| IVOD_ID |
15871 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Full/1M/15871 |
| 日期 |
2024-05-02 |
| 會議資料.會議代碼 |
委員會-11-1-26-14 |
| 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14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 |
14 |
| 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14次全體委員會議 |
| 影片種類 |
Full |
| 開始時間 |
2024-05-02T08:31:01+08:00 |
| 結束時間 |
2024-05-02T13:20:00+08:00 |
| 影片長度 |
04:48:59 |
| 支援功能[0] |
ai-transcript |
| video_url |
https://h264media01.ly.gov.tw:443/vod_1/_definst_/mp4:1M/bfaf9b39ac01a685e1784ed6585ee25eb6918ac9a81339753be8d109af184be457667a92e55d0d4b5ea18f28b6918d91.mp4/playlist.m3u8 |
| 會議時間 |
2024-05-02T09:00:00+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14次全體委員會議（事由：審查
一、委員王育敏等19人擬具「全民健康保險法第六十二條條文修正草案」案。
二、委員蘇清泉等28人擬具「全民健康保險法第六十二條條文修正草案」案。
三、國民黨黨團擬具「全民健康保險法第六十二條條文修正草案」案。
【以上議案，如經復議則不予審查】） |
| 委員名稱 |
完整會議 |
| 委員發言時間 |
08:31:01 - 13:20:00 |
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0.009 |
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一、委員 |
| transcript.whisperx[1].start |
996.484 |
| transcript.whisperx[1].end |
999.467 |
| transcript.whisperx[1].text |
違憲測試違憲測試一、二、三一、二、三違憲測試一、二、三 |
| transcript.whisperx[2].start |
1741.57 |
| transcript.whisperx[2].end |
1754.382 |
| transcript.whisperx[2].text |
初期委員已足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13次全體委員會議議事錄時間113年4月22日星期一90至13時7分4月24日星期三90至13時49分 |
| transcript.whisperx[3].start |
1760.948 |
| transcript.whisperx[3].end |
1784.768 |
| transcript.whisperx[3].text |
lapt��月二十五日星期四九時一分至十三十八分地點群賢樓八零一會議室出席委員陳昭芝等15人列席委員吳秉瑞等35人列席官員四月二十二日環境部部長薛富聖等相關人員四月二十四日衛生福利部部長薛瑞元等相關人員四月二十五日勞動部部長許明春等相關人員主席黃兆吉委員秀芳 |
| transcript.whisperx[4].start |
1785.268 |
| transcript.whisperx[4].end |
1797.495 |
| transcript.whisperx[4].text |
四月二十二日報告事項,宣讀上次會議議事錄決定確定,邀請環境部部長、交通部、經濟部、內政部警政署就噪音管制與加速推動排氣管噪音認證進行專題報告並被質詢。 |
| transcript.whisperx[5].start |
1800.296 |
| transcript.whisperx[5].end |
1817.916 |
| transcript.whisperx[5].text |
本日會議由環境部部長報告後,委員陳昭芝等22人提出質詢,軍經環境部部長、交通部公共運輸及監理司司長林福山、內政部警政署副署長李熙和及經濟部標準檢驗局副局長謝漢章及各相關主管等及其答覆。 |
| transcript.whisperx[6].start |
1818.436 |
| transcript.whisperx[6].end |
1840.97 |
| transcript.whisperx[6].text |
委員黃仁、邱振鈞、廖先祥及陳冠廷所提書面質詢列入紀錄刊登公報決定一、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中內書面答覆委員另要求期限者從其所定通過臨時提案六項4月24日邀請衛生福利部部長就家暴林榮忍 |
| transcript.whisperx[7].start |
1842.211 |
| transcript.whisperx[7].end |
1857.033 |
| transcript.whisperx[7].text |
檢討一一二年家庭暴力防治法修正施行概況進行專題報告並被質詢,邀請衛生福利部部長、國家通訊傳播委員會、數位發展部、內政部警政署、法務部、文化部、金融監督管理委員會就。 |
| transcript.whisperx[8].start |
1858.376 |
| transcript.whisperx[8].end |
1887.459 |
| transcript.whisperx[8].text |
非法網站創意私房案件提出兒少性影像防治具體作為檢討報告並就兒童及少年性剝削防治條例修正方向進行專題報告並被質詢本日會議專題報告綜合詢答由衛生福利部部長報告後委員陳昭芝等23人提出質詢軍警衛生福利部部長國家通訊傳播委員會網際網路傳播辦公室主任詹文旭法務部檢察司司長郭永發 |
| transcript.whisperx[9].start |
1888.28 |
| transcript.whisperx[9].end |
1904.065 |
| transcript.whisperx[9].text |
內政部警政署警政委員甲勒及數位發展部資源管理司司長牛信仁、司法院少年及家事廳副廳長李坤林及金融監督管理委員會證券期貨局組長黃錫和及各相關主管等及其答覆。 |
| transcript.whisperx[10].start |
1904.565 |
| transcript.whisperx[10].end |
1922.66 |
| transcript.whisperx[10].text |
委員楊耀、盧憲一、蘇清泉、鍾嘉斌及牛許廷所提書面質詢列入紀錄刊登公報。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書面答覆。委員另要求期限者從其所定。通過臨時提案八項。 |
| transcript.whisperx[11].start |
1924.121 |
| transcript.whisperx[11].end |
1942.619 |
| transcript.whisperx[11].text |
|
| transcript.whisperx[12].start |
1942.719 |
| transcript.whisperx[12].end |
1972.459 |
| transcript.whisperx[12].text |
本日會議由勞動部部長報告後,委員陳昭芝等22人提出質詢。均經勞動部部長、援助民族委員會社會福利處處長羅赫祿及各相關主管等及其答覆,委員廖偉祥、楊耀、盧憲一、龔小林及羅志強所提書面質詢,列入紀錄刊登公報,決定一、報告及詢答完畢,二、委員質詢為其答覆或請補充資料者,請相關機關於二周內書面答覆,委員令要求期限者從其鎖定。 |
| transcript.whisperx[13].start |
1972.839 |
| transcript.whisperx[13].end |
1998.462 |
| transcript.whisperx[13].text |
通過臨時提案以上宣讀完畢。請問委員會上次議事錄有錯誤或遺漏之處?好,沒有。議事錄確定本日會議議程委審查委員王育敏等19人委員蘇清泉等28人及國民黨黨團分別擬具全民健康保險法第六十二條條文修正草案共計三案。現在介紹 |
| transcript.whisperx[14].start |
1999.281 |
| transcript.whisperx[14].end |
2025.682 |
| transcript.whisperx[14].text |
出席在場的委員及列席官員蘇清泉委員陳金輝委員圖全吉委員陳昭芝委員王振旭委員林月琴委員介紹列席官員衛生福利部薛瑞元部長社會保險司劉育娟司長 |
| transcript.whisperx[15].start |
2027.352 |
| transcript.whisperx[15].end |
2047.907 |
| transcript.whisperx[15].text |
法規會陳信成參事、中央健康保險署石崇良署長、行政院主計總署基金預算處黃厚吉專門委員、公務預算處廖玉琳專門委員、國家發展委員會人力發展處謝嘉怡署長、 |
| transcript.whisperx[16].start |
2051.684 |
| transcript.whisperx[16].end |
2059.99 |
| transcript.whisperx[16].text |
好,現在我們請提案委員說明提案要旨每位委員兩分鐘我們請蘇清泉委員說明主席還有各位委員還有我們部長還有列席官員今天提出來的62條修正條文 |
| transcript.whisperx[17].start |
2079.023 |
| transcript.whisperx[17].end |
2091.532 |
| transcript.whisperx[17].text |
說明如下:「全民健康保險財務收支不平衡的壓力,長期採用支出結控策略由全國的醫療機構來承擔,使得醫療給付低廉。雖然民眾滿意度高,但全台醫療機構 |
| transcript.whisperx[18].start |
2100.646 |
| transcript.whisperx[18].end |
2126.083 |
| transcript.whisperx[18].text |
面對經營生存困境採行健保總額支出上限制超過額度就斷頭活動點值出現一點0.6到0.8不等的不合理打折給付導致整個醫療體系崩壞現行的制度面對高齡化的社會 |
| transcript.whisperx[19].start |
2127.441 |
| transcript.whisperx[19].end |
2136.785 |
| transcript.whisperx[19].text |
通貨膨脹萬路起漲最近又漲電價我們的支出我們的負擔又增加3%長久下去將會導致臺灣整個醫療機構虧損倒閉醫療從業人員長期低薪出走心要嚴實進入臺灣市場醫學生不願選擇集中男等科的困境 |
| transcript.whisperx[20].start |
2153.806 |
| transcript.whisperx[20].end |
2177.017 |
| transcript.whisperx[20].text |
我提出的第六十二條修正案總共有12位委員共同提案27位連署已經五十幾位、四十幾位將健保總額支出由支出的上限制改成支出的目標制我們外界都認為我們要廢掉總額沒有!我們是希望改成支出的目標制 |
| transcript.whisperx[21].start |
2181.094 |
| transcript.whisperx[21].end |
2207.015 |
| transcript.whisperx[21].text |
讓醫療支出有合理固定點值至少0.95以上最好是一點預言0.95就已經很誇張了啦如果每點費用低於預言的時候由政府公務預算補儲至於行政單位要怎麼來修改其他的法規那行政單位就要去用功我們兩位總統三位總統的候選人在 |
| transcript.whisperx[22].start |
2209.115 |
| transcript.whisperx[22].end |
2234.673 |
| transcript.whisperx[22].text |
繼選期間提出的政見希望能夠兌現尤其是賴副總統,現在要當總統了讓年度的支出目標更合理反映出當時社會人口結構及醫療科技發展的費用需求期盼政府部門協助與提供資源共同穩住臺灣健康保險及卓越的醫療照護系統提高醫療機構的韌性永續發展 |
| transcript.whisperx[23].start |
2239.806 |
| transcript.whisperx[23].end |
2246.23 |
| transcript.whisperx[23].text |
我們國民黨黨版的宗旨也差不多是這樣但是希望最少0.95以上一併說明謝謝好 謝謝蘇清泉委員的說明那本席也有提出版本跟國民黨黨團是一致的就是不得低於0.95就一併說明那接下來我們請我補充介紹一下盧憲一委員也來到現場 |
| transcript.whisperx[24].start |
2270.832 |
| transcript.whisperx[24].end |
2272.853 |
| transcript.whisperx[24].text |
接下來我們就請衛福部薛部長說明時間5分鐘。 |
| transcript.whisperx[25].start |
2289.228 |
| transcript.whisperx[25].end |
2304.118 |
| transcript.whisperx[25].text |
主席、各位委員、女士先生今天是大院第11屆第1會期社會福利及衛生環境委員會召開的第14次全體委員會議本部曾邀列席報告深感榮幸 |
| transcript.whisperx[26].start |
2305.138 |
| transcript.whisperx[26].end |
2321.971 |
| transcript.whisperx[26].text |
今天僅就委員王育敏等18人、委員蘇清泉等27人以及國民黨黨團等分別擬具的《全民健康保險法第六十二條條文修正草案》案等三案提出本部的意見,敬請各位委員不吝會議指教。 |
| transcript.whisperx[27].start |
2323.956 |
| transcript.whisperx[27].end |
2339.324 |
| transcript.whisperx[27].text |
那有關各委員及國民黨黨團所提的全民健康保險法第六十二條條文修正草案,保障點值每點不得低於0.95元或者保障點值1.1元。那本部的意見說明如下。 |
| transcript.whisperx[28].start |
2340.933 |
| transcript.whisperx[28].end |
2366.49 |
| transcript.whisperx[28].text |
第一,相關的提案並沒有具體指明彌補資金的來源。這有違財政紀律法第五條第一項的規定,也就是由中央政府各級機關、立法委員所提法律案大幅增加政府稅出或減少稅入者應先具體指明彌補資金的來源。 |
| transcript.whisperx[29].start |
2367.29 |
| transcript.whisperx[29].end |
2387.663 |
| transcript.whisperx[29].text |
第二、保障點指以現行的總額制度是抵觸的。法律規定互相衝突恐怕會無法執行。如果沒有適當的方法可以控制醫療機構的充量,補助的金額可能比我底下要講的這個金額更高。第三、 |
| transcript.whisperx[30].start |
2388.644 |
| transcript.whisperx[30].end |
2405.728 |
| transcript.whisperx[30].text |
如果由政府額外編列預算來支應保障點值每點不得低於0.95元或保障點值1.1元依照本部中央健康保險署的推估需要增加財源大約是新台幣705億元及1155億元且未來要每年編列 |
| transcript.whisperx[31].start |
2412.91 |
| transcript.whisperx[31].end |
2418.365 |
| transcript.whisperx[31].text |
那所需要的費用也會伴隨整個總額的增加隨著成長。 |
| transcript.whisperx[32].start |
2419.642 |
| transcript.whisperx[32].end |
2445.582 |
| transcript.whisperx[32].text |
那又預算是涉及到其他教育、文化、經濟、國防、交通等政府總體預算資源分配,那以及主力總數的資金分配,所以不得要強加思考。第四,如果由既有的健保財源來支援,安全準備會在114年,也就是明年一次就用完。 |
| transcript.whisperx[33].start |
2446.743 |
| transcript.whisperx[33].end |
2474.358 |
| transcript.whisperx[33].text |
現前費率5.17%將不足以支應所以113年底就必須要來也就是今年年底就必須要調整費率而且這個調整恐怕會超過健保法第18條所定的費率上限6%所以也必須要同時來修法調高費率的上限 |
| transcript.whisperx[34].start |
2475.592 |
| transcript.whisperx[34].end |
2498.96 |
| transcript.whisperx[34].text |
adequ案子因為沒有跟各界去協商取得公司,恐怕未來會引起相當程度的民眾的反彈。這個必須要謹慎評估。那有關健保資源的合理配置,本部除了指免透過全民健保專款積極應用之外,也為了兼顧 |
| transcript.whisperx[35].start |
2500.02 |
| transcript.whisperx[35].end |
2520.306 |
| transcript.whisperx[35].text |
bicyn保永續經營及醫療體系之穩定發展。那也會持續就健保收支重大議題進行檢討研議。所以我本案建議維持現行的條文。那本部呈大任各委員的指教及監督。在此敬致謝誠並請各委員繼續予以支持。以上報告。 |
| transcript.whisperx[36].start |
2524.861 |
| transcript.whisperx[36].end |
2553.1 |
| transcript.whisperx[36].text |
好 謝謝部長的說明有關本次會議各項書面資料均列入紀錄刊登公報現在開始詢答做以下宣告本會委員詢答時間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暫定10點30分休息5分鐘依往例審查法案不處理臨時提案現在我們請登記第一位陳昭芝委員發言 |
| transcript.whisperx[37].start |
2560.444 |
| transcript.whisperx[37].end |
2562.389 |
| transcript.whisperx[37].text |
謝謝主席。有請部長。好,請薛部長。 |
| transcript.whisperx[38].start |
2570.305 |
| transcript.whisperx[38].end |
2570.405 |
| transcript.whisperx[38].text |
國人好。 |
| transcript.whisperx[39].start |
2600.145 |
| transcript.whisperx[39].end |
2621.852 |
| transcript.whisperx[39].text |
|
| transcript.whisperx[40].start |
2621.852 |
| transcript.whisperx[40].end |
2646.032 |
| transcript.whisperx[40].text |
|
| transcript.whisperx[41].start |
2646.152 |
| transcript.whisperx[41].end |
2671.979 |
| transcript.whisperx[41].text |
adequ安全的上樁那台北慈濟如所言他就成為這個醫學中心然後這個雙核醫院在準醫學中心又很爭議的變成了一個醫學中心然後最後台大新竹醫院也加入進來總共你一口氣增加了在數目上增加了三家醫學中心您當時有人大概包括這個醫院管理協會的理事長說這個是不是為某個門系某個派系為他們這個授意 |
| transcript.whisperx[42].start |
2673.439 |
| transcript.whisperx[42].end |
2699.036 |
| transcript.whisperx[42].text |
|
| transcript.whisperx[43].start |
2699.176 |
| transcript.whisperx[43].end |
2717.805 |
| transcript.whisperx[43].text |
bicyn 部長參考部長我差點幫你升官也是有機會的每兩百萬人口應該設立一家醫學中心這是醫療網的規劃那臺大新竹升個位我覺得是合情合理不管他因為那個地方他人口增加了增加為到750增加的人數但是臺北區才750萬人 |
| transcript.whisperx[44].start |
2720.606 |
| transcript.whisperx[44].end |
2745.026 |
| transcript.whisperx[44].text |
|
| transcript.whisperx[45].start |
2745.326 |
| transcript.whisperx[45].end |
2766.977 |
| transcript.whisperx[45].text |
bicyn 醫學中心還不夠多嗎?我們在健保實施之前是很正常的一個醫療機構構造這個一地區醫院的大概600家那醫學中心十幾家等等那後來二十幾年後變成轉成這個怪模型我還問你說地區醫院少了將近腰斬變成300出頭這樣加速您覺得OK嗎?您當時回答我說還有門診啊還有這個還有門診啊但是 |
| transcript.whisperx[46].start |
2772.86 |
| transcript.whisperx[46].end |
2799.556 |
| transcript.whisperx[46].text |
况々部長怎麼會認為門診跟地區醫院跟醫院是服務同一群病人嗎?醫院等同診所嗎?部長您的回答我就覺得很奇怪而且如果你要談診所我就要談社區藥局了。好那衛福部不顧醫療網計劃帶頭違規爭亂社醫學中心那我想請問部長如果未來中區南區出現跟一樣的理由什麼辨識度啊什麼有問題那你是不是也要一併都爭額入群呢? |
| transcript.whisperx[47].start |
2800.276 |
| transcript.whisperx[47].end |
2800.736 |
| transcript.whisperx[47].text |
我可以回答? |
| transcript.whisperx[48].start |
2817.566 |
| transcript.whisperx[48].end |
2837.72 |
| transcript.whisperx[48].text |
你還能回答什麼嗎?可以啊。如果你覺得我是對的,你就可以繼續回答我。如果你認為我是錯的,你就說我講的都是錯的。因為我本人就是從雙核醫院這邊介調過來。當然我如果卸下職務之後,一定必須要回去歸建。但是回去歸建也不見得就是在醫院。我祝福你回到,也但是在這個程度當中、爭議當中。 |
| transcript.whisperx[49].start |
2842.91 |
| transcript.whisperx[49].end |
2847.812 |
| transcript.whisperx[49].text |
adequ一開始的時候兩百萬人一家醫學中心就是一個參考的標準,因為在當時的時候台北區就已經八家了。 |
| transcript.whisperx[50].start |
2866.47 |
| transcript.whisperx[50].end |
2880.146 |
| transcript.whisperx[50].text |
但是你繼續加碼啊。好,部長不好意思,那我們繼續往後講好了。我大概知道你要談什麼,我了解。那只是要違法給付30年,部長有話講嗎?健保法第51條第4款規定只是要不屬於健保給付範圍啦。 |
| transcript.whisperx[51].start |
2881.528 |
| transcript.whisperx[51].end |
2898.564 |
| transcript.whisperx[51].text |
那你也部長你不要再跟我說齁前人不守法我也跟著不守法這個是小混混講的話不要用部長級的高度跟我這樣回答沒有這部分就是要必須要漸進的不管任何的制度在調整的時候部長搞不好你沒有我熟喔我們來看看怎麼漸進法喔好來 |
| transcript.whisperx[52].start |
2899.565 |
| transcript.whisperx[52].end |
2919.889 |
| transcript.whisperx[52].text |
|
| transcript.whisperx[53].start |
2919.949 |
| transcript.whisperx[53].end |
2947.426 |
| transcript.whisperx[53].text |
那當時也做了一些配套措施我今天沒有辦法在這個地方分享因為我都有參與2014年3月健保署宣布依法不再給付這個指示要年底完成然後也是空頭支票2014年12月二代健保總檢討還有2015年全國藥品政策會議說非處方要退出保大不保小2017年健保會有提出喔說要回歸法條但是這些都是一場空那有人說指示要只不過二十億嘛一二十億嘛這個影響不大 |
| transcript.whisperx[54].start |
2949.667 |
| transcript.whisperx[54].end |
2967.807 |
| transcript.whisperx[54].text |
|
| transcript.whisperx[55].start |
2967.807 |
| transcript.whisperx[55].end |
2995.674 |
| transcript.whisperx[55].text |
� |
| transcript.whisperx[56].start |
2995.934 |
| transcript.whisperx[56].end |
3010.25 |
| transcript.whisperx[56].text |
這是我們要的健保嗎?這符合這個社會保險的精神嗎?小病保得好,小病保得滿,大病大缺口。好,請部長思考。這個部分的話我不贊成。我們現在大病難道都沒有保嗎? |
| transcript.whisperx[57].start |
3011.118 |
| transcript.whisperx[57].end |
3039.275 |
| transcript.whisperx[57].text |
|
| transcript.whisperx[58].start |
3040.151 |
| transcript.whisperx[58].end |
3066.071 |
| transcript.whisperx[58].text |
您大腦中的數字,要價差有多少?差不多在500億啦。但是總要價的話是2300億。欸,那個500億還是低估了啦齁?這不能隨便講低估就低估喔。是你要告訴我,我已經查過了。啊我就跟你講說500億啊。你要負責告訴我,其實實質上是啦。對,我就說500億啊。啊你如果不同意這個數字,你要提出來啊。 |
| transcript.whisperx[59].start |
3067.551 |
| transcript.whisperx[59].end |
3084.923 |
| transcript.whisperx[59].text |
|
| transcript.whisperx[60].start |
3084.983 |
| transcript.whisperx[60].end |
3085.443 |
| transcript.whisperx[60].text |
當然這個都有感性的空間啦。 |
| transcript.whisperx[61].start |
3113.046 |
| transcript.whisperx[61].end |
3140.691 |
| transcript.whisperx[61].text |
|
| transcript.whisperx[62].start |
3140.691 |
| transcript.whisperx[62].end |
3158.541 |
| transcript.whisperx[62].text |
|
| transcript.whisperx[63].start |
3158.922 |
| transcript.whisperx[63].end |
3187.296 |
| transcript.whisperx[63].text |
adequ部長?這樣可以嗎?我想最重要的是整個要價的部分透明化、可預測。這個其實也都有。部長已經30年了,好逐步。30年每一個階段逐步的改啊。你不能說30年然後要跳到現在,然後要一次斷年式的。如果每個都做一點就不會是這樣的。當然啊,本來就是這樣,所以我們現在也在做啊。我沒有看到效果。好,謝謝部長。 |
| transcript.whisperx[64].start |
3189.784 |
| transcript.whisperx[64].end |
3213.561 |
| transcript.whisperx[64].text |
好 謝謝接下來我們請陳金輝委員質詢主席各位委員各位官員大家早安我也想請薛部長好請薛部長委員好 |
| transcript.whisperx[65].start |
3219.806 |
| transcript.whisperx[65].end |
3244.045 |
| transcript.whisperx[65].text |
議長早。今天其實是部長您即將離開這個衛福部之後呢我們也要回歸醫療也要回歸基層的醫療所以您今天的態度非常的重要許許多多您未來的下屬都在看因為他們現在是一個生死存亡的保衛戰為什麼今天醫界 |
| transcript.whisperx[66].start |
3245.026 |
| transcript.whisperx[66].end |
3275.026 |
| transcript.whisperx[66].text |
|
| transcript.whisperx[67].start |
3275.126 |
| transcript.whisperx[67].end |
3280.767 |
| transcript.whisperx[67].text |
你是不希望?現在沒有說哪一家的薪水是少一點議員了。 |
| transcript.whisperx[68].start |
3282.159 |
| transcript.whisperx[68].end |
3308.832 |
| transcript.whisperx[68].text |
netesa 每一家都是1.1元不是嗎?這過去8年齁醫護人員真的很久沒有走上街頭了他們為什麼走上街頭好現在所有的急診喔大家躺在那邊他會告訴你說你今天就開day surgery因為我們上面沒有病床我已經一大堆朋友他今天被開我原本應該知道day surgery的話有他的條件不是每一個病都可以day surgery啊 |
| transcript.whisperx[69].start |
3309.462 |
| transcript.whisperx[69].end |
3331.374 |
| transcript.whisperx[69].text |
� |
| transcript.whisperx[70].start |
3331.834 |
| transcript.whisperx[70].end |
3353.794 |
| transcript.whisperx[70].text |
這個是蔡英文總統八年前醫療服務講的喔他說健保給各位點值一直在打折我們很感謝醫師為守護國人健康所付出的犧牲未來我們也願意來檢討健保支付標準表你剛有講我們一直在改好這八年點值從 |
| transcript.whisperx[71].start |
3355.075 |
| transcript.whisperx[71].end |
3368.264 |
| transcript.whisperx[71].text |
二、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：事由．立法院第11屆第12會期社會福利及衛生環境委員會第12條條文修正草案．事由．立法院第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第13會期社會福利及衛生環境委員會第13會期社會福利及衛生環境委員會第14會期社會福利及衛生環境委員會第14會期社會福利及衛生環境委員會第15會期社會 |
| transcript.whisperx[72].start |
3381.152 |
| transcript.whisperx[72].end |
3403.49 |
| transcript.whisperx[72].text |
|
| transcript.whisperx[73].start |
3404.25 |
| transcript.whisperx[73].end |
3418.959 |
| transcript.whisperx[73].text |
полне度。滿意度。你看得出醫療品質嗎?我們過去每年在爭取參加WHA今年也要去。WHA的精神是什麼?是促進健康。結果我們每一年齁這個所有的指標結結敗退 |
| transcript.whisperx[74].start |
3421.22 |
| transcript.whisperx[74].end |
3446.203 |
| transcript.whisperx[74].text |
|
| transcript.whisperx[75].start |
3446.874 |
| transcript.whisperx[75].end |
3448.035 |
| transcript.whisperx[75].text |
我可以不可以就這個問題回答。好。 |
| transcript.whisperx[76].start |
3465.069 |
| transcript.whisperx[76].end |
3466.87 |
| transcript.whisperx[76].text |
我把去年所有的競選影片都看完了。其他兩黨的總統候選人提出任何醫療相關的政見,你都很有意見。 |
| transcript.whisperx[77].start |
3486.243 |
| transcript.whisperx[77].end |
3486.343 |
| transcript.whisperx[77].text |
我剛為報告﹗ |
| transcript.whisperx[78].start |
3504.514 |
| transcript.whisperx[78].end |
3506.075 |
| transcript.whisperx[78].text |
我沒有批評我是說我做不到 |
| transcript.whisperx[79].start |
3533.965 |
| transcript.whisperx[79].end |
3542.298 |
| transcript.whisperx[79].text |
bicyn 蘇清泉等28人擬具:「全民健康保險法第六十二條條文修正草案案 案 。 bicyn 蘇清泉等28人擬具:「全民健康保險法第六十二條條文修正草案 案 。 bicyn 蘇清泉等28人擬具:「全民健康保險法第六十二條條文修正草案 案 。 |
| transcript.whisperx[80].start |
3547.594 |
| transcript.whisperx[80].end |
3566.563 |
| transcript.whisperx[80].text |
我只能就我職責之內去做這一個回答所以您的書面報告是不是應該要具體寫出這個是有處理方法因為拼起來你是覺得做得到但是你今天書面報告一夜半我書面報告講的是如果要這樣做可能那些困難就必須要去排除 |
| transcript.whisperx[81].start |
3567.91 |
| transcript.whisperx[81].end |
3581.237 |
| transcript.whisperx[81].text |
|
| transcript.whisperx[82].start |
3581.752 |
| transcript.whisperx[82].end |
3592.598 |
| transcript.whisperx[82].text |
bedingt consider the source of the source of the source of the source of the source of the source of the source of the |
| transcript.whisperx[83].start |
3608.049 |
| transcript.whisperx[83].end |
3612.585 |
| transcript.whisperx[83].text |
