| IVOD_ID |
16051 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Full/1M/16051 |
| 日期 |
2024-07-01 |
| 會議資料.會議代碼 |
委員會-11-1-26-23 |
| 會議資料.會議代碼:str |
第11屆第1會期社會福利及衛生環境委員會第23次全體委員會議 |
| 會議資料.屆 |
11 |
| 會議資料.會期 |
1 |
| 會議資料.會次 |
23 |
| 會議資料.種類 |
委員會 |
| 會議資料.委員會代碼[0] |
26 |
| 會議資料.委員會代碼:str[0] |
社會福利及衛生環境委員會 |
| 會議資料.標題 |
第11屆第1會期社會福利及衛生環境委員會第23次全體委員會議 |
| 影片種類 |
Full |
| 開始時間 |
2024-07-01T08:30:21+08:00 |
| 結束時間 |
2024-07-01T13:40:00+08:00 |
| 影片長度 |
05:09:39 |
| 支援功能[0] |
ai-transcript |
| video_url |
https://h264media01.ly.gov.tw:443/vod_1/_definst_/mp4:1M/bfaf9b39ac01a685a446d8028d5ab087b7f286250d59554a4f242ceca9577839a9099bd55937a0345ea18f28b6918d91.mp4/playlist.m3u8 |
| 會議時間 |
2024-07-01T09:00:00+08:00 |
| 會議名稱 |
立法院第11屆第1會期社會福利及衛生環境委員會第23次全體委員會議（事由：邀請衛生福利部部長就「有關健保合理支付、保障醫護人員收入、設置百億癌症基金及健康投資等事項」進行專題報告，並備質詢。） |
| 委員名稱 |
完整會議 |
| 委員發言時間 |
08:30:21 - 13:40:00 |
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49.104 |
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MING PAO CANADA MANGA |
| transcript.whisperx[1].start |
133.387 |
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134.206 |
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響鐘 |
| transcript.whisperx[2].start |
310.557 |
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316.738 |
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主席 |
| transcript.whisperx[3].start |
455.598 |
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455.683 |
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本集完 |
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1993.817 |
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2022.686 |
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好,出席委員已逐法定人數現在開會,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22次全體委員會議議事錄,時間113年6月26日星期三,90至93分,地點群賢樓801會議室,出席委員陳昭芝等15人,列席委員顏寬恆等10人,主席王兆吉委員喻名,報告事項,宣讀上次會議議事錄,決定確定,宣讀完畢。 |
| transcript.whisperx[5].start |
2024.146 |
| transcript.whisperx[5].end |
2051.609 |
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請問委員會：上次議事錄有無錯誤或遺漏之處：沒有：好那議事錄確定本日會議議程為邀請衛生福利部部長：有關健保合理支付、保障醫護人員收入、設置百億癌症基金及健康投資等事項．進行專題報告．並備質詢現在介紹在場委員及列席官員陳昭芝委員林月琴委員 |
| transcript.whisperx[6].start |
2053.496 |
| transcript.whisperx[6].end |
2073.944 |
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王振旭委員那今天列席的有衛福部邱太元部長以及衛福部主任秘書兼代理口腔健康司司長張雍敏張司長社會保險司劉玉娟司長護理及健康照護司蔡淑鳳司長 |
| transcript.whisperx[7].start |
2075.339 |
| transcript.whisperx[7].end |
2103.401 |
| transcript.whisperx[7].text |
副署醫療及社會福利機構管理會副執行長楊南平副執行長醫事司郭威中專門委員中央健康保險署石崇亮署長國民健康署吳昭君署長食品藥物管理署王德元副署長疾病管制署曾淑慧副署長好那接下來請衛福部邱部長報告時間5分鐘 |
| transcript.whisperx[8].start |
2112.222 |
| transcript.whisperx[8].end |
2131.642 |
| transcript.whisperx[8].text |
主席、各位委員、女士、先生本部今日設邀至委員會進行專論報告．個人深感榮幸以下請就本部執行健保合理支付、保障醫護人員收入、設置百億癌症基金及健康投資等事項提出專題報告．請各位委員指教 |
| transcript.whisperx[9].start |
2132.796 |
| transcript.whisperx[9].end |
2152.084 |
| transcript.whisperx[9].text |
一、健保合理支付因應臨床照顧需求需要本部健保署持續增修支付標準至113年7月共計168次公告調整超過3000項診療項目再回應醫事人力部分強化集中症男寒 |
| transcript.whisperx[10].start |
2153.493 |
| transcript.whisperx[10].end |
2155.214 |
| transcript.whisperx[10].text |
為改善醫療服務給付本部健保屬於113年成立支付標準橫屏性評量規劃專家小組 |
| transcript.whisperx[11].start |
2171.546 |
| transcript.whisperx[11].end |
