說其實這東西的確就是說這個是民眾多數民眾一看到說這個過號費可能會調會調漲的時候其實大家這個心理壓力其實也蠻大的那當然整個醫療收入的支出醫療收入的部分到底是這個這個過號費比較重要還是這個健保的費用比較重要因為今天時間不太夠所以我有有有機會再跟部長討論那最後一點喔另外一個話題就是這個大家很在注重這個蘇丹紅的議題 |
| transcript.whisperx[490].start |
13339.585 |
| transcript.whisperx[490].end |
13342.167 |
| transcript.whisperx[490].text |
蘇丹紅的原料他好像是工業產品所以這是不是不在目前的食安五環的管制範圍裡面應該說他作為食品添加物是一個不合法的這樣我們還是要管 |
| transcript.whisperx[491].start |
13364.301 |
| transcript.whisperx[491].end |
13386.587 |
| transcript.whisperx[491].text |
因為他理論上進來他申報不會說我要加到食品裡面去嘛他進來申報的時候他一定是用什麼其他的名義可能工業製品所以他申報要進入台灣然後在台灣來加工目前的狀況不是這樣目前的狀況是他在國外的話就是已經已經是加到這個辣椒粉裡面所以我們看到的是辣椒粉我們做出來看到成品就對了蘇丹侯 |
| transcript.whisperx[492].start |
13388.027 |
| transcript.whisperx[492].end |
13415.356 |
| transcript.whisperx[492].text |
那並不是說蘇丹紅另外進來然後在國內去攬那並不是這個樣子那如果是成品進來的話理論上應該在這個邊境管制的時候就應該查到才對所以我們現在會提升那個管制的一個措施也就是說像這一類的我們會跟那個環境部一起來討論由哪一些工業產品工業的使用的這些原料 |
| transcript.whisperx[493].start |
13415.976 |
| transcript.whisperx[493].end |
13439.955 |
| transcript.whisperx[493].text |
它不可以加在食品裡面,我們會把它找出來一旦驗到的話,那就是100%去擋了部長還有這個食藥署,我想提供一個民間的建議因為我們家以前自己做食品業的很清楚其實這個食品哪些不肖業者會把不該加在食品裡面的東西放進食品的添加物裡面這些我想食藥署去業界了解一下就很清楚那我想這個部分 |
| transcript.whisperx[494].start |
13440.896 |
| transcript.whisperx[494].end |
13462.282 |
| transcript.whisperx[494].text |
不能用善良民眾的心的想法去想這個事情要去從不肖廠商的想法節省成本的想法去想這個事情哪些工業製品會被添加到食物裡面包含在這個境外管制的包含在這個港口管制的時候就應該要去處理不是進來之後食安風暴才去查緝所以部分我是希望說部長跟我們署長 |
| transcript.whisperx[495].start |
13462.802 |
| transcript.whisperx[495].end |
13481.869 |
| transcript.whisperx[495].text |
要辛苦一點去瞭解一下業界實際上面它會被拿來添加的工業物質有哪些那也把它列出清單這個可能不是你們衛福部第一線的管這不是你們直接的業務但是可能是經濟部或財政部的業務那這部分你們也要提供清單在進出口的時候就應該有一個有效的管制好 謝謝 |
| transcript.whisperx[496].start |
13504.775 |
| transcript.whisperx[496].end |
13508.317 |
| transcript.whisperx[496].text |
接下來我們請謝一鳳委員進行質詢 |
| transcript.whisperx[497].start |
13523.099 |
| transcript.whisperx[497].end |
13541.648 |
| transcript.whisperx[497].text |
謝謝主席。我想要請我們薛部長。好,來,有請薛部長。委員好。部長好。我想請問一下,去年我們補健保多少錢?去年中央政府預算補健保多少錢?去年的話是240億。是不是?240億。240億。今年是200億。 |
| transcript.whisperx[498].start |
13548.011 |
| transcript.whisperx[498].end |
13565.291 |
| transcript.whisperx[498].text |
對阿,我們每年都在補健保的錢,然後你們又給人家調漲那個掛號,不是取消不是調漲,你們比較符合原意叫做取消掛號費的上限嘛那如果,好了醫療機構就是這樣子 |
| transcript.whisperx[499].start |
13568.054 |
| transcript.whisperx[499].end |
13568.974 |
| transcript.whisperx[499].text |
對於整個健保的結構有沒有改善? |
| transcript.whisperx[500].start |
13589.595 |
| transcript.whisperx[500].end |
13612.686 |
| transcript.whisperx[500].text |
當然有一些在行政成本提升的部分的話那醫療機構可能會有這種調漲花費來支應的這樣的情形但是健保是歸健保因為健保指的是醫療費用醫療費用的這一個部分的話那在總額預算制度之下仍然還是必須要另外去做處理 |
| transcript.whisperx[501].start |
13614.086 |
| transcript.whisperx[501].end |
13632.224 |
| transcript.whisperx[501].text |
委員剛剛提到的這個公務預算補助的部分其實我們是用於在這個癌症新藥的這個部分還有就是護理人員他的待遇提升了這個部分那也是健保支出的是不是?你說去年的今年的200億跟去年的240億 |
| transcript.whisperx[502].start |
13633.825 |
| transcript.whisperx[502].end |
13652.752 |
| transcript.whisperx[502].text |
去年的240億同時也去處理到所謂的補點子的問題因為這個COVID-19的停止之後的話那整個的整個的這一個三呼吸道感染的這種case大增那這部分的話讓這整個的點子是下降的所以去年的240億也同時在處理這個問題 |
| transcript.whisperx[503].start |
13655.533 |
| transcript.whisperx[503].end |
13679.026 |
| transcript.whisperx[503].text |
因為我實在很納悶就是說當我們的中央政府總預算一直在就是說預注健保但是健保第一個醫院也沒拿到錢然後我們又要多花錢也沒有拿到足額的錢嘛我們又要多花錢然後這是三輸耶就是社會大眾也沒有覺得整體的 |
| transcript.whisperx[504].start |
13680.487 |
| transcript.whisperx[504].end |
13691.007 |
| transcript.whisperx[504].text |
就是我們整體的醫療的那個就是改善了那是不是有點刪除啊?那已經有多年都不用再去調保費了這個是其實是這樣 |
| transcript.whisperx[505].start |
13693.805 |
| transcript.whisperx[505].end |
13716.837 |
| transcript.whisperx[505].text |
我有點怕說你說你不要續任我現在質詢你了你講的也不代表未來的就是說未來的部長說不定你會不會騙我們你會不會騙我們你說你不續任最後部長還是你那個不是我決定的對啊所以你也沒有辦法說啊你現在你也沒有鎖匙嘛所以我的意思就是不用再質詢我 |
| transcript.whisperx[506].start |
13718.024 |
| transcript.whisperx[506].end |
13738.792 |
| transcript.whisperx[506].text |
我怎麼...不是啦還是要討論出一個解決的方案啦因為我認為說第一個中央政府的總預算一直在挹注健保然後你們取消這個上限的問題讓民眾覺得說好即便是你們改善了就是醫療診所的行政費用但是沒有改善整個健保的結構嘛 |
| transcript.whisperx[507].start |
13740.012 |
| transcript.whisperx[507].end |
13755.242 |
| transcript.whisperx[507].text |
但是對醫療院所來講,他可以改善他的醫療品質,包括說可以聘用更多的這些護理人員來處理病人,所以這個是非常馬上就要去面對的問題 |
| transcript.whisperx[508].start |