我跟委員報告如果我考慮到薪資的部分的話我根本不會來這裡 |
| transcript.whisperx[84].start |
3614.809 |
| transcript.whisperx[84].end |
3639.03 |
| transcript.whisperx[84].text |
謝謝你其實我目前呢看到基層很多人都很有愛心你願意做護理的人真的很有愛心但是你的愛心沒有辦法撐一輩子這個世界上有什麼工作對所以制度上必須要去做調整沒有錯這個是的確要去做改革但是是否就是這樣一點一元下去的話那個連改革的空間都沒有那你覺得你可以做到一點幾元嗎 |
| transcript.whisperx[85].start |
3640.651 |
| transcript.whisperx[85].end |
3659.116 |
| transcript.whisperx[85].text |
議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。」案。議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。案。」議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案。案。」議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案。案。」議員王育敏等19人擬具:「全民健康保險法第六十二條條條文修正草案。案。」議員王育敏等19人擬具:「全民健康保險法第六十二條條條文� |
| transcript.whisperx[86].start |
3665.265 |
| transcript.whisperx[86].end |
3686.613 |
| transcript.whisperx[86].text |
|
| transcript.whisperx[87].start |
3686.613 |
| transcript.whisperx[87].end |
3702.705 |
| transcript.whisperx[87].text |
|
| transcript.whisperx[88].start |
3702.705 |
| transcript.whisperx[88].end |
3720.162 |
| transcript.whisperx[88].text |
|
| transcript.whisperx[89].start |
3721.363 |
| transcript.whisperx[89].end |
3748.72 |
| transcript.whisperx[89].text |
�所以其實只要你願意做從各方面都可以改革你應該要具體的寫到你的書面報告裡面啊你從八年前的健康政策委員並沒有今天我們沒有請主席總書上來做一個口頭報告主席總書他有他的意見主席總書如果錢沒有下來的話或者沒有這個財源的話對不起 |
| transcript.whisperx[90].start |
3749.36 |
| transcript.whisperx[90].end |
3775.435 |
| transcript.whisperx[90].text |
|
| transcript.whisperx[91].start |
3775.555 |
| transcript.whisperx[91].end |
3795.423 |
| transcript.whisperx[91].text |
adequ大前提是不可能的因為新藥新的技術新的醫療技術就是不斷的在進步而這些人當然會越活越長慢性病也會越來越多所以你的總和的成長率根本不足以應付你這個預設的全國的醫療資源支出是不會有任何改變你這個 |
| transcript.whisperx[92].start |
3796.243 |
| transcript.whisperx[92].end |
3797.044 |
| transcript.whisperx[92].text |
bicyn 蘇清泉等19人擬具 |
| transcript.whisperx[93].start |
3820.486 |
| transcript.whisperx[93].end |
3843.336 |
| transcript.whisperx[93].text |
|
| transcript.whisperx[94].start |
3843.336 |
| transcript.whisperx[94].end |
3859.667 |
| transcript.whisperx[94].text |
|
| transcript.whisperx[95].start |
3860.874 |
| transcript.whisperx[95].end |
3876.364 |
| transcript.whisperx[95].text |
來清德總統啦。所以你們還是要想個辦法定期一定要把點值達到一點議員,這就是他提出來的目標。委員剛剛說要問盧縣議委員,你問一下盧縣議委員他過去在基層的時候,他的收入怎麼樣?私底下問問看。謝謝你關心盧縣議委員,謝謝部長,謝謝。好,謝謝。 |
| transcript.whisperx[96].start |
3888.561 |
| transcript.whisperx[96].end |
3916.998 |
| transcript.whisperx[96].text |
待會那個主席處也可以上來說明,看起來是主席處也不支持。來我們請林月琴委員。好,有請部長。好,請部長。部長早,辛苦了。 |
| transcript.whisperx[97].start |
3917.776 |
| transcript.whisperx[97].end |
3942.718 |
| transcript.whisperx[97].text |
那部長針對我們的那個健保的保費費率大概在民國99年第一次調漲之後最近一次調漲是110年所以想請問部長健保從106年就開始赤字今年要動之我們的調節非預期風險跟其他非預期政策改變所需經費要8億的預算 |
| transcript.whisperx[98].start |
3946 |
| transcript.whisperx[98].end |
3955.954 |
| transcript.whisperx[98].text |
厲注在全民健保基金240億元才不調漲,可是以預算的去填補健保赤字是最好的方法嗎? |
| transcript.whisperx[99].start |
3957.508 |
| transcript.whisperx[99].end |
3977.653 |
| transcript.whisperx[99].text |
用這個預算去填補這個赤字的話當然不是一個好的方法不過之前的話我們在去年做這個貶值的這個等於是補足是009這樣子的一個機制是真的是COVID之後 |
| transcript.whisperx[100].start |
3978.413 |
| transcript.whisperx[100].end |
4001.028 |
| transcript.whisperx[100].text |
bicyn 本來是公務預算在支應的這些COVID的醫療費用轉移到健保去,所以會產生這個衝擊,那這個部分的話是有原因的。可是據我所知,事實上現在很多項目也都健保都要去做支付,不過如果這樣的預算我比較擔心,因為我估計 |
| transcript.whisperx[101].start |
4002.09 |
| transcript.whisperx[101].end |
4029.497 |
| transcript.whisperx[101].text |
二、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．立法院第14次全民健康保險法第六十二條條文修正草案．立法院第14次全民健康保險法第16次全民健康保險法第17次全民健康保險法第18次全民健康保險法第19次全民健康保險法第20次全民健康保險法第21次全民健康保險法第22次全民健康保險法第23次全民健康保險法第24次全民健康保險法第25次全民健康保險法第26次全民健康保險法第27次全民健康保險法第28次全民健康 |
| transcript.whisperx[102].start |
4031.799 |
| transcript.whisperx[102].end |
4056.197 |
| transcript.whisperx[102].text |
這個部分的話是這樣子啊,如果以健保本身來講的話,因為它是保費的結構,那如果不去特別去談到這個公務預算的話,那基本上不會排擠到社府的預算。但是如果說必須要公務預算進來的話,那當然會有可能有排擠的這個效果。不過以去年跟今年,240億的公務預算抑制是去年,那今年是210億。 |
| transcript.whisperx[103].start |
4057.918 |
| transcript.whisperx[103].end |
4083.113 |
| transcript.whisperx[103].text |
這樣的進來的他的這個範圍他的規模大概還不至於還不至於但是如果說以今天的提案的那一個的話那是一年700億或者是1150億那個就會有影響所以儘管112年編列113年的預算避掉了一些預算排擠的效應如果明年的預算要在今年編列的話 |
| transcript.whisperx[104].start |
4083.865 |
| transcript.whisperx[104].end |
4090.021 |
| transcript.whisperx[104].text |
bicyn 要怎麼去避免?因為今天要談的是62條,就是我們的排擠社會預算的一些效應。 |
| transcript.whisperx[105].start |
4092.628 |
| transcript.whisperx[105].end |
4110.865 |
| transcript.whisperx[105].text |
這個部分的話當然就是會等下委員也可以問主席總署,但是預算編列大概是這樣子。我們現在就要編概算了,明年的概算。如果說這個法通過的話,如果它是通過的是1.1億元,那我們明年就要編1,150億的公務預算進來。 |
| transcript.whisperx[106].start |
4114.338 |
| transcript.whisperx[106].end |
4129.915 |
| transcript.whisperx[106].text |
所以這就是我很擔心,如果編到這樣的話,會不會排擠到我們很關心的社會福利預算?當然最後是主席總署這邊可能會有更詳細的一個說明。因為底層的社會問題要解決,真的要靠經費預算。 |
| transcript.whisperx[107].start |
4132.297 |
| transcript.whisperx[107].end |
4132.617 |
| transcript.whisperx[107].text |
bicyn M. |
| transcript.whisperx[108].start |
4162.417 |
| transcript.whisperx[108].end |
4186.948 |
| transcript.whisperx[108].text |
bicyn 蘇的計算那病人如果住院費的話一人一天的話是7900點原則上是1點的價格是1元的那過去當然有一些浮動0.6到0.8那後來是保證去年政府是宣誓每一點最低的值是要0.9元差了預算去補那那個補就已經會花掉一些公務預算那如果 |
| transcript.whisperx[109].start |
4187.944 |
| transcript.whisperx[109].end |
4207.773 |
| transcript.whisperx[109].text |
|
| transcript.whisperx[110].start |
4208.106 |
| transcript.whisperx[110].end |
4220.432 |
| transcript.whisperx[110].text |
bicyn 美典事實上是0.95元或是還是1元的話都將破壞現行壓縮每點價格的彈性所造成的效果就是天花板就要被掀開來 |
| transcript.whisperx[111].start |
4221.857 |
| transcript.whisperx[111].end |
4250.396 |
| transcript.whisperx[111].text |
我理解的應該沒有錯吧所以就想問這個修法的提議去年度底就有委員提出來可是衛福部表示如果每點0.9條高到1元的話那今年至少要增加113年就要增加到650億元那今天衛福部提出明年如果要的話那會增加到1155億的健保支出就會一直在累加上去 |
| transcript.whisperx[112].start |
4251.22 |
| transcript.whisperx[112].end |
4279.497 |
| transcript.whisperx[112].text |
|
| transcript.whisperx[113].start |
4281.186 |
| transcript.whisperx[113].end |
4297.483 |
| transcript.whisperx[113].text |
|
| transcript.whisperx[114].start |
4297.671 |
| transcript.whisperx[114].end |
4323.998 |
| transcript.whisperx[114].text |
netesi 如果我賺個錢一百塊的話那到底我要承擔到多少的成本?就是說如果是零點九五的話那可能就是算起來那明年可能就要漲保費那漲的幅度可能就是到了上限百分之六那如果是一點億元的話那可能就連六都不夠 |
| transcript.whisperx[115].start |
4325.418 |
| transcript.whisperx[115].end |
4354.462 |
| transcript.whisperx[115].text |
|
| transcript.whisperx[116].start |
4354.824 |
| transcript.whisperx[116].end |
4379.749 |
| transcript.whisperx[116].text |
因為對他們來講那的確剛剛前面委員有提到可是所以就想問醫事團體這樣提可是事實上相對的也有其他的團體像醫療改革跟健保監督團體表示反對所以如果貿然打破天花板的話民眾的這個保費勢必要翻漲的話那過去有沒有進行先去做溝通 |
| transcript.whisperx[117].start |
4381.15 |
| transcript.whisperx[117].end |
4395.823 |
| transcript.whisperx[117].text |
我跟委員報告,這裡面還有兩個小細節,如果說保障一點議員的話,有兩個小細節會造成以後的風險會越來越高。第一個就是支付標準要不要調。 |
| transcript.whisperx[118].start |
4397.125 |
| transcript.whisperx[118].end |
4422.653 |
| transcript.whisperx[118].text |
netesure 標準就我做這樣服務的話那調支付標準就是單價提高如果1.1元的話單每一個你的服務量都沒有變但是支付標準一提高的話那就會更加提高但是現在支付標準還是存在了一些不合理或者是說需要去做調整比方說兒科的支付標準應該要增加那這個部分的話如果說 |
| transcript.whisperx[119].start |
4424.346 |
| transcript.whisperx[119].end |
4448.455 |
| transcript.whisperx[119].text |
一點議員的話,我們一千一百億就丟進去了之後的話,這個支付標準幾乎就不要動了。不太可能還有足夠的錢再來調整這個。所以部長應該也同意,應該要聽聽其他人的聲音,不是只有一單一的,否則的話也會造成,就像我剛剛擔憂的,社福團體或者是民眾他們的壓迫感,甚至有些人本來就健保費繳不出來的話, |
| transcript.whisperx[120].start |
4449.475 |
| transcript.whisperx[120].end |
4451.136 |
| transcript.whisperx[120].text |
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,請薛部長。 |
| transcript.whisperx[121].start |
4480.748 |
| transcript.whisperx[121].end |
4487.271 |
| transcript.whisperx[121].text |
議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．事由、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．事由、 |
| transcript.whisperx[122].start |
4503.7 |
| transcript.whisperx[122].end |
4504.681 |
| transcript.whisperx[122].text |
bicylson Hsieh﹗ |
| transcript.whisperx[123].start |
4529.804 |
| transcript.whisperx[123].end |
4549.224 |
| transcript.whisperx[123].text |
|
| transcript.whisperx[124].start |
4549.744 |
| transcript.whisperx[124].end |
4568.634 |
| transcript.whisperx[124].text |
我基本上這在剛剛恐龍報告的時候也已經提到過了,那因為如果說一點一元的話補到這樣的程度的話,我們大概一年就是公務預算就要用掉一千一百多億,那這只是用現在的量去估計而已,但是 |
| transcript.whisperx[125].start |
4569.394 |
| transcript.whisperx[125].end |
4569.654 |
| transcript.whisperx[125].text |
bicylman |
| transcript.whisperx[126].start |
4585.384 |
| transcript.whisperx[126].end |
4606.408 |
| transcript.whisperx[126].text |
|
| transcript.whisperx[127].start |
4606.408 |
| transcript.whisperx[127].end |
4636.374 |
| transcript.whisperx[127].text |
|
| transcript.whisperx[128].start |
4636.664 |
| transcript.whisperx[128].end |
4659.104 |
| transcript.whisperx[128].text |
|
| transcript.whisperx[129].start |
4659.184 |
| transcript.whisperx[129].end |
4679.938 |
| transcript.whisperx[129].text |
essee 方法嘛。放大回推啦、那個核三啦、另外就是斷頭啦等等這些。這個依據要能夠接受。要不然的話這個是變成是一個沒有指定的。可是這樣會變成說有的就是剛量如果沒辦法控制的話可能會變成我做越多然後被砍的越多。 |
| transcript.whisperx[130].start |
4680.638 |
| transcript.whisperx[130].end |
4681.058 |
| transcript.whisperx[130].text |
neteso |
| transcript.whisperx[131].start |
4697.924 |
| transcript.whisperx[131].end |
4698.605 |
| transcript.whisperx[131].text |
bicylman |
| transcript.whisperx[132].start |
4713.625 |
| transcript.whisperx[132].end |
4715.968 |
| transcript.whisperx[132].text |
議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。」 |
| transcript.whisperx[133].start |
4733.626 |
| transcript.whisperx[133].end |
4754.65 |
| transcript.whisperx[133].text |
|
| transcript.whisperx[134].start |
4754.65 |
| transcript.whisperx[134].end |
4770.384 |
| transcript.whisperx[134].text |
|
| transcript.whisperx[135].start |
4770.657 |
| transcript.whisperx[135].end |
4789.677 |
| transcript.whisperx[135].text |
disciplinary目前健保的資訊系統裡面大概都可以看得到啦。過去的這些檢查或者是過去所開的藥。所以要重複的話其實機會不大啦。除非就是說這個醫師真的是很懶他都沒有去check。 |
| transcript.whisperx[136].start |
4790.277 |
| transcript.whisperx[136].end |
4790.857 |
| transcript.whisperx[136].text |
bicyn P. |
| transcript.whisperx[137].start |
4812.249 |
| transcript.whisperx[137].end |
4818.711 |
| transcript.whisperx[137].text |
bicyn 其實我碰到好幾個就是說有的民眾他可能到醫院或到診所那他拿藥他的藥不一定會吃啦齁 |
| transcript.whisperx[138].start |
4833.114 |
| transcript.whisperx[138].end |
4852.961 |
| transcript.whisperx[138].text |
|
| transcript.whisperx[139].start |
4852.961 |
| transcript.whisperx[139].end |
4876.476 |
| transcript.whisperx[139].text |
|
| transcript.whisperx[140].start |
4877.239 |
| transcript.whisperx[140].end |
4895.081 |
| transcript.whisperx[140].text |
這些剛剛委員提到的這些都是我們要做的,我們要努力的方向,也許現在沒有辦法做到盡善盡美,但是必須要持續的去推動。但是我沒有辦法說,只要做了這一個的話,那就可以確保一點一點,這我沒有辦法說。 |
| transcript.whisperx[141].start |
4895.942 |
| transcript.whisperx[141].end |
4912.309 |
| transcript.whisperx[141].text |
議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次 |
| transcript.whisperx[142].start |
4920.393 |
| transcript.whisperx[142].end |
4920.654 |
| transcript.whisperx[142].text |
bicyn 沈 沈 |
| transcript.whisperx[143].start |
4935.717 |
| transcript.whisperx[143].end |
4964.204 |
| transcript.whisperx[143].text |
bicyn 可能會跟他講說健保會不好啦可能這個自費的這個醫材會比較好或者是這個藥可能是這個健保的不好可能會有一些副作用那自費的可能會比較好那類似這樣的一個狀況啦其實當然就是說醫院或者是醫療器材他隨著這個時間可能會有更好的這個藥或者是更先進的這個醫療的方式那當然都是我們樂見的那當然是有健保的話 |
| transcript.whisperx[144].start |
4964.964 |
| transcript.whisperx[144].end |
4968.386 |
| transcript.whisperx[144].text |
bedingt 這裡面可能會有一個地方是有誤會的。 |
| transcript.whisperx[145].start |
4982.513 |
| transcript.whisperx[145].end |
5009.756 |
| transcript.whisperx[145].text |
閱外收入當然就是停車場、美食街那個是沒有錯是閱外收入但是醫療本業的部分的話剛剛委員提到說自費事實上在醫院的財報裡面它有一個健保收入收入裡面閱外收入之外的話就是醫務收入醫務收入分健保跟非健保非健保不等於是自費因為如果是從公務預算裡面提出來一些計畫 |
| transcript.whisperx[146].start |
5010.737 |
| transcript.whisperx[146].end |
5031.794 |
| transcript.whisperx[146].text |
bicyn 或是說像那個COVID中間疫情期間的時候我們這個醫療費用是有公務預算補助的它都會列入到這一個非健保的收入這個部分的話其實也不小所以並不是那些非健保收入都是屬於自費的收入 |
| transcript.whisperx[147].start |
5031.974 |
| transcript.whisperx[147].end |
5034.876 |
| transcript.whisperx[147].text |
我相信就是說健保是需要改革的。目前的總和預算制度也存在了一些缺點。 |
| transcript.whisperx[148].start |
5058.493 |
| transcript.whisperx[148].end |
5081.019 |
| transcript.whisperx[148].text |
bicyn 但是要怎麼樣改,可能不是只有單修這個條文就能夠處理的。單修這個條文沒有其他的配套的話,可能會造成那個風險的控管會更加厲害。搞不好健保三年之後就倒了。這樣是我們需要的嗎?健保是台灣一個非常珍貴的一個資產。 |
| transcript.whisperx[149].start |
5083.88 |
| transcript.whisperx[149].end |
5098.871 |
| transcript.whisperx[149].text |
讓這個民眾的安全,不管是主觀的安全感或事實上的在經濟上面不會因病而病。這樣子的一個社會安全的自治,我們覺得說應該大家要珍惜。 |
| transcript.whisperx[150].start |
5099.611 |
| transcript.whisperx[150].end |
5102.832 |
| transcript.whisperx[150].text |
essee to cherish this asset. |
| transcript.whisperx[151].start |
5124.636 |
| transcript.whisperx[151].end |
5138.239 |
| transcript.whisperx[151].text |
好,我們希望說下禮拜的公聽會可以廣聽各界的這個意見。好,謝謝。好,接下來請我們王育敏委員。好,謝謝主席。我們是不是請薛部長,還有我們主計處的黃專門委員。 |
| transcript.whisperx[152].start |
5153.254 |
| transcript.whisperx[152].end |
5178.511 |
| transcript.whisperx[152].text |
好,請問薛部長以及主席處的還有健保署的施署長也一起上來。好,施署長。好,部長我先請教您一個問題。賴清德總統他提出他的競選政見就是說最高目標這個健保點子可以用1.1為目標。這件事情他有徵詢過您的意見嗎?當他提出這個政見的時候相關團隊有徵詢過您的意見嗎? |
| transcript.whisperx[153].start |
5180.622 |
| transcript.whisperx[153].end |
5201.434 |
| transcript.whisperx[153].text |
在過去我們並沒有對這一點受到徵詢,不過我想委員這個可能要做一點挑戰,它不是一點意願,而是健保點子,一點意願。一點意願,健保點子,一點意願。好。對。它沒有徵詢過你的意見嗎?沒有。所以是競選團隊提出來的。是。所以難怪您在 |
| transcript.whisperx[154].start |
5202.436 |
| transcript.whisperx[154].end |
5228.652 |
| transcript.whisperx[154].text |
剛剛的答詢之間好像是完全否定這項政見,你覺得是?我沒有否定,我是說在我的任內我沒有辦法去支持。我剛剛有聽出來你的意思,我要請主席總署,那可能是未來邱財遠部長要去承擔的。來,這個主席總署,剛剛其實我一直聽到部長說要請主席總署來說明,看起來你們是很不支持,那我請教你同樣的問題,賴清德準總統, |
| transcript.whisperx[155].start |
5231.614 |
| transcript.whisperx[155].end |
5238.735 |
| transcript.whisperx[155].text |
incarcerate 總統的政見。那我就請教你,他要來當我們總統了。那他要落實他的政見。那你們主席總書會支持這個未來準總統的這樣的一個政見嗎? |
| transcript.whisperx[156].start |
5257.868 |
| transcript.whisperx[156].end |
5277.087 |
| transcript.whisperx[156].text |
是,委員可不可以讓我說明一下,因為基本上目前這個案子是大院提的嘛,那依我們的預算法的規定。你先不用講這部分,我只問你,未來總統如果他要去落實他的政見,他要去力推健保點子要調高,那你們主計總署會配合嗎? |
| transcript.whisperx[157].start |
5278.029 |
| transcript.whisperx[157].end |
5306.076 |
| transcript.whisperx[157].text |
bicyn 應該是說要怎麼落實這個政見其實不一定是由公益算來處理那當然我們目前是健保總額制度原則上如果有健保有需求那當然是從總額的額度那是看是提高我只問你嘛主席總書如果總統他說他政見就是要推你們當然是配合啊沒有第二句話啊不是嗎我就問你現在台電的財務虧損一千億的補貼就過去了有沒有主席總書有沒有答應 |
| transcript.whisperx[158].start |
5308.24 |
| transcript.whisperx[158].end |
5335.382 |
| transcript.whisperx[158].text |
有啊 對不對就是政策決定你有沒有錢嘛就是這樣子啊整個國家的預算的大餅是看這個錢要放在哪裡嘛要不然台建的虧損為什麼要由這個政府你主計總署要答應一千億就要過去合理嗎照再來講是補貼他比較合理還是在補貼健保健保還照顧全國的所有的民眾欸那你的政策標準在哪裡主計總署的給錢的標準在哪裡 |
| transcript.whisperx[159].start |
5337.622 |
| transcript.whisperx[159].end |
5338.642 |
| transcript.whisperx[159].text |
bicyn 沈 沈 沈 沈 沈 |
| transcript.whisperx[160].start |
5365.616 |
| transcript.whisperx[160].end |
5367.136 |
| transcript.whisperx[160].text |
ympt. |
| transcript.whisperx[161].start |
5367.136 |
| transcript.whisperx[161].end |
5380.581 |
| transcript.whisperx[161].text |
我聽明白你的意思了。但是這件事情不是在於政府有沒有錢的問題,很多時候都是來自於更高層,他決定我這筆錢要往哪個方向去。 |
| transcript.whisperx[162].start |
5383.442 |
| transcript.whisperx[162].end |
5398.927 |
| transcript.whisperx[162].text |
bicyn 也不是說用了這筆錢就會影響到社會福利預算。我不同意這樣的一個看法。是政府有錢,如果他補貼台電也是可以。老保基金虧損,他不做制度的改革,他一直用撥補。1200億也有錢啊。就只有你健保沒有錢。你健保要個這個幾百億就沒有錢。 |
| transcript.whisperx[163].start |
5403.988 |
| transcript.whisperx[163].end |
5423.753 |
| transcript.whisperx[163].text |
bicyn- 這是你國家整體的資源往哪邊擺放的問題。當然我也同意制度的改革要有合理,要合理。所以這一件事情,這個兩位都從一屆來喔。這一件事情為什麼一屆反彈聲音這麼大?你光去看這個健保點子,這個圖你來看,這樣子上上下下。 |
| transcript.whisperx[164].start |
5424.633 |
| transcript.whisperx[164].end |
5445.333 |
| transcript.whisperx[164].text |
� |
| transcript.whisperx[165].start |
5445.333 |
| transcript.whisperx[165].end |
5460.435 |
| transcript.whisperx[165].text |
|
| transcript.whisperx[166].start |
5460.575 |
| transcript.whisperx[166].end |
5480.238 |
| transcript.whisperx[166].text |
但是請記得不要馬而好又要馬而不吃草。天底下沒有這樣的事情。我們需要所有的醫療人員用最專業的醫療人員要他們在第一線的崗位上面守護國人的健康跟安全。但是另外一方面我們應該要提供給他合理 |
| transcript.whisperx[167].start |
5480.899 |
| transcript.whisperx[167].end |
5488.223 |
| transcript.whisperx[167].text |
bicyn 全的一個醫療保障的制度我覺得這個是我們應該要去追求的所以合理的改革是我們應該要去討論的而不是用這樣子的方式說因為這樣子這個我們健保可能會倒我覺得也不要用這樣子的話語而是應該指出來說我們如果要這樣調的話我所有搭配的制度我很遺憾可能部長你要離開了所以沒有提出你完整的報告 |
| transcript.whisperx[168].start |
5508.114 |
| transcript.whisperx[168].end |
5534.633 |
| transcript.whisperx[168].text |
|
| transcript.whisperx[169].start |
5534.753 |
| transcript.whisperx[169].end |
5553.687 |
| transcript.whisperx[169].text |
�二、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。」案﹖而接下來才是討論健保費要不要調漲的問題。我覺得談事情應該是要這樣子談。所以這件事情我覺得沒有什麼是非對錯的問題,而是遇到問題了。就是醫界有反應,我們來共同解決。那解決的方案作為衛福部應該提出你們認為可行的幾個方案,這樣來討論比較容易。 |
| transcript.whisperx[170].start |
5564.485 |
| transcript.whisperx[170].end |
5573.179 |
| transcript.whisperx[170].text |
你怎麼確定一次性?他現在...他並沒有講說每年,但是如果這一個案子下去的話,如果通過的話,就是每年。 |
| transcript.whisperx[171].start |
5574.572 |
| transcript.whisperx[171].end |
5600.432 |
| transcript.whisperx[171].text |
那你認為我們政府財政做不到嗎?我們現在每一年我們多出來的稅有多少你知道嗎?幾千億欸!對,那個是最近這幾年,因為我們的經濟情況好。已經超徵稅額都是幾千億欸!那為什麼不能優先來改善這部分呢?那個如果是只有一次性的,那可能就是問題會比較小。但是這個健保的這一個六十二條的修正如果過的話是每年。 |