2190.916 |
| transcript.whisperx[11].text |
初步規劃朝向擴大實施住院DRG以及優先調整醫事人力為主及集中男寒症相關支付標準．並持續邀相關專業團體召開會議共同研議支付標準調整方案．反映實際醫療成本及臨床人員的辛勞 |
| transcript.whisperx[12].start |
2192.017 |
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2220.966 |
| transcript.whisperx[12].text |
二保障醫護人員收入近10年來本部健保署共計議數約678.68億元用於調整護理會的支付點數全日平均護理比、年動加成等項目因應疫情後及未來老化護理招呼需求行政院112年9月28日會議的會議合備護理人力中長程整備透過 |
| transcript.whisperx[13].start |
2221.997 |
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2229.7 |
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人力培育、正向職場、以薪資改善三個方向十二項策略我們來整備2024-2030年護理人力為強化醫療醫院月班護理照護量能 |
| transcript.whisperx[14].start |
2239.458 |
| transcript.whisperx[14].end |
2253.081 |
| transcript.whisperx[14].text |
本部於113年推動全民健康保險強化住院護理照護量能方案支付即興一般病床護理人員夜班獎勵及其他護理獎勵。113年1至5月已撥付獎勵金共11.21億元。另規劃三班戶並比達標醫院獎勵 |
| transcript.whisperx[15].start |
2263.023 |
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2287.822 |
| transcript.whisperx[15].text |
同時亦請各機關提升公職護理人員比例改善護理職場環境公務人員奉集法及醫事人員人事條例以明確醫事人員依其任職之職務應給予各項奉集及加給以確保醫事人員收入本部將配合行政院人事、行政總署嚴厲調整公立醫院醫事人員的待遇 |
| transcript.whisperx[16].start |
2288.874 |
| transcript.whisperx[16].end |
2309.072 |
| transcript.whisperx[16].text |
立羅志及留任醫事人員一起帶動施立醫療院所薪資待遇的改善。三、設置百億癌症基金為癌症病人用藥權益本部優先規劃爭取公務預算撥入全民健康保險基金指定用於癌症診療暫時性支付專管作為 |
| transcript.whisperx[17].start |
2313.556 |
| transcript.whisperx[17].end |
2319.44 |
| transcript.whisperx[17].text |
據醫療破缺需求及治療潛力但臨床效益財務衝擊評估不確定之癌症診療或新適應症的緩衝搭配前瞻預算機制減少對健保總額點值的衝擊 |
| transcript.whisperx[18].start |
2334.412 |
| transcript.whisperx[18].end |
2350.972 |
| transcript.whisperx[18].text |
本部健康政策及醫療科技評估中心專者辦公室於113年1月1日開始運作,協助本部健保署及食藥署執行平行送審相關作業,一劑藥品與取得 |
| transcript.whisperx[19].start |
2351.973 |
| transcript.whisperx[19].end |
2370.812 |
| transcript.whisperx[19].text |
藥品許可證或約6個月內健保幾戶後續規劃成立行政法人國家醫療科技評估中心強化醫療科技再評估量能發展醫療科技評估技術培育人才加速癌症新藥收藏 |
| transcript.whisperx[20].start |
2373.088 |
| transcript.whisperx[20].end |
2390.649 |
| transcript.whisperx[20].text |
有關健康投資方面本部持續推動具實證的子宮腺癌、乳癌、大腸癌、口腔癌、肺癌等五項癌症篩檢服務以早期發現早期治療及時提供高品質治療及醫療照護以提高存活力,為強化醫護婦幼健康照護 |
| transcript.whisperx[21].start |
2391.59 |
| transcript.whisperx[21].end |
2417.488 |
| transcript.whisperx[21].text |
提供孕婦產前檢查新生兒先天性代謝異常疾病篩檢及聽力篩檢兒童預防保健及衛教指導透過優化健康投資增進孕產婦及兒童健康自110年起本部國民健康署及健保署合作推動代謝症候群防治方案目前已有20萬民眾參與降低主要慢性病毒發生為加速多項 |
| transcript.whisperx[22].start |
2419.213 |
| transcript.whisperx[22].end |
2439.267 |
| transcript.whisperx[22].text |
新癌藥納入健保給付項目提升新藥可見性本部健保署自112年實施暫時性支付制度截至113年7月共收載11項預計約1100人受惠並自113年1月1日其推動平行送水新措施其縮短等要 |
| transcript.whisperx[23].start |
2440.609 |
| transcript.whisperx[23].end |
2447.798 |
| transcript.whisperx[23].text |
等待這個藥品洗口、審查及健保核准給付期間,同時積極爭取預算113年用於新增新藥及擴增己要的藥品相關預算共60.49億,為112年的兩倍。 |
| transcript.whisperx[24].start |
2458.434 |
| transcript.whisperx[24].end |
2484.603 |
| transcript.whisperx[24].text |
為確保健保永續經營、增加健康投資若實賴總統倡議健康臺灣願景醫療改革以維護全民醫療品質使醫事人員有尊嚴、安全的發揮專業且有合理的收入另外就是對幫助醫療院所的運作順暢三大改革項目積極推動各項措施本部城大院各委員之指教及監督在此盡致卸診 |
| transcript.whisperx[25].start |
2486.311 |
| transcript.whisperx[25].end |
2488.343 |
| transcript.whisperx[25].text |
並請各位委員繼續予以支持以上謝謝 |
| transcript.whisperx[26].start |
2496.379 |
| transcript.whisperx[26].end |
2517.631 |
| transcript.whisperx[26].text |