13756.796 |
| transcript.whisperx[508].end |
13770.383 |
| transcript.whisperx[508].text |
對可是民眾就會覺得他們就醫的那個然後你們同樣的在其他的政策方面好我們說當然我們取消陸配那你們也知道說明明就是一年的上限就是60個還70 |
| transcript.whisperx[509].start |
13772.544 |
| transcript.whisperx[509].end |
13795.895 |
| transcript.whisperx[509].text |
這個因為沒有寫到法律上面去啦所以以後會不會又要做調整這個我們實在是沒有辦法所以現在我們沒有辦法去講說這個陸配的這個年限是減短了之後的話依親的人是否會有影響陸配本身不會有影響但是他依親的這個部分是否有影響這個我們不知道 |
| transcript.whisperx[510].start |
13801.579 |
| transcript.whisperx[510].end |
13817.127 |
| transcript.whisperx[510].text |
每年60個,這是寫在一個表上面,算是一個行政命令的一環而已你是擔心取消了,說有影響,是不是?你是擔心說上限取消了會影響?沒有的話,600個、6000個、6萬個,我們健保就受不了了 |
| transcript.whisperx[511].start |
13824.6 |
| transcript.whisperx[511].end |
13844.278 |
| transcript.whisperx[511].text |
可是我是說其實我們健保的問題你也清楚啦還不是不用算到這一塊不用算到那一塊其實我們目前的結構性的問題就存在了啦然後我們一直挹注健保資源其實都沒有辦法改善整個健保的結構啦 |
| transcript.whisperx[512].start |
13845.179 |
| transcript.whisperx[512].end |
13845.419 |
| transcript.whisperx[512].text |
我們還是會監測啦 |
| transcript.whisperx[513].start |
13868.27 |
| transcript.whisperx[513].end |
13895.036 |
| transcript.whisperx[513].text |
你怎麼監測主席站起來了我只是覺得說好像還是沒有改善主要是說有一些地區的話他的資源是比較不足的這部分的話那個關會我們就要注意因為他已經事實上的一個獨佔或者是一個寡佔的情形這個就要特別要去注意了好謝謝好我們謝謝謝一鋒委員的質詢接下來我們請鍾嘉斌委員進行質詢 |
| transcript.whisperx[514].start |
13906.189 |
| transcript.whisperx[514].end |
13934.386 |
| transcript.whisperx[514].text |
主席、在場委員、先進、列席的政府機關長、官員、會長、工作夥伴、媒體記者、女士先生有請薛部長跟吳署長好,請部長跟署長委員好部長好、署長好今天這個題目在這之前可能怕很多人都關心也問過了但是我還是要請教一下報載說年底恐怕會缺藥,六百萬人無藥可用那個標題包括說什麼年底會有缺藥潮啦六百萬人沒有藥啦,年底會缺藥嗎? |
| transcript.whisperx[515].start |
13936.286 |
| transcript.whisperx[515].end |
13955.57 |
| transcript.whisperx[515].text |
這事實上是你怎麼定義缺藥的問題你聽聽部長的定義如果是缺藥講的是比較正確的一個定義的話是國內都沒有辦法提供而不是說某一家醫院診所或者是當然我們關心的是國內這個藥拿不到嘛那國內拿不到這個藥就嚴重囉是不是這樣 |
| transcript.whisperx[516].start |
13960.831 |
| transcript.whisperx[516].end |
13988.808 |
| transcript.whisperx[516].text |
好 那我們來看一下這次因為都說缺藥的原因是因為我們把藥品的採購的調降幅度嘛比如說第一名的他從這個2500降到1600降幅35%第二名的乳癌從36降到26降了28%第三名是胃潰瘍從36降到26也是降了27%那好 那我們再往下看降幅最大的包括心血管、神經系統、抗感染的請問需要用到這些項目的病患他會不會受到影響呢 |
| transcript.whisperx[517].start |
13990.461 |
| transcript.whisperx[517].end |
14000.231 |
| transcript.whisperx[517].text |
這基本上不會因為他都有都有這個替代的藥品替代藥品是的好但是有人提到說因為藥局怕被砍藥價就不禁藥 |
| transcript.whisperx[518].start |
14001.226 |
| transcript.whisperx[518].end |
14023.878 |
| transcript.whisperx[518].text |
那就是包括藥局在備藥啊等醫生開處方啊那3月30日前備的藥好事業藥調降了那因為他怕被砍掉他就不再進了會不會有這樣的事情發生比如說空中拿不到藥他就不進了會不會有這樣的情況他是基本上利潤會稍微減少在這一段時間因為他原來進藥的時候的成本可能是比較高因為預期的藥價是比較高是的 |
| transcript.whisperx[519].start |
14024.858 |
| transcript.whisperx[519].end |
14049.364 |
| transcript.whisperx[519].text |
現在藥價調降下來所以會壓縮到他的利潤空間但是只有在一段時間因為他就可以再跟那個藥廠再去就是說這是過渡時間啊就是未來他再進藥的成本也就也降低了賣的藥價也低了好那開始呢我們我想最近很多的相關醫事團體藥廠他們就在聚集在討論這個事情那有人提出說如果在台灣製造藥品並給國產的 |
| transcript.whisperx[520].start |
14051.783 |
| transcript.whisperx[520].end |
14052.843 |
| transcript.whisperx[520].text |
我們希望說有一些專利過期的話那可以讓這個國產能夠來製造 |
| transcript.whisperx[521].start |
14069.411 |
| transcript.whisperx[521].end |
14094.662 |
| transcript.whisperx[521].text |
如果是原料藥的這個部分的話使用的是國產的原料我們會再讓它核價更高一點所以你們已經往這個方向有在研議了好很好那另外呢比如說我們舉例啦齁所謂的這個軟便劑只剩下藥廠願意生產它是很簡單的一個氧化酶嘛一顆才兩塊錢人家說是糖果價、地板價再砍一次到醫院再砍一次廠商說現在一顆剩八毛那目前呢這個藥證有五張 |
| transcript.whisperx[522].start |
14096.403 |
| transcript.whisperx[522].end |
14097.944 |
| transcript.whisperx[522].text |
所以本來他就按照規則的話就會一直砍一直砍下來 |
| transcript.whisperx[523].start |
14125.297 |
| transcript.whisperx[523].end |
14149.852 |
| transcript.whisperx[523].text |
但是後來因為有這個缺藥而且這個藥的確還是好用所以我們現在已經調升它的價格而且給它保護了那所以這個就是說類似像剛剛說的藥證藥證如果有限這些藥廠願意生產的藥或有這個藥廠就要很小心的把它保住嘛很怕它一時打個噴嚏它就不生產了那病患就麻煩了你們有在注意啦 |
| transcript.whisperx[524].start |
14150.592 |
| transcript.whisperx[524].end |
14170.335 |
| transcript.whisperx[524].text |
所以有人提出說稀缺藥證像剛剛那種只有5張或只有2張3張的供應有限而且臨場需求的藥物不列入每年調價範圍你說如果有人提出這個主張有沒有有助於避免斷藥應該是有有助於所以你們會評估對我們現在就往這一方面來做處理所以最後我就兩個訴求 |
| transcript.whisperx[525].start |
14172.457 |
| transcript.whisperx[525].end |
14194.733 |
| transcript.whisperx[525].text |
針對剛剛那兩個訴求在臺製造藥品並使用國產原料藥品給予適當的價格保護請你們分析它對藥品供應的影響三個月內提出一個書面報告可以嗎?那同樣的對於稀缺的藥證或供應有限且有臨場需求的藥物不再列入每年調教的範圍請你們也分析一下這對藥品供應的影響好不好?一樣在三個月內提供給本席跟委員會好謝謝部長謝謝署長找錯了應該是找了 |