| transcript.whisperx[172].start |
5601.303 |
| transcript.whisperx[172].end |
5607.118 |
| transcript.whisperx[172].text |
是每年而且這個規模會每年就越來越大。你可以搭配你其他的方案進來啊。 |
| transcript.whisperx[173].start |
5608.857 |
| transcript.whisperx[173].end |
5627.55 |
| transcript.whisperx[173].text |
你懂我意思嗎?為什麼沒有其他的方案,你剛剛會講,然後講到這個,所以我覺得你好像是完全反對這樣的調整。沒有,我只是提出警告,我之前也報告過嘛,我剩下17天。我知道,我知道。我沒有辦法去預測。因為賴總統也沒有先來徵詢你的意見,然後他就這樣子丟出來了,所以你提出這樣的一個警告。 |
| transcript.whisperx[174].start |
5633.954 |
| transcript.whisperx[174].end |
5651.6 |
| transcript.whisperx[174].text |
bicyn 但是我覺得這個方案是一屆已經反映多次而且一直在反映那你看看我們的健保點子這樣子一直浮動式的坦白講也有它不合理的地方所以其實應該是要好好的來討論到底怎麼樣來檢討我們有一個共識全民健保很好這是臺灣的驕傲但是全民健保也不能建構在壓榨第一線 |
| transcript.whisperx[175].start |
5663.544 |
| transcript.whisperx[175].end |
5676.177 |
| transcript.whisperx[175].text |
disadvant二、委員王育敏等19人擬具 «全民健康保險法第六十二條條文修正草案»案。stanbul一、委員王育敏等19人擬具 «全民健康保險法第六十二條條文修正草案»案。stanbul一、委員王育敏等19人擬具 «全民健康保險法第六十二條條文修正草案»案。stanbul一、委員王育敏等19人擬具 «全民健康保險法第六十二條條文修正草案»案。stanbul一、委員王育敏等19人擬具 «全民健康保險法第六十二條條條文修正草案»案。stanbul一、委員王育敏等19人擬具 «全 |
| transcript.whisperx[176].start |
5687.108 |
| transcript.whisperx[176].end |
5714.104 |
| transcript.whisperx[176].text |
|
| transcript.whisperx[177].start |
5715.224 |
| transcript.whisperx[177].end |
5737.834 |
| transcript.whisperx[177].text |
bicyn 蘇 先討論民眾的服務到哪個範圍,然後再回過頭來籌措財源。在上週的健康台灣論壇裡面,大家也提出了健保的多元財源的一些方案,我們也都會一個一個很仔細地來研究,來設法為健保創造更多的財源。好,您會繼續擔任署長吧? |
| transcript.whisperx[178].start |
5740.476 |
| transcript.whisperx[178].end |
5740.896 |
| transcript.whisperx[178].text |
二、國民黨黨團擬具 |
| transcript.whisperx[179].start |
5771.462 |
| transcript.whisperx[179].end |
5793.166 |
| transcript.whisperx[179].text |
好,謝謝。那我們請這個邱正軍委員咨詢。好,主席好。我們還是有請我們薛部長。好,請薛部長。 |
| transcript.whisperx[180].start |
5798.649 |
| transcript.whisperx[180].end |
5823.142 |
| transcript.whisperx[180].text |
主席,您本身也是醫生。剛剛談論了很多次。目前健保點值低於0.9的狀況,您認為這是正常的嗎?目前平均點值並沒有低於0.9。那現在呢?現在是多少?當然要看結算,但是應該是在0.9以上目前。 |
| transcript.whisperx[181].start |
5824.309 |
| transcript.whisperx[181].end |
5848.899 |
| transcript.whisperx[181].text |
|
| transcript.whisperx[182].start |
5848.985 |
| transcript.whisperx[182].end |
5865.469 |
| transcript.whisperx[182].text |
|
| transcript.whisperx[183].start |
5866.365 |
| transcript.whisperx[183].end |
5868.267 |
| transcript.whisperx[183].text |
hington 原來是新冠是第五級 |
| transcript.whisperx[184].start |
5885.942 |
| transcript.whisperx[184].end |
5911.536 |
| transcript.whisperx[184].text |
adequ五類的傳染病。那因為到後來的話,它的致病率以及它的致重症率是降低的。所以我們就把它調為四級。這全世界都是這樣子。我雖然不在醫界啦,但是也有在醫界的同事跟朋友,包括很多醫療團體,他們對於今天要審的修改案都非常的支持。你個人的看法呢? |
| transcript.whisperx[185].start |
5913.232 |
| transcript.whisperx[185].end |
5936.674 |
| transcript.whisperx[185].text |
當然以各種不同的團體來看一屆一定是支持這個是沒話講因為他可以讓他的收入增加但是他的影響這必須要好好去做討論選前你看一下我們看一下圖你說過健保點子一元一點草野同意就沒有難度這句話的意思是不是表示認同 |
| transcript.whisperx[186].start |
5937.967 |
| transcript.whisperx[186].end |
5940.109 |
| transcript.whisperx[186].text |
bicyn 建保典籍的部分有沒有修改的部分? |
| transcript.whisperx[187].start |
5940.109 |
| transcript.whisperx[187].end |
5944.053 |
| transcript.whisperx[187].text |
bicyn 建保典籍的部分有沒有修改的部分? |
| transcript.whisperx[188].start |
5944.053 |
| transcript.whisperx[188].end |
5947.636 |
| transcript.whisperx[188].text |
bicyn 建保典籍的部分有沒有修改的部分? |
| transcript.whisperx[189].start |
5959.767 |
| transcript.whisperx[189].end |
5967.674 |
| transcript.whisperx[189].text |
incarcerator 還有一個意思就是說反對的人覺得醫護就該犧牲奉獻你們都喜歡說有政府勞保就不會倒現在就變成有政府健保就不會倒 |
| transcript.whisperx[190].start |
5983.069 |
| transcript.whisperx[190].end |
5999.435 |
| transcript.whisperx[190].text |
你們繼續壓榨醫護,先倒的是醫院齁,倒楣的就是全台灣人。這個不會是這個樣子啦,這樣太過簡化的說法。那我再問你齁,我們賴總統當選人有說過什麼,你有印象嗎?呃,他說過的東西沒有說過。你放,我們看一下影片。 |
| transcript.whisperx[191].start |
6005.464 |
| transcript.whisperx[191].end |
6008.986 |
| transcript.whisperx[191].text |
這是本人吧?這是本人吧?應該不是AI啦? |
| transcript.whisperx[192].start |
6023.922 |
| transcript.whisperx[192].end |
6044.753 |
| transcript.whisperx[192].text |
議長,剛剛那個是本人吧?應該不是AI做的吧?那是真的有說過還是詐騙?應該是有說過。所以賴清德是總統候選人的時候,到處去講健保點數要保固在0.9以上,目標要到1.1元。那當時衛福部也配合啊,不是嗎? |
| transcript.whisperx[193].start |
6045.495 |
| transcript.whisperx[193].end |
6050.299 |
| transcript.whisperx[193].text |
二、委員王育敏等19人擬具 «全民健康保險法第六十二條條文修正草案》案。 |
| transcript.whisperx[194].start |
6064.189 |
| transcript.whisperx[194].end |
6084.574 |
| transcript.whisperx[194].text |
我已經剛剛有提到過,我在這17天之內的話,給我能夠掌握的資源,就是我沒有辦法去執行這個...不是,就是說當時你不知道,部長你能不能留任,現在知道了520你沒有辦法留任之後,你就是故意要找...不是故意喔,這不是故意,這本來就是權責。新的部長...那你當時為什麼不講呢? |
| transcript.whisperx[195].start |
6086.538 |
| transcript.whisperx[195].end |
6112.368 |
| transcript.whisperx[195].text |
為什麼當時總統府選人開這種政見的時候你們自己不提出來?你不糾正對不對?我沒有被問到我怎麼可能會去做這種事。這不就跟當這個我們選後長、調長店家一樣嗎?通通都是選票的考量。通通都是為了選舉。不是啊,我跟委員報告啦齁。今天如果是我主這個其證的話我當然可以來想辦法還是我請教部長齁就是說 |
| transcript.whisperx[196].start |
6113.679 |
| transcript.whisperx[196].end |
6137.077 |
| transcript.whisperx[196].text |
現在你們提出的意見是新政府的意見?就是選後不算了嗎?沒有沒有,就是我們現在的意見,衛福部的意見,我們現在。現在,所以跟以後沒有關係?新政府也許他有新的財源能夠去規劃出來。我們就今天5月2號行政院要通過追加預算,撥補台電1000億,這個資金來源有沒有明確? |
| transcript.whisperx[197].start |
6142.25 |
| transcript.whisperx[197].end |
6149.236 |
| transcript.whisperx[197].text |
bicyn 現在健保點數補到我們講的0.9元,是不是也要用公務預算?為什麼臺電就可以用公務預算,我們健保的就要調漲我們的健保費? |
| transcript.whisperx[198].start |
6149.236 |
| transcript.whisperx[198].end |
6150.677 |
| transcript.whisperx[198].text |
bicyn 這個意思是這樣子。 |
| transcript.whisperx[199].start |
6169.215 |
| transcript.whisperx[199].end |
6183.849 |
| transcript.whisperx[199].text |
netesle 因為有這個稅計剩餘所以他給他一千億做這個調查健保的話如果按照今天的法案通過的話是每年要那就必須要看政府是不是每年都有那麼多的稅計剩餘這個不確定 |
| transcript.whisperx[200].start |
6187.671 |
| transcript.whisperx[200].end |
6199.889 |
| transcript.whisperx[200].text |
� |
| transcript.whisperx[201].start |
6200.981 |
| transcript.whisperx[201].end |
6216.852 |
| transcript.whisperx[201].text |
bicyn 您的報告裡傳遞的訊息就是醫護就該犧牲奉獻來表達,來達成你們的政治目的嗎?不是,這必須要各種的配套,而不是單單用條文去調整就可以做得到的。 |
| transcript.whisperx[202].start |
6223.109 |
| transcript.whisperx[202].end |
6229.392 |
| transcript.whisperx[202].text |
二、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。」案﹖一、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。」 |
| transcript.whisperx[203].start |
6239.991 |
| transcript.whisperx[203].end |
6268.302 |
| transcript.whisperx[203].text |
|
| transcript.whisperx[204].start |
6268.402 |
| transcript.whisperx[204].end |
6279.533 |
| transcript.whisperx[204].text |
你們報告說持續健保收支進行檢討研議本席也相信你們有研議現在就請你告訴大家你們對於針對健保點數你們研議的怎麼樣 |
| transcript.whisperx[205].start |
6282.332 |
| transcript.whisperx[205].end |
6307.552 |
| transcript.whisperx[205].text |
這也是根本包括就今天的報告裡面,如果是0.9億的話,我們每年就公務預算必須要支出700億,如果是1.1億的話就要1151億。好啦,我是希望啦,你們在做決定的時候一定要多方的考慮,好不好?當然,我也希望說這個法要通過要多方的考慮。好啦,謝謝部長。 |
| transcript.whisperx[206].start |
6310.495 |
| transcript.whisperx[206].end |
6331.281 |
| transcript.whisperx[206].text |
好,謝謝邱委員。那等一下廖偉祥委員質詢結束後,我們休息五分鐘。現在請圖全集委員質詢。好,謝謝主席。那請我們薛部長。好,請薛部長。 |
| transcript.whisperx[207].start |
6336.22 |
| transcript.whisperx[207].end |
6353.451 |
| transcript.whisperx[207].text |
委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．事由．立法院第11屆第12會期社會福利及衛生環境委員會第11屆第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第13會期社會福利及衛生環境委員會第13會期社會福利及衛生環境委員會第14會期社會福利及衛生環境委員會第14會期社會福利 |
| transcript.whisperx[208].start |
6364.298 |
| transcript.whisperx[208].end |
6382.863 |
| transcript.whisperx[208].text |
lapt��四月三十號國務院的亞太助理國務卿康達也再次表達為美國發聲說希望支持台灣以觀察員的身份來參加。那2023年也有22個國家支持美國的立場。那他們也預計今年 |
| transcript.whisperx[209].start |
6383.443 |
| transcript.whisperx[209].end |
6412.065 |
| transcript.whisperx[209].text |
netesure我們台灣以觀察員身份參加世界衛生大會的這個國家的數也會增加我們看得到從2018年一直到2024年美國一直都是看起來都從官方來表態很支持台灣來參加WHA那我也想請問一下我們部長對於美國支持這部分部長是不是覺得美國一直以來都是真的也都是非常支持我們參加WHA |
| transcript.whisperx[210].start |
6413.526 |
| transcript.whisperx[210].end |
6433.363 |
| transcript.whisperx[210].text |
這是沒有錯,美國一直以來都是支持我們來參加WHA,作為世界衛生組織裡面有意義參與的一員。這是美國從過去官方的態度都顯現出來,我們對這一點非常感謝。 |
| transcript.whisperx[211].start |
6434.264 |
| transcript.whisperx[211].end |
6463.006 |
| transcript.whisperx[211].text |
那實際上很多的這一些我們為什麼這幾年來那受到世界各方的支持是越來越大裡面相同國家越來越多那在WHA的大會裡面也持續的在我們發聲那這個當然我們在對各方面的進行了一些努力那也是我們的一些成果雖然就是說 |
| transcript.whisperx[212].start |
6463.626 |
| transcript.whisperx[212].end |
6483.319 |
| transcript.whisperx[212].text |
|
| transcript.whisperx[213].start |
6484.56 |
| transcript.whisperx[213].end |
6511.943 |
| transcript.whisperx[213].text |
從2019年我們看到從2019年我們很多的友邦國家一直到2023年每年都很多的友邦國家來提案來支持我們來參加WHA那在WHA裡面一百九十幾個會員國幾乎都是美國的邦交國那當然我們也希望美國盡量多出一點力讓我們能夠來參加WHA可是我們不了解就是說 |
| transcript.whisperx[214].start |
6512.743 |
| transcript.whisperx[214].end |
6539.838 |
| transcript.whisperx[214].text |
為什麼這麼多提案裡面美國沒有一次提案是支持我們的那這一部分部長可以幫我們說明嗎?這部分的話通常都是我們又藉由友邦來做提案大概是這樣那在大會裡面有時候美國也會跟其他裡面上線國家在這邊在大會裡面有一些發言來支持我們但是提案的部分都是透過友邦 |
| transcript.whisperx[215].start |
6540.838 |
| transcript.whisperx[215].end |
6554.091 |
| transcript.whisperx[215].text |
對那可不可以請部長為我們說明那難道美國他跟著這些友邦國家如果他來提案的話我覺得這力量會更強大還是有什麼因素他沒有辦法跟著友邦國家提案支持我們 |
| transcript.whisperx[216].start |
6555.295 |
| transcript.whisperx[216].end |
6579.207 |
| transcript.whisperx[216].text |
這當然是有必須要去做整體外交的一些考量那美國也不會說這跟台灣的關係只有在支持WHA的這一個部分那還有許多的合作的關係在進行當中那整體的考量的話那也許就是說他們美國的政府方面的話的一個策略 |
| transcript.whisperx[217].start |
6580.526 |
| transcript.whisperx[217].end |
6589.988 |
| transcript.whisperx[217].text |
那如果美國力挺我們用中華台北去參加WHA的話,那你覺得我們用中華台北的名義參加這是去還是不去? |
| transcript.whisperx[218].start |
6591.141 |
| transcript.whisperx[218].end |
6594.505 |
| transcript.whisperx[218].text |
所以如果以中華台北去,部長也覺得是可以的沒有矮化的問題吧? |
| transcript.whisperx[219].start |
6612.665 |
| transcript.whisperx[219].end |
6614.887 |
| transcript.whisperx[219].text |
三、國民黨黨團擬具 «全民健康保險法第六十二條條文修正草案》案。 |
| transcript.whisperx[220].start |
6628.319 |
| transcript.whisperx[220].end |
6654.104 |
| transcript.whisperx[220].text |
|
| transcript.whisperx[221].start |
6659.197 |
| transcript.whisperx[221].end |
6676.617 |
| transcript.whisperx[221].text |
市長我請問一下因為這跟我們那個部桃我們新屋分院擴建有關係因為我們次長好像從2020年沒有我們署長是2020年的時候是擔任次長那我記得當初好像對這個部桃新屋分院擴建這個計畫次長有瞭解嗎? |
| transcript.whisperx[222].start |
6680.965 |
| transcript.whisperx[222].end |
6708.755 |
| transcript.whisperx[222].text |
時間有點久。再請委員提醒一下。因為據我們瞭解你在109年的時候就有立委詢問到關於部桃新屋分院擴建的問題。那你也回答說則無旁貸。那所以我一直想瞭解說我們署長那時候擔任是次長。從2020年你一直擔任到2023年。那針對這部桃新屋分院擴建這到底有沒有計畫?到底有沒有進行?到底有沒有進度? |
| transcript.whisperx[223].start |
6710.598 |
| transcript.whisperx[223].end |
6711.72 |
| transcript.whisperx[223].text |
這個是計畫是有通過啦。 |
| transcript.whisperx[224].start |
6718.337 |
| transcript.whisperx[224].end |
6746.211 |
| transcript.whisperx[224].text |
bicyn Kwan- 預算是從部桃本身的基金預算去支援所以這個經費預算已經有編列出來嗎?我的印象中是有對,因為這個我們希望來爭取一下因為我一直在講我們桃園這個醫療資源真的非常的匱乏桃園是現在兩百三十幾萬人口唯一的醫學中心就是在我們 |
| transcript.whisperx[225].start |
6746.971 |
| transcript.whisperx[225].end |
6767.056 |
| transcript.whisperx[225].text |
|
| transcript.whisperx[226].start |
6767.396 |
| transcript.whisperx[226].end |
6796.345 |
| transcript.whisperx[226].text |
對,因為沿海的部分真的看起來真的沒有連這個地區型的醫院都沒有你急診病房都看不到所以我們對這部桃新屋分院這個擴建大家都非常的重視而且我一直在重申我們蔡總統在2019年的時候就告訴我們民眾說衛福部已經通過這個案子然後對2023年我們的那時候的副總統也是我們的準總統賴清德也一直說 |
| transcript.whisperx[227].start |
6797.125 |
| transcript.whisperx[227].end |
6816.69 |
| transcript.whisperx[227].text |
bicyn 將要擴建這個部桃新屋分院第二醫療大樓所以我一直不瞭解說從2023年那時候我們的時署長當時的次長對這個案子都說已經責無旁貸要進行到現在2024年我可不可以請部長幫我們說明一下這到底進行到哪裡 |
| transcript.whisperx[228].start |
6820.011 |
| transcript.whisperx[228].end |
6837.265 |
| transcript.whisperx[228].text |
這個是進度上面可能有一點落後,因為其實預算都已經有了,現在就是要做這個計畫書的一個審查。詳細的情形,因為今天依依福惠沒有派人過來,所以 |
| transcript.whisperx[229].start |
6840.425 |
| transcript.whisperx[229].end |
6869.137 |
| transcript.whisperx[229].text |
所以我們確定這個案子已經有預算有在進行了嗎?對,可能就是計畫書的審查的這個部分的話是不是還有哪一些地方必須要做補?我想明天是不是我請醫護會的同仁、大委員、辦公室去跟你們做補?好,這部分也感謝部長,因為我們希望這個政策要有延續性,包含建設也是一樣。雖然我們部長在520即將要卸任,但是像我們石署長本身也是事務官, |
| transcript.whisperx[230].start |
6869.737 |
| transcript.whisperx[230].end |
6870.017 |
| transcript.whisperx[230].text |
接下來我們請廖偉祥委員質詢。 |
| transcript.whisperx[231].start |
6915.371 |
| transcript.whisperx[231].end |
6925.938 |
| transcript.whisperx[231].text |
謝主席,有請我們薛部長。好,請薛部長。部長你好。部長,這個 |
| transcript.whisperx[232].start |
6928.456 |
| transcript.whisperx[232].end |
6951.442 |
| transcript.whisperx[232].text |
|
| transcript.whisperx[233].start |
6952.23 |
| transcript.whisperx[233].end |
6980.927 |
| transcript.whisperx[233].text |
adequ要場研發的新冠疫苗接種後在少數的情況下會導致接種者出現血栓或血小板低下症候群並且也已經有疫苗的這個受害者提出集體訴訟想要請教部長雖然我國目前已經有預防接種的受害救濟的程序那國內因為AZ疫苗而有負重的民眾可不可以去這個國外參加集體訴訟或者是受害者自己組織起來去國外提起跨海的訴訟 |
| transcript.whisperx[234].start |
6982.815 |
| transcript.whisperx[234].end |
7006.352 |
| transcript.whisperx[234].text |
如果自行組織起來去參加國外的集體訴訟我想這個在法律上並沒有說不可以只是說我們需不需要給他做什麼樣的一個資源的確如果說這個跨國訴訟其實是非常成本非常高而且是曠日廢時的 |
| transcript.whisperx[235].start |
7007.193 |
| transcript.whisperx[235].end |
7019.411 |
| transcript.whisperx[235].text |
|
| transcript.whisperx[236].start |
7019.571 |
| transcript.whisperx[236].end |
7040.641 |
| transcript.whisperx[236].text |
adequa做這個幫忙所以你們會站在這個受害者的立場給予他們最大的幫忙對不對如果是有這樣子對於國內的這種接種心但是但是這裡面有一個問題必須要特別要去做處理就雖然AZ可能他自己也承認有這種風險在 |
| transcript.whisperx[237].start |
7042.222 |
| transcript.whisperx[237].end |
7066.088 |
| transcript.whisperx[237].text |
但是...部長沒關係我沒有要問這麼細我只想問說我們衛福部的立場是什麼是不是努力從寬的幫助這些疫苗新冠接種的受害者去幫他們這個找到救濟的方式和管道就是說就是如果有這樣的管道我們會予以支持但是就是說是否就能夠達到這個當然...部長沒關係我是問你們對部長我是問你們衛福部的態度喔 |
| transcript.whisperx[238].start |
7068.969 |
| transcript.whisperx[238].end |
7096.763 |
| transcript.whisperx[238].text |
adequ?你們應該是要用從寬的方式去努力幫他們爭取他們應該有的賠償,對不對?部長是這樣吧?應該我們會幫忙。沒錯齁,那你們態度應該是這樣,我可以這樣說。但是部長我告訴你喔,我四月初的時候發文詢問你們VICP的審議辦法,關在我們國內的受害者的救濟部分喔。從一百一十一年的八月以後的會議記錄跟錄音檔,我問他們說有沒有。結果你知道我拿到的回文是什麼嗎? |
| transcript.whisperx[239].start |
7100.433 |
| transcript.whisperx[239].end |
7110.346 |
| transcript.whisperx[239].text |
說我拿到回文是說你們出席的委員是主案討論然後所以沒有另定並未另定議事規範然後呢還有什麼沒有保留會議記錄的錄音檔 |
| transcript.whisperx[240].start |
7113.404 |
| transcript.whisperx[240].end |
7131.596 |
| transcript.whisperx[240].text |
|
| transcript.whisperx[241].start |
7134.145 |
| transcript.whisperx[241].end |
7140.892 |
| transcript.whisperx[241].text |
總審議的件數是162件,有相關是2件,無法確定是8件,無關是152件。但是你知道那天開會是從下午2點開到4點15分鐘,總共135分鐘。 |
| transcript.whisperx[242].start |
7145.35 |
| transcript.whisperx[242].end |
7163.404 |
| transcript.whisperx[242].text |
|
| transcript.whisperx[243].start |
7163.544 |
| transcript.whisperx[243].end |
7175.174 |
| transcript.whisperx[243].text |
但是採用線上會議的專家學者並非全程參加審查會。有些人甚至只參加20分鐘、21分鐘、半個小時。所以很少數是全程參與。我想要請問你們這樣的審議方法是真的有在審查嗎?其實在進大會這個審議小組大會的討論之前都會有預審。 |
| transcript.whisperx[244].start |
7190.612 |
| transcript.whisperx[244].end |
7213.52 |
| transcript.whisperx[244].text |
我知道所以你要說前面會先有兩家專家這個兩兩位專家先行鑑定對但是部長你知道嗎我們以前也是很信任專家但是最近有一個訴訟案在台北高等行政法院的第112年的這個數字第454號判決理由我們看到這整個過程從一開始的鑑定到最後的審議結果根本就是大有問題 |
| transcript.whisperx[245].start |
7215.522 |
| transcript.whisperx[245].end |
7235.044 |
| transcript.whisperx[245].text |
從剛剛你們內部開會我們就覺得是黑箱程序有問題到這個這個鑑定的結果整個過程都是有問題喔兩位鑑定委員的鑑定報告是超法醫的解剖報告而且但是這個解剖報告是要給檢察官作為認定是否自殺或他殺基本上他是一個與疫苗沒有關聯性的鑑定報告 |
| transcript.whisperx[246].start |
7236.428 |
| transcript.whisperx[246].end |
7260.541 |
| transcript.whisperx[246].text |
但鑑定委員直接因為該份的解剖就認定受害者的死因和疫苗無關。後面的程序就是審議小組我們剛剛講的VICP這個審議小組沒有會議的規範沒有開會錄音檔沒有出席規定沒有表決規定就直接這樣判定無關如此粗糙所以才被行政法院打臉。 |
| transcript.whisperx[247].start |
7262.153 |
| transcript.whisperx[247].end |
7277.436 |
| transcript.whisperx[247].text |
甚至你們疾管署引用的一篇什麼國際期刊根本只是一個先導的研究。連作者都在內文中寫還沒有完全完成就被你們拿來亂引用。所以我要請教部長台北高等行政法院的這個判決你們還有臉上訴嗎? |
| transcript.whisperx[248].start |
7278.217 |
| transcript.whisperx[248].end |
7299.821 |
| transcript.whisperx[248].text |
️ ️ ️ |
| transcript.whisperx[249].start |
7300.122 |
| transcript.whisperx[249].end |
7302.185 |
| transcript.whisperx[249].text |
netese 法院都直接判決了。 |
| transcript.whisperx[250].start |
7313.103 |
| transcript.whisperx[250].end |
7331.514 |
| transcript.whisperx[250].text |
ignty 說你們呈現在網頁上的公開的資料都顯現程序根本很大的問題就是黑箱就是亂審你們最後決定補償的金額標準就是沒有標準這樣子的審查過程和結果我想是受害者家屬都沒有辦法接受你即將卸任了你不覺得卸任前應該要做一點 |
| transcript.whisperx[251].start |
7332.23 |
| transcript.whisperx[251].end |
7348.717 |
| transcript.whisperx[251].text |
adequ?是不是應該對於這個案件就不要再上訴?甚至是第二就是希望把過去這些有審過的程序根本有問題的就應該要重審嗎?而且應該要重新訂定這個議事的程序和規範。我們現在有幾千案,這不可能是重審。 |
| transcript.whisperx[252].start |
7349.735 |
| transcript.whisperx[252].end |
7368.122 |
| transcript.whisperx[252].text |
bicyn 但是你過程中很多受害家屬都出事的問題。 齊 這是科學的問題,英國關係有沒有是科學的問題。 bicyn 是科學的問題沒有做,所以剛剛我已經講了嘛,你們鑑定你們最後審查的過程沒有用跟疫苗相關的。 齊 所以我們會上訴。 bicyn 好,如果你還要堅持這樣子的話,我們還是會持續為我們受害者家屬來發聲。 |
| transcript.whisperx[253].start |
7370.103 |
| transcript.whisperx[253].end |
7390.718 |
| transcript.whisperx[253].text |
再來部長這次在討論健保的問題我自己本身我們也跟這個14位委員共體26位連署然後推動一個健全醫療法人特別條例那跟今天我們的兩位委員提案的這個概念上這個有點基本上都是希望保障點子的部分當然這個預算的來源特別條例是不一樣 |
| transcript.whisperx[254].start |
7391.701 |
| transcript.whisperx[254].end |
7412.663 |
| transcript.whisperx[254].text |
沒關係我要講的事情是部長去年9月14日賴清德說健保點值不足的問題不可以歸咎醫界因為醫師開設診所並不知道其他人的服務量能增加多少那醫療法規定醫師沒有拒絕病人的權利依照法律提供病人服務跟解決病痛反而收入減少這個制度有必要調整這是賴清德說的話 |
| transcript.whisperx[255].start |
7413.484 |
| transcript.whisperx[255].end |
7442.282 |
| transcript.whisperx[255].text |