有關本次會議各項書面資料均列入紀錄刊登公報那現在開始詢答做以下宣告本會委員詢答時間6加2分鐘練習委員4加1分鐘10點30分截止發言登記委員如有書面質詢請於散會前提出預期不受理暫定10點30分休息10分鐘原則上11點30分處理臨時提案10點30分截止收案 |
| transcript.whisperx[27].start |
2523.915 |
| transcript.whisperx[27].end |
2526.841 |
| transcript.whisperx[27].text |
現在請登記第一位委員陳昭芝委員發言謝謝主席有請邱部長請邱部長 |
| transcript.whisperx[28].start |
2542.113 |
| transcript.whisperx[28].end |
2569.341 |
| transcript.whisperx[28].text |
委員好 主席好部長早安部長賴總統在大選期間提出了一系列的健康臺灣政策其中有包含這個百億癌藥基金那今天我想就跟部長您一起來討論這個部分這個6月中有一場這個臺美合作的肺癌倡議的活動那這個表格是健保署官方的這個資料那我對這份資料裡面有很多的問題想請教部長首先就是部長這個預算是不是都編列了 |
| transcript.whisperx[29].start |
2571.393 |
| transcript.whisperx[29].end |
2587.959 |
| transcript.whisperx[29].text |
這個預算這筆預算是不是已經編列了?我們明年已經爭取了明年的公務預算明年的公務預算?因為今年是健保的今年嘛就2025嗎?就是114年這個百億基金您預計何時撥款?何時開始運作?可不可以有個參考日期? |
| transcript.whisperx[30].start |
2594.285 |
| transcript.whisperx[30].end |
2620.21 |
| transcript.whisperx[30].text |
應該是明年初就可以開始2025年那我想再請教這個計畫是長久性的還是一年的計畫當然是長久性的那再來我想確定一下這個內涵就是有關這個基金的名稱跟這個用途賴總統說這個基金是讓癌症新藥使用正確嗎到底是癌症新藥還是新藥包含癌症新藥的所有新藥 |
| transcript.whisperx[31].start |
2621.343 |
| transcript.whisperx[31].end |
2625.088 |
| transcript.whisperx[31].text |
請問這個基金據說有個運作委員會 這個委員會組成了嗎 有沒有包括病友 |
| transcript.whisperx[32].start |
2641.192 |
| transcript.whisperx[32].end |
2644.354 |
| transcript.whisperx[32].text |
那部長因為賴總統講了一句話他說2030年癌症死亡率要讓他減三分之一根據我的想法我在醫學背景我覺得這個願望非常的奢侈 |
| transcript.whisperx[33].start |
2665.569 |
| transcript.whisperx[33].end |
2673.894 |
| transcript.whisperx[33].text |
如果能夠降低三分之一在醫學上是一個突破所以我再來我想請教部長部長你知道每年癌症的死亡人數是多少 |
| transcript.whisperx[34].start |
2675.026 |
| transcript.whisperx[34].end |
2677.888 |
| transcript.whisperx[34].text |
總統的意思是說要把這個5萬降成3萬多嗎?你們有去了解嗎?因為他說要降低癌症死亡率三分之一啊 |
| transcript.whisperx[35].start |
2697.905 |
| transcript.whisperx[35].end |
2720.132 |
| transcript.whisperx[35].text |
我想這個要一步一步來啦不是你也是要告訴他這個願望可能太奢侈達不到那我們再來看這個基金的適用部分上面的定義是據醫療破解剛剛也讀到了醫療破解需要治療潛力但臨床效益、債務衝擊評估等不確定的癌藥新藥或新適應症部長您覺得這個定義有清楚嗎?您讀起來清楚嗎? |
| transcript.whisperx[36].start |
2725.362 |
| transcript.whisperx[36].end |
2748.198 |
| transcript.whisperx[36].text |
我可以跟部長講因為我在這個委員會已經滿29年健保第一天開始光是這個你剛也用英文唸出來就是醫療迫切需求我可以告訴部長一個新藥有三個定位一個叫做突破創新一個叫比現在的好一個叫做跟現在的一樣你知道我看過多少案例一個藥三個主審都是專家三個人的定位都不一樣 |
| transcript.whisperx[37].start |
2749.059 |
| transcript.whisperx[37].end |
2773.325 |
| transcript.whisperx[37].text |
所以我可以先告訴部長這個迫切需求這個大家各說各話好這是第一個第二個臨床效益如果指的是每讓病人多增加一個有品質的存活年所需要的額外費用那這個叫埃塞爾子沒有一個專業名詞那這個爭議更大了因為太高一定不給那低也不一定就給那因為我們過去整個對性要評估從來沒有將生活或生命的品質放在裡面 |
| transcript.whisperx[38].start |
2774.105 |
| transcript.whisperx[38].end |
2774.225 |
| transcript.whisperx[38].text |
您覺得清楚嗎? |
| transcript.whisperx[39].start |
2801.274 |
| transcript.whisperx[39].end |
2821.907 |
| transcript.whisperx[39].text |
非常敬佩我們委員這麼專業那個幾十年來的經驗告訴我們這些事情那我們當然會收集各國的資料那也會其實部長這樣這個就是在運作的時候我們大家都要有好好的一個共識跟這個資料的support一定跟專家一起來討論還有還有財務衝擊這還在第一句話財務衝擊老實說因為自從2007年11月開始有提供財務衝擊給專家們去討論新藥的時候 |
| transcript.whisperx[40].start |
2831.033 |
| transcript.whisperx[40].end |
2852.338 |
| transcript.whisperx[40].text |
我從來沒看過健保署的評估資料跟這個廠商的評估資料或是專家學會的評估資料是一模一樣的而且差距甚至非常大超過一億的都有所以我向部長確認這裡的費用財務衝擊他不是申報費用對不對他是指如果這個病人假設他不用現在有的治療 |
| transcript.whisperx[41].start |
2853.338 |
| transcript.whisperx[41].end |
2860.425 |
| transcript.whisperx[41].text |
他要去改用這個新的療法所額外增加來的費用,對嗎?是不是這個定義?財務衝擊是這個定義,這才叫財務衝擊,不是申報費用。那但是財務衝擊就是說,我剛剛講說,甘算得清楚?有真相嗎? |