| transcript.whisperx[526].start |
14199.847 |
| transcript.whisperx[526].end |
14206.388 |
| transcript.whisperx[526].text |
好,謝謝中嘉賓委員的質詢接下來我們請林益君委員進行質詢主席好,有請薛部長及石署長,謝謝好,請部長跟石署長 |
| transcript.whisperx[527].start |
14230.765 |
| transcript.whisperx[527].end |
14258.812 |
| transcript.whisperx[527].text |
委員好有請薛部長你知道針對藥價的問題是本席長期關心的議題本席必須要用自己的專業向部長指出幾個問題的嚴重性因為藥價的調整不但涉及民眾的用藥權益甚至造成缺藥的情況會發生那更是危及國人的生命、身體及健康甚至可能會是國安的問題 |
| transcript.whisperx[528].start |
14259.952 |
| transcript.whisperx[528].end |
14278.285 |
| transcript.whisperx[528].text |
而且藥局根本沒有囤藥的問題只有缺藥的問題最近有許多醫事人員反應不合理的狀況就是想請教部長一個問題如果有一個慢性患者他在3月1號就醫後拿到醫生開出的慢性處方簽三個月他原來已經領了一個月了 |
| transcript.whisperx[529].start |
14280.547 |
| transcript.whisperx[529].end |
14302.166 |
| transcript.whisperx[529].text |
但是健保署卻公告說藥價準備在4月1號要將健保價調降所以請問當這個患者4月2號要第二次領藥的時候是不是應該要以就一期日計算呢還是請問健保署對於這個藥價的計算覺得要用哪一天來計算才合理呢 |
| transcript.whisperx[530].start |
14304.573 |
| transcript.whisperx[530].end |
14311.401 |
| transcript.whisperx[530].text |
這基本上他已經有這一個處方了他就讓他處方去拿藥拿了藥之後再申報 |
| transcript.whisperx[531].start |
14313.584 |
| transcript.whisperx[531].end |
14327.774 |
| transcript.whisperx[531].text |
是部長你知道嗎?如果依照4月1號計算藥價在目前這樣的制度執行對於給藥的醫療機構實在是非常的不公平因為這個基層醫療的機構紛紛在反映說並不是說政府已經有預告何時調整藥價醫療機構就馬上要隨時的配合多出的成本反映的 |
| transcript.whisperx[532].start |
14338.041 |
| transcript.whisperx[532].end |
14348.33 |
| transcript.whisperx[532].text |
今天如果一個弱勢的醫療機構他平常在進藥品的時候他的藥通常都贏不了大型醫院所以北行是不是可以趁部長今天來備詢這個機會我們把基層醫療的問題來釐清 |
| transcript.whisperx[533].start |
14353.334 |
| transcript.whisperx[533].end |
14367.07 |
| transcript.whisperx[533].text |
所以本席在此想針對藥價調整的問題為民眾及基於藥食法則那就是過去就有一個就有一些案例是已經確定的就是說有一個有關慢性病連續處方簽對於健保藥價調整金額後 |
| transcript.whisperx[534].start |
14371.275 |
| transcript.whisperx[534].end |
14394.745 |
| transcript.whisperx[534].text |
而因為換藥情況導致缺藥的可能而先前就是因為健保代碼支付價格歸零或藥品取消健保給付的問題健保署就有實施以原處方就是就醫期日或者治療的結束日支付該藥品的健保費 |
| transcript.whisperx[535].start |
14396.079 |
| transcript.whisperx[535].end |
14412.481 |
| transcript.whisperx[535].text |
這個大概不太可行不是這個是已經是確定執行的只是我想要把剛才這樣的例子看看有沒有辦法套用例子來講第一個就是藥已經開出去了就是那一個藥所以處方箱裡面就是那一個藥 |
| transcript.whisperx[536].start |
14413.742 |
| transcript.whisperx[536].end |
14431.627 |
| transcript.whisperx[536].text |
這一個藥的話去做調劑不管是怎麼樣回原業運手去做調劑還是收到社區藥局去做調劑那調劑完之後跟健保申報費用的時候那本來就是按年薪的啊至少在年度例行這個問題就是出在於藥品支付價格之後民眾領導 |
| transcript.whisperx[537].start |
14433.007 |
| transcript.whisperx[537].end |
14449.595 |
| transcript.whisperx[537].text |
會有接受到領藥的衝擊還有在幫助緩解基層診所和社區藥局備藥的壓力所以既然慢性處方簽是3月開出的新藥價生效日是不是就應該以醫生處方日認定呢這個的話我想說想健保署可以 |
| transcript.whisperx[538].start |
14450.095 |
| transcript.whisperx[538].end |
14453.44 |
| transcript.whisperx[538].text |
演繹一下看看有沒有辦法因為在慢性處方針開立後藥價調整其實導致非常多的病人難以取得藥物這是因為行政程序所以卻導致了病人權益的完全受損 |
| transcript.whisperx[539].start |
14465.758 |
| transcript.whisperx[539].end |
14479.344 |
| transcript.whisperx[539].text |
所以這個的話我想說沒關係可以請部長一個星期內給本席正面的滿意回覆可以嗎這個跟病的權益沒有影響這個是跟藥局跟健保署沒關係這個的話再書面報告一下 |
| transcript.whisperx[540].start |
14484.726 |
| transcript.whisperx[540].end |
14495.792 |
| transcript.whisperx[540].text |
主席可以再一分鐘OK好部長你同意支持三同藥物嗎來協助國人度過這個缺藥的危機嗎這我們當然就是政策目標就這樣做 |
| transcript.whisperx[541].start |
14496.331 |
| transcript.whisperx[541].end |
14523.365 |
| transcript.whisperx[541].text |
那你們過去一年來宣傳學名藥的預算還執行率有多少呢?這一個部分的話到我手上是沒有這個資料啦那預算的部分好 因為我有請我們的助理跟你們食藥署索取資料但是索取了兩次之後到現在依舊沒有回覆然後這是不是藐視國會議員啊?沒有 對不對衛福部針對是否有三通藥物做宣導是不是宣傳的力道太弱了呢?然後 |
| transcript.whisperx[542].start |
14524.065 |
| transcript.whisperx[542].end |
14538.661 |
| transcript.whisperx[542].text |
以致缺藥大家又沒有辦法接受學民藥這樣的話我們是不是應該要來編列預算然後積極作為呢以免缺藥造成民眾之間的恐慌這是不是衛福部的責任呢 |
| transcript.whisperx[543].start |
14539.762 |
| transcript.whisperx[543].end |
14557.695 |
| transcript.whisperx[543].text |
所以我們今年在這一個部分的宣導的費用我們會增加但是我們經常這個宣導費用到了那個立法院：好沒關係部長是否可以在此承諾重新檢討一個跨部會的我們學民藥的政策把它分成短中長的目標短程就是宣導中程就是穩定生產的供應長程就是扶植我國MIT的製造的指示藥學民藥產業那可以嗎 |
| transcript.whisperx[544].start |
14567.142 |
| transcript.whisperx[544].end |
14570.965 |
| transcript.whisperx[544].text |
好,謝謝部長。好,我們謝謝林益君委員的質詢。接下來我們請劉建國委員進行質詢。好,謝謝周委。有請部長。好,有請薛部長。 |
| transcript.whisperx[545].start |
14588.462 |
| transcript.whisperx[545].end |
14602.913 |
| transcript.whisperx[545].text |