今年北區也已經大幅滑落到0.81等於是打八折給付那近年的物價上漲藥物以及人事成本的激增那健保申報醫療給付卻被打折這都是賴清德講的話所以今天國民黨委員要幫賴總統實現政見提出修法版本請教部長那執政黨的版本呢你們一直講各種理由就是不想做就是沒有改善這個醫療的問題那請問我們執政黨有沒有版本衛福部的版本呢 |
| transcript.whisperx[256].start |
7442.662 |
| transcript.whisperx[256].end |
7465.773 |
| transcript.whisperx[256].text |
bicyn 呃,國務部的版本現在正在處理當中。也就是說我們是對於全民健保法整體的一個修正。不是只有單一條文。因為單一條文的修正的話,造成的後續的風險是非常高的。所以我們沒有全盤去討論。不是,你們講全盤討論已經很久了喔。所以這個東西就是執政黨的東西沒有做過了喔。有人認為這個事情是那麼簡單嗎? |
| transcript.whisperx[257].start |
7466.793 |
| transcript.whisperx[257].end |
7489.619 |
| transcript.whisperx[257].text |
當然不是那麼簡單,但是問題是你們總是要給一個方向嘛。我上任只有一年多,這中間的話我們這個建法的、修法的小組已經好了一年了。反映就是民間的問題喔,醫療體系這些血汗醫護,醫療體系也快要崩潰,影響的也是最終也是全體人,台灣人的醫療的權益喔。 |
| transcript.whisperx[258].start |
7491.139 |
| transcript.whisperx[258].end |
7508.697 |
| transcript.whisperx[258].text |
難道您不知道現在急診室很多人滿為患然後也有醫護人員不足的問題有一些病床沒有辦法開那我覺得今天看了你們的報告簡單來講你們就是找各種理由嘛你就是找各種理由說不行不行不行政府沒錢那想要請教部長賴總統的政見現在衛福部是什麼態度 |
| transcript.whisperx[259].start |
7510.342 |
| transcript.whisperx[259].end |
7523.927 |
| transcript.whisperx[259].text |
這個部分的話要去處理那這個處理必須要有全部的一個配套包括錢的來源今年1月8號也就是在選前幾天賴清德總統承諾若當選要召開改革健保給付擴大會議 |
| transcript.whisperx[260].start |
7525.167 |
| transcript.whisperx[260].end |
7542.734 |
| transcript.whisperx[260].text |
單選後到現在我們只有看到賴清德跟他的老師辦的什麼健康臺灣論壇那這場論壇在上週六也做出結論有關健保的部分是第四點確保健保永續經營就這樣那請問部長這是就是有關健保的結論嗎 |
| transcript.whisperx[261].start |
7544.111 |
| transcript.whisperx[261].end |
7548.234 |
| transcript.whisperx[261].text |
還是有沒有什麼大家不知道的事情或大家都知道的事情要怎麼解決具體方案? |
| transcript.whisperx[262].start |
7574.211 |
| transcript.whisperx[262].end |
7574.231 |
| transcript.whisperx[262].text |
閱讀者﹖ |
| transcript.whisperx[263].start |
7609.493 |
| transcript.whisperx[263].end |
7612.363 |
| transcript.whisperx[263].text |
三、國民黨黨團擬具:「全民健康保險法第六十二條條文修正草案案。」案。 |
| transcript.whisperx[264].start |
7623.167 |
| transcript.whisperx[264].end |
7647.937 |
| transcript.whisperx[264].text |
一、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．一、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．一、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．一、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．一、委員王育敏等19人擬具:「全民健康保險法第六十二條條條文修正草案．一、 |
| transcript.whisperx[265].start |
7648.097 |
| transcript.whisperx[265].end |
7663.526 |
| transcript.whisperx[265].text |
三、國民黨黨團擬具:「全民健康保險法第六十二條條文修正草案案 案 、國民黨黨團擬具:「全民健康保險法第六十二條條文修正草案 案 、國民黨黨團擬具:「全民健康保險法第六十二條條文修正草案 案 、國民黨黨團擬具:「全民健康保險法第六十二條條條文修正草案 案 、國民黨黨團擬具:「全民健康保險法第六十二條條條文修正草案 案 、國民黨黨團擬具:「全民健康保險法第六十二條條條文修正草案 案 、國民黨黨黨團擬具:「全民健� |
| transcript.whisperx[266].start |
7673.454 |
| transcript.whisperx[266].end |
7681.119 |
| transcript.whisperx[266].text |
三、國民黨黨團擬具:「全民健康保險法第六十二條條文修正草案 案。」案。 |
| transcript.whisperx[267].start |
7704.514 |
| transcript.whisperx[267].end |
7720.769 |
| transcript.whisperx[267].text |
一、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．立法院第11屆第1會期社會福利及衛生環境委員會第12次全民健康保險法第六十二條條文修正草案．立法院第11屆第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全 |
| transcript.whisperx[268].start |
7721.309 |
| transcript.whisperx[268].end |
7725.512 |
| transcript.whisperx[268].text |
三、國民黨黨團擬具:「全民健康保險法第六十二條條文修正草案案。」案。 |
| transcript.whisperx[269].start |
7746.437 |
| transcript.whisperx[269].end |
7775.335 |
| transcript.whisperx[269].text |
一、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。」案。閱讀委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。」案。閱讀委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。案。閱讀委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。案。閱讀委員王育敏等19人擬具:「全民健康保險法第六十二條條條文修正草案案。案。閱讀委員王育敏等19人� |
| transcript.whisperx[270].start |
7784.961 |
| transcript.whisperx[270].end |
7793.47 |
| transcript.whisperx[270].text |
二、國民黨黨團擬具:「全民健康保險法第六十二條條文修正草案案。」案。 |
| transcript.whisperx[271].start |
7806.425 |
| transcript.whisperx[271].end |
7807.169 |
| transcript.whisperx[271].text |
三、國民黨黨團擬具 |
| transcript.whisperx[272].start |
7924.025 |
| transcript.whisperx[272].end |
7927.809 |
| transcript.whisperx[272].text |
好,我們繼續開會。接下來我們請劉建國委員進行質詢。劉建國委員 |
| transcript.whisperx[273].start |
7959.978 |
| transcript.whisperx[273].end |
7974.187 |
| transcript.whisperx[273].text |
我先肯定趙薇跟蘇委員今天把這個健保點數一點要等值一元這樣的一個提案法律的修正案提到委員會來討論 |
| transcript.whisperx[274].start |
7976.203 |
| transcript.whisperx[274].end |
7993.473 |
| transcript.whisperx[274].text |
|
| transcript.whisperx[275].start |
7994.174 |
| transcript.whisperx[275].end |
8022.677 |
| transcript.whisperx[275].text |
但是這高度共識的一件事情的過程裡面我是剛剛也看到這個衛務部的相關的報告那也看到很多委員的槌尋然後看到部長的答覆我是真的從一個角度來做思考我們站在醫界還有政府還有僱主還有被保險人就是要保惠的就是我們全體國民的這樣的事情這角度來做這樣的思考情況之下 |
| transcript.whisperx[276].start |
8023.277 |
| transcript.whisperx[276].end |
8048.127 |
| transcript.whisperx[276].text |
然後部長跟署長還有我們先剛到的王委員都是來自一屆下一屆的部長也是來自一屆我想針對這些事情的處理應該不能只有站在一屆的角度那當然要從一屆的角度來做思考探討那也不為過因為畢竟提案的委員除了王昭偉之外蘇清泉委員也是來自一屆 |
| transcript.whisperx[277].start |
8049.068 |
| transcript.whisperx[277].end |
8072.113 |
| transcript.whisperx[277].text |
bicyn 要很多的這樣的一個面向都要去思考的情況之下才可以把這樣的一個制度可長可久不會去因為要達到這個目標反而去造成沒有必要的後續的一些擔憂或是困擾我想這才是我們真正要解決的一個方式我先給部長跟署長還有委員會看一個資料 |
| transcript.whisperx[278].start |
8077.734 |
| transcript.whisperx[278].end |
8090.354 |
| transcript.whisperx[278].text |
我說這個人離開之後講的話都會比較中肯一些這是前署長他直接就講了健保點子什麼叫做一點議員我也可能要速度快一點 |
| transcript.whisperx[279].start |
8091.67 |
| transcript.whisperx[279].end |
8102.583 |
| transcript.whisperx[279].text |
disadvant二、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．立法院第11屆第11會期社會福利及衛生環境委員會第12條條文修正草案．立法院第11會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第13會期社會福利及衛生環境委員會第13會期社會福利及衛生環境委員會第14會期社會福利及衛生環境委員會第14會期社會福利及衛生環境 |
| transcript.whisperx[280].start |
8111.013 |
| transcript.whisperx[280].end |
8116.017 |
| transcript.whisperx[280].text |
disadvant二、委員王育敏等19人擬具〈全民健康保險法第六十二條條文修正草案〉案。�二、委員王育敏等19人擬具〈全民健康保險法第六十二條條文修正草案〉案。�二、委員王育敏等19人擬具 |
| transcript.whisperx[281].start |
8141.033 |
| transcript.whisperx[281].end |
8164.492 |
| transcript.whisperx[281].text |
還是這個第18條有匯率的部分還有這個準備金的安全準備金的部分這都是三個面向都必須要去思考的問題至於公務預算的挹注那公務預算是不是要常態性的一個配套這個我想都是有討論的空間那前書長就提到每年訂定花位的醫療費用就是總額那其幾戶適用點數 |
| transcript.whisperx[282].start |
8167.261 |
| transcript.whisperx[282].end |
8184.926 |
| transcript.whisperx[282].text |
adequ不斷在衝業務量時醫療點數就超過總額也就是最近很夯的點值下降當大家減少不必要浪費的醫療行為那總額高於醫療點數點值就會上升醫療費用主要是藥品費用和醫療服務的手術診療費 |
| transcript.whisperx[283].start |
8187.108 |
| transcript.whisperx[283].end |
8207.466 |
| transcript.whisperx[283].text |
|
| transcript.whisperx[284].start |
8207.807 |
| transcript.whisperx[284].end |
8230.384 |
| transcript.whisperx[284].text |
� |
| transcript.whisperx[285].start |
8231.175 |
| transcript.whisperx[285].end |
8258.337 |
| transcript.whisperx[285].text |
則承諾健保點子不低於0.9並朝1.1的目標邁進這是負責任的正式風範我想這剛剛很多委員都有提出來我再把這個當時有講的話的歷史背景再拿出來這是在選前的前一天這個頭到最後廣場是在今年的1月12號那政府只是一個團體沒有錢錢都是來自國民的稅收所以去調這個調那個調那個也是都對 |
| transcript.whisperx[286].start |
8261.411 |
| transcript.whisperx[286].end |
8265.154 |
| transcript.whisperx[286].text |
bicyn Kwan-yong |
| transcript.whisperx[287].start |
8279.113 |
| transcript.whisperx[287].end |
8307.919 |
| transcript.whisperx[287].text |
而七、七零九二億啦齁。稅數是兩兆八千多億。民運隊的國防預算是在六千應該他是講今年啦齁。六千出啦。但是健保的總額現在已經高達八千三百多億啦。應該還更高吧。齁。署長你會比我更清楚。一屆的組的是想得到更多的總額的錢來補足這個點值齁。一點億元。但是在收支這個平衡之下就必須要提高健保匯率。 |
| transcript.whisperx[288].start |
8310.02 |
| transcript.whisperx[288].end |
8315.263 |
| transcript.whisperx[288].text |
bicyn Kwan-kwan-kwan-kwan-kwan-kwan |
| transcript.whisperx[289].start |
8339.901 |
| transcript.whisperx[289].end |
8357.693 |
| transcript.whisperx[289].text |
bicyn 蘇以治療等支付標準,讓辛苦的醫療人員都能夠獲得合理的報酬,讓醫療院所以專業獲取合理利潤,不靠充病人數多、藥物使用量大來賺取這個藥價差。下面應該還有啦齁。但事實上是這樣啦齁。最後一段的話是應該講說 |
| transcript.whisperx[290].start |
8365.905 |
| transcript.whisperx[290].end |
8388.4 |
| transcript.whisperx[290].text |
disadvant二、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．事由、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．事由、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．事由、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．事由、委員王育敏等19人擬具:「全民健康保險法第六十二條條條文修正草案． |
| transcript.whisperx[291].start |
8392.462 |
| transcript.whisperx[291].end |
8416.773 |
| transcript.whisperx[291].text |
厲此禮賢署長也把相關的現狀都點出來。但是我們要去處理這事情,如果單純去修正這一條就可以解決,那沒有理由去反對。那如果單純修這一條,還有很多事情要去做思考,那是不是大家應該有更多的討論的空間。我是不是請署長回應一下。 |
| transcript.whisperx[292].start |
8421.271 |
| transcript.whisperx[292].end |
8447.274 |
| transcript.whisperx[292].text |
二、委員王育敏等19人擬具 «全民健康保險法第六十二條條文修正草案》案。netesi,跟委員報告,確實像委員所提到的,那麼過去我們這幾年也不斷地在修這些支付標準,希望讓各科之間可以平衡,但是它也是會影響到點值的下降,從我們的分析裡面它也是一個因素,所以還是要全面性的思考,包含這個總額如何適當的成長,還有各項的財源多元化的這個 |
| transcript.whisperx[293].start |
8448.835 |
| transcript.whisperx[293].end |
8449.937 |
| transcript.whisperx[293].text |
二、委員王育敏等19人擬具 |
| transcript.whisperx[294].start |
8462.075 |
| transcript.whisperx[294].end |
8478.748 |
| transcript.whisperx[294].text |
就這樣。我講這麼多,你就要講那樣?因為時間到了。時間到了,人家主席都沒有講,奇怪了。部長,請補充吧。你們都是來自一屆嘛,對不對?蘇委員是一屆,王委員是一屆。 |
| transcript.whisperx[295].start |
8481.698 |
| transcript.whisperx[295].end |
8497.244 |
| transcript.whisperx[295].text |
|
| transcript.whisperx[296].start |
8497.244 |
| transcript.whisperx[296].end |
8519.684 |
| transcript.whisperx[296].text |
|
| transcript.whisperx[297].start |
8520.049 |
| transcript.whisperx[297].end |
8546.751 |
| transcript.whisperx[297].text |
但是這個問題是否就從一點一元這樣子一個單純的修法就能夠解決?我不認為。因為裡面要去處理的事情是非常多。但是你如果今天通過一點一元,假設這個通過了,健保幾乎沒有能力再去處理其他的事情。因為所有的資源都弄到去增加這一個點子。 |
| transcript.whisperx[298].start |
8548.325 |
| transcript.whisperx[298].end |
8553.347 |
| transcript.whisperx[298].text |
二、委員王育敏等19人擬具〈全民健康保險法第六十二條條文修正草案案〉案〈全民健康保險法第六十二條條文修正草案〉 |
| transcript.whisperx[299].start |
8579.101 |
| transcript.whisperx[299].end |
8583.148 |
| transcript.whisperx[299].text |
只要處理得好,就有辦法解決所有問題,我才會做。 |
| transcript.whisperx[300].start |
8588.669 |
| transcript.whisperx[300].end |
8605.404 |
| transcript.whisperx[300].text |
蘇清泉等28人擬具:「全民健康保險法第六十二條條文修正草案：立法院第11屆第1會期社會福利及衛生環境委員會第16次全民健康保險法第六十二條條文修正草案：立法院第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次 |
| transcript.whisperx[301].start |
8616.274 |
| transcript.whisperx[301].end |
8617.816 |
| transcript.whisperx[301].text |
這個本來就是健保的制度就是有收入面跟支出面的問題。 |
| transcript.whisperx[302].start |
8637.011 |
| transcript.whisperx[302].end |
8656.517 |
| transcript.whisperx[302].text |
那現在是這個條文是要處理的是收入面。我希望是把這一個引入公務預算來預注。但是它的金額是必須要在我們整體的國家的財政的收入能夠負擔的一個條件之下。 |
| transcript.whisperx[303].start |
8657.037 |
| transcript.whisperx[303].end |
8657.758 |
| transcript.whisperx[303].text |
bicylson |
| transcript.whisperx[304].start |
8673.251 |
| transcript.whisperx[304].end |
8701.636 |
| transcript.whisperx[304].text |
所以,如果說這條文要這樣子,等於說把總額支付制度的精神已經拿掉了。拿掉之後的話,公務預算每年要去做補貼,事先就要先預估。如果說我今年預估明年要有一千億,我公務預算也編了,明年如果超出一千億的部分,就是要健保那邊的安全準備要去用。 |
| transcript.whisperx[305].start |
8703.029 |
| transcript.whisperx[305].end |
8732.278 |
| transcript.whisperx[305].text |
|
| transcript.whisperx[306].start |
8733.258 |
| transcript.whisperx[306].end |
8754.605 |
| transcript.whisperx[306].text |
公務預算不是燙害,要啟示不禁用字不解,不是這個樣子。我知道啦,因為主席也站起來很久了,不想就一句話就好啦,就剩下十多天,我們要來處理這事情,因你的智慧跟經驗。我大概沒有什麼智慧啦。你這麼講我怎麼接下去? |
| transcript.whisperx[307].start |
8758.47 |
| transcript.whisperx[307].end |
8785.175 |
| transcript.whisperx[307].text |
沒有,這其實是全國各界大家都必須要好好來做討論啦。是,沒有錯,沒有錯,對。方方面面大家都要全部都想清楚了。不是,不是,不是,不是,最後一句話啦齁。我想,我想有時候秤值比值秤更重要,這個你都比我更清楚了。所以我才會想說,這其實也是,也是大家的一個痛啦。坦白講嘛,對不對。那如果在最後十多天,也因為你的秤值, |
| transcript.whisperx[308].start |
8785.862 |
| transcript.whisperx[308].end |
8808.524 |
| transcript.whisperx[308].text |
|
| transcript.whisperx[309].start |
8809.434 |
| transcript.whisperx[309].end |
8810.515 |
| transcript.whisperx[309].text |
接下來我們請王振旭委員質詢。 |
| transcript.whisperx[310].start |
8842.391 |
| transcript.whisperx[310].end |
8869.082 |
| transcript.whisperx[310].text |
謝謝主席。麻煩薛部長還有石署長。好,薛部長、石署長請。國安好。部長好。石署長好。經過剛剛很熱烈的討論,我們知道其實這個真的非常非常重要。期待透過很好的討論,得到社會大家共同來面對這個問題。 |
| transcript.whisperx[311].start |
8870.526 |
| transcript.whisperx[311].end |
8894.407 |
| transcript.whisperx[311].text |
bicyn Kwan-hung﹗一、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案﹗一、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案﹗一、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案﹗一、委員王育敏等19人擬具:「全民健康保險法第六十二條條條文修正草案﹗一、委員王育敏等19人擬具:「全民健康保險法第六十二條條條文修正草案﹗一、委員王育敏等19人 |
| transcript.whisperx[312].start |
8898.57 |
| transcript.whisperx[312].end |
8919.237 |
| transcript.whisperx[312].text |
bicyn 想要跟部長討論的就是下一張的幻燈片告訴我們說除了這個高度滿意以外基本上就是提升了這個醫療的可敬性讓民眾在就醫的時候可以很方便而且可以及時的得到整個疾病的照護那也促進了國人的健康 |
| transcript.whisperx[313].start |
8920.057 |
| transcript.whisperx[313].end |
8940.653 |
| transcript.whisperx[313].text |
那過去這20年來總額支付制度執行下來其實也真的能夠讓這個健保的資源除了控管以外也得到有效的利用那當然它的造成的影響尤其是疫情之後造成的影響讓我們整體的這個醫療的韌性受到很大的考驗 |
| transcript.whisperx[314].start |
8941.734 |
| transcript.whisperx[314].end |
8960.15 |
| transcript.whisperx[314].text |
那對於醫療我從業人員剛剛提到很多次包括部長、署長還有現場服務員還有我本身都是來自醫界我們非常非常的認同健保制度有這麼好的優點可是還是需要做一些調整做一些改革 |
| transcript.whisperx[315].start |
8960.931 |
| transcript.whisperx[315].end |
8989.707 |
| transcript.whisperx[315].text |
那透過這個改革除了繼續照顧民眾的健康的同時也希望能夠來建立一個友善的醫療環境讓所有的從事的醫療同仁都能夠得到該有的保障這個是我們非常非常期待的那我們可以了解剛剛也提過很多相關有關於新政府賴總統當選人他未來希望能夠對健保的部分做哪一些的 |
| transcript.whisperx[316].start |
8990.788 |
| transcript.whisperx[316].end |
8993.19 |
| transcript.whisperx[316].text |
bicyn 蘇清泉等28人擬具 |
| transcript.whisperx[317].start |
9007.501 |
| transcript.whisperx[317].end |
9016.128 |
| transcript.whisperx[317].text |
二、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第11屆第12會期社會福利及衛生環境委員會第12條條文修正草案：立法院第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會 |
| transcript.whisperx[318].start |
9025.316 |
| transcript.whisperx[318].end |
9040.185 |
| transcript.whisperx[318].text |
unintendant to the future administrative team of the Ministry of Health and Welfare, we need to put forward some comprehensive and comprehensive planning strategies for the long-term goal of fostering wealth and promoting健康. |
| transcript.whisperx[319].start |
9040.185 |
| transcript.whisperx[319].end |
9051.112 |
| transcript.whisperx[319].text |
We can see from the next slide that if the document of the current president can be presented and realized, in fact, last Saturday, |
| transcript.whisperx[320].start |
9051.312 |
| transcript.whisperx[320].end |
9061.584 |
| transcript.whisperx[320].text |
bicynkong Taiwan的論壇裡面就有提出了一些財務策略的方向來作為改革的一個大的方向的依據那這邊就羅列了六點那這六點請問部長未來我們 |
| transcript.whisperx[321].start |
9066.75 |
| transcript.whisperx[321].end |
9068.431 |
| transcript.whisperx[321].text |
議員,可以請部長先來讓我們知道這個大方向可行的部分。 |
| transcript.whisperx[322].start |
9084.386 |
| transcript.whisperx[322].end |
9089.655 |
| transcript.whisperx[322].text |
二、委員王育敏等19人擬具 «全民健康保險法第六十二條條文修正草案案。」案。 |
| transcript.whisperx[323].start |
9098.439 |
| transcript.whisperx[323].end |
9102.182 |
| transcript.whisperx[323].text |
bicyn Kwan-kwan-kwan-kwan |
| transcript.whisperx[324].start |
9123.479 |
| transcript.whisperx[324].end |
9125.641 |
| transcript.whisperx[324].text |
bicyn Kwan-hung, 國民黨黨團擬具 |
| transcript.whisperx[325].start |
9146.876 |
| transcript.whisperx[325].end |
9151.641 |
| transcript.whisperx[325].text |
bicyn 蘇清泉等28人擬具:「全民健康保險法第六十二條條文修正草案案 案 條文修正草案 案 條文修正草案 案 |
| transcript.whisperx[326].start |
9169.938 |
| transcript.whisperx[326].end |
9182.706 |
| transcript.whisperx[326].text |
是,所以部長意思是說如果透過這些健保財務策略的這個改善方向來看的話未來還是有機會去增加整體的醫療資源這個是可以肯定的 |
| transcript.whisperx[327].start |
9184.671 |
| transcript.whisperx[327].end |
9203.701 |
| transcript.whisperx[327].text |
這都是一樣啦,就是說公務預算放到這個健保裡面去移住,或者是公務預算另外去支援這一些計畫,其實都是公務預算。就是有機會可以去做調整的,如果說主計總數這邊的話,能夠把這個預算容許我們編列出來,那這個就 |
| transcript.whisperx[328].start |
9210.024 |
| transcript.whisperx[328].end |
9211.106 |
| transcript.whisperx[328].text |
bedingt. |
| transcript.whisperx[329].start |
9229.446 |
| transcript.whisperx[329].end |
9258.032 |
| transcript.whisperx[329].text |
那針對於下一頁我們可以看到的就是總和制度的改革其實最重要的目標就是希望能夠穩定醫療的服務點值那就包括這幾大項那這部分除了部長來說明以外那署長也可以來補充說明未來針對於這個彈性總和制度總和目標制等等的話如果能夠讓民眾或者是整個醫療團隊醫療團體對於我們如何穩定醫療服務點值是更有信心 |
| transcript.whisperx[330].start |
9259.974 |
| transcript.whisperx[330].end |
9279.308 |
| transcript.whisperx[330].text |
這個部分的話,第一個我們在座討論。第二個部分的話,其實都已經現在是在做了。包括這些偏鄉的保障一點議員,或者是他的給付加成,這個現在都在做。DRG的部分的話,其實是可以持續在座推動,這個也應該是可以做得到。 |
| transcript.whisperx[331].start |
9280.129 |
| transcript.whisperx[331].end |
9307.992 |
| transcript.whisperx[331].text |
那高價集中性的這些醫療服務獨立在總額之外其實目前都是先用專款在做處理它嚴格來講也是屬於說在總額之外所以問題點是出在第一個所謂的彈性總額制度這邊寫的是總額目標制總額目標制的定義必須要清楚假設說我們今年預定的總額是九千億 |
| transcript.whisperx[332].start |
9309.366 |
| transcript.whisperx[332].end |
9317.779 |
| transcript.whisperx[332].text |
那最後超出了,要怎麼處理?你如果堅持是1.1元的話,幾乎可以說是沒有總額的。 |
| transcript.whisperx[333].start |
9321.288 |
| transcript.whisperx[333].end |
9347.928 |
| transcript.whisperx[333].text |
adequ目標是假的因為超出你還是1.1人嘛0.95也是一樣所以如果是要目標制的話就超出總額之外的話必須要打折那問題就是要打幾折以現在是打零折啦就是通通超出了就不付啦那以後的話要打幾折這個大家要講清楚如果說所謂的總額目標制要去推這個的話 |
| transcript.whisperx[334].start |
9348.985 |
| transcript.whisperx[334].end |
9373.057 |
| transcript.whisperx[334].text |
adequer我們的改革真的是要執行要進行那來怎麼做會是最適當我們可以看下一張其實六十二健保法六十二條就是在規範這個總額制度之下這個點子的調整的這個部分的要求我們再往下看知道說那如果真的把這個部分點子做一個下線上的這個要求的話那未來的實質運作還算是 |
| transcript.whisperx[335].start |
9373.677 |