| transcript.whisperx[42].start |
2871.827 |
| transcript.whisperx[42].end |
2895.353 |
| transcript.whisperx[42].text |
我要講的是說因為我從來搞不清新藥預算是怎麼算過去只編2、30億今年好像編的多一點60億那如果再看來明年要編的更多那我們都不知道新藥預算怎麼算說用的多少怎麼用這個搞不清楚因為計算很複雜非常的複雜那計算的方法也是有爭議的部長那這怎麼辦財務中局 |
| transcript.whisperx[43].start |
2897.814 |
| transcript.whisperx[43].end |
2920.63 |
| transcript.whisperx[43].text |
報告委員因為這個財務風險評估的確是不太確定所以才會用暫時性支付這個主基礎的那個GDP成長一年可以調整十幾次你這裡不能調啊這裡就是很固定的就是這樣好我們再來看期成經費目前預估是每年100億所以我再確定一次這個100億是健保署的實際支出 |
| transcript.whisperx[44].start |
2922.391 |
| transcript.whisperx[44].end |
2950.38 |
| transcript.whisperx[44].text |
還是醫院的申報費用我們都知道現在有所謂藥廠跟健保簽有所謂的價量協議跟這個所謂的這個支付協議應該是實際的支出實際支出因為這個差很大部長這定義差很大因為去年可能還了70億左右去年大概在前一年是50億在前一年是26億這跟百億都靠近了你如果定義不清楚就模糊了那部長您今天說是 |
| transcript.whisperx[45].start |
2951.76 |
| transcript.whisperx[45].end |
2977.026 |
| transcript.whisperx[45].text |
實際支出實際支出好確定好再來請問健保屬2024年編列的新藥新科技預算有包含新藥新特才NGS還有暫時性支付大概六七十億剛剛你也報告了請問這兩塊區分的開嗎就是這個一百億跟這個區分的開嗎還是說你這個一百億存在了你這個原來的編列你就開始縮減了最後都混在一起了所以事實上這個百億基金並沒有提供百億事實上是打折扣的 |
| transcript.whisperx[46].start |
2977.426 |
| transcript.whisperx[46].end |
2979.47 |
| transcript.whisperx[46].text |
百億基金應該就是設計在專款專用不會去影響到健保裡面的 |
| transcript.whisperx[47].start |
2985.645 |
| transcript.whisperx[47].end |
3005.985 |
| transcript.whisperx[47].text |
但是原來就有編新藥新科技,那現在又有個百億嘛,所以我要確定這兩塊切得開嗎?切得開嗎?切得開啊。切得開,好,但願如此。那財務推廣部分非常非常重要,但是因為健保要永續嘛,一定要控制。那我再請教,如果療效很好,超過了比預估量還高,或是超過所謂一個上限值,因為這已經發生太多次了。 |
| transcript.whisperx[48].start |
3009.267 |
| transcript.whisperx[48].end |
3031.858 |
| transcript.whisperx[48].text |
請問這個多出來的費用都要廠商依比例來提供嗎?來分攤嗎?就超過的東西是你廠商的部長你覺得這樣合理嗎?這個因為是參考英國的Cancel Drug Fund的一個制度啦那由廠商來分攤你應該知道醫院還會向廠商要求那個要價差啊我可以問一下部長您知道要價差有多少嗎?一年的要價差有多少嗎?要價差是這個百億基金的幾倍啊? |
| transcript.whisperx[49].start |
3039.729 |
| transcript.whisperx[49].end |
3046.174 |
| transcript.whisperx[49].text |
這個所謂的要價差就是說健保的合價跟我們做這個市場調查的醫院競價那這中間的差額以去年為例大概是在550億左右 |
| transcript.whisperx[50].start |
3057.543 |
| transcript.whisperx[50].end |
3058.464 |
| transcript.whisperx[50].text |
請問會不會回到現況就是說他就不參加健保給付或留在自費市場 |
| transcript.whisperx[51].start |
3073.985 |
| transcript.whisperx[51].end |
3098.067 |
| transcript.whisperx[51].text |
那現在就回到現在的狀況大家還是用不到藥因為這些都是來自所謂的突破創新都是來自國外的廠商他們有國際的價格要去某些程度的保障那現在怎麼避免呢那還是回到現況我預期他會回到現況這個百億基金會最後還是回到現況那沒關係這個部分不是這麼容易回答那個效益評估的部分效益評估包括這個納入給付之前跟之後 |
| transcript.whisperx[52].start |
3098.587 |
| transcript.whisperx[52].end |
3111.334 |
| transcript.whisperx[52].text |
那之前我們只能靠科學文具跟科學文獻跟台灣的這個流行病學資料那之後是用真實世界的這個資料那請問真實世界資料的品質如何呢可信嗎 |
| transcript.whisperx[53].start |
3114.659 |
| transcript.whisperx[53].end |
3133.126 |
| transcript.whisperx[53].text |
Real world data你有沒有找真正的專家來處理這是一個非常嚴謹的科學我想我們所有任何的研究相關的計畫一定都找最適當的專家這個我再來討論而且CHPTA我覺得不應該under在健保屬下它是一個獨立超然的這個機構那請問這個100億是不是包括登錄系統維護系統或是檢測會在裡面就放在裡面嗎那最後一張請書記再給我一點點時間因為100億實在是很大的均額 |
| transcript.whisperx[54].start |
3143.791 |
| transcript.whisperx[54].end |
3159.021 |
| transcript.whisperx[54].text |
那個健保署在公開對外務共理會很棒成員、利益迴避書、書面基調甚至這個所謂的錄音檔全部公開那我也希望外部部其他的委員會也可以效法部長尤其包括疫苗的部分好嗎看病的部分都要公開透明的 |
| transcript.whisperx[55].start |
3162.402 |
| transcript.whisperx[55].end |
3180.786 |
| transcript.whisperx[55].text |