市長也一起來,食藥署署長好來,食藥署署長部長好部長我剛剛看到王釗瑋最後一個提案,我本人也是競表同意但是從這個案我要去延伸很多問題 |
| transcript.whisperx[546].start |
14604.178 |
| transcript.whisperx[546].end |
14607.18 |
| transcript.whisperx[546].text |
這個案過了,它會延伸什麼問題?你有思考過嗎? |
| transcript.whisperx[547].start |
14634.287 |
| transcript.whisperx[547].end |
14654.237 |
| transcript.whisperx[547].text |
就像前幾天在講,那個所謂的零食嘛,然後火鍋店的壓血。現在這種天氣,台灣的餐飲業者火鍋店所佔的比例多高。那火鍋店的使用者,小朋友會不會去?也一定會去嘛。 |
| transcript.whisperx[548].start |
14655.307 |
| transcript.whisperx[548].end |
14675.252 |
| transcript.whisperx[548].text |
要不要處理?小朋友的事情我們要特別重視但臺灣任何一個消費者的事情我們更加重視衛生部的官員我剛剛看到是吃了很大塊的雞排雞腿飯那雞腿有沒有外加辣椒粉?要不要進? |
| transcript.whisperx[549].start |
14677.529 |
| transcript.whisperx[549].end |
14705.161 |
| transcript.whisperx[549].text |
所以跟我們報告這一個辣椒粉的問題之所以不好解決就原因就在這對所以第一天禮拜四我就特別講說其實食安風暴像這種添加物它不是單一的成品它不像以前的毒奶粉對不對它是一個添加物你們要非常慎重嚴謹的積極的甚至也就是說阻絕中國 |
| transcript.whisperx[550].start |
14707.297 |
| transcript.whisperx[550].end |
14716.664 |
| transcript.whisperx[550].text |
進到臺灣的這些東西,就是要馬上當機立斷,不能有錢就不能再有錢委員,這個問題就是這樣,我們現在目前的辣椒粉,都是大部分的仰賴進口那中國大陸那邊有80%,佔80%阿現在這些違規的是50% |
| transcript.whisperx[551].start |
14728.573 |
| transcript.whisperx[551].end |
14737.116 |
| transcript.whisperx[551].text |
所以你一下子通通禁的話我們會沒有辣的可以吃啦對國人的飲食習慣來講還是會有一個影響不是這樣啦部長80%是全部仰賴中國進口出的問題是50% |
| transcript.whisperx[552].start |
14746.809 |
| transcript.whisperx[552].end |
14766.866 |
| transcript.whisperx[552].text |
這個在80%裡面的50%出的問題就已經佔了一半了嘛?對,但是出那個你也是要讓人家來啦,不可以看到中間就一直進入進口,這個就不太好的一個管制措施。所以你們要更加嚴謹的看怎麼去做相關的意義,什麼地方該進你就該進嘛對不對? |
| transcript.whisperx[553].start |
14768.587 |
| transcript.whisperx[553].end |
14793.338 |
| transcript.whisperx[553].text |
包含因為前幾天有些縣市是針對營養午餐就已經禁了嘛那有些縣市是還沒有嘛那裡是禁表尊重嘛不對啊不對啊就不對嘛那今天王昭偉提出的這個案就是全國通用了嘛我要表達的就是說可能有些事情你要事先的就去展現該怎麼做就怎麼做了啦這個時間會很長嗎就看 |
| transcript.whisperx[554].start |
14795.697 |
| transcript.whisperx[554].end |
14815.437 |
| transcript.whisperx[554].text |
可能食品主要辛苦一點,積極的看怎麼去做相關的查緝、比對、檢驗對一些可能會發生的還是比喻比較高的地方,可能你們依序的就必須直接的去對外做公告、對外做表示這可能比較危險、這比較高風險,我們先處理掉,先吃飯不可以 |
| transcript.whisperx[555].start |
14819.94 |
| transcript.whisperx[555].end |
14836.905 |
| transcript.whisperx[555].text |
現在往下追查就是這個原則,委員說的如果他的下游廠商產品量是大的,那我們就要先處理部長跟署長都沒有經歷過過去的神風暴這不會是有這項東西發生,這嚴重,後來會再對一項來會再對一項來,一直來,會被刷到你不要把這個 |
| transcript.whisperx[556].start |
14847.852 |
| transcript.whisperx[556].end |
14853.735 |
| transcript.whisperx[556].text |
我聽你們感到非常憂心甚至也很擔心真的啦因為我剛來的時候看到林委員在質詢其實他那些追查的方向 |
| transcript.whisperx[557].start |
14871.227 |
| transcript.whisperx[557].end |
14891.739 |
| transcript.whisperx[557].text |
是沒有問題的喔?那一個部分的話其實是有一個困難點是說我們如果要個別的公司去做查、積查而且這個要把它是不是有相關的這些子公司或分公司要一起查出來我們就變成經濟部的商業司啊 |
| transcript.whisperx[558].start |
14897.602 |
| transcript.whisperx[558].end |
14909.128 |
| transcript.whisperx[558].text |
但是遇到重大食安的事情基本上就是跨部會的一個合作嘛這基本上是這樣嘛因為我不希望它持續的流竄持續的被使用嘛 |
| transcript.whisperx[559].start |
14909.448 |
| transcript.whisperx[559].end |
14910.148 |
| transcript.whisperx[559].text |
今天主題還是缺藥問題 |
| transcript.whisperx[560].start |
14935.205 |
| transcript.whisperx[560].end |
14962.326 |
| transcript.whisperx[560].text |
那剛剛議員委員特別問部長嘛在議會的時候那部長有用這個說法嘛我是覺得部長在講一些話是蠻重點的蠻經典的啊這個會讓人家特別記憶清楚未嘗不是一件好事啦因為若堅持用原廠藥只能等死嘛就部長的講法嘛對不對但是但是他在前面如果再配一句話就會表達今天召委排的這個議題嘛 |
| transcript.whisperx[561].start |
14963.632 |
| transcript.whisperx[561].end |
14969.394 |
| transcript.whisperx[561].text |
政府怎麼會讓人民搞到沒有這個藥可以來用,然後我們要去跟病患講說,你就要跟病患講,所以你只有丹氏。 |
| transcript.whisperx[562].start |
14989.036 |
| transcript.whisperx[562].end |
14996.725 |
| transcript.whisperx[562].text |
這句話不是,但這句話要有底氣的,不是,對我知道啦,我現在齁,這句話你講到是一個重點嘛,也能讓人記得很清楚,就是部長你要討論很多問題嘛,有八款藥物可以用你不用,你要單這個藥物,當然你只有單四嘛,你藝術是要表達這樣嘛對不對,另外一個角度也是希望 |
| transcript.whisperx[563].start |
15010.72 |
| transcript.whisperx[563].end |
15038.635 |
| transcript.whisperx[563].text |
國人可以對自己的國內的這些學民藥有一定程度的信心嘛對不對應該是這樣講嘛但是我看我讓部長看一個數據我說講這句話很重點大家記得起來但是這個講話也有底氣嘛2018台灣學民血壓藥被驗出致癌物300萬顆下架回收19就累積四起學民藥在安定性試驗後組成分不符標準而回收事件這個都不是在部長的論內啦但是在署長的論內喔 |
| transcript.whisperx[564].start |
15041.464 |
| transcript.whisperx[564].end |
15067.474 |
| transcript.whisperx[564].text |
2023未達化學資料在三個月內出發三次八款藥回收同年發現台灣這個學名藥前列腺癌的這個膠囊已是組成混融解不全導致囊內的出現白色顆粒7月5號宣布回收這是在部長任內這是我簡單調出幾個啦這中間還有沒有書長應該比我更清楚嘛好 |