| transcript.whisperx[335].end |
9402.363 |
| transcript.whisperx[335].text |
� |
| transcript.whisperx[336].start |
9402.363 |
| transcript.whisperx[336].end |
9404.605 |
| transcript.whisperx[336].text |
議員王育敏等19人擬具〈全民健康保險法第六十二條條文修正草案〉案 |
| transcript.whisperx[337].start |
9422.702 |
| transcript.whisperx[337].end |
9450.658 |
| transcript.whisperx[337].text |
�那如何在以現有的基礎上在做一些適度的調控來改善支付基準的這些改革讓全民也都了解讓醫界也共同來了解說我們希望建構一個良善的好的醫療環境讓所有的醫療同仁持續的來照顧全民的健康那同時又能夠讓這個支付達到一個更好的合理的分配還有合理的這個醫療資源的提供 |
| transcript.whisperx[338].start |
9451.098 |
| transcript.whisperx[338].end |
9469.834 |
| transcript.whisperx[338].text |
我相信這個大家一定要共同來努力。那也期待部長在未來的時間裡面,持續往這個方向一起來貢獻您的力量。好,謝謝。謝謝部長。好,謝謝王振旭委員。接下來我們請蘇清泉委員質詢。 |
| transcript.whisperx[339].start |
9481.27 |
| transcript.whisperx[339].end |
9499.098 |
| transcript.whisperx[339].text |
我請部長還有石崇亮,石長。好,部長、蘇長請。委員好。委員好。府長,我都很認識你,所以大家都很了解。我問你,為什麼台灣所有的服務業只有醫療在做總合資? |
| transcript.whisperx[340].start |
9505.646 |
| transcript.whisperx[340].end |
9510.531 |
| transcript.whisperx[340].text |
二、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。」 |
| transcript.whisperx[341].start |
9525.686 |
| transcript.whisperx[341].end |
9526.927 |
| transcript.whisperx[341].text |
bicyn Kwan-hung,執政局長 |
| transcript.whisperx[342].start |
9551.553 |
| transcript.whisperx[342].end |
9561.1 |
| transcript.whisperx[342].text |
你看這個支付這麼健保的啦,這支付這個和美國幣、和澳門幣這都是你看我們啦,代票啦,我看過美國人來看計程,看起來我說聽聽說,我們說要納300塊的代票,他說他會納300塊的美金啦,所以我們就這麼這樣,下一張。 |
| transcript.whisperx[343].start |
9578.414 |
| transcript.whisperx[343].end |
9594.216 |
| transcript.whisperx[343].text |
來,我們先講醫療暴力啦。我在第八屆的時候,劉建國委員,大家也很認真。所以我們第八屆修了醫療法,看護醫護人員的職業環境安全,我們也做到了喔。所以跟部長讓你了解。 |
| transcript.whisperx[344].start |
9595.077 |
| transcript.whisperx[344].end |
9613.523 |
| transcript.whisperx[344].text |
adequ時候就已經修改王育敏也有那昨天全天我們屏東榮總發生暴力事件暴力事件我也第一時間跟院長跟吳東麟跟他瞭解詳細情況 |
| transcript.whisperx[345].start |
9615.299 |
| transcript.whisperx[345].end |
9644.514 |
| transcript.whisperx[345].text |
|
| transcript.whisperx[346].start |
9645.06 |
| transcript.whisperx[346].end |
9667.875 |
| transcript.whisperx[346].text |
|
| transcript.whisperx[347].start |
9667.955 |
| transcript.whisperx[347].end |
9680.727 |
| transcript.whisperx[347].text |
也是要到該要處理的時候了。我剛才跟劉建國說,劉建國說,我們都做了這麼久,現在不一定可以做的事情就像李明亮那樣沖沖的做磚。這樣你就全世界、全台灣都要感謝你。我不會付啦。不會付那條健保費。 |
| transcript.whisperx[348].start |
9692.421 |
| transcript.whisperx[348].end |
9718.398 |
| transcript.whisperx[348].text |
總統三個候選人都同樣的訴求,現在你賴清德你當選了,你就要面對那種幫你耍,洗肝腦就有事了。你要說每一行都要蓋每一行都要照顧好自己,不用怕啦。所以你今天這個發生了過去,過去你其他要怎麼配套,出委員會,我們自己去合作,我也同意啦。我們保險司也說過,大家一起去合作。 |
| transcript.whisperx[349].start |
9721.34 |
| transcript.whisperx[349].end |
9740.435 |
| transcript.whisperx[349].text |
|
| transcript.whisperx[350].start |
9740.987 |
| transcript.whisperx[350].end |
9741.647 |
| transcript.whisperx[350].text |
ympt. |
| transcript.whisperx[351].start |
9741.647 |
| transcript.whisperx[351].end |
9759.196 |
| transcript.whisperx[351].text |
八個工協會全部都跑出來挺了。所以這個也不是你部長的問題啦。但是你部長你現在有一個很好的成十五天喔。你如果衝過來喔。他會感謝你二十年啦。所以...他會感謝我二十年,我會讓民眾湊五十年。不會啦。不會啦。我告訴你啦。不會啦。現在喔。 |
| transcript.whisperx[352].start |
9768.26 |
| transcript.whisperx[352].end |
9775.886 |
| transcript.whisperx[352].text |
不是要買的問題,這是現況。如果只是這個法案過,沒有其他配套的原因,有可能兩黨擬補就倒了。擬補永遠都不會倒啦。擬補所有執政的人、做總統的人,他絕對不會有擬補意。如果沒有的話,石崇良並是全台灣最大的債務人。他結幹,我們事情都不用做,自己去做三年罷就好。 |
| transcript.whisperx[353].start |
9796.007 |
| transcript.whisperx[353].end |
9797.007 |
| transcript.whisperx[353].text |
我們現在政府的導出不足。 |
| transcript.whisperx[354].start |
9813.097 |
| transcript.whisperx[354].end |
9839.565 |
| transcript.whisperx[354].text |
|
| transcript.whisperx[355].start |
9841.847 |
| transcript.whisperx[355].end |
9842.387 |
| transcript.whisperx[355].text |
我們去德國看,德國也做總額。 |
| transcript.whisperx[356].start |
9870.257 |
| transcript.whisperx[356].end |
9890.495 |
| transcript.whisperx[356].text |
結果他是用總和目標制啊,石署長。德國是用總和目標制喔。所以呢,因今年沒夠的經費,因為未能挪進來。所以是卯吃遠糧。不管啦,他們都是這樣,都挪、挪、挪。到現在他們幾乎是廢紙總和了嘛。他們的總和也沒... |
| transcript.whisperx[357].start |
9892.15 |
| transcript.whisperx[357].end |
9903.996 |
| transcript.whisperx[357].text |
adequ?這樣他們的醫療會失控嗎?沒有嘛。時間還不夠啊。時間還不夠。我們這個總額,你跟社會說我們要把這個總額廢掉,我沒有,我是說做目標制。我沒有要做目標。所以橋櫃目標是委員的想法是要打幾折? |
| transcript.whisperx[358].start |
9917.924 |
| transcript.whisperx[358].end |
9921.786 |
| transcript.whisperx[358].text |
二、委員王育敏等19人擬具〈全民健康保險法第六十二條條文修正草案案〉案 |
| transcript.whisperx[359].start |
9948.724 |
| transcript.whisperx[359].end |
9963.34 |
| transcript.whisperx[359].text |
bicyn Kwan-可以啦。做得到啦。然後我們的全民健保是臺灣唯一臺灣最大的安定力量。就是這一些醫界,包括你,包括石署長。大家,署長做急診的。大家這樣,這樣繞起來啦。 |
| transcript.whisperx[360].start |
9967.825 |
| transcript.whisperx[360].end |
9981.681 |
| transcript.whisperx[360].text |
那現在年輕人跟我們以前想法不一樣以前醫師來我都會跟他講我們的目標我們在偏遠地區要怎麼樣怎麼樣理想都講現在我連講都不講了現在一來就講代議講休假講稅金這樣而已 |
| transcript.whisperx[361].start |
9985.485 |
| transcript.whisperx[361].end |
9989.091 |
| transcript.whisperx[361].text |
議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。」 |
| transcript.whisperx[362].start |
9998.371 |
| transcript.whisperx[362].end |
10025.88 |
| transcript.whisperx[362].text |
所以這……這……這……畢業生跟道德力那麼低,然後現在在住院的病人齁,你不要想說他們會爛住院,沒有可能,現在沒有,現在別人要住院的部分都在管啦,所以他現在要住院,他是要認為,我們認為他要住院,他也自己覺得他要住院的,欸,他才會住呢,結果住了在急診室,在急診室啊,三十五歲、四十五歲、五十歲,每天都要帶床,我們知道在外國委員每天都在體驗很長, |
| transcript.whisperx[363].start |
10027.841 |
| transcript.whisperx[363].end |
10040.832 |
| transcript.whisperx[363].text |
一、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第11屆第12次全民健康保險法第六十二條條文修正草案：立法院第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全民健康保險法第12次全 |
| transcript.whisperx[364].start |
10042.102 |
| transcript.whisperx[364].end |
10048.146 |
| transcript.whisperx[364].text |
要勇敢面對的時候啦。對啦。對啦。但是要整體線去考量,因為你如果單單處理,像我這樣單一的,單要放一點議員的話,可能你那問題要來解決就先倒了。 |
| transcript.whisperx[365].start |
10061.515 |
| transcript.whisperx[365].end |
10084.766 |
| transcript.whisperx[365].text |
要考慮的這一點,我現在在很語重心長地提出來就是這個樣子。你沒有說全盤的,不用說百分之百做得perfect,但是有幾個重點必須要去顧不住的。這些東西你如果顧不住,只要再衝一下就到了。賣負你做那些,剛才委員在顧那些,那些改革賣負人家做,你檢保的位置就不會落眼了。 |
| transcript.whisperx[366].start |
10091.547 |
| transcript.whisperx[366].end |
10108.673 |
| transcript.whisperx[366].text |
好,我們答詢完畢之後,我希望我們這個案子是給他出委員會,然後我們來好好討論。以上。好,謝謝。好,謝謝。謝謝蘇清泉委員。接下來我們請林淑芬委員質詢。 |
| transcript.whisperx[367].start |
10120.438 |
| transcript.whisperx[367].end |
10125.036 |
| transcript.whisperx[367].text |
謝謝主席。我是不是還是請我們這個薛部長。好,請薛部長。 |
| transcript.whisperx[368].start |
10131.32 |
| transcript.whisperx[368].end |
10147.599 |
| transcript.whisperx[368].text |
委員長,雖然你剩下十幾天,不過我想你從選舉前到現在,態度大概看起來都還算是一致。就是說其實都要很務實的去討論,而不是基於一些因素就可以隨便說說。 |
| transcript.whisperx[369].start |
10150.539 |
| transcript.whisperx[369].end |
10169.486 |
| transcript.whisperx[369].text |
bicyn 剛才蘇委員也講到說這個我們是不是要把這個制度改成支付目標制這樣子所以今天的修法看起來如果朝這個方向去的話我們可能討論的不是只有點值的這個問題可能還會談到到底要不要取消總額制度那 |
| transcript.whisperx[370].start |
10170.026 |
| transcript.whisperx[370].end |
10187.022 |
| transcript.whisperx[370].text |
|
| transcript.whisperx[371].start |
10187.462 |
| transcript.whisperx[371].end |
10188.303 |
| transcript.whisperx[371].text |
bicyn 沈 沈 |
| transcript.whisperx[372].start |
10207.176 |
| transcript.whisperx[372].end |
10222.329 |
| transcript.whisperx[372].text |
� |
| transcript.whisperx[373].start |
10222.529 |
| transcript.whisperx[373].end |
10233.031 |
| transcript.whisperx[373].text |
bicyn 但是我現在問的是說這是一個非常時期的暫時的一時的變化還是說整個必然的趨勢就是說整體的看診量的會一直持續的一直往上漲這樣子那如果他是一時的只是疫情過後的各種病毒的這個跑出來一時的現象那我們還可以討論但如果是總的必然的趨勢永遠的看診的量就一直要往上漲的話那我們就要討論這個總額或是這個餅一定要變大 |
| transcript.whisperx[374].start |
10252.295 |
| transcript.whisperx[374].end |
10266.374 |
| transcript.whisperx[374].text |
|
| transcript.whisperx[375].start |
10266.903 |
| transcript.whisperx[375].end |
10292.756 |
| transcript.whisperx[375].text |
|
| transcript.whisperx[376].start |
10293.377 |
| transcript.whisperx[376].end |
10313.393 |
| transcript.whisperx[376].text |
厲不是說只有繳健保費獎部分這個致富而不是真的變相的名目很多很多那在這種狀況裡面啊我我我今天比較想跟你討論的就會變成說到底這個總額制度是不是罪魁禍首這個總額管制到底是不是問題啊 |
| transcript.whisperx[377].start |
10315.49 |
| transcript.whisperx[377].end |
10318.991 |
| transcript.whisperx[377].text |
為什麼要引入這個總額管制的制度?因為一開始不是嘛,從91年2002年才開始的。為什麼?那當時的費用控制有什麼問題? |
| transcript.whisperx[378].start |
10338.792 |
| transcript.whisperx[378].end |
10349.132 |
| transcript.whisperx[378].text |
因為在過去的話那如果說費用成長那比超出預期之外的話那唯一的能夠做的話就是由健保那邊去做核酸。 |
| transcript.whisperx[379].start |
10350.389 |
| transcript.whisperx[379].end |
10359.131 |
| transcript.whisperx[379].text |
netes看到就是說因為這個醫改會有數據他說87年為例投保金額成長率大概成長5%但醫療費用成長超過10%所以在這種狀況面臨巨額的虧損的時候開源不易所以當時就大家都認為說要 |
| transcript.whisperx[380].start |
10372.295 |
| transcript.whisperx[380].end |
10398.575 |
| transcript.whisperx[380].text |
� |
| transcript.whisperx[381].start |
10399.135 |
| transcript.whisperx[381].end |
10418.623 |
| transcript.whisperx[381].text |
但是理論上當初在執行這個總額管制的時候我們是希望透過也是透過預估年度的預算總額然後以醫事服務提供者要去發揮同儕制約的效果因為當時沒有總額管制以前就有一種充量也在充量計價不斷的在過度醫療的問題都跑出來嘛 |
| transcript.whisperx[382].start |
10422.585 |
| transcript.whisperx[382].end |
10438.592 |
| transcript.whisperx[382].text |
|
| transcript.whisperx[383].start |
10438.712 |
| transcript.whisperx[383].end |
10455.755 |
| transcript.whisperx[383].text |
第二、在執行過程當中也邀請醫事服務的提供者討論訂出支付標準以及主導醫療服務的審查這個角色。第三、保險人角色收卸為統籌輔導政策評估和規劃提高醫療專業團體的自治空間。但是這個是當初2002年要實施總額管制當時的理論上的理想 |
| transcript.whisperx[384].start |
10467.037 |
| transcript.whisperx[384].end |
10495.544 |
| transcript.whisperx[384].text |
但是大家多年到現在都覺得總額管制的制度早已經名存實亡。為什麼呢?真正的現實面到現在理想為什麼幻滅?這是一改會講的啦一改會說從實務面來看政府透過保障收入補點值這一種本來都不是總額管制裡面該有的制度裡面早就打破了總額的規範而健保方案計畫的制定 |
| transcript.whisperx[385].start |
10496.004 |
| transcript.whisperx[385].end |
10523.365 |
| transcript.whisperx[385].text |
bicyn 更違背了各種各式各樣的方案,違背了總而洽的評估和管理精神,以至於協議難以順利進行。從制度面來看,當時要配套要有加醫制度、分級醫療制度、論人、論病病例、計酬、支付標準、衡平性的檢討,可以改變病人的就醫行為還有醫師診療行為的配套措施也都沒有辦法真正的落實。 |
| transcript.whisperx[386].start |
10525.667 |
| transcript.whisperx[386].end |
10550.459 |
| transcript.whisperx[386].text |
bicy 專業團體的同儕制約自主審查也不健全。大家漸漸地就覺得說到最後都是劣幣驅逐良幣。所以依改會的講法是說大家不論是醫界或是使用者或者是專業的團體都認為總額制急切已經走到了一個很像是名存實往的這個地步了。 |
| transcript.whisperx[387].start |
10550.979 |
| transcript.whisperx[387].end |
10569.454 |
| transcript.whisperx[387].text |
bicyn 但是呢我覺得這裡面啊整個社會的變化太大我們有一點沒有考慮到你知道在要實施總額管制的時候那時候的65歲以下的老年人口多少數量你知道嗎沒有他是9%左右就是200萬 |
| transcript.whisperx[388].start |
10571.636 |
| transcript.whisperx[388].end |
10577.54 |
| transcript.whisperx[388].text |
而以你知道實施到現在65歲以上的人口從197萬、200萬到現在是多少萬嗎?450萬 |
| transcript.whisperx[389].start |
10584.787 |
| transcript.whisperx[389].end |
10614.633 |
| transcript.whisperx[389].text |
|
| transcript.whisperx[390].start |
10614.773 |
| transcript.whisperx[390].end |
10641.205 |
| transcript.whisperx[390].text |
但是你遇到人口老化你看光是老年人口從總額管制到現在增加了一倍以上一倍250萬未來還要再增加那再疾病慢性化再加上少子女化未來健保的財務繳的人少用的人多多更多不是成長幾%是倍數成長 |
| transcript.whisperx[391].start |
10644.326 |
| transcript.whisperx[391].end |
10674.053 |
| transcript.whisperx[391].text |
|
| transcript.whisperx[392].start |
10674.974 |
| transcript.whisperx[392].end |
10702.273 |
| transcript.whisperx[392].text |
你的客觀的看法當然委員剛剛講的大部分都是其實就現在的一個狀況那不過健保這一個部分的話本來就是很複雜那剛剛提到的總額總額支付制度的話執行了這麼多年的確有達到費用控管的一個成效不能完全都否定掉 |
| transcript.whisperx[393].start |
10702.913 |
| transcript.whisperx[393].end |
10716.222 |
| transcript.whisperx[393].text |
但是未來如果說要總額的部分的話要去做修正這個我個人也覺得但是這個財務本來就已經是建立在一個非常岌岌可危的基礎上了結構上 |
| transcript.whisperx[394].start |
10718.063 |
| transcript.whisperx[394].end |
10733.933 |
| transcript.whisperx[394].text |
� |
| transcript.whisperx[395].start |
10734.053 |
| transcript.whisperx[395].end |
10750.515 |
| transcript.whisperx[395].text |
ernto必須要其他取代的方式,比方說某種程度某種對象的論文記酬。另外的話當然就有一些特殊的一些狀況。當時的理想的啊,可是你們都沒有執行啊。 |
| transcript.whisperx[396].start |
10751.156 |
| transcript.whisperx[396].end |
10776.457 |
| transcript.whisperx[396].text |
bicyn-沒有落實我們其實都在進展當中啦尤其是剛剛委員提到的這些老年人慢性病者這個部分的話其實就是我們現在正在推的在那個健保制度之下現在正在推動的但是這個要轉變醫療界的他的長久以來的作業模式這個是需要時間啦 |
| transcript.whisperx[397].start |
10777.638 |
| transcript.whisperx[397].end |
10793.344 |
| transcript.whisperx[397].text |
所以依改會有提出幾個,就是說提升資源可敬性,強化資源分配的效率,照顧近貧和弱勢,拒絕便宜形式的政策補貼,遏止未竟周延的選舉買票,大家都要很嚴肅的去面對。那他還提出了一個就是說,這個總額這個視否存序,這個財務改革的腳步都不應該停止。 |
| transcript.whisperx[398].start |
10800.026 |
| transcript.whisperx[398].end |
10830.026 |
| transcript.whisperx[398].text |
� |
| transcript.whisperx[399].start |
10830.026 |
| transcript.whisperx[399].end |
10847.978 |
| transcript.whisperx[399].text |
|
| transcript.whisperx[400].start |
10848.274 |
| transcript.whisperx[400].end |
10869.974 |
| transcript.whisperx[400].text |
好,謝謝林淑芬委員的質詢。好啦,這個的確是很多困難,但是我們還是想說,最後主席我講一點,就是說你說你固定點值,然後打破了總額管制,然後等於架空了總額,但是你說沒關係這個叫公務預算去買單,公務預算我們並不是沒有稅入短促,然後財政赤字過,有。 |
| transcript.whisperx[401].start |
10871.135 |
| transcript.whisperx[401].end |
10899.07 |
| transcript.whisperx[401].text |
|
| transcript.whisperx[402].start |
10910.712 |
| transcript.whisperx[402].end |
10919.537 |
| transcript.whisperx[402].text |
謝謝主席。是不是請薛部長。好,我們請薛部長。部長你好。111年齁,這個健保幾戶 |
| transcript.whisperx[403].start |
10922.594 |
| transcript.whisperx[403].end |
10939.732 |
| transcript.whisperx[403].text |
bicyn 而前二十大藥品就高血壓、高血脂、高血糖等三高藥物用量最多,凸顯高齡化社會用藥的狀況。那西藥供應資訊平台從今年一月到現在,社區藥局共通 |
| transcript.whisperx[404].start |
10943.673 |
| transcript.whisperx[404].end |
10961.926 |
| transcript.whisperx[404].text |
adequ報過52種藥品短缺有藥師擔心年底恐怕會有缺藥潮那藉時全國有600多萬名慢性病患用藥權益可能會受損那本席提醒衛福部不要讓民眾有斷藥的風險同時也要進行專案稽查 |
| transcript.whisperx[405].start |
10965.469 |
| transcript.whisperx[405].end |
10987.8 |
| transcript.whisperx[405].text |
bicylman 做好藥品品質的把關以避免廠商動手腳影響民眾用藥的權益,部長你有什麼看法?這目前我們都是一直在接受通報當中,我們也持續在monitor這件事情,那缺藥的情形如果是在事前是可以發現的話,那我們會去做一些處理。 |
| transcript.whisperx[406].start |
10988.2 |
| transcript.whisperx[406].end |
10988.46 |
| transcript.whisperx[406].text |
bicyC. |
| transcript.whisperx[407].start |
10988.46 |
| transcript.whisperx[407].end |
11003.9 |
| transcript.whisperx[407].text |
我希望另外一方面的話我們也希望說如果有取代的學民藥那就大家都不要太過擔心好啦我是認為這個要去重視啦那個部長首先本席支持減少重複用藥啦 |
| transcript.whisperx[408].start |
11005.101 |
| transcript.whisperx[408].end |
11029.011 |
| transcript.whisperx[408].text |
一、減少不必要的醫療行為感謝基層同仁的把關減少全民健保的浪費當民眾就醫量暴增而且超過預估的服務總量時健保點值就會被稀釋醫療院所收入將會減少現行費用的總額推估難免有失準之處 |
| transcript.whisperx[409].start |
11030.111 |
| transcript.whisperx[409].end |
11055.615 |
| transcript.whisperx[409].text |
那預估不足的部分全由醫療人員吸收承擔不盡合理。因此,112年行政院動資51億元,51億的錢來補貼健保點子本席支持法治化來補足健保的點子。希望衛務部能審慎考慮不要一味反對在野黨的提案。你的看法勒? |
| transcript.whisperx[410].start |
11056.675 |
| transcript.whisperx[410].end |
11078.931 |
| transcript.whisperx[410].text |
基本上以去年度的到今年度還在執行的點子補到0.9,我們目前已經用掉50幾億了。這個部分的話,的確是我們看到了新冠疫情從公共預算支付變成健保支付造成的服務量增加。 |
| transcript.whisperx[411].start |
11079.551 |
| transcript.whisperx[411].end |
11102.854 |
| transcript.whisperx[411].text |
第二個就基層來講的話其實我們也發現說這一段時間我們看到的是基層的這種看感冒啦等等這一些這些疾病的比例是降低的而慢性病尤其是拿慢簽的長期慢性病長期處方簽的在基層的數量增加很多 |
| transcript.whisperx[412].start |
11103.354 |
| transcript.whisperx[412].end |
11107.236 |
| transcript.whisperx[412].text |
二、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。」案。 |
| transcript.whisperx[413].start |
11121.323 |
| transcript.whisperx[413].end |
11141.886 |
| transcript.whisperx[413].text |
� |
| transcript.whisperx[414].start |
11142.006 |
| transcript.whisperx[414].end |
11169.358 |
| transcript.whisperx[414].text |
bicylian在地檢。那請問那個衛福部,乍領健保的情況竹林減少主要原因是為何?因為我們是很有用系統性的去做查核。所以許多這種乍領的案件的話就比較容易去發生。所以說這個健保乍期損失金額是不是竹林在降低?應該會是比較一直是在降低的。好最後一個議題齁。 |
| transcript.whisperx[415].start |
11171.345 |
| transcript.whisperx[415].end |
11195.336 |
| transcript.whisperx[415].text |
根據媒體報導目前正值長病毒流行期那上週上門診的急診就有超14000多人次叫前一週上升17.3%那請問衛福部全國長病毒疫情高峰期你認為過了嗎還沒有還在持續上升中 |
| transcript.whisperx[416].start |
11197.037 |
| transcript.whisperx[416].end |
11222.99 |
| transcript.whisperx[416].text |
據瞭解目前整個實驗室監測到腸病毒以這個克沙奇A型為主而且容易引起重症的腸病毒71型只有林興輕症個案那請問衛福部腸病毒71型是否會在今年大流行呢目前還沒有這個跡象沒有這個跡象沒有這個跡象不過我們也在密切的注意要多注意謝謝謝謝 |
| transcript.whisperx[417].start |
11225.131 |
| transcript.whisperx[417].end |
11240.416 |
| transcript.whisperx[417].text |
好,謝謝林德福委員的諮詢接下來我們請賴世保委員諮詢賴世保委員諮詢賴世保委員諮詢賴世保委員諮詢賴世保委員諮詢賴世保委員諮詢賴世保委員諮詢賴世保委員諮詢賴世保委員諮詢賴世保委員諮詢 |
| transcript.whisperx[418].start |
11253.007 |
| transcript.whisperx[418].end |
11266.439 |
| transcript.whisperx[418].text |
我從民國106年的8月回到衛福部。10年喔?沒有啦,106,現在113,差不多7年。7年,時間也很久了喔。你要離開部長這個位置,心裡會不會覺得有點遺憾?不會,我很開心。很開心喔。 |
| transcript.whisperx[419].start |
11277.628 |
| transcript.whisperx[419].end |
11299.616 |
| transcript.whisperx[419].text |
議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第11屆第12屆議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第12屆議員王育敏等19人擬具:「全民健康保險法第12屆議員王育敏等19人擬具:「全民健康保險法第12屆 |
| transcript.whisperx[420].start |
11300.97 |
| transcript.whisperx[420].end |
11316.557 |
| transcript.whisperx[420].text |
應該不是說這樣子的,應該是說,城市不必在握,後面的人有他處理的方式。但是點子一塊錢是可以做到的嗎?你給你時間你可以處理。Depends啊。Depends,因為你沒有在位子上嘛。 |
| transcript.whisperx[421].start |
11317.877 |
| transcript.whisperx[421].end |
11337.158 |
| transcript.whisperx[421].text |
對,因為不需要很多的配套才可能做得到。所以,你如果繼續在位置上可以處理,是這個意思?我不敢這樣講。但是有機會?這個都是角色性的問題,我就沒有辦法回答。我跟你說喔,這個東西,這個賴清德的政見, |
| transcript.whisperx[422].start |
11338.806 |
| transcript.whisperx[422].end |
11356.03 |
| transcript.whisperx[422].text |