財務衝擊預估現在有很大的空間其實對病人來說因為你現在叫衛福部你不只是衛生而已那如果說你這個醫療或非醫療你幫助小孩子回去上課幫助成人回到職場上班減輕家庭的照顧減少長照費資源的使用這個東西是不是應該納入醫療科技的評估裡面但是從來沒有醫療科技從2007年提供到現在還留在算數 |
| transcript.whisperx[56].start |
3187.907 |
| transcript.whisperx[56].end |
3201.74 |
| transcript.whisperx[56].text |
多少病人多少錢取代哪個費用直接把它加減扣掉部長這個只有價格沒有價值的算法部長您同意嗎我比較希望用價值的算法最後不好意思最後一張這個是我個人統計因為台灣沒有其他人做這個統計我的統計癌症新藥平均納保持癌藥這是782天 |
| transcript.whisperx[57].start |
3211.269 |
| transcript.whisperx[57].end |
3222.921 |
| transcript.whisperx[57].text |
那我們因為沒有錢一直限縮所以我們的癌藥跟其他國家不一樣你要參考別的國家就要小心因為我們頂多只有三成的病人在裡面支付那要怎麼去接軌呢?怎麼用他們資料來做這個詮釋呢?那所以現在這個癌症的這個基金已經在眼前但是我覺得醫藥新科技戰線給付的這個當然你剛剛提到說是劃分的開 |
| transcript.whisperx[58].start |
3233.492 |
| transcript.whisperx[58].end |
3252.818 |
| transcript.whisperx[58].text |
這份基金很珍貴得來不易我希望他要釐清很多點如果你不釐清的話你將來他的效益評估他的實際的成效搞不清楚部長也要清楚才能夠你實際在運作的時候跟評估是會清楚的這樣才能夠讓民眾得到保障也兌現賴總統的一個承諾馬部長謝謝委員專業的指導我們會努力謝謝 |
| transcript.whisperx[59].start |
3260.356 |
| transcript.whisperx[59].end |
3264.559 |
| transcript.whisperx[59].text |
好 謝謝陳昭芝委員的發言接下來請林月琴委員發言麻煩部長請邱部長 |
| transcript.whisperx[60].start |
3286.692 |
| transcript.whisperx[60].end |
3303.63 |
| transcript.whisperx[60].text |
從一直在討論健保點子的時候常常就會被提到說因為醫護人員的薪資非常的低不過看起來就是說講他很低可是實際上我們去整體看長久以來大概護理師的薪資大概都是由政府來主導調薪 |
| transcript.whisperx[61].start |
3304.727 |
| transcript.whisperx[61].end |
3319.023 |
| transcript.whisperx[61].text |
包括夜班的獎勵繁重佳績都是由衛福部來主導甚至在104年我們推動的醫護筆跟健保的支付連動那實測結果也是降低醫護筆有效心知不知道 |
| transcript.whisperx[62].start |
3319.944 |
| transcript.whisperx[62].end |
3339.487 |
| transcript.whisperx[62].text |
建保典子在講的時候都說應該要針對可是實際上看這個表格可以知道說基本上都是因為我們的薪資因為基本工資調的時候連動否則看到護理師的這樣的一個薪資跟我們醫療保健的業的平均薪資事實上是 |
| transcript.whisperx[63].start |
3339.986 |
| transcript.whisperx[63].end |
3342.547 |
| transcript.whisperx[63].text |
有關這個部分是不是趙復師可以簡要回應一下 |
| transcript.whisperx[64].start |
3371.685 |
| transcript.whisperx[64].end |
3381.933 |
| transcript.whisperx[64].text |
關於護理人員的薪資改善我們大概從幾個方面因為主要醫院還是直接的雇主所以我們現在三班互併比夜班獎勵的目的是讓專責夜班的能力可以固定那這個 |
| transcript.whisperx[65].start |
3389.434 |
| transcript.whisperx[65].end |
3416.57 |
| transcript.whisperx[65].text |
也整體可以帶動這個護理人員薪資可是看起來沒有啊就是說因為三月壓制之後最後還是事實上低我們就來看一個醫院收入跟支付是兩個不相關的程序所以政府要幫我們的護理人員加薪的話錢如果沒有指定用途的話或者是規定代收代付的話根本沒有辦法保證我們醫護人員所以想問部長說這樣的原因像是夜班的獎勵金繁重加急 |
| transcript.whisperx[66].start |
3417.21 |
| transcript.whisperx[66].end |
3429.792 |
| transcript.whisperx[66].text |
未來你現在上任之後你應該還是會持續推動這個政策對吧這個是直接給護理人員的業班獎勵是直接給護理人員對所以我說部長接下來你這些政策你會持續推動 |
| transcript.whisperx[67].start |
3430.563 |
| transcript.whisperx[67].end |
3449.494 |
| transcript.whisperx[67].text |
我想我們已經有擬定了在今年的3月1號有擬行政院通過三個方向十二大目標我想這十二個目標我們目前非常積極在啟動包括當然就是夜班的這個部分改善工作環境 |
| transcript.whisperx[68].start |
3457.779 |
| transcript.whisperx[68].end |
3473.067 |
| transcript.whisperx[68].text |
本席多次就依據社工跟長照人員加薪的經驗提出從政府要支付給醫院的錢裡面是不是可以劃出一定的比例特定用來支付醫事人員的薪資這個做法你同意嗎我覺得應該朝這個方向來努力 |
| transcript.whisperx[69].start |
3477.412 |
| transcript.whisperx[69].end |
3501.704 |
| transcript.whisperx[69].text |
上限型醫院的自費項目幾乎是不被管理的那心理不准開刀健保給付19萬自費21萬那攝護腺肥大開刀健保給付9萬那自費16萬白內障開刀健保給付3萬可是自費的話一樣是3萬可是自費是一塊很大的收益這個全數的利益歸法人所有 |
| transcript.whisperx[70].start |
3502.523 |
| transcript.whisperx[70].end |
3524.23 |
| transcript.whisperx[70].text |
那這是不是不太合理的應該是呈現在我們的薪資上跟所有的醫事人員共享所以想問一下本席要求衛福部推動自費收入列入管理那設定點值並將30%用於我們的薪資給付所以可不可以帶回去研議然後一個月內提出研議的結果你同意嗎 |
| transcript.whisperx[71].start |