| transcript.whisperx[565].start |
15068.544 |
| transcript.whisperx[565].end |
15069.752 |
| transcript.whisperx[565].text |
那你要怎麼建立國人對這個信心? |
| transcript.whisperx[566].start |
15072.607 |
| transcript.whisperx[566].end |
15099.925 |
| transcript.whisperx[566].text |
這個部分有一些是廠商主動他自己的來通報然後這個下架的所以我們其實是當然如果要建立國產藥的信心的話那食藥署這邊還是必須要加強那對於後市場的一個稽查包括說那是不是都能夠這一些藥都一直符合能夠符合我們的安全標準跟它的這個劑量的一個標準這個我們 |
| transcript.whisperx[567].start |
15101.926 |
| transcript.whisperx[567].end |
15121.798 |
| transcript.whisperx[567].text |
後市場一定要繼續來做追蹤但是其實以現在的機制來看的話那廠商他的主動性也是有的啦所以這可以建立信心嗎因為他只能夠上市的時候已經都符合PIX GMP的標準了 |
| transcript.whisperx[568].start |
15122.378 |
| transcript.whisperx[568].end |
15146.707 |
| transcript.whisperx[568].text |
那就是後市場以後繼續再製造到底是不是仍然符合當初做這個查案登記的這個標準這個我們必須要去後市場我把這個過程這件事情提出來我並不是講說全部都是這個樣子但是也因為有這些事情當然有的是廠商主動提出來就像蘇丹農現在有廠商自己去檢驗發現有問題 |
| transcript.whisperx[569].start |
15149.188 |
| transcript.whisperx[569].end |
15149.208 |
| transcript.whisperx[569].text |
致詢問題 |
| transcript.whisperx[570].start |
15168.463 |
| transcript.whisperx[570].end |
15188.763 |
| transcript.whisperx[570].text |
這樣跟原廠藥都是一致的對好我們怎麼你們也有做宣導啊你們有很多的相關的預算都有在推廣嘛對不對對但顯然好像力道不是很足對所以我們今年呢在這方面的話必須要增加這個預算但是不是現在發生這個事情我們現在才在做嗎之前為什麼會做到這個效益這麼不好這個有需檢討吧 |
| transcript.whisperx[571].start |
15192.066 |
| transcript.whisperx[571].end |
15218.515 |
| transcript.whisperx[571].text |
對啦,食藥署這邊在明年度的預算一定這部分會增加,但是我想委員也知道嘛我們的宣導費用經常在立法院的話就會被殺掉一部分啦所以在這部分還要請委員來協助,那能夠來支持我過去還在這邊的時候幾乎沒有去刪你們什麼宣導費用是哪一個你可以試一下跟我講省綠算的時候我們好好地跟他溝通一下 |
| transcript.whisperx[572].start |
15220.508 |
| transcript.whisperx[572].end |
15235.174 |
| transcript.whisperx[572].text |
對不對?但是山可能也一次兩次也不會全部爬也全部拿掉嗎?每年都會通山一個爬樹啦還好吧你這麼講這個會期沒有在審預算你在審預算的時候你講這樣很危險 |
| transcript.whisperx[573].start |
15240.777 |
| transcript.whisperx[573].end |
15263.638 |
| transcript.whisperx[573].text |
因為委員剛好在問,所以我講一下,就是希望說委員能夠支持我當然是支持,但是有時候也不是只有靠宣導就可以解決這個事情,對不對?國人對這個學品藥的信心,除了你怎麼鼓勵這些學品藥的廠家,然後制定更完整的配套還有相關的一些政策,我想不只是宣導,是講到這個地方,對不對? |
| transcript.whisperx[574].start |
15265.585 |
| transcript.whisperx[574].end |
15283.412 |
| transcript.whisperx[574].text |
我時間到了啦,我最後還是要提供幾個訊息啦齁,因為當然過去來講是有,這也是從部長所講的嘛,航運受阻嘛,所謂的鴻海危機嘛齁,過去還有巴拉園運河的事件等等等,但是這個缺藥不單止這個原因啦, |
| transcript.whisperx[575].start |
15285.701 |
| transcript.whisperx[575].end |
15309.33 |
| transcript.whisperx[575].text |
最近的情形是這個原因是主要的因素這不是只有臺灣那是國際性的這種特別的一個缺藥草社區藥局要所謂的這個成立藥品合作社還有與物流藥水合作這個有什麼問題嗎?為什麼要把它拿掉? |
| transcript.whisperx[576].start |
15310.031 |
| transcript.whisperx[576].end |
15315.035 |
| transcript.whisperx[576].text |
不是這兩項完全你們都沒有辦法處理?不會這樣吧?你說物流業者還是可以溝通啊?還是可以 |
| transcript.whisperx[577].start |
15338.485 |
| transcript.whisperx[577].end |
15346.109 |
| transcript.whisperx[577].text |
對啦,但是這個溝通的時候,我們就必須要找人來,因為我們不是主管機關,人家不一定會聽我們的啦。沒有啦,欠有聘是什麼問題?這絕對都是看不回可以處理的事情嗎? |
| transcript.whisperx[578].start |
15357.155 |
| transcript.whisperx[578].end |
15380.862 |
| transcript.whisperx[578].text |
這應該不是,我感覺不對,你說的話我會,你給我的感覺就不是這樣做的人啦,你這樣說不出,我覺得這有問題餒。不是這樣啦。這要讓我們的,像食藥署這個單位的話,能夠讓他可以,因為這個決議的執行都是有時間性的嘛。因為你們對外講說只有酒,像這個藥品嘛對不對,其實不只嘛。 |
| transcript.whisperx[579].start |
15386.083 |
| transcript.whisperx[579].end |
15387.745 |
| transcript.whisperx[579].text |
其實是不止嗎?你沒說9項嗎?社區藥局連這9項都沒有啊? |
| transcript.whisperx[580].start |
15393.7 |
| transcript.whisperx[580].end |
15420.475 |
| transcript.whisperx[580].text |
市區藥局的缺藥不是真正的缺藥,它是剛好是沒藥啦一個是他可能他沒有採購,另外一個就是剛好是斷藥,這個個別的狀況他沒有採購,剛好是斷藥,他跟他的上個廠家跟這個藥廠都訂不到資訊貨的情況之下那市區藥局...所以他要通報嘛,我們可以幫他來做協調嘛,我們可以去調度嘛現在的問題就...市區藥局都沒有通報? |
| transcript.whisperx[581].start |
15421.976 |
| transcript.whisperx[581].end |
15442.626 |
| transcript.whisperx[581].text |
很多都沒有通報阿 很多都沒有通報也代表是有通報嘛 很多都沒有通報畢竟還是有通報嘛 有通報我們都有處理了沒有通報的我們就無從知道阿 為什麼會有的藥都沒有通報 我不知道阿 他就通報媒體 沒啦 不然你不會知道 硬公不知道啦你可能不知道 署長應該會知道 我沒有要跟他阿 |
| transcript.whisperx[582].start |
15445.627 |
| transcript.whisperx[582].end |
15469.821 |
| transcript.whisperx[582].text |
不是你把他騙,是怎麼有的會去跟你們通報,有的不會跟你們通報,是什麼問題?我們在管理這整個藥品的供應無虞情況之下。一點點說明,有一些他自己是可以處理的,碰到他自己在業界之間互相調貨,大部分都是這樣處理掉,少部分的話就是沒有,但是他就不通報,我真的也不知道為什麼。市長也不知道為什麼? |
| transcript.whisperx[583].start |
15474.241 |
| transcript.whisperx[583].end |