是啊是啊當然可以可以你現在來講差700多億如果0.95的700億是不是?700億左右我們去年稅收增加多少你知道嗎?我知道增加3680億3680億你爭取一下這三年每年都給三千億 |
| transcript.whisperx[423].start |
11362.951 |
| transcript.whisperx[423].end |
11363.991 |
| transcript.whisperx[423].text |
ympt. |
| transcript.whisperx[424].start |
11363.991 |
| transcript.whisperx[424].end |
11365.112 |
| transcript.whisperx[424].text |
如果改成一塊錢 |
| transcript.whisperx[425].start |
11390.546 |
| transcript.whisperx[425].end |
11393.713 |
| transcript.whisperx[425].text |
二、委員王育敏等19人擬具〈全民健康保險法第六十二條條文修正草案〉案。 |
| transcript.whisperx[426].start |
11399.394 |
| transcript.whisperx[426].end |
11424.531 |
| transcript.whisperx[426].text |
|
| transcript.whisperx[427].start |
11425.515 |
| transcript.whisperx[427].end |
11425.535 |
| transcript.whisperx[427].text |
對阿! |
| transcript.whisperx[428].start |
11435.896 |
| transcript.whisperx[428].end |
11459.275 |
| transcript.whisperx[428].text |
|
| transcript.whisperx[429].start |
11460.391 |
| transcript.whisperx[429].end |
11468.897 |
| transcript.whisperx[429].text |
所以這個很清楚看得到是不回也不是不能贏因為只要政府不給你就有了啊不給你就有了你差700多億算什麼對我們來講當年給三、四千億去年給四、五千億 |
| transcript.whisperx[430].start |
11487.847 |
| transcript.whisperx[430].end |
11504.674 |
| transcript.whisperx[430].text |
二、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第11屆第12會期社會福利及衛生環境委員會第11屆第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第13會期社會福利及衛生環境委員會第13會期社會福利及衛生環境委員會第14會期社會福利及衛 |
| transcript.whisperx[431].start |
11517.062 |
| transcript.whisperx[431].end |
11541.532 |
| transcript.whisperx[431].text |
所以今天來講我最後一句話啦齁最後一句欸請問你喔最後你講台灣那邊華贊族華贊民主之光阿諾特之光健保是不是台灣之光當然是絕對是而且是NO.1對對不對對這麼讚勒一天一塊錢就是這樣而已啊這樣大家看不出來你知道嗎POINT你知道什麼POINT我不知道那營地不知道要怎麼換我不知道是不是到了 |
| transcript.whisperx[432].start |
11543.387 |
| transcript.whisperx[432].end |
11549.991 |
| transcript.whisperx[432].text |
|
| transcript.whisperx[433].start |
11552.657 |
| transcript.whisperx[433].end |
11554.398 |
| transcript.whisperx[433].text |
kiye賴世保委員 |
| transcript.whisperx[434].start |
11582.577 |
| transcript.whisperx[434].end |
11584.198 |
| transcript.whisperx[434].text |
接下來我們請李燕秀委員質詢。李燕秀委員 |
| transcript.whisperx[435].start |
11601.929 |
| transcript.whisperx[435].end |
11618.338 |
| transcript.whisperx[435].text |
委員好部長雖然快要離開這個位置階段性的角色但是我覺得重點重要的理念跟想法我還是要再一次確認部長來我們看一下部長裡面有哪幾句話是你說的這個表格裡面哪一句部長 |
| transcript.whisperx[436].start |
11625.802 |
| transcript.whisperx[436].end |
11638.386 |
| transcript.whisperx[436].text |
議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．事由．委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．事由．委員王育敏等19人擬具:「全民健康保險法第六十二條條條文修正草案．事由．委員王育敏等19人擬具:「全民健康保險法第六十二條條條文修正草案．事由．委員王育敏等19人擬具:「全民健康保險法第六十二條條條條文修正草案．事由．委員王育 |
| transcript.whisperx[437].start |
11639.241 |
| transcript.whisperx[437].end |
11657.705 |
| transcript.whisperx[437].text |
|
| transcript.whisperx[438].start |
11657.705 |
| transcript.whisperx[438].end |
11661.327 |
| transcript.whisperx[438].text |
bicyn 您覺得這個目標到底合不合理?這個目標到底對不對? |
| transcript.whisperx[439].start |
11679.94 |
| transcript.whisperx[439].end |
11699.667 |
| transcript.whisperx[439].text |
|
| transcript.whisperx[440].start |
11699.667 |
| transcript.whisperx[440].end |
11714.684 |
| transcript.whisperx[440].text |
|
| transcript.whisperx[441].start |
11714.684 |
| transcript.whisperx[441].end |
11733.2 |
| transcript.whisperx[441].text |
|
| transcript.whisperx[442].start |
11733.34 |
| transcript.whisperx[442].end |
11750.365 |
| transcript.whisperx[442].text |
netesa yi ke lu dan zai bian dang li mian cong 10 kuai, 12 kuai, 15 kuai, 18 kuai, zai jia yi ke lu dan yu xie yao jia dao 20 kuai, yu yi xie bian dang dien biao yu ming de yao jia dao 20 kuai, 22 kuai, zhen zhen 25 kuai de douyou。但是我們的醫療服務點值多年都沒有調整過。 |
| transcript.whisperx[443].start |
11751.305 |
| transcript.whisperx[443].end |
11766.425 |
| transcript.whisperx[443].text |
� |
| transcript.whisperx[444].start |
11766.425 |
| transcript.whisperx[444].end |
11788.592 |
| transcript.whisperx[444].text |
|
| transcript.whisperx[445].start |
11788.592 |
| transcript.whisperx[445].end |
11813.985 |
| transcript.whisperx[445].text |
|
| transcript.whisperx[446].start |
11814.325 |
| transcript.whisperx[446].end |
11839.158 |
| transcript.whisperx[446].text |
這是長期啊我長期在未還我的想法我很訝異說你覺得這個目標你沒有辦法支持我覺得你坐在這個位置上我很訝異你這樣子講所以剛才賴氏華委員講說其實你還是可以去爭取林佑昌內政部長在最後一個禮拜都還可以給里長春節慰問金他也爭取到你比他小一點對不對不是這樣說嘛 |
| transcript.whisperx[447].start |
11841.719 |
| transcript.whisperx[447].end |
11852.496 |
| transcript.whisperx[447].text |
厲?你要去爭取啊還是你沒有在交接過程當你還沒有跟邱太元溝通還是你還沒有跟我們賴清德底下私底下陳志宏溝通這個都沒有交接到嗎? |
| transcript.whisperx[448].start |
11855.34 |
| transcript.whisperx[448].end |
11880.509 |
| transcript.whisperx[448].text |
這個不是交接的問題。交接我有跟邱...這個是政策延續的問題。部長你同意這個是政策延續性的問題。這是耐心的重要的政策。你知道嘛。因為委員我說一下就是說我跟邱部長有交接這個事情他知道。但是你剛剛提到陳志宏老師那個他沒有從來沒有問我這件問題。 |
| transcript.whisperx[449].start |
11882.43 |
| transcript.whisperx[449].end |
11898.062 |
| transcript.whisperx[449].text |
bicyn 它就是規劃賴清德重要的醫療政策,你知道啦。但是我覺得這個政策是延續性的,特別都是民進黨執政。這是賴清德重要的目標。我可以接受未來有審查機制在裡面。 |
| transcript.whisperx[450].start |
11898.863 |
| transcript.whisperx[450].end |
11899.123 |
| transcript.whisperx[450].text |
我講一句話就好。 |
| transcript.whisperx[451].start |
11917.603 |
| transcript.whisperx[451].end |
11931.974 |
| transcript.whisperx[451].text |
如果說這點子1.1元的話是通過的,也沒有辦法保證剛剛委員所講的分級醫療、醫護的這個薪水可以上升這些,沒有辦法保證那個。 |
| transcript.whisperx[452].start |
11933.015 |
| transcript.whisperx[452].end |
11945.921 |
| transcript.whisperx[452].text |
所以我覺得政策目標對太多事情都要去努力但是不能因為說你沒有辦法保證分級醫療也是長期你們應該去努力的啊然後健保點是不要讓醫界做血汗也是你應該的每一項都是在現場我們 |
| transcript.whisperx[453].start |
11951.476 |
| transcript.whisperx[453].end |
11981.476 |
| transcript.whisperx[453].text |
|
| transcript.whisperx[454].start |
11982.156 |
| transcript.whisperx[454].end |
11982.557 |
| transcript.whisperx[454].text |
接下來我們請盧憲一委員質詢。 |
| transcript.whisperx[455].start |
12010.861 |
| transcript.whisperx[455].end |
12037.334 |
| transcript.whisperx[455].text |
稍微請部長。好,請薛部長。我很好。辛苦了,剩下18天,再忍耐一下。其實我們講了也聽了很多關於一點音樂的事情,那其實我一直在想是不是我們國家投資的不夠? |
| transcript.whisperx[456].start |
12038.444 |
| transcript.whisperx[456].end |
12050.776 |
| transcript.whisperx[456].text |
ernt?因為我們在看OECD平均是9.7而且它是從7一直逐漸上升到現在的9.7那我們國家一直停留在6.6你覺得我們國家應該要怎麼做來彌補這樣的一個空間? |
| transcript.whisperx[457].start |
12055.26 |
| transcript.whisperx[457].end |
12081.941 |
| transcript.whisperx[457].text |
當然增加這個衛生醫療方面的投資這個是有必要這前提我先講但是要怎麼樣增加的方法以及說資源要怎麼樣配置這個就必須要大家來做討論那目前來講的話說當然這個6.6是沒有把那個長照那個算進去如果長照算進去應該7點多了好那不管怎麼樣 |
| transcript.whisperx[458].start |
12082.822 |
| transcript.whisperx[458].end |
12103.975 |
| transcript.whisperx[458].text |
bicyn保所佔的比例已經差不多4點多。已經差不多4點多。那我們是希望能夠逐步調高好不好?當然是有可能,但是每年的成長本來就會,成長率就會有這個調高的一個指數。我們今天的訴求大概就是0.95以上嘛,就是下一頁。 |
| transcript.whisperx[459].start |
12104.957 |
| transcript.whisperx[459].end |
12121.254 |
| transcript.whisperx[459].text |
|
| transcript.whisperx[460].start |
12121.929 |
| transcript.whisperx[460].end |
12124.051 |
| transcript.whisperx[460].text |
bicyn Kwan-kwan﹗ |
| transcript.whisperx[461].start |
12145.503 |
| transcript.whisperx[461].end |
12161.57 |
| transcript.whisperx[461].text |
議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案．事由．立法院第11屆第11會期社會福利及衛生環境委員會第12屆第11會期社會福利及衛生環境委員會第12屆第11會期社會福利及衛生環境委員會第12屆第11會期社會福利及衛生環境委員會第12屆第11會期社會福利及衛生環境委員會第12屆第11會期社會福利及衛生環境委員會第12屆第11會期社會福利及衛生環境委員會第12屆第11會期社會福利及衛生環境委員會第12 |
| transcript.whisperx[462].start |
12169.974 |
| transcript.whisperx[462].end |
12192.21 |
| transcript.whisperx[462].text |
|
| transcript.whisperx[463].start |
12192.483 |
| transcript.whisperx[463].end |
12194.305 |
| transcript.whisperx[463].text |
二、委員王育敏等19人擬具〈全民健康保險法第六十二條條文修正草案案〉案。 |
| transcript.whisperx[464].start |
12215.123 |
| transcript.whisperx[464].end |
12231.638 |
| transcript.whisperx[464].text |
bicyn 要進一步去做討論,因為新藥新科技它終究是醫療的一部分,那說不含在健保裡面的話其實是有一點問題的。 |
| transcript.whisperx[465].start |
12232.619 |
| transcript.whisperx[465].end |
12252.722 |
| transcript.whisperx[465].text |
� |
| transcript.whisperx[466].start |
12252.722 |
| transcript.whisperx[466].end |
12282.295 |
| transcript.whisperx[466].text |
|
| transcript.whisperx[467].start |
12282.381 |
| transcript.whisperx[467].end |
12297.995 |
| transcript.whisperx[467].text |
|
| transcript.whisperx[468].start |
12298.933 |
| transcript.whisperx[468].end |
12314.48 |
| transcript.whisperx[468].text |
|
| transcript.whisperx[469].start |
12314.82 |
| transcript.whisperx[469].end |
12338.21 |
| transcript.whisperx[469].text |
bicyn 因爲我們希望能夠看見不一樣的投資。因爲在山地離島,在這些地區的醫院來講都是比較是小型的。所以現在健保署有一個計畫叫做燈塔型的醫院要怎麼樣去協助他,讓他不能倒。目前正在,已經規劃好,現在要跟醫界來做協商。 |
| transcript.whisperx[470].start |
12341.493 |
| transcript.whisperx[470].end |
12364.616 |
| transcript.whisperx[470].text |
️﹏﹏ |
| transcript.whisperx[471].start |
12364.776 |
| transcript.whisperx[471].end |
12391.376 |
| transcript.whisperx[471].text |
bicyn 呃,這有一些傳說是不正確的啦。我們這偏鄉的醫療計畫裡面,那包括了有牙醫。因爲目前在臺灣﹖所以我們看這個數目是非常多,是高於全國各國的各個學校的醫學牙醫系。是現在是博博牙醫系是占最高的比例。現在問題是這些牙醫系畢業之後考上牙醫師執照的, |
| transcript.whisperx[472].start |
12393.317 |
| transcript.whisperx[472].end |
12412.267 |
| transcript.whisperx[472].text |
adequ在都會區。所以偏鄉還有很多是無牙醫師。可是我們很多養成班的牙醫系的學生並沒有分發到位啊。對,所以我們現在這個制度就希望這些牙醫師能夠到偏鄉去做服務。 |
| transcript.whisperx[473].start |
12413.148 |
| transcript.whisperx[473].end |
12431.374 |
| transcript.whisperx[473].text |
|
| transcript.whisperx[474].start |
12431.834 |
| transcript.whisperx[474].end |
12448.744 |
| transcript.whisperx[474].text |
當然是可以啦,這開始運行之後的話我們會做一些報告但是我們也不排斥說這國外回來的這些牙醫師能夠來這邊來做服務反正本國的願意來我們優先我希望部長能夠轉達我們養成計畫裡面的牙醫工費生畢業的確實能夠到衛生所到位 |
| transcript.whisperx[475].start |
12455.128 |
| transcript.whisperx[475].end |
12458.631 |
| transcript.whisperx[475].text |
對,我們希望說是在衛生所,但是也不完全都在衛生所。其實他要自己去租個地方開業診所,我們也都讓他有補助。 |
| transcript.whisperx[476].start |
12474.667 |
| transcript.whisperx[476].end |
12501.203 |
| transcript.whisperx[476].text |
|
| transcript.whisperx[477].start |
12502.281 |
| transcript.whisperx[477].end |
12503.461 |
| transcript.whisperx[477].text |
謝謝主席楊瓊發言,我們再請部長。好,請薛部長。 |
| transcript.whisperx[478].start |
12527.38 |
| transcript.whisperx[478].end |
12554.597 |
| transcript.whisperx[478].text |
議長,今天修了這第六十二條呢,那本席也有提案。那本席的提案是直接在點子方面呢,就是一塊。那我們中國國民黨的提案呢,也就是超過每年度醫療給付費用呢,總額的部分由中央主管機關編列預算支應。那在這個平均點子的部分呢,是不得低於這個0.95。請教部長,你支持吧。 |
| transcript.whisperx[479].start |
12555.919 |
| transcript.whisperx[479].end |
12574.011 |
| transcript.whisperx[479].text |
這部分的話必須要去算,我已經有把這個數據提供給我們的這個委員會。提供的方向是大家推認的嗎?如果0.95的話,那就是一年必須要有700億,而且它是長期的,而且這700億會越來越多。 |
| transcript.whisperx[480].start |
12574.855 |
| transcript.whisperx[480].end |
12604.855 |
| transcript.whisperx[480].text |
|
| transcript.whisperx[481].start |
12604.855 |
| transcript.whisperx[481].end |
12632.671 |
| transcript.whisperx[481].text |
|
| transcript.whisperx[482].start |
12633.352 |
| transcript.whisperx[482].end |
12655.872 |
| transcript.whisperx[482].text |
只有處理電池的問題的話是沒有辦法解決,台灣現在健康的問題在…你也是有作為的啦,所以我第一個就是我們發覺到疫情前跟疫情後,我也要謝謝你把疫情後大家增加的這些你用安全基金來撥補給我們所有的這個醫療體系嘛這樣子就是真正的在協助我們的醫療體系嘛 |
| transcript.whisperx[483].start |
12658.334 |
| transcript.whisperx[483].end |
12661.595 |
| transcript.whisperx[483].text |
bicyn 因為你要針對目前的樣態去解決他們的問題。我一直在跟你討論說本席說我們尤其診所的 |
| transcript.whisperx[484].start |
12686.923 |
| transcript.whisperx[484].end |
12691.086 |
| transcript.whisperx[484].text |
bicyn 您是有作為。我跟你討論的也就點值。我要確認一件事情。點值來加為至少是0.5以上。您應該是同意這樣子的方式嗎?就是我們今天要修的62條的這個條例啊。 |
| transcript.whisperx[485].start |
12716.664 |
| transcript.whisperx[485].end |
12736.425 |
| transcript.whisperx[485].text |
|
| transcript.whisperx[486].start |
12736.605 |
| transcript.whisperx[486].end |
12737.965 |
| transcript.whisperx[486].text |
gines1.0.95以上本期提案是一塊。 |
| transcript.whisperx[487].start |
12764.093 |
| transcript.whisperx[487].end |
12773.617 |
| transcript.whisperx[487].text |
厲點絕五以上,這個方向大家是共同的,那配套?那配套錢怎麼來?好,就是中央政府要來撥補資嗎?怎麼沒有?您的零點絕五怎麼會沒有?要撥稿來撥?就跟你安全基金一樣來補一樣啦,對不對?你固定電池,你如果是量沒辦法控制, |
| transcript.whisperx[488].start |
12783.561 |
| transcript.whisperx[488].end |
12802.511 |
| transcript.whisperx[488].text |
我跟你講,我們目前採取德國的方式用總額來簽。德國的是超過總額的部分的話他是打折支付,要怎麼樣打折。每一個國情不一樣,我本期告訴你的是你目前這個總額是由陳時中部長從德國的制度拿過來的啦,對不對? |
| transcript.whisperx[489].start |
12804.412 |
| transcript.whisperx[489].end |
12807.593 |
| transcript.whisperx[489].text |
所以沒關係我們每一個時間的樣態不一樣所以你就否決了陳時中了每一個樣態不一樣的時候我們就要去討論的確我們需要這樣子的一個協調我也希望調整我也希望你待會我們在討論的時候能夠支持那還有一點我要拜託你一下也就是說我們的這個老年人口跟醫療的需求 |
| transcript.whisperx[490].start |
12830.981 |
| transcript.whisperx[490].end |
12851.51 |
| transcript.whisperx[490].text |
� |
| transcript.whisperx[491].start |
12851.51 |
| transcript.whisperx[491].end |
12878.012 |
| transcript.whisperx[491].text |
|
| transcript.whisperx[492].start |
12879.866 |
| transcript.whisperx[492].end |
12904.501 |
| transcript.whisperx[492].text |
但是我們的需求增加,你不用跟我咬文絕字啦,因為我們知道健保給付的不足會導致護理人員他沒有辦法去調薪嘛,加班費等啊,所以你如果只有專案的給他補一下,那個只有治病,所以我還是回來根源,我還是回來根源,三班的護病比,你要什麼時候可以去入法。 |
| transcript.whisperx[493].start |
12905.181 |
| transcript.whisperx[493].end |
12916.874 |
| transcript.whisperx[493].text |
現在就已經是有,至於入法的部分的話就是說,如果沒有達到的必須要做處罰,因為小機構要有一個時間去把人找到啊。所以你有說了一句名言我蠻認同,你說到小飯修,那小飯修要飯修什麼? |
| transcript.whisperx[494].start |
12926.645 |
| transcript.whisperx[494].end |
12927.085 |
| transcript.whisperx[494].text |
adequ? |
| transcript.whisperx[495].start |
12955.787 |
| transcript.whisperx[495].end |
12981.624 |
| transcript.whisperx[495].text |
好,謝謝楊委員接下來我們請黃國昌委員質詢謝謝主席,馬上有請部長好,有請薛部長委員好 |
| transcript.whisperx[496].start |
12982.851 |
| transcript.whisperx[496].end |
13007.222 |
| transcript.whisperx[496].text |
部長,我相信部長來自一屆對於台灣這麼方便的健保制度事實上是建立在所有醫護同仁的血汗之上這個現況我相信你一定有了解我不是來自一屆我事實上對健保的制度我也沒有什麼太深入的研究有一所以要說清楚但 |
| transcript.whisperx[497].start |
13009.383 |
| transcript.whisperx[497].end |
13032.417 |
| transcript.whisperx[497].text |
我相信跟我有相同經歷的台灣民眾非常的多。我因為自己父親重病,我曾經在台大的家務病房的外面睡了30天。那30天的過程當中,讓我非常近距離的觀察我們的醫生跟我們的護理人員,他們到底有多辛苦。 |
| transcript.whisperx[498].start |
13033.717 |
| transcript.whisperx[498].end |
13043.275 |
| transcript.whisperx[498].text |
也正是因為這個樣子去支持醫護能夠有更好的制度不能讓這個國家健保制度的維繫以及 |
| transcript.whisperx[499].start |
13046.277 |
| transcript.whisperx[499].end |
13072.753 |
| transcript.whisperx[499].text |
一般民眾就醫的方便是建築在醫護同仁的血淚上我覺得這件事情我們大家都有共識那也正是因為這個樣子所以我們要解決這個問題的時候我其實有很仔細的聆聽部長剛剛回答的問題部長說健保值一點億元今天修過了也沒有辦法解決問題某個程度上我是同意您的說法 |
| transcript.whisperx[500].start |
13073.851 |
| transcript.whisperx[500].end |
13094.173 |
| transcript.whisperx[500].text |
但我覺得另外一件事情也要講清楚就政治人物選前不要隨便開支票你開了支票就要兌現這個是我覺得一般民眾對政治人物的要求你不要選前跟大家說我要一點議員選後的時候開始藉口一堆 |
| transcript.whisperx[501].start |
13095.074 |
| transcript.whisperx[501].end |
13115.3 |
| transcript.whisperx[501].text |
一般的民眾會想說奇怪你開選舉支票的時候怎麼沒講一堆藉口啊怎麼沒有講說一點議員那但還要如何如何如何如何那現在啦因為時間很尷尬您在18天就要脫離這個痛苦的位置了 |
| transcript.whisperx[502].start |
13116.821 |
| transcript.whisperx[502].end |
13143.899 |
| transcript.whisperx[502].text |
所以那個政策進一步去問你恐怕您也說不出什麼具體的東西出來因為我也看了在相關問題的討論上的時候您曾經說過這個需要一個大型的審議會議大家針對整個健保制度怎麼整體的改善仔細的來討論好那就您所知我們目前當選的總統賴清德先生他心裡面已經胸有成竹 |
| transcript.whisperx[503].start |
13144.659 |
| transcript.whisperx[503].end |
13157.153 |
| transcript.whisperx[503].text |
要怎麼樣進行全體的改革,履行他的政見而且不會發生你剛剛所講的狀況,即使調了一點議員,錢也不會落入醫事人員的口袋。 |
| transcript.whisperx[504].start |
13159.1 |
| transcript.whisperx[504].end |
13178.361 |
| transcript.whisperx[504].text |
這部分的話我可能要再講一下啦。就是說在總統當選人他在講的是不低於0.9。但是...0.9也可以?所以今天你會贊成0.9嗎?0.9的話我覺得是可以的。今天喔?對,今天。因為這以財源來看的話是沒有問題。 |
| transcript.whisperx[505].start |
13180.349 |
| transcript.whisperx[505].end |
13204.787 |
| transcript.whisperx[505].text |
但是如果0.95一點議員的話那可能就會有問題所以賴總統他也是提到就是說朝向那個目標去做前進我相信八大醫師團體他們的聲明他們的期待你應該都有聽到了那大家會質疑的就是說選前選後的態度其實要一致要不然一般民眾真的會 |
| transcript.whisperx[506].start |
13205.968 |
| transcript.whisperx[506].end |
13215.141 |
| transcript.whisperx[506].text |
我覺得政治人物好像選舉支票亂開,開完就沒事了。選前是朝野同意就沒有難度嘛。那選後是會破壞制度嘛。 |
| transcript.whisperx[507].start |
13217.404 |
| transcript.whisperx[507].end |
13241.273 |
| transcript.whisperx[507].text |
這個條件是不一樣我在講的是總額預算制度如果總額預算制度要拿掉的話只要朝野同意就沒有問題好沒關係啦等一下馬上會進行審議啦那時間到但我希望借兩分鐘的時間再幫我們的護理師能夠說幾句話三班護病筆入法本來是衛福部選前就要積極推動的事情嘛那 |
| transcript.whisperx[508].start |
13242.193 |
| transcript.whisperx[508].end |
13258.912 |
| transcript.whisperx[508].text |
bicyn年我們的護病筆的確是有公告但是入法可能還要有一段的期間昨天五一勞動節的時候我相信有很多護理師的同仁他們也走上街頭了他們的訴求很明確就是說 |
| transcript.whisperx[509].start |
13259.853 |
| transcript.whisperx[509].end |
13279.344 |
| transcript.whisperx[509].text |
三、國民黨黨團擬具:「全民健康保險法第六十二條條文修正草案：立法院第14次全民健康保險法第六十二條條文修正草案：立法院第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次 |
| transcript.whisperx[510].start |
13285.517 |
| transcript.whisperx[510].end |
13310.55 |
| transcript.whisperx[510].text |
以目前來講,我們之前所估算的,如果要達到三萬戶病比,那全體來講,人員的缺額大概是7000多人。那我們目前一年是可以的,如果在我們各種措施之下,那人力可以補進來的,差不多是在,如果在醫院的部分,大概會在1500多人左右。這樣還要7年喔?沒有。 |
| transcript.whisperx[511].start |
13311.05 |
| transcript.whisperx[511].end |
13329.493 |
| transcript.whisperx[511].text |
五七千是所有的包括診所的沒有關係因為時間到您就直接跟我講您覺得還需要多久我是覺得至少要四年的時間四年喔對哇那個跟戴總統開出來的證件差蠻多的還是戴總統他語言比較有藝術他說兩年內或他任內 |
| transcript.whisperx[512].start |
13331.193 |
| transcript.whisperx[512].end |
13351.09 |
| transcript.whisperx[512].text |