3525.404 |
| transcript.whisperx[71].end |
3528.785 |
| transcript.whisperx[71].text |
本席知道目前癌藥基金已經有預擬的方案所以想來問一下就是說這個計畫裡邊有提到財務衝擊評估的不確定 |
| transcript.whisperx[72].start |
3551.534 |
| transcript.whisperx[72].end |
3574.65 |
| transcript.whisperx[72].text |
的藥品可以列入我們的暫時性支付,如果其中兩三項的財務衝擊評估不確定的品項超出了預算,超出的費用由藥商分攤,這個制度設計的效果不是要由我們的藥商替負責做評估的HTA被黑鍋嗎?而且投資風險這麼大,部長你會覺得西藥代理商還會願意進口嗎?因為你這邊寫了一個就計畫財務衝擊 |
| transcript.whisperx[73].start |
3580.339 |
| transcript.whisperx[73].end |
3581.24 |
| transcript.whisperx[73].text |
可是這寫了這樣子的一個到底什麼叫財務衝擊評估不確定 |
| transcript.whisperx[74].start |
3606.147 |
| transcript.whisperx[74].end |
3611.349 |
| transcript.whisperx[74].text |
跟委員說明這個不確定有兩種情形一種情形就是說我們官方我們委託的這個HTA科技醫藥科技評估報告跟廠商所提的這個報告中間的落差很大 |
| transcript.whisperx[75].start |
3632.598 |
| transcript.whisperx[75].end |
3654.435 |
| transcript.whisperx[75].text |
這個就所謂的不確定就是等於各說各話那這個時候呢我們就會把它列入暫時性支付而沒有辦法直接進入到健保這是一種情況阿第二個是說我們評估起來如果我們按照它的價值來看也就是ISER值來看非常的高以英國為例它的ISER值呢它是定在大概在人年的藥費在3億3 |
| transcript.whisperx[76].start |
3658.158 |
| transcript.whisperx[76].end |
3661.6 |
| transcript.whisperx[76].text |
原來在健保的財務裡邊暫時性支付的費用大概20億那新藥大概40億 |
| transcript.whisperx[77].start |
3679.208 |
| transcript.whisperx[77].end |
3705.471 |
| transcript.whisperx[77].text |
那現今要把暫時性支付從健保裡拉出來健保給付拉出來那連帶把新藥跟新適應症的藥品一起拉出來那成立我們的基金並增加40億的經費擴充到100億實際上用於癌症用藥的大概費用20億到60億所以如果要達到我們總統降低我們的癌症死亡率三分之一的願景會不會打折 |
| transcript.whisperx[78].start |
3707.416 |
| transcript.whisperx[78].end |
3723.358 |
| transcript.whisperx[78].text |
應該不會啦,因為我們依照實際上的需要,從20幾億,也許我們努力增加整個量能來到60億,我想3年應該就可以達到百億,也是會完成到這樣的一個百億基金 |
| transcript.whisperx[79].start |
3725.229 |
| transcript.whisperx[79].end |
3751.439 |
| transcript.whisperx[79].text |
本期期待為了強化我們的藥品供應鏈的韌性所以政府在新的制度還是要應該要扶持我們的國產製藥的思維原因在於我們臺灣本來就比較受地緣政治的影響如果供應鏈脆弱的話那學民藥跟國產藥的費用平均又只有我們進口藥的三分之一而且還可以增加品項所以想問一下國建署在我們的 |
| transcript.whisperx[80].start |
3752.179 |
| transcript.whisperx[80].end |
3776.76 |
| transcript.whisperx[80].text |
建保藥物及負項目及支付標準修正案的討論當中一直有免除國產新藥廠商跟健保署簽訂MEA的那個責任所以在未來的基金規則裡邊應該要延續這個思維你同意嗎同意啊那盡量延長我們國內代理商收集臨床資料進行HTR的 |
| transcript.whisperx[81].start |
3777.45 |
| transcript.whisperx[81].end |
3801.07 |
| transcript.whisperx[81].text |
評估的期限讓廠商降低我們進口的風險提高代理意願部長同意嗎這個也可以考慮那再來就是一項有療效的藥品但有時候為何遲遲不納入所以原因在於國健署跟藥商彼此費用都談不攏所以在有限的財源上要不要減少每預計年支付 |
| transcript.whisperx[82].start |
3801.61 |
| transcript.whisperx[82].end |
3821.679 |
| transcript.whisperx[82].text |
我們的藥物的那個品項的數量要不就是增加財源這件事很重要早一天納入健保病友就早一天有得到存活的機會所以想問的是健保重大傷病免除部分負擔有沒有跟病友徵詢過是不是願意支付部分負擔用以減輕全額自費的壓力 |
| transcript.whisperx[83].start |
3823.471 |
| transcript.whisperx[83].end |
3823.591 |
| transcript.whisperx[83].text |
以上謝謝 |
| transcript.whisperx[84].start |
3850.229 |
| transcript.whisperx[84].end |
3876.722 |
| transcript.whisperx[84].text |
好 謝謝委員指教好 謝謝林月琴委員的發言接下來請陳金輝委員發言主席各位委員各位官員早安我也想請邱部長謝謝邱部長委員長我們先到第一張 |
| transcript.whisperx[85].start |
3879.636 |
| transcript.whisperx[85].end |
3903.895 |
| transcript.whisperx[85].text |
部長早安這個是非常多因為你知道醫生週末就是參加醫學會所以許許多多的外科醫師跟我反映這件事情我們才剛去WHO跟大家說臺灣can help結果才不到一個月我們就發生了輸疫事件而且這個輸疫看起來短期內是無法結束我也很遺憾有跟食藥署討論過 |
| transcript.whisperx[86].start |
3905.596 |
| transcript.whisperx[86].end |
3934.503 |
| transcript.whisperx[86].text |