15474.361 |
| transcript.whisperx[583].text |
目前為止 |
| transcript.whisperx[584].start |
15496.131 |
| transcript.whisperx[584].end |
15513.6 |
| transcript.whisperx[584].text |
有些比較特殊的用藥還是說他這些藥源基本上是病患特別需要使用的然後我們也會因為像鴻海的這種事件嘛對不對還是一些一些緊急事件我們自己向農業去建立這種冷鏈的系統 |
| transcript.whisperx[585].start |
15514.48 |
| transcript.whisperx[585].end |
15541.386 |
| transcript.whisperx[585].text |
然後把這些藥可以妥善的剛剛委員講的這一類的藥的話因為他會通報大部分都是因為藥廠來通報所以我們就會緊急來開始做專案的採購專案的輸入或專案的製造如果國內自己能夠製造所以這個部分的話都有處理的機制那現在是有一些是個別的像社區藥局這樣他自己沒有備這個藥 |
| transcript.whisperx[586].start |
15543.434 |
| transcript.whisperx[586].end |
15552.402 |
| transcript.whisperx[586].text |
那這個部分結果人家拿處房間來了那他就要調劑嘛啊都沒有這個藥沒有這個藥的時候有幾種解決的方式第一個就是 |
| transcript.whisperx[587].start |
15553.386 |
| transcript.whisperx[587].end |
15573.637 |
| transcript.whisperx[587].text |
業界之間互相去調要第二種情形的話就是請病人把這個處方錢拿回去原來的這個醫療院所看是要改處方還是說就在那個醫療院所去做調劑這個是這樣另外除此之外的case為什麼他就不通報我就不知道了 |
| transcript.whisperx[588].start |
15576.033 |
| transcript.whisperx[588].end |
15602.986 |
| transcript.whisperx[588].text |
時間到了我這邊有一些具體的建議我先順便給部長跟署長做參考好不好但是我覺得部長剛剛這種說明還是有點不太能夠理解你現在講到第二點在社區疫情裡面有然後再回到原有的醫院那不是去到原有醫院又造成排擠的相關的一些情況又會發生所以我們不希望是這樣對嘛我們就在做這樣的一個分歧的怎麼還讓社區的這邊領不到藥然後又再回到原有的醫院 |
| transcript.whisperx[589].start |
15604.101 |
| transcript.whisperx[589].end |
15620.228 |
| transcript.whisperx[589].text |
這個顯然制度上是有問題的啊好謝謝謝謝專委謝謝謝謝劉建國委員的質詢接下來我們請徐欣穎徐欣穎徐欣穎委員不在張家俊張家俊張家俊委員不在鄭振前鄭振前鄭振前委員不在我們請陳瑩委員進行質詢 |
| transcript.whisperx[590].start |
15630.645 |
| transcript.whisperx[590].end |
15657.664 |
| transcript.whisperx[590].text |
謝謝主席,麻煩請衛福部部長還有健保署署長好,請部長跟署長部長好部長好,署長好部長這個是你去年9月8號受訪的時候有提到明年將要規劃65歲以上的經濟弱勢長者那如果是健保第6類的話,就可以免付保費 |
| transcript.whisperx[591].start |
15658.484 |
| transcript.whisperx[591].end |
15672.236 |
| transcript.whisperx[591].text |
那去年呢我也要你們在這個長者的年齡規定上呢就原住民的部分應該要下修到55歲我想要請教一下部長這個目前規劃的進度如何那所需要的經費大概是多少 |
| transcript.whisperx[592].start |
15675.517 |
| transcript.whisperx[592].end |
15697.196 |
| transcript.whisperx[592].text |
這部分的話我想我現在手上是沒有資料因為規劃是在社家署今天我們沒有來出席所以我想會後是不是我再把資料給委員另外接下來我想在這邊先跟部長說明一下再講一下就是 |
| transcript.whisperx[593].start |
15700.27 |
| transcript.whisperx[593].end |
15729.169 |
| transcript.whisperx[593].text |
就是我是屬於那個山要管海也要管然後台灣本島要管外島也要管的這個管很大的原住民選區的立委但是我沒有要選金門縣長但是特別報告一下在所有這個離島的這個涉及的原住民其實已經超過2000多位了那首先呢我要在這邊特別感謝這個衛福部去年在選舉完之後呢 |
| transcript.whisperx[594].start |
15732.071 |
| transcript.whisperx[594].end |
15755.243 |
| transcript.whisperx[594].text |
金門縣政府有向我澄清希望說我來協助爭取提高金門的醫療給付效益提升計畫也就是所謂的IDS的部分我接到他們的澄清之後也馬上召開了協調會 |
| transcript.whisperx[595].start |
15758.025 |
| transcript.whisperx[595].end |
15761.91 |
| transcript.whisperx[595].text |
很感謝衛福部還有臺北榮總的幫忙在過年之後你們就有同意我的建議增加了400萬元的補助給金門這個部分真的非常感謝 |
| transcript.whisperx[596].start |
15773.904 |
| transcript.whisperx[596].end |
15802.403 |
| transcript.whisperx[596].text |
這件事情我另外要講另外一個層面的問題我在協助爭取金門縣的IDS補助之後縣府有發了新聞稿我想在這個新聞稿上面金門縣政府也特別記錄了整個過程從去年我到金門去拜會我的選民拜會金門縣政府 |
| transcript.whisperx[597].start |
15804.405 |
| transcript.whisperx[597].end |
15828.019 |
| transcript.whisperx[597].text |
現場也很認真也整理了這個他們金門的醫療問題然後後來我們辦公室我在回到臺北之後我們辦公室也非常積極的跟衛福部開協調會協助金門縣政府那在這個過程當中呢多次金門縣政府的同仁也到立法院來我們也在繼續的討論所以這個部分 |
| transcript.whisperx[598].start |
15833.424 |
| transcript.whisperx[598].end |
15846.478 |
| transcript.whisperx[598].text |
現府有發新聞稿在特別把這個整個過程去還原那也特別感謝部長的幫忙也謝謝衛福部那也謝謝我們協助金門縣政府來爭取只是說 |
| transcript.whisperx[599].start |
15849.361 |
| transcript.whisperx[599].end |
15857.991 |
| transcript.whisperx[599].text |
這個新聞出來這個新聞出來之後呢有某委員辦公室就打電話去臭罵了你們一頓據說罵了30幾分鐘那這個 |
| transcript.whisperx[600].start |
15864.7 |
| transcript.whisperx[600].end |
15881.358 |
| transcript.whisperx[600].text |
責備你們的內容主要是因為說為什麼這個金門的事情沒有跟他們辦公室說明啦那這個部分我是覺得說這樣子的責備其實有一點很好笑那為什麼好笑是因為我剛剛講了嘛就是說 |
| transcript.whisperx[601].start |
15883.641 |
| transcript.whisperx[601].end |
15899.759 |
| transcript.whisperx[601].text |
這個原住民立委爭取政策或者是推動這個建設這個行政機關有義務要跟該選區的這個漢人立委做說明嗎那如果按照這樣子的邏輯來講那不管就是說 |
| transcript.whisperx[602].start |
15900.66 |
| transcript.whisperx[602].end |
15920.743 |
| transcript.whisperx[602].text |
任何哪一位立委的跟你們建議或爭取的政策那你們這個全部的人都要來跟我講啊都要來跟我回報啊因為我就跟你說我的選區是全國嘛好同理可證對不對這樣你們不就很累我就打電話去罵你們說為什麼那個南投的沒有跟我講屏東的沒有跟我講 |