兩年內的可以來入法,但是實施期間的話可能要有一些時間。沒關係啦,因為我知道您真的在18天就要走了。今天你剛剛如果做任何承諾我反而會懷疑你講話不老實,因為你做了承諾18天你就要走了嘛。但我利用這個機會就是呼籲新的政府。 |
| transcript.whisperx[513].start |
13352.014 |
| transcript.whisperx[513].end |
13379.769 |
| transcript.whisperx[513].text |
要記得自己選前做了承諾三班互併比入法是我們非常多護理師他們共同的心聲好謝謝好謝謝黃國昌委員的質詢接下來我們請蔓玉珍蔓玉珍蔓玉珍委員不在王美惠王美惠王美惠委員不在謝一鳳謝一鳳謝一鳳委員不在陳亭飛陳亭飛陳亭飛委員不在何欣淳何欣淳何欣淳委員不在 |
| transcript.whisperx[514].start |
13380.287 |
| transcript.whisperx[514].end |
13381.828 |
| transcript.whisperx[514].text |
我們請賴慧媛委員質詢。賴慧媛委員 |
| transcript.whisperx[515].start |
13394.918 |
| transcript.whisperx[515].end |
13417.502 |
| transcript.whisperx[515].text |
蘇定,我想跟你請教一下,這個我們健保在民國84年開始實施以後已經接近這個30年,接近30年的時間。那其實長期以來基層醫師的這個點子一直是被詬病的。哇,我的助理沒有來。等一下,暫停一下。 |
| transcript.whisperx[516].start |
13430.566 |
| transcript.whisperx[516].end |
13433.307 |
| transcript.whisperx[516].text |
政天才、政天才、政天才委員不在。我們請陳英委員質詢。 |
| transcript.whisperx[517].start |
13454.773 |
| transcript.whisperx[517].end |
13459.455 |
| transcript.whisperx[517].text |
請施署長。今天討論的主題是如何保障醫護的權益。大家聚焦在這個點子的部分,我今天想要質詢的內容也是跟點子有關係。 |
| transcript.whisperx[518].start |
13481.305 |
| transcript.whisperx[518].end |
13510.299 |
| transcript.whisperx[518].text |
|
| transcript.whisperx[519].start |
13510.299 |
| transcript.whisperx[519].end |
13534.639 |
| transcript.whisperx[519].text |
bicynny 人口數、收入情況、年齡分布、還有醫療資源等等。所以很多的影響因素在進行統計的時候,最後在進行預算分配的討論。一般是這樣。依照這個六個區,我們來看一下。其實這個六個區的分區,我們一起來看一下這個奇怪的地方。 |
| transcript.whisperx[520].start |
13535.52 |
| transcript.whisperx[520].end |
13552.478 |
| transcript.whisperx[520].text |
bicyn Man 與 Lien Chiang 與臺北地區的環境與形態有相當大的差異。如果你們是按照專業的評估之後覺得離島應該是歸在臺北區,我們也只能尊重。 |
| transcript.whisperx[521].start |
13553.419 |
| transcript.whisperx[521].end |
13579.836 |
| transcript.whisperx[521].text |
但是同樣離島的澎湖它是歸在這個高屏區這樣的分法是非常的怪異那後來呢我去追根究柢了解了一下我才知道說原來六個區的分區是依照你們組織法裡面的六個業務組然後是直接用六個業務組的模式做縣市分區然後直接做這個預算的分配 |
| transcript.whisperx[522].start |
13581.577 |
| transcript.whisperx[522].end |
13607.926 |
| transcript.whisperx[522].text |
disciplinary,我知道你們對於這個偏鄉跟離島有很多這個支付模式調整的這個專案讓點數加成或者讓這個點值保障一的計劃但是最基礎的這個縣市分區有問題還是需要好好的來檢討因為過去有你們在總額分配的時候通常不會去考慮到交通障礙導致醫療成本太高這樣的一個問題 |
| transcript.whisperx[523].start |
13609.947 |
| transcript.whisperx[523].end |
13634.052 |
| transcript.whisperx[523].text |
但是交通問題卻是影響離島醫療成本一個最大的因素。但影響層面包括醫療設備還有物資甚至在醫護的人力人才等等。讓金門連江醫院所的醫院醫療院所的這個點子跟臺北市一樣怎麼看就還是覺得很奇怪我不曉得署長對這件事情有什麼看法。 |
| transcript.whisperx[524].start |
13634.672 |
| transcript.whisperx[524].end |
13657.71 |
| transcript.whisperx[524].text |
二、跟委員報告這個我們總額的分配是這樣我們先有一個大總額就是全國夏年度的總額之後會按照我們現在的六個分區的RS值去分配這個RS值就是主要是會考慮到人口的這個變化情形跟我們開辦之初的那個時候醫療的利用情形去做一個調教 |
| transcript.whisperx[525].start |
13658.911 |
| transcript.whisperx[525].end |
13664.496 |
| transcript.whisperx[525].text |
bicyn Muen Lien Chiang等19人擬具 «全民健康保險法第六十二條條文修正草案案案。」案。 |
| transcript.whisperx[526].start |
13674.065 |
| transcript.whisperx[526].end |
13701.36 |
| transcript.whisperx[526].text |
bicy,第二個當然也會考慮到整個醫療的使用情形,那麼它還有後送,經常需要習慣要後送就醫的地方的流動,會大家一起考慮。所以我們的建議還是說,仍然是歸在臺北區,但是我們會有特別的一些保障措施,那麼包含在過去委員指導讓我們重新去思考,那麼也從今年5月1號開始, |
| transcript.whisperx[527].start |
13702.301 |
| transcript.whisperx[527].end |
13720.292 |
| transcript.whisperx[527].text |
bicyn Kwan- 三個離島的醫院的住院部分都是加成30%來讓他能夠落實去發展在地醫療提升病人能夠留在離島當地來醫療他所需要的一些成本。 |
| transcript.whisperx[528].start |
13720.452 |
| transcript.whisperx[528].end |
13742.108 |
| transcript.whisperx[528].text |
|
| transcript.whisperx[529].start |
13742.108 |
| transcript.whisperx[529].end |
13758.473 |
| transcript.whisperx[529].text |
�⋯⋯ |
| transcript.whisperx[530].start |
13758.553 |
| transcript.whisperx[530].end |
13760.055 |
| transcript.whisperx[530].text |
bicyn 如果他們的要求是合理的,那 |
| transcript.whisperx[531].start |
13774.053 |
| transcript.whisperx[531].end |
13795.052 |
| transcript.whisperx[531].text |
adequah算一算其實數字會說話嘛所以我覺得大家就先不要太抗拒這件事情就大家來算一算那是不是說在未來現在的六區有沒有機會改成七個區那這個部分可以就是試算然後研議一下再來跟我們辦公室說明 |
| transcript.whisperx[532].start |
13795.452 |
| transcript.whisperx[532].end |
13822.602 |
| transcript.whisperx[532].text |
ﻏ﹏﹏ |
| transcript.whisperx[533].start |
13822.602 |
| transcript.whisperx[533].end |
13822.622 |
| transcript.whisperx[533].text |
полне好。 |
| transcript.whisperx[534].start |
13851.559 |
| transcript.whisperx[534].end |
13868.907 |
| transcript.whisperx[534].text |
議長,今天我要再跟您討論一下健保補助的問題。這個是目前關於經濟弱勢的原住民長者補助健保費的資料。我們看一下低收入戶的全部都有補助,這個部分已經沒有問題。 |
| transcript.whisperx[535].start |
13869.907 |
| transcript.whisperx[535].end |
13895.323 |
| transcript.whisperx[535].text |
但是我們再看一下中低收入戶的部分中低收入戶的原住民依照社會救助法的模式全部補助二分之一那70歲以上的原住民另外的二分之一則是依照你們的這個老人福利法把預算編列二分之一補起來那我們再看一下55到64歲的原住民也是一樣中低收入戶全部補助二分之一 |
| transcript.whisperx[536].start |
13895.643 |
| transcript.whisperx[536].end |
13912.67 |
| transcript.whisperx[536].text |
二、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第11會期社會福利及衛生環境委員會第12條條文修正草案：立法院第11會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第12會期社會福利及衛生環境委員會第13 |
| transcript.whisperx[537].start |
13918.792 |
| transcript.whisperx[537].end |
13945.173 |
| transcript.whisperx[537].text |
bicyn 他們也覺得很奇怪說怎麼過了65歲他卻要繳1⅔的這個保費他會覺得說怎麼年紀越大繳得越多補助反而越少了所以部長這樣子的狀況沒有注意到嗎?知道的話是1⅔是縣市補助1⅔中央補助對沒錯自己不用繳自己沒有說要繳不是有部分的縣市他們沒有 |
| transcript.whisperx[538].start |
13946.237 |
| transcript.whisperx[538].end |
13948.859 |
| transcript.whisperx[538].text |
bicyn 今天如果這樣的質詢你們有注意到其他縣市有這樣的狀況那我們就統一大家一起看看 |
| transcript.whisperx[539].start |
13975.478 |
| transcript.whisperx[539].end |
13992.816 |
| transcript.whisperx[539].text |
ymm�把它全部統一補齊也更好。有一件事情我跟委員報告一下。剛剛您問石書長的那件事情。欸我聽得不太清楚。就是說你剛剛詢問石書長那個是不是離島要成為自己獨立一個區域。我要跟委員報告是說這樣對離島不見得有益。 |
| transcript.whisperx[540].start |
13996.059 |
| transcript.whisperx[540].end |
14023.845 |
| transcript.whisperx[540].text |
對,第一個就是說現在會有這種訴求應該就是那個金門馬祖啦因為他們跟那個台北區同一區嘛最近點子是比較下來的所以他們覺得說不放心啦但是我們可以藉由一些離島的方案來提高他的結束另外再做調整對對對這樣子是比較好要不然的話你如果給他一個總和齁你遇到那個觀光季節齁 |
| transcript.whisperx[541].start |
14025.426 |
| transcript.whisperx[541].end |
14029.765 |
| transcript.whisperx[541].text |
一大堆外來客充一筆,你還是只能用那一塊總額。 |
| transcript.whisperx[542].start |
14030.811 |
| transcript.whisperx[542].end |
14055.896 |
| transcript.whisperx[542].text |
閱讀。閱讀。閱讀。 |
| transcript.whisperx[543].start |
14055.936 |
| transcript.whisperx[543].end |
14057.257 |
| transcript.whisperx[543].text |
接下來我們請賴會員委員進行視訊。謝謝主席。有請那個市署長。好請。市署長。 |
| transcript.whisperx[544].start |
14083.899 |
| transcript.whisperx[544].end |
14084.259 |
| transcript.whisperx[544].text |
二、委員王育敏等19人擬具 |
| transcript.whisperx[545].start |
14095.708 |
| transcript.whisperx[545].end |
14124.991 |
| transcript.whisperx[545].text |
|
| transcript.whisperx[546].start |
14124.991 |
| transcript.whisperx[546].end |
14146.493 |
| transcript.whisperx[546].text |
|
| transcript.whisperx[547].start |
14146.653 |
| transcript.whisperx[547].end |
14163.601 |
| transcript.whisperx[547].text |
我要特別謝謝這個是我們的那個外務部部長還有就是署長其實你剛才特別在講到的就是說這個燈塔式的這個獨立總額其實你們兩位就是一屆的燈塔那我們也希望就是說看到了這一個明亮的地方 |
| transcript.whisperx[548].start |
14164.341 |
| transcript.whisperx[548].end |
14189.854 |
| transcript.whisperx[548].text |
bicycyn醫療院所這個長期存在的一個困境點子沒有辦法調升點子沒有辦法調升甚至我們講到的就是在去年就是新冠肺炎在下一頁那就是說它的一個降級以後那就是衛務部的專案補助不見了那我們回歸到健保的一個總額那這總額以後我們發現更大的一個困難就是點子大幅的下降 |
| transcript.whisperx[549].start |
14190.774 |
| transcript.whisperx[549].end |
14219.807 |
| transcript.whisperx[549].text |
adequ�的一個問題我要請教署長有沒有一個改善的方式呢?跟委員報告當然去年的這個點值會有大幅的下降一方面是因為疫情的關係所以那個後面就用這個我們的一個健保基金去補那個點值所以最終都是把它保證到0.9這是一個那第二個我們在整個分析之後如果跟疫情前相比 |
| transcript.whisperx[550].start |
14220.447 |
| transcript.whisperx[550].end |
14225.889 |
| transcript.whisperx[550].text |
bicyn 此慢性處方簽在基層就醫的情形有增加。 bicyn 此慢性處方簽在基層就醫的情形有增加。 |
| transcript.whisperx[551].start |
14243.496 |
| transcript.whisperx[551].end |
14266.372 |
| transcript.whisperx[551].text |
bedingt 因為我們過去以減表也就是日資藥費的支付方式就有很大的那個藥費的落差因為慢性病病人的藥費是比較高的所以就會影響到整個基層的總額所以也就是說未來在整個總額的設算上面特別是基層總額的部分我們也要另外再有一些調整的機制 |
| transcript.whisperx[552].start |
14267.493 |
| transcript.whisperx[552].end |
14290.154 |
| transcript.whisperx[552].text |
謝謝署長。我想這個漫遷的一個用藥的調整其實是在這一次就是整個那個疫情那個降級以後點植的這一個大家引起基層上的一個很大的一個恐慌我們有做到一個很好的一個益備也就是一個補償那針對的就是說我們的預算的一個預估不準確 |
| transcript.whisperx[553].start |
14291.135 |
| transcript.whisperx[553].end |
14318.234 |
| transcript.whisperx[553].text |
� |
| transcript.whisperx[554].start |
14318.755 |
| transcript.whisperx[554].end |
14319.135 |
| transcript.whisperx[554].text |
議員王育敏等 |
| transcript.whisperx[555].start |
14339.889 |
| transcript.whisperx[555].end |
14366.783 |
| transcript.whisperx[555].text |
|
| transcript.whisperx[556].start |
14369.232 |
| transcript.whisperx[556].end |
14370.676 |
| transcript.whisperx[556].text |
電費的補貼目前是指? |
| transcript.whisperx[557].start |
14375.736 |
| transcript.whisperx[557].end |
14383.361 |
| transcript.whisperx[557].text |
在3月27日的時候,行政院有一個協商會議裡面。去整醫療院所?它目前是在那個部分是說列入明年的那個總額,就是整醫療機構裡面列入明年的總額去協商。所以就表示是沒有的?對。 |
| transcript.whisperx[558].start |
14400.486 |
| transcript.whisperx[558].end |
14430.094 |
| transcript.whisperx[558].text |
� |
| transcript.whisperx[559].start |
14430.174 |
| transcript.whisperx[559].end |
14430.354 |
| transcript.whisperx[559].text |
好,請署長﹖ |
| transcript.whisperx[560].start |
14463.769 |
| transcript.whisperx[560].end |
14467.951 |
| transcript.whisperx[560].text |
議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。」案。 |
| transcript.whisperx[561].start |
14479.338 |
| transcript.whisperx[561].end |
14481.179 |
| transcript.whisperx[561].text |
ympt. |
| transcript.whisperx[562].start |
14481.179 |
| transcript.whisperx[562].end |
14504.492 |
| transcript.whisperx[562].text |
跟委員報告就是說第一部齁那麼離島的醫院幾乎都是燈塔型醫院啦所以我們先在 因為離島的雖然它比如說澎湖好了澎湖有三家醫院啦當然主要醫院是兩家是我們三種的澎湖分院跟我們部立澎湖醫院為主另外還有一個惠民醫院那 |
| transcript.whisperx[563].start |
14504.872 |
| transcript.whisperx[563].end |
14528.353 |
| transcript.whisperx[563].text |
|
| transcript.whisperx[564].start |
14528.473 |
| transcript.whisperx[564].end |
14529.114 |
| transcript.whisperx[564].text |
bicyn Kwan-kwan |
| transcript.whisperx[565].start |
14558.353 |
| transcript.whisperx[565].end |
14562.177 |
| transcript.whisperx[565].text |
議員王育敏等19人擬具 «全民健康保險法第六十二條條文修正草案》案。 |
| transcript.whisperx[566].start |
14575.769 |
| transcript.whisperx[566].end |
14600.139 |
| transcript.whisperx[566].text |
adequ?因為其實我大概也講一下就是說其實金門早期有兩家醫院然後後來合併成功了那澎湖經過了一段大概在2000年左右有一段時間因為兩院的合併出了一些問題所以也造成澎湖 |
| transcript.whisperx[567].start |
14601.66 |
| transcript.whisperx[567].end |
14607.985 |
| transcript.whisperx[567].text |
醫療史上最黑暗的時候,那現在兩家醫院就是有一個問題,這我的看法就是雖然有兩家可是兩家都不夠完整 |
| transcript.whisperx[568].start |
14621.457 |
| transcript.whisperx[568].end |
14639.531 |
| transcript.whisperx[568].text |
而兩家加起來又大概就是加起來大概就是1.3家醫院的量能所以把這兩家醫院這三家醫院列為燈塔醫院然後在有關住院 |
| transcript.whisperx[569].start |
14642.935 |
| transcript.whisperx[569].end |
14670.387 |
| transcript.whisperx[569].text |
Reporter 蘇長,因為跟委員報告我們在考慮燈塔型醫院的時候一定會除了考慮當地的人口變化之外也會考慮到他的交通動線那因為這個離島的交通不如本島的方便後送商都有一定的障礙所以我們一定會有特別的考慮 |
| transcript.whisperx[570].start |
14673.392 |
| transcript.whisperx[570].end |
14677.58 |
| transcript.whisperx[570].text |
對,對,這個欸,其實,其實就是不管是 |
| transcript.whisperx[571].start |
14679.121 |
| transcript.whisperx[571].end |
14705.028 |
| transcript.whisperx[571].text |
二、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第14次全民健康保險法第六十二條條文修正草案：立法院第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次 |
| transcript.whisperx[572].start |
14707.422 |
| transcript.whisperx[572].end |
14713.964 |
| transcript.whisperx[572].text |
委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。」案。委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。案。 |
| transcript.whisperx[573].start |
14735.436 |
| transcript.whisperx[573].end |
14758.984 |
| transcript.whisperx[573].text |
bicyn 像衛福部近年推了很多項的醫療資源的整合相關政策比如說家庭醫師的整合照護計畫然後分級醫療等等那這個當然就是在推動上、成效上其實 |
| transcript.whisperx[574].start |
14761.98 |
| transcript.whisperx[574].end |
14774.678 |
| transcript.whisperx[574].text |
cellence Department and the Legislative Department of the Legislative Department of the Legislative Department of the Legislative Department of the Legislative Department of the Legislative Department of the Legislative Department of the Legislative Department of |
| transcript.whisperx[575].start |
14775.751 |
| transcript.whisperx[575].end |
14799.886 |
| transcript.whisperx[575].text |
怎麼讓它落實?這兩個部分分級醫療本來就是一個比較困難去推動,因為我們的制度裡面民眾就醫是自由的。所以它並沒有說要先去看一個守門員,也就是家庭醫師,之後的話轉診才可以到醫院去。我們沒有這樣的制度,所以分級醫療本來在處理的時候就會比較困難。 |
| transcript.whisperx[576].start |
14800.926 |
| transcript.whisperx[576].end |
14820.041 |
| transcript.whisperx[576].text |
至於剛剛委員有提到一個家庭醫師整合顯示,這個是我們逐步在推動而且會有成效的。這個現在我在澎湖觀察是做得不錯。對,這個成效會出來。而且現在是我們健保署這邊已經把這個所謂的在宅醫療的範圍要擴大。 |
| transcript.whisperx[577].start |
14822.703 |
| transcript.whisperx[577].end |
14842.93 |
| transcript.whisperx[577].text |
bicyn 會有更多的基層醫師來投入,這部分對民眾,尤其是我們老年化的社會來臨,對於一些失能、就醫不便的民眾是非常重要的,所以這個一定會是越來越好。 |
| transcript.whisperx[578].start |
14845.612 |
| transcript.whisperx[578].end |
14873.354 |
| transcript.whisperx[578].text |
因為分級醫療就是有涉及轉診像我這邊的資料就是我們台灣原本的預定是兩千萬兩百萬人口有一家醫學中心那現在我算一算我們已經有二十二家醫學中心然後大概就是平均一百萬人就有一家那醫學中心太多 |
| transcript.whisperx[579].start |
14874.668 |
| transcript.whisperx[579].end |
14896.805 |
| transcript.whisperx[579].text |
對於區議院的排擠,像剛剛部長也講嘛,就是我們民眾本來就可以自行選擇嘛。醫學中心多了,對區議院本身就有排擠。然後呢,就是醫學中心假如說未經轉診門診的部分,未經轉診門診的部分負擔費用是420, |
| transcript.whisperx[580].start |
14903.31 |
| transcript.whisperx[580].end |
14903.791 |
| transcript.whisperx[580].text |
對,是很高。 |
| transcript.whisperx[581].start |
14933.731 |
| transcript.whisperx[581].end |
14937.975 |
| transcript.whisperx[581].text |
bicyn Kwan-kwan-kwan |
| transcript.whisperx[582].start |
14957.591 |
| transcript.whisperx[582].end |
14965.359 |
| transcript.whisperx[582].text |
我們也發現上轉下轉上的轉整的比例高可是呢上轉下 |
| transcript.whisperx[583].start |
14967.745 |
| transcript.whisperx[583].end |
14993.401 |
| transcript.whisperx[583].text |
adequ..的案件其實並不常見。這個能不能也看有什麼方法可以。因為第一就是醫學中心的資源縱使現在已經設到22家他總是最終的守護者嘛。他的資源應該要給最需要的人。那另外一個就是 |
| transcript.whisperx[584].start |
14995.162 |
| transcript.whisperx[584].end |
15018.78 |
| transcript.whisperx[584].text |
unintendent to the district Council, even to the District Council, to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even to the District Council, even |
| transcript.whisperx[585].start |
15019.161 |
| transcript.whisperx[585].end |
15035.884 |
| transcript.whisperx[585].text |
好 謝謝本日會議詢答全部結束現在做以下決議一、說明及詢答完畢二、委員質詢未及答覆或請補充資料者請相關機關於兩周內以書面答覆委員另要求期限者從其鎖定現在請宣讀提案條文內容 |
| transcript.whisperx[586].start |
15036.707 |
| transcript.whisperx[586].end |
15063.842 |
| transcript.whisperx[586].text |
全民健康保險法第六十二條條文修正草案委員王育敏等19人提案委員蘇清泉等28人提案國民黨黨團提案現行法條文對照表委員王育敏等19人提案國民黨黨團提案修正第六十二條第三項如下保險人因依前條分配後之醫療給付費用總額及經其審查後之醫療服務總點數和算每點費用為每點平均點值不得低於0.95 |
| transcript.whisperx[587].start |
15065.263 |
| transcript.whisperx[587].end |
15091.306 |
| transcript.whisperx[587].text |
並按各保險醫療服務機構經審查後之點數和付其費用,超過每年度醫療給付費用總額之部分由中央主管機關編列預算致應,其予以現行法同。委員蘇清泉等28人提案,第62條第三具前段句末增列,逗號若每點費用低於一元時,由政府公務預算補足至一元等文字,其予以現行法同。宣讀完畢。 |
| transcript.whisperx[588].start |
15093.117 |
| transcript.whisperx[588].end |
15105.455 |
| transcript.whisperx[588].text |
好,我們現在進行全民健康保險法第六十二條條文修正草案之審查。請委員表示意見。好,有沒有人要表示意見?蘇委員。都可以。 |
| transcript.whisperx[589].start |
15124.249 |
| transcript.whisperx[589].end |
15129.534 |
| transcript.whisperx[589].text |
今天提這個案子事實上民進黨的委員大家也我們沒意見 |
| transcript.whisperx[590].start |
15130.68 |
| transcript.whisperx[590].end |
15133.202 |
| transcript.whisperx[590].text |
議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案案。」案。 |
| transcript.whisperx[591].start |
15162.944 |
| transcript.whisperx[591].end |
15184.793 |
| transcript.whisperx[591].text |
這個案子如果過,會牽扯到什麼法案啊,到處要怎麼改啊,要改什麼改什麼。我跟你講,這個案子如果沒有先案,外部也沒什麼壓力啦。沒壓力就直接拖啦。第三點,這個醫療到現在已經是不得不處理啦。 |
| transcript.whisperx[592].start |
15185.953 |
| transcript.whisperx[592].end |
15204.642 |
| transcript.whisperx[592].text |
adequ不得不處理為什麼很多今天早上委員不管藍綠都提出來了我們的醫療品質是在下降我們的平均移民輸韓國輸日本香港、澳門、新加坡都輸我們的癌症品質也在下降所以我們必須要很嚴肅的來正視這個問題 |
| transcript.whisperx[593].start |
15207.267 |
| transcript.whisperx[593].end |
15219.392 |
| transcript.whisperx[593].text |
netesure 提這個案會崩盤?健保會崩盤會怎樣?我們都可以討論。所以呢我在這邊跟大家報告就是,事實上我早上一直在跟王委員、楊耀大家都有討論就是說, |
| transcript.whisperx[594].start |
15222.329 |
| transcript.whisperx[594].end |
15226.87 |
| transcript.whisperx[594].text |
好 謝謝蘇委員還有沒有委員要發言?還有沒有委員要發言? |
| transcript.whisperx[595].start |
15250.543 |
| transcript.whisperx[595].end |
15254.341 |
| transcript.whisperx[595].text |
好,來,剛剛是楊委員先嘛,來王正旭委員還有陳昭芝委員,來。 |
| transcript.whisperx[596].start |
15257.597 |
| transcript.whisperx[596].end |
15281.823 |
| transcript.whisperx[596].text |
好,謝謝主席。依照剛剛蘇委員的建議,從醫界的角度,的確醫界這幾年來透過很多很多醫療服務的情形之下,是很多委屈,包括很血汗的部分。那當然從這個,我本身也是醫界出身,所以我非常認同健保。 |
| transcript.whisperx[597].start |
15282.363 |
| transcript.whisperx[597].end |
15310.715 |
| transcript.whisperx[597].text |
bicyn 目前的制度一定要做適度的調控跟做修正那怎麼修正或是怎麼研議如果能夠讓保護全民健康的同時也能夠讓整個醫療環境可以更好這個是一種可能性那在面對這個可能性的時候等一下也要麻煩我們的這個行政部門這邊讓我們了解一下如果說依照現在的這個修正動議來看的話 |
| transcript.whisperx[598].start |
15312.056 |
| transcript.whisperx[598].end |
15328.427 |
| transcript.whisperx[598].text |