7月、8月、9月、10月現在至少4個月而且10月我們還沒有辦法確認這個廠家有沒有辦法改善他的流程因為他總共有63項的違規現在很確定的是7、8、94個月我們要靠跟國外進口兩到三倍的價格500CC另外一個很確定的事情是大規格的2公升、3公升的生理鹹水沒有 |
| transcript.whisperx[87].start |
3936.403 |
| transcript.whisperx[87].end |
3961.991 |
| transcript.whisperx[87].text |
這個週末呢我遇到我的同業他現在如果要排子宮鏡手術他先取消了沒辦法我也在這邊示範給其他委員看邱正軍委員看其他官員看沒有接觸醫療很久你們可能有點忘記了這個是500CC的生理食鹽水就這麼一小包我們現在只有這個不管是進口或者是台灣其他廠商做的 |
| transcript.whisperx[88].start |
3962.791 |
| transcript.whisperx[88].end |
3987.945 |
| transcript.whisperx[88].text |
一個外科手術他可能需要平常兩公升或三公升兩三包就夠了所以臨床像我遇到醫生他開比較複雜的手術他就這樣子換了三十包三十幾包所以不知道部長有沒有回憶起來通常我們做手術的時候我們需要一個加壓器你要把身體食鹽水加進去他才會加壓嘛他才會滴注到病人的體內 |
| transcript.whisperx[89].start |
3989.686 |
| transcript.whisperx[89].end |
4018.565 |
| transcript.whisperx[89].text |
所以這個加壓器打開你把它關起來就要好幾秒的時間再來你要把外面的包裝拆開接下來你要接這個外面輸液的頭欸所以你一台手術因為這樣子浪費了多少護理人員時間還有麻醉科醫生的時間還有手術醫生的時間因為光是在換輸液這件事情至少要4個月而且你還不知道10月的時候永豐有沒有辦法恢復2公升3公升1公升這樣子規格喔 |
| transcript.whisperx[90].start |
4019.125 |
| transcript.whisperx[90].end |
4048.285 |
| transcript.whisperx[90].text |
你還不知道喔所以現在有的機構是把需要大規格輸液的手術暫停那有些他就這樣換護理師跟他老闆說老闆如果你要我站在這個加壓器旁邊站一路換30包那我的手已經斷掉了我等一下什麼事都不用做了他平常在手術中他要做手術記錄他要聯絡下一台他要記錄生命真相等等他就光是在那邊換輸液就好了 |
| transcript.whisperx[91].start |
4049.386 |
| transcript.whisperx[91].end |
4057.721 |
| transcript.whisperx[91].text |
這也不是最大的重點,最大的重點是這是一個國安危機啊,如果今天我們有很重大的公安意外 |
| transcript.whisperx[92].start |
4059.141 |
| transcript.whisperx[92].end |
4079.267 |
| transcript.whisperx[92].text |
或是天災或是目前大家也很擔心我們的這個戰略位置很危險我們沒有辦法做出自己的生理鹹水請問有30幾家有藥證願意復工的部長您現在知道有哪些了嗎有幾家願意嗎你們有給他誘因你們有去輔導他嗎 |
| transcript.whisperx[93].start |
4081.345 |
| transcript.whisperx[93].end |
4102.282 |
| transcript.whisperx[93].text |
我想這個輔導還有提供誘因是一直在做那我也非常感謝委員提出來的醫療現場的一些非常重要的狀況因為我也是臨床醫師我很清楚有些手術真的會造成這樣的一個問題那我想整個衛福部的團隊在維護我們醫療的品質 |
| transcript.whisperx[94].start |
4107.071 |
| transcript.whisperx[94].end |
4119.929 |
| transcript.whisperx[94].text |
人民的健康之下當然有它一定的規定那在這規定當中有些配套措施需要再加強這個我們一定都去彌補那希望醫療院所能夠先體諒那個 |
| transcript.whisperx[95].start |
4122.392 |
| transcript.whisperx[95].end |
4122.532 |
| transcript.whisperx[95].text |
也是從永豐嗎? |
| transcript.whisperx[96].start |
4162.271 |
| transcript.whisperx[96].end |
4171.917 |
| transcript.whisperx[96].text |
所以這個是我大概上個禮拜一就所知但至今沒有任何的回覆我們也很想知道說您 |
| transcript.whisperx[97].start |
4172.717 |
| transcript.whisperx[97].end |
4190.452 |
| transcript.whisperx[97].text |
近五年來衛福部有沒有掌握這些廠商違規的事件還有他們的生理食鹽水市場佔有率因為很明顯的很明顯的為什麼我們今天會出現生理食鹽水大缺是因為一家廠商獨佔了七八成 |
| transcript.whisperx[98].start |
4191.092 |
| transcript.whisperx[98].end |
4205.243 |
| transcript.whisperx[98].text |
沒有人要做本來有30幾家的人要做最後只有一個人願意做好結果你們去年11月就發現他違規那個時候你們沒有想到說他有可能最後會做不出來導致現在這樣子的狀況 |
| transcript.whisperx[99].start |
4207.358 |
| transcript.whisperx[99].end |
4224.959 |
| transcript.whisperx[99].text |
其實也非常多人關心不管是輸液、一般的用藥、腸胃藥、胃藥、胃潰瘍的藥、止痛藥、退燒藥這些都是我們國家如果發生重大公安事件或是天災或是戰爭有可能一下就全部短缺 |
| transcript.whisperx[100].start |
4225.76 |
| transcript.whisperx[100].end |
4233.264 |
| transcript.whisperx[100].text |
我這邊也很希望跟你們所知你們可不可以統計出來不管是醫材或是輸液或是藥品如果有什麼東西因為你們的健保點值導致本來幾十家在做現在只剩一兩家還佔了七八成如果這一兩家你怎麼知道今年是生理食鹽水 |
| transcript.whisperx[101].start |
4245.231 |
| transcript.whisperx[101].end |
4263.107 |
| transcript.whisperx[101].text |
明年又是什麼後年又是什麼可是你們沒有去做風險管理啊你們也沒有列出一個表我們現在到底有哪些這些很緊急的重大的醫材藥品或是輸液其實只剩一兩家在做了然後一兩家又佔了七八成以上你們也不知道嘛對不對你們知道嗎 |