| transcript.whisperx[603].start |
15922.224 |
| transcript.whisperx[603].end |
15947.517 |
| transcript.whisperx[603].text |
那所以我也要在這邊呼籲一下我們也是當然就是說很熱心的這些同仁們那我想說自己想要爭取的政見大家就是各自去努力不要為難這個行政機關那部長我還想再提一下就是說我記得你有曾經跟我講過這句經典名言我記得非常清楚 |
| transcript.whisperx[604].start |
15948.177 |
| transcript.whisperx[604].end |
15954.064 |
| transcript.whisperx[604].text |
你有說這個好的政策就不需要去強調著作權了那因為這個離島交通的問題導致這個 |
| transcript.whisperx[605].start |
15959.845 |
| transcript.whisperx[605].end |
15979.133 |
| transcript.whisperx[605].text |
這個離島的這個醫療成本明顯高於本島的這個醫療院所那去年9月我有在這邊質詢要求請你們研議將離島的健保點數加成那而且這件事情我後來我們也是開了好幾場的這個協調會我想這個不曉得你們昨天好像也是有開了針對這個問題又有開會 |
| transcript.whisperx[606].start |
15983.674 |
| transcript.whisperx[606].end |
16004.124 |
| transcript.whisperx[606].text |
聽說有一些好的結果,不曉得你們目前這個狀況是怎麼樣?那這部分是請署長來回答,因為他有比較是經營基金的。謝謝委員關心這個離島的經營成本。那在昨天的醫院總額部門的協商裡面呢,那麼有 |
| transcript.whisperx[607].start |
16005.024 |
| transcript.whisperx[607].end |
16031.65 |
| transcript.whisperx[607].text |
得到同意在這個今年的這個總額裡面有關於這個離島包含這個連江包含這個金門跟澎湖都適用那麼在住院部分那麼加成30%就是加三成這個後面的程序還要再經過共理會然後再爭過預告所以最快的話應該會是在5月1號以後實施 |
| transcript.whisperx[608].start |
16032.568 |
| transcript.whisperx[608].end |
16051.997 |
| transcript.whisperx[608].text |
好謝謝那我想我也很高興聽到有我們初步有這樣子的一個好消息那這個我理解本期理解就是說或許在這樣子的提議要求如果沒有衛福部的這個很強力的這個支持 |
| transcript.whisperx[609].start |
16053.178 |
| transcript.whisperx[609].end |
16053.638 |
| transcript.whisperx[609].text |
委員會主席 |
| transcript.whisperx[610].start |
16067.694 |
| transcript.whisperx[610].end |
16085.53 |
| transcript.whisperx[610].text |
我幫這個金門爭取到這個IDS400萬元經費的新聞是2月22號見報的那因為這個報紙被其他同仁看到了所以打電話去罵完你們之後呢2月24號 |
| transcript.whisperx[611].start |
16088.642 |
| transcript.whisperx[611].end |
16116.538 |
| transcript.whisperx[611].text |
這個內容呢這件爭取這件事情我們就把我爭取這個提高就是離島健保點數的這件事情拿去做新聞然後寫成是他們辦公室爭取的那我是說我只是想心裡有一個疑惑啦會不會是他們打完電話罵完你們之後我也很想了解說是有哪一位有特別提醒 |
| transcript.whisperx[612].start |
16121.45 |
| transcript.whisperx[612].end |
16135.562 |
| transcript.whisperx[612].text |
陳穎有在幫離島爭取健保點數的加成所以被拿去做新聞我希望我這個情況如果說是我剛剛講的那個樣子的話 |
| transcript.whisperx[613].start |
16138.965 |
| transcript.whisperx[613].end |
16139.005 |
| transcript.whisperx[613].text |
主席 |
| transcript.whisperx[614].start |
16155.097 |
| transcript.whisperx[614].end |
16155.897 |
| transcript.whisperx[614].text |
民眾有知的權利我們這個部分還是要 |
| transcript.whisperx[615].start |
16176.363 |
| transcript.whisperx[615].end |
16204.57 |
| transcript.whisperx[615].text |
長長就是讓民眾很清楚的知道這個過程我們要去還原那因為本席我們辦公室所有同仁的努力也是常常被收割所以呢在經過多年的這個領悟之後呢我覺得未來遇到這種事情我就是要在這裡講清楚那大概是這樣子一起爭取是好事但是馬後炮、移花接木、收割這樣子就不太好 |
| transcript.whisperx[616].start |
16205.766 |
| transcript.whisperx[616].end |
16223.665 |
| transcript.whisperx[616].text |
委員的努力結果大家都看得見但是難免會有這種被收割的一個情況不過我們的同仁被罵也是很習慣好啦 那我們在這邊也是再一次謝謝大家的努力 謝謝 |
| transcript.whisperx[617].start |
16225.96 |
| transcript.whisperx[617].end |
16226.661 |
| transcript.whisperx[617].text |
主席,我請一下部長 |
| transcript.whisperx[618].start |
16254.909 |
| transcript.whisperx[618].end |
16255.36 |
| transcript.whisperx[618].text |
好啊,部長請 |
| transcript.whisperx[619].start |
16260.247 |
| transcript.whisperx[619].end |
16266.87 |
| transcript.whisperx[619].text |
部長我們談缺藥的問題之前有個問題我想要先跟部長做個探討就是為什麼我們民國70幾年就有掛號費的上限的規定那時候沒有那從什麼時候開始有 |
| transcript.whisperx[620].start |
16288.516 |
| transcript.whisperx[620].end |
16316.408 |
| transcript.whisperx[620].text |
我記得是一百零幾年的時候才有這個公告那為什麼會突然想要取消因為我跟委員報告因為從七十幾年的時候那時候的衛生署就有一個解釋這一個所謂的醫療機構的括號費那不是屬於醫療費用是屬於行政費用 |
| transcript.whisperx[621].start |
16317.448 |
| transcript.whisperx[621].end |
16344.733 |
| transcript.whisperx[621].text |
他的目的就是說他不在醫療法的收費標準必須要到衛生局去備查範圍之內所以本來都是這個樣子但是一百零幾年我不知道當時的背景是怎麼樣就突然有一個公告說醫療費的話醫療機構的掛號費如果超出什麼樣的上限之後的話 |
| transcript.whisperx[622].start |
16345.433 |
| transcript.whisperx[622].end |
16369.849 |
| transcript.whisperx[622].text |
那就必須要到衛生局去備查那後來地方的衛生局大部分就拿了這一個公告就去做審查而不是備查就是說那個送過來的我就看如果說超出我們的所謂的一個參考標準的話通通都不准變成實質審查那這樣子就是違反法律的規定 |
| transcript.whisperx[623].start |
16371.97 |
| transcript.whisperx[623].end |
16397.367 |
| transcript.whisperx[623].text |
因為法律沒有規定花費這種行政費用的話必須要去做審查沒有授權行政機關可以做這樣子部長講的我覺得是很有道理可是會不會有一個情形就是說因為他原本可能假如當初就沒有上線的規定 |