bicyn 如欲每年度醫療給付總額應由中央政府特種基金或公務預算經費支應。那這些特種基金或者是公務預算的這部分在編列的時候是要根據現有的規範 |
| transcript.whisperx[599].start |
15329.428 |
| transcript.whisperx[599].end |
15329.448 |
| transcript.whisperx[599].text |
議員王 |
| transcript.whisperx[600].start |
15346.5 |
| transcript.whisperx[600].end |
15361.037 |
| transcript.whisperx[600].text |
如果要這樣做的話在實際執行上會碰到哪一種困境也要麻煩行政部門這邊讓我們多了解因為我認為未來在執行上如果碰到這個困境的時候我們應該還有哪一些因應的部分 |
| transcript.whisperx[601].start |
15361.537 |
| transcript.whisperx[601].end |
15376.921 |
| transcript.whisperx[601].text |
議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第11屆第12會期社會福利及衛生環境委員會第14次全民健康保險法第六十二條條文修正草案：立法院第12會期社會福利及衛生環境委員會第13次全民健康保險法第12會期社會福利及衛生環境委員會第13次全民健康保險法第12會期社會福利及衛生環境委員會第13次全民健康保險法第12會期社會福利及衛生環境委員會第13次全民健康保險法第12會期社會福利及衛生環境 |
| transcript.whisperx[602].start |
15386.923 |
| transcript.whisperx[602].end |
15399.616 |
| transcript.whisperx[602].text |
則不至於引起除了在針對醫界的照顧的同時也要從這個全民的這個需求或者是對這個影響能夠把它減到最低以上好陳昭志委員 |
| transcript.whisperx[603].start |
15409.155 |
| transcript.whisperx[603].end |
15433.729 |
| transcript.whisperx[603].text |
|
| transcript.whisperx[604].start |
15434.029 |
| transcript.whisperx[604].end |
15458.202 |
| transcript.whisperx[604].text |
我用三個數據來形容我們只用3.5個GDP來cover涵蓋健保但是這個check out涵蓋了百分之百的民眾這兩個數字在全世界都是奇蹟就是你用3.5%的GDP可以照顧百分之百這是奇蹟然後加上這個包山包海從感冒發燒咳嗽流鼻水到這個寒冰中病致死性疾病重大疾病全部都涵蓋在裡面這個叫血汗 |
| transcript.whisperx[605].start |
15458.882 |
| transcript.whisperx[605].end |
15487.261 |
| transcript.whisperx[605].text |
|
| transcript.whisperx[606].start |
15487.261 |
| transcript.whisperx[606].end |
15516.937 |
| transcript.whisperx[606].text |
|
| transcript.whisperx[607].start |
15516.937 |
| transcript.whisperx[607].end |
15543.626 |
| transcript.whisperx[607].text |
|
| transcript.whisperx[608].start |
15543.626 |
| transcript.whisperx[608].end |
15573.183 |
| transcript.whisperx[608].text |
|
| transcript.whisperx[609].start |
15573.905 |
| transcript.whisperx[609].end |
15586.822 |
| transcript.whisperx[609].text |
我當主席你就是當委員阿對不對部長你一直否定我的那個資格阿對我在那邊29年聘書是你發的我還在等你的獎章欸對不過我也得過獎章阿我跟你講矮要矮要齁平均787天 |
| transcript.whisperx[610].start |
15588.865 |
| transcript.whisperx[610].end |
15615.606 |
| transcript.whisperx[610].text |
|
| transcript.whisperx[611].start |
15615.606 |
| transcript.whisperx[611].end |
15632.432 |
| transcript.whisperx[611].text |
|
| transcript.whisperx[612].start |
15632.432 |
| transcript.whisperx[612].end |
15633.333 |
| transcript.whisperx[612].text |
unintendent |
| transcript.whisperx[613].start |
15648.285 |
| transcript.whisperx[613].end |
15665.145 |
| transcript.whisperx[613].text |
|
| transcript.whisperx[614].start |
15665.505 |
| transcript.whisperx[614].end |
15690.664 |
| transcript.whisperx[614].text |
韓國百分之七十我們是六十各位不要再沉浸於不要再沉浸於臺灣世界這個醫療第一了剛剛連楊浩文都有談到這個蘇維也有談到我們蘇添添啦蘇添添我們蘇就這樣但是不是醫師不好不是整個醫療投資是不夠的好那我也希望這個以藥養醫早上當然上次不過一個月前部長跟我說藥價差是四百億啦他今天進步了一點點啦齁 |
| transcript.whisperx[615].start |
15692.125 |
| transcript.whisperx[615].end |
15716.783 |
| transcript.whisperx[615].text |
|
| transcript.whisperx[616].start |
15716.783 |
| transcript.whisperx[616].end |
15734.889 |
| transcript.whisperx[616].text |
|
| transcript.whisperx[617].start |
15734.889 |
| transcript.whisperx[617].end |
15757.705 |
| transcript.whisperx[617].text |
� |
| transcript.whisperx[618].start |
15757.705 |
| transcript.whisperx[618].end |
15783.609 |
| transcript.whisperx[618].text |
|
| transcript.whisperx[619].start |
15783.609 |
| transcript.whisperx[619].end |
15805.64 |
| transcript.whisperx[619].text |
|
| transcript.whisperx[620].start |
15805.64 |
| transcript.whisperx[620].end |
15826.544 |
| transcript.whisperx[620].text |
|
| transcript.whisperx[621].start |
15826.544 |
| transcript.whisperx[621].end |
15839.036 |
| transcript.whisperx[621].text |
|
| transcript.whisperx[622].start |
15839.608 |
| transcript.whisperx[622].end |
15852.597 |
| transcript.whisperx[622].text |
�二、國民黨黨團擬具:「全民健康保險法第六十二條條文修正草案：立法院第14次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次全民健康保險法第16次 |
| transcript.whisperx[623].start |
15866.067 |
| transcript.whisperx[623].end |
15889.24 |
| transcript.whisperx[623].text |
bedingt bundle payment,就是說如果你做得好,以結果來論,這群人照顧得很好,我們就給你更好的包裹給你幾副。我想這個有一些品質的方案的進來,就不會讓大家疑慮說,也當政府擔心說,你就一直充一直充,那我們現在把點子天花板都打開了,那會不會浪費錢。確實有時候不免如此。所以我們希望有一些相對的配套措施。那我們黨,我們支持0.5。謝謝。 |
| transcript.whisperx[624].start |
15893.602 |
| transcript.whisperx[624].end |
15902.484 |
| transcript.whisperx[624].text |
二、委員王育敏等19人擬具 «全民健康保險法第六十二條條文修正草案》案。厲典黨團擬具 «全民健康保險法第六十二條條文修正草案》案。厲典黨團擬具 |
| transcript.whisperx[625].start |
15924.264 |
| transcript.whisperx[625].end |
15926.84 |
| transcript.whisperx[625].text |
謝謝主席。主席我先請教石署長。 |
| transcript.whisperx[626].start |
15928.749 |
| transcript.whisperx[626].end |
15929.77 |
| transcript.whisperx[626].text |
你還要諮詢喔?你還要諮詢喔? |
| transcript.whisperx[627].start |
15929.77 |
| transcript.whisperx[627].end |
15929.83 |
| transcript.whisperx[627].text |
你還要諮詢喔? |
| transcript.whisperx[628].start |
15929.83 |
| transcript.whisperx[628].end |
15929.89 |
| transcript.whisperx[628].text |
你還要諮詢喔? |
| transcript.whisperx[629].start |
15929.89 |
| transcript.whisperx[629].end |
15930.631 |
| transcript.whisperx[629].text |
你還要諮詢喔? |
| transcript.whisperx[630].start |
15930.631 |
| transcript.whisperx[630].end |
15930.891 |
| transcript.whisperx[630].text |
你還要諮詢喔? |
| transcript.whisperx[631].start |
15930.891 |
| transcript.whisperx[631].end |
15931.491 |
| transcript.whisperx[631].text |
你還要諮詢喔? |
| transcript.whisperx[632].start |
15931.491 |
| transcript.whisperx[632].end |
15931.691 |
| transcript.whisperx[632].text |
你還要諮詢喔? |
| transcript.whisperx[633].start |
15931.691 |
| transcript.whisperx[633].end |
15931.972 |
| transcript.whisperx[633].text |
你還要諮詢喔? |
| transcript.whisperx[634].start |
15931.972 |
| transcript.whisperx[634].end |
15932.232 |
| transcript.whisperx[634].text |
你還要諮詢喔? |
| transcript.whisperx[635].start |
15932.232 |
| transcript.whisperx[635].end |
15932.452 |
| transcript.whisperx[635].text |
你還要諮詢喔? |
| transcript.whisperx[636].start |
15932.452 |
| transcript.whisperx[636].end |
15932.652 |
| transcript.whisperx[636].text |
你還要諮詢喔? |
| transcript.whisperx[637].start |
15932.652 |
| transcript.whisperx[637].end |
15932.852 |
| transcript.whisperx[637].text |
你還要諮詢喔? |
| transcript.whisperx[638].start |
15932.852 |
| transcript.whisperx[638].end |
15933.073 |
| transcript.whisperx[638].text |
你還要諮詢喔? |
| transcript.whisperx[639].start |
15933.073 |
| transcript.whisperx[639].end |
15933.253 |
| transcript.whisperx[639].text |
你還要諮詢喔? |
| transcript.whisperx[640].start |
15933.253 |
| transcript.whisperx[640].end |
15933.473 |
| transcript.whisperx[640].text |
你還要諮詢喔? |
| transcript.whisperx[641].start |
15933.473 |
| transcript.whisperx[641].end |
15933.673 |
| transcript.whisperx[641].text |
你還要諮詢喔? |
| transcript.whisperx[642].start |
15933.673 |
| transcript.whisperx[642].end |
15934.073 |
| transcript.whisperx[642].text |
你還要諮詢喔? |
| transcript.whisperx[643].start |
15934.073 |
| transcript.whisperx[643].end |
15934.274 |
| transcript.whisperx[643].text |
你還要諮詢喔? |
| transcript.whisperx[644].start |
15934.274 |
| transcript.whisperx[644].end |
15934.594 |
| transcript.whisperx[644].text |
你還要諮詢喔? |
| transcript.whisperx[645].start |
15934.594 |
| transcript.whisperx[645].end |
15935.054 |
| transcript.whisperx[645].text |
你還要諮詢喔? |
| transcript.whisperx[646].start |
15935.054 |
| transcript.whisperx[646].end |
15935.555 |
| transcript.whisperx[646].text |
你還要諮詢喔? |
| transcript.whisperx[647].start |
15935.555 |
| transcript.whisperx[647].end |
15935.995 |
| transcript.whisperx[647].text |
你還要諮詢喔? |
| transcript.whisperx[648].start |
15935.995 |
| transcript.whisperx[648].end |
15936.816 |
| transcript.whisperx[648].text |
你還要諮詢喔? |
| transcript.whisperx[649].start |
15936.816 |
| transcript.whisperx[649].end |
15937.096 |
| transcript.whisperx[649].text |
你還要諮詢喔 |
| transcript.whisperx[650].start |
15955.287 |
| transcript.whisperx[650].end |
15975.977 |
| transcript.whisperx[650].text |
好請問我只是確定這一件我為什麼確定這一件呢就我們從整個保險的概念來看應該是要先檢討保險費率而不是先用公務基金撥補就是說我們法定的上限保險費率保險費率提高 |
| transcript.whisperx[651].start |
15976.988 |
| transcript.whisperx[651].end |
16004.309 |
| transcript.whisperx[651].text |
|
| transcript.whisperx[652].start |
16005.492 |
| transcript.whisperx[652].end |
16026.854 |
| transcript.whisperx[652].text |
我是從不管你1.1塊、1.0.8塊我全部反對的。我是全部反對的因為我覺得必須要健保是一個強制性的社會保險。我們還是要先從保險的概念來看。為什麼我反對用公務預算來撥補呢? |
| transcript.whisperx[653].start |
16028.967 |
| transcript.whisperx[653].end |
16057.164 |
| transcript.whisperx[653].text |
這個大家必須要想想看,勞保造成了多大的一個洞。假如說健保也比照這樣子來做處理,這個合不合理?這個第一點。第二點,醫療品質假如不好,到底跟醫生的收入有沒有直接相關聯?是不是必然的因果關係? |
| transcript.whisperx[654].start |
16061.911 |
| transcript.whisperx[654].end |
16082.384 |
| transcript.whisperx[654].text |
我的看法還有另外一個觀點就是雖然強制的社會保險可是被保險人必須要強制醫療院所可以自行脫離健保體系的這個觀念應該沒有錯你可以存自費你假如認為 |
| transcript.whisperx[655].start |
16087.176 |
| transcript.whisperx[655].end |
16108.199 |
| transcript.whisperx[655].text |
adjac.1.只有0.8,你覺得你覺得沒好,你可以退出健保體系,你收自費。我覺得大家應該真的要認真想一想,老保帶給政府多大的財政黑洞,健保再加一筆,這個到底好不好? |
| transcript.whisperx[656].start |
16109.093 |
| transcript.whisperx[656].end |
16130.798 |
| transcript.whisperx[656].text |
我最後還是要講一句話,就是說我來自澎湖,我在未還已經13年了。其實我向來支持醫界,這個很多醫界的朋友也都知道。為什麼?因為醫事人員的待遇不好,或者是醫事人員的工作環境不好,醫療品質就沒有辦法提升。 |
| transcript.whisperx[657].start |
16131.834 |
| transcript.whisperx[657].end |
16152.671 |
| transcript.whisperx[657].text |
� |
| transcript.whisperx[658].start |
16153.592 |
| transcript.whisperx[658].end |
16176.357 |
| transcript.whisperx[658].text |
|
| transcript.whisperx[659].start |
16176.966 |
| transcript.whisperx[659].end |
16192.193 |
| transcript.whisperx[659].text |
那假如說今天一定要出委員會,那我希望連帶所有的附帶決議、附帶的修正條文全部一起送出。好,謝謝大家。好,謝謝。我們現在先休息五分鐘。 |
| transcript.whisperx[660].start |
16201.892 |
| transcript.whisperx[660].end |
16202.552 |
| transcript.whisperx[660].text |
議員王育敏等19人擬具 |
| transcript.whisperx[661].start |
16436.084 |
| transcript.whisperx[661].end |
16436.324 |
| transcript.whisperx[661].text |
二、國民黨黨團擬具 |
| transcript.whisperx[662].start |
16508.444 |
| transcript.whisperx[662].end |
16527.532 |
| transcript.whisperx[662].text |
好,我們繼續開會,那剛剛那個林淑芬委員要拔眼來請。好,我再講一次,就是說因為我們看到這個看病的總人口數其實就是越來越多,那所以這個總的支出面的擴大是不可避免的。 |
| transcript.whisperx[663].start |
16528.052 |
| transcript.whisperx[663].end |
16544.289 |
| transcript.whisperx[663].text |
netesure 面的這個擴大是一定也是必然的狀況裡面我們到底要不要檢討總額管制的這個制度那因為他就會連動到點值那這種狀況裡面支出面的擴大那會牽扯到那收入面財源要怎麼解決的問題那 |
| transcript.whisperx[664].start |
16546.531 |
| transcript.whisperx[664].end |
16554.34 |
| transcript.whisperx[664].text |
bicylson 調整保費是一種,那這種基金或公務預算來也都是一種可能。但是我們的意思是說,現在今天這些問題是結構上出問題,你現在在這一條法律上定死了,把它定死了,連察言都給它講死了,這會不會造成一種失去了彈性。 |
| transcript.whisperx[665].start |
16567.875 |
| transcript.whisperx[665].end |
16590.742 |
| transcript.whisperx[665].text |
� |
| transcript.whisperx[666].start |
16591.633 |
| transcript.whisperx[666].end |
16610.129 |
| transcript.whisperx[666].text |
好了我們請廖偉祥委員發言接下來是陳金輝委員接下來黃秀芳謝謝主席我簡單講過去所有參選總統的候選人在面對這個議事團體的時候選前都信誓旦旦開支票承諾要改革健保保障點子選後都默默裝傻都跳票 |
| transcript.whisperx[667].start |
16610.729 |
| transcript.whisperx[667].end |
16611.13 |
| transcript.whisperx[667].text |
bicylfman |
| transcript.whisperx[668].start |
16630.777 |
| transcript.whisperx[668].end |
16653.867 |
| transcript.whisperx[668].text |
好,我們請陳金輝委員。早上很多人看到自由時報有一篇文章叫做CEO World評比台灣醫療是第一名結果剛剛台大醫院我們台灣醫學中心的燈塔指標院長出來講說這個第一名是血汗醫護換來的所以 |
| transcript.whisperx[669].start |
16654.667 |
| transcript.whisperx[669].end |
16673.882 |
| transcript.whisperx[669].text |
|
| transcript.whisperx[670].start |
16673.882 |
| transcript.whisperx[670].end |
16702.193 |
| transcript.whisperx[670].text |
|
| transcript.whisperx[671].start |
16702.473 |
| transcript.whisperx[671].end |
16716.47 |
| transcript.whisperx[671].text |
好其實很明顯陳委員陳昭芝委員已經講了要用這個PUA的方法叫大家要繳健保費結果呢其實就是GDP不足啊GDP不足全世界的報告都已經告訴你了 |
| transcript.whisperx[672].start |
16717.551 |
| transcript.whisperx[672].end |
16743.899 |
| transcript.whisperx[672].text |
|
| transcript.whisperx[673].start |
16743.899 |
| transcript.whisperx[673].end |
16765.623 |
| transcript.whisperx[673].text |
|
| transcript.whisperx[674].start |
16765.623 |
| transcript.whisperx[674].end |
16781.391 |
| transcript.whisperx[674].text |
� |
| transcript.whisperx[675].start |
16783.553 |
| transcript.whisperx[675].end |
16789.555 |
| transcript.whisperx[675].text |
二、委員黃秀芳等19人擬具:「全民健康保險法第六十二條條文修正草案案。一、委員黃秀芳等19人擬具:「全民健康保險法第六十二條條文修正草案。 |
| transcript.whisperx[676].start |
16807.841 |
| transcript.whisperx[676].end |
16824.872 |
| transcript.whisperx[676].text |
|
| transcript.whisperx[677].start |
16831.243 |
| transcript.whisperx[677].end |
16837.527 |
| transcript.whisperx[677].text |
我請教署長當時在健保上路的時候健保署是採支出嘛但是主計是採收入公司不同分母是不一樣的喔 |
| transcript.whisperx[678].start |
16855.998 |
| transcript.whisperx[678].end |
16873.831 |
| transcript.whisperx[678].text |
|
| transcript.whisperx[679].start |
16873.831 |
| transcript.whisperx[679].end |
16890.725 |
| transcript.whisperx[679].text |
|
| transcript.whisperx[680].start |
16893.187 |
| transcript.whisperx[680].end |
16912.219 |
| transcript.whisperx[680].text |
這個有兩個層面,一個是這個36%算的時候是以收來推估還是以支來計算。那麼這個其實各有利弊。像我們這幾年補充保費收得好的時候,以收來計算政府的負擔比較多。 |
| transcript.whisperx[681].start |
16914.582 |
| transcript.whisperx[681].end |
16936.647 |
| transcript.whisperx[681].text |
|
| transcript.whisperx[682].start |
16937.315 |
| transcript.whisperx[682].end |
16939.839 |
| transcript.whisperx[682].text |
bicyn Kwan-Ni-Tung |
| transcript.whisperx[683].start |
16952.222 |
| transcript.whisperx[683].end |
16971.937 |
| transcript.whisperx[683].text |
adequ年的做法都是以收就是說民間所收來的那麼我們去推除以百分之六十四算成總總數之後那扣掉民間2017年整個都已經死亡交叉了就是不夠所以基本上疫情先不管去年的收大於資 |
| transcript.whisperx[684].start |
16973.078 |
| transcript.whisperx[684].end |
16974.598 |
| transcript.whisperx[684].text |
bicyn 根據這個法?不是啊 這跟今天要討論的就無關了 |
| transcript.whisperx[685].start |
16990.848 |
| transcript.whisperx[685].end |
16992.088 |
| transcript.whisperx[685].text |
我現在做一下決議因為剛剛大家有共識齁 |
| transcript.whisperx[686].start |
17014.117 |
| transcript.whisperx[686].end |
17041.226 |
| transcript.whisperx[686].text |
我能不能因為我們今天這個點子的問題其實就牽扯到醫事人員的收入因為大概醫療醫事人員醫事人員那我能我不知道衛福部這邊有沒有有沒有就是醫生的收入的資料 |
| transcript.whisperx[687].start |
17043.626 |
| transcript.whisperx[687].end |
17067.424 |
| transcript.whisperx[687].text |
因為我們要看看到底是不是真的很偏低比如說法官跟檢察官也算是學法律裡面最高的精英那他們的收入我在看也了不起不到20萬那看醫師的平均收入 |
| transcript.whisperx[688].start |
17068.485 |
| transcript.whisperx[688].end |
17078.998 |
| transcript.whisperx[688].text |
唉呦,我在看應該三、四十萬都有啦,齁?沒有?這樣喔?各有不同嘛齁?各有... |
| transcript.whisperx[689].start |
17082.014 |
| transcript.whisperx[689].end |
17098.001 |
| transcript.whisperx[689].text |
哦!好!那就講到重點就是說到底醫療院所分配到的是不是有利益精湛讓整個醫療體系的人都可以獲得適當的工作報酬這個問題我覺得也是一個重點 |
| transcript.whisperx[690].start |
17104.404 |
| transcript.whisperx[690].end |
17131.479 |
| transcript.whisperx[690].text |
就是說不能不能夠我們在討論大概都是覺得好像醫院虧錢可是大家又拼命往醫學中心擠醫生好像收入很差可是大家又一直要讀醫學院這個我不大懂我聽不下去了 |
| transcript.whisperx[691].start |
17133.72 |
| transcript.whisperx[691].end |
17143.676 |
| transcript.whisperx[691].text |
啊我講兩分鐘就好兩分鐘就好兩分鐘就好我跟大家報告今天在講點子點子是一個國啦國齁那 |
| transcript.whisperx[692].start |
17148.877 |
| transcript.whisperx[692].end |
17167.633 |
| transcript.whisperx[692].text |
議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第11屆第12屆議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第12屆議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第12屆議員王育敏等19人擬具:「全民健康保險法第12屆議員王育敏等19人擬具:「全民健康保險法第12屆議員王育敏等19人擬具:「全民健康保險法第12屆議員王育敏 |
| transcript.whisperx[693].start |
17170.58 |
| transcript.whisperx[693].end |
17190.131 |
| transcript.whisperx[693].text |
議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第11屆第12屆議員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第12屆議員王育敏等19人擬具:「全民健康保險法第12屆議員王育敏等19人擬具:「全民健康保險法第12屆議員王育敏等19人擬具:「全民健康保險法第12屆議員王育敏等19人擬具:「全民健康保險法第12屆議員王育敏等19人擬具:「全民健康保險法第12屆 |
| transcript.whisperx[694].start |
17195.629 |
| transcript.whisperx[694].end |
17220.997 |
| transcript.whisperx[694].text |
二、委員王育敏等19人擬具:「全民健康保險法第六十二條條文修正草案：立法院第11屆第12次全民健康保險法第6次全民健康保險法第6次全民健康保險法第6次全民健康保險法第6次全民健康保險法第6次全民健康保險法第6次全民健康保險法第6次全民健康保險法第6次全民健康保險法第6次全民健康保險法第6次全民健康保險法第6次全民健康保險法第6次全民健康保險法第6次全民健康保險法第6次全民健康保險法第6次全民健康保險法第 |
| transcript.whisperx[695].start |
17222.546 |
| transcript.whisperx[695].end |
17230.77 |
| transcript.whisperx[695].text |
現在醫生都...我沒有這樣說...我沒有這樣說...我沒有這樣說...現在吼...現在...我沒有這樣說...現在吼...現在吼...現在吼...現在吼...現在吼...現在吼...現在吼...現在吼...現在吼...現在吼...現在吼...現在吼...現在吼... |
| transcript.whisperx[696].start |
17244.099 |
| transcript.whisperx[696].end |
17248.24 |
| transcript.whisperx[696].text |
二、委員王育敏等19人擬具〈全民健康保險法第六十二條條文修正草案案〉案 |
| transcript.whisperx[697].start |
17270.851 |
| transcript.whisperx[697].end |
17274.676 |
| transcript.whisperx[697].text |
現在做以下決議。全民健保法第六十二條條文修正草案計三案審查完略。 |
| transcript.whisperx[698].start |
17286.83 |
| transcript.whisperx[698].end |
17305.841 |
| transcript.whisperx[698].text |
並按審據審查報告提報院會討論。院會討論本案時由王昭吉委員玉敏補充說明,包括修正動議一件,附帶動議三件,交由黨團協商。本次會議到此結束,現在散會。謝謝大家。 |