| transcript.whisperx[624].start |
16398.53 |
| transcript.whisperx[624].end |
16416.204 |
| transcript.whisperx[624].text |
部長現在講的 我覺得立場上完全認同因為現在有上限 有上限的標準那現在突然取消了 有沒有可能所有的醫院 |
| transcript.whisperx[625].start |
16418.482 |
| transcript.whisperx[625].end |
16445.194 |
| transcript.whisperx[625].text |
如果是聯合的話,那就是公平會會介入,以前曾經有過某一個地區的幾家診所,他們講好了就同時把這瓜費調高,那這公平會就進去了,所以聯合行為是絕對不可以的。我知道啦,可是他總是會有規避的方式,因為大概就是各 |
| transcript.whisperx[626].start |
16448.602 |
| transcript.whisperx[626].end |
16451.245 |
| transcript.whisperx[626].text |
醫療層級相同的他的行政費用其實 |
| transcript.whisperx[627].start |
16454.244 |
| transcript.whisperx[627].end |
16455.744 |
| transcript.whisperx[627].text |
聯合行為最怕的就是同一個區域? |
| transcript.whisperx[628].start |
16484.731 |
| transcript.whisperx[628].end |
16499.967 |
| transcript.whisperx[628].text |
如果不同區域去聯合的話沒有太大意義因為病人都是會就近去就醫嘛所以如果他同一個區域有幾家的醫療院所同時都長起來的話那我們就請公平會去查 |
| transcript.whisperx[629].start |
16502.011 |
| transcript.whisperx[629].end |
16504.013 |
| transcript.whisperx[629].text |
所以這個問題我覺得最容易發生在醫學中心 |
| transcript.whisperx[630].start |
16523.727 |
| transcript.whisperx[630].end |
16548.849 |
| transcript.whisperx[630].text |
醫學中心因為醫學中心呢就是大家沒得選啦應該也不會啦他已經到最高層級了啦那假如說大家但是要看什麼病啦有些病可能是醫學中心才會處理的那但是大部分的病不會因為醫學中心他也可能可能就是就是以以價自量啦我現在怕產生這個問題啦 |
| transcript.whisperx[631].start |
16551.431 |
| transcript.whisperx[631].end |
16577.436 |
| transcript.whisperx[631].text |
部長你懂我的意思嗎?我知道因為醫學中心他假如說覺得他的病患病患太多他可能當他所有的醫學中心一起一起漲價的時候其實他區域是分散的啦那這當然我們也會監測啦因為情況當然是不一樣不是用區域去看這個 |
| transcript.whisperx[632].start |
16580.939 |
| transcript.whisperx[632].end |
16604.99 |
| transcript.whisperx[632].text |
其實我要來質詢的時候我就知道部長會怎麼回答,我也認同你的觀點不過就是有一些後續的問題我們還是要特別是漲價以後對於經濟比較弱勢的人的權益,這個後續可能要觀察一下 |
| transcript.whisperx[633].start |
16605.75 |
| transcript.whisperx[633].end |
16623.913 |
| transcript.whisperx[633].text |
這個部分的話也跟委員報告,其實我們是在這一個所謂的公財的回饋金的部分的話,有分給各個縣市那他其中要補貼的就是一些低收中低收,他的醫療費、就醫的這個括號費那個是已經寫在那裡?這個有?對對對好,謝謝部長還沒問完藥的部分呢 |
| transcript.whisperx[634].start |
16635.305 |
| transcript.whisperx[634].end |
16649.157 |
| transcript.whisperx[634].text |
我們缺藥的因素大概可以分為三個可能性一個是國際情勢的影響一個原物料的短缺一個國內用藥需求的激增 |
| transcript.whisperx[635].start |
16650.678 |
| transcript.whisperx[635].end |
16671.506 |
| transcript.whisperx[635].text |
請問部長這三個因素哪一個因素對於臺灣影響最大?發生的時候其實是影響最大是第一個啦就是國際情勢國際情勢影響就是找不到了全世界都找不到了全世界都找不到或者說臺灣人家都不會提供到臺灣 |
| transcript.whisperx[636].start |
16673.463 |
| transcript.whisperx[636].end |
16701.668 |
| transcript.whisperx[636].text |
這比方說那有這所謂的封鎖等等這類的情形那假如發生的話怎麼因應?所以我們就必須要在反應要在前面要去做這種預防措施預防措施就是我們會把必要的一些藥品的項目把它列出來然後我們這些藥品的項目的話要增加它的庫存、占備庫存那第二個就是要 |
| transcript.whisperx[637].start |
16703.122 |
| transcript.whisperx[637].end |
16716.738 |
| transcript.whisperx[637].text |
鼓勵國內自己生產,不然的話到時候一封鎖的話,那原廠就進不來了。那自己又沒有辦法製造,這個就會有風險。也就是必須要準備盤點、監控相關的庫存?我們現在有480多項。 |
| transcript.whisperx[638].start |
16722.504 |
| transcript.whisperx[638].end |
16745.046 |
| transcript.whisperx[638].text |
那另外像國內用藥需求激增的話,我們還可以透過加速進口來做處理。我最後再問一個問題就是,我們實施藥品費用分配比例目標 |
| transcript.whisperx[639].start |
16747.491 |
| transcript.whisperx[639].end |
16770.257 |
| transcript.whisperx[639].text |
每年檢討以及調整藥價以後藥商必須要事先跟醫事機構重新議價藥品市場的穩定性會不會比之前兩年調整一次 |
| transcript.whisperx[640].start |
16772.028 |
| transcript.whisperx[640].end |
16798.525 |
| transcript.whisperx[640].text |
會不會不穩定?其實如果他習慣了就會穩定簡單來講這個答案還不錯就可預期可預期的話所有的廠商跟醫療院所都會先預作準備所以這部分的話是如果是他形成一個規則的一個制度的話那應該就會相對是因為之前兩年兩年一次比較可能產生藥價黑洞 |
| transcript.whisperx[641].start |
16800.846 |
| transcript.whisperx[641].end |
16818.461 |
| transcript.whisperx[641].text |
那個幅度會變大,其實對藥廠來講的話也不是我那一年,部長的回答就是只要有預期,大家就會做準備,所以就不會有太大的變化好,謝謝部長、謝謝主席 |
| transcript.whisperx[642].start |
16820.694 |
| transcript.whisperx[642].end |
16846.011 |
| transcript.whisperx[642].text |
好 謝謝楊耀委員的質詢本日會議詢答全部結束委員楊耀、楊瓊英所提書面質詢列入紀錄刊登公報現在做以下決定報告及詢答完畢委員質詢未及答覆或請補充資料者請相關機關於兩週內以書面答覆委員另要求期限者從其鎖定本次會議到此結束現在散會謝謝大家 |
| transcript.whisperx[643].start |
16850.695 |
| transcript.whisperx[643].end |
16851.457 |
| transcript.whisperx[643].text |
委員會主席 |
| transcript.whisperx[644].start |
16866.316 |
| transcript.whisperx[644].end |
16866.517 |
| transcript.whisperx[644].text |
主席 |