| transcript.whisperx[102].start |
4264.696 |
| transcript.whisperx[102].end |
4280.471 |
| transcript.whisperx[102].text |
其實有6個月就會公告那個衛生部就會公告這個重要的藥品或醫材的清單那如果有任何問題就趕快解決那如果這樣都還我非常同意委員所提的雞蛋也不要放在一個 |
| transcript.whisperx[103].start |
4281.272 |
| transcript.whisperx[103].end |
4294.381 |
| transcript.whisperx[103].text |
對,可是你們有知道比例嗎?你們當然知道說你們有提供給國防部或是退府會一些重大的清單我們面臨緊急狀況最需要哪些東西但是你們知道他們現在廠商分布的比例嗎?你說現在的藥品嗎?還是對,就是臨床上不可或缺的 |
| transcript.whisperx[104].start |
4304.98 |
| transcript.whisperx[104].end |
4327.606 |
| transcript.whisperx[104].text |
你現在只知道永豐佔了八成啊你怎麼知道其他的不管是其他的書藝或是其他的藥品有沒有是一兩家廠商獨佔的有關你重要的藥品跟醫材怎麼樣我們來管理那真的是比較安全另外呢因為我們現在專案所以你們找了七家其中有一家叫做恆山我們來看一下齁 |
| transcript.whisperx[105].start |
4329.447 |
| transcript.whisperx[105].end |
4345.222 |
| transcript.whisperx[105].text |
這個恆山啊是以前你們列在你們網站上有嚴重違反GDP在111年你們把他列在你們網站說嚴重的影響GDP的名單之一另外呢臺中的國軍總醫院在109年也有公布說有 |
| transcript.whisperx[106].start |
4349.006 |
| transcript.whisperx[106].end |
4351.368 |
| transcript.whisperx[106].text |
好,謝謝,這個部分是不是請石教授回答?請你回答是,各位委員報告 |
| transcript.whisperx[107].start |
4373.104 |
| transcript.whisperx[107].end |
4388.275 |
| transcript.whisperx[107].text |
過去曾經如果有被我們說有嚴重違反GDP的業者我們都會要求他提出矯正措施的改善報告那如果這個業者已經提出改善報告而且經過我們確認沒有問題的話那這等於他的違規已經矯正那就是可以繼續的執行那另外剛剛委員提到有兩家 |
| transcript.whisperx[108].start |
4388.855 |
| transcript.whisperx[108].end |
4402.928 |
| transcript.whisperx[108].text |
專案輸入業者目前還沒確認的部分因為我們目前在公開徵求的時候第一個都會要求他的GMP要符合PIX GMP就跟我國的GMP要求是一樣第二個是在當地的國家要有上市的許可然後要有相關的這些檢驗規格要符合要點的規範 |
| transcript.whisperx[109].start |
4403.909 |
| transcript.whisperx[109].end |
4424.756 |
| transcript.whisperx[109].text |
這些條件符合之下我們才會允許他專案輸入那至於說剛剛委員提到有兩家那是目前還在洽談之中就是在確認他的生產是不是可以提供1L有多少量500cc多少量這個部分確認之後我們就會核發專案輸入函那他就會繼續跟健保那邊去洽商以上但是你們現在有找到比較大容量的願意進口的你們有找到比較大容量願意製作的嗎還是要維持只有原封 |
| transcript.whisperx[110].start |
4428.22 |
| transcript.whisperx[110].end |
4431.502 |
| transcript.whisperx[110].text |
所以部長你有沒有什麼想法要怎麼樣讓大於一家的廠商願意製作這個手術非常需要的輸益 |
| transcript.whisperx[111].start |
4457.216 |
| transcript.whisperx[111].end |
4473.05 |
| transcript.whisperx[111].text |
好,我想我們會往這方面來研議啦,這樣對國安啦,或者是說像這一次我們在找的,我有問過在負責的林經理次長我去找這麼多金,大家知道比較不方便啦 |
| transcript.whisperx[112].start |
4473.51 |
| transcript.whisperx[112].end |
4475.292 |
| transcript.whisperx[112].text |
部長這可能都不是重點,重點是我們國家還是要有大於一家廠商做不同規格的輸易 |
| transcript.whisperx[113].start |
4493.712 |
| transcript.whisperx[113].end |
4509.698 |
| transcript.whisperx[113].text |
而不是你現在花了多少錢進口進口了多少家有幾家願意進口這個不是重點所以也許我們未來還是要討論要什麼方法才能讓每一種東西可以大於一家可以做讓它市佔率不要到七八成 |
| transcript.whisperx[114].start |
4512.159 |
| transcript.whisperx[114].end |
4539.179 |
| transcript.whisperx[114].text |
是另外這邊我也希望要幫基層醫療請命這個2022年的時候 疾管署曾經編列845億的後疫情防治經費當時您是立委所以您也有被拜訪過但是您應該也知道2023年3月防疫指揮中心在沒有做社會溝通也沒有醫界溝通之下突然公告COVID-19門診相關費用改由健保來給付 |
| transcript.whisperx[115].start |
4540.56 |
| transcript.whisperx[115].end |
4564.285 |
| transcript.whisperx[115].text |
那因為這個的確非常不公平因為2023年的健保總額是在2022年就協商完成所以你2023年3月才說我又要把COVID的東西納入健保這個很不合理那為什麼最近我們一定要解決這件事情是因為你也看到從上個月開始確診達到10萬死亡人數不斷的升高所以呢 |
| transcript.whisperx[116].start |
4565.265 |
| transcript.whisperx[116].end |
4589.453 |
| transcript.whisperx[116].text |
精神醫療算一算再加上攤扣今年的第一劑低於0.8的點值第二劑可能會更低因為現在確診數一直上升還缺藥所以2023年的時候我們有抑注241元當然這個金額跟2022年不能比可是你現在並沒有看到疫情有減緩那同時你規劃2024年要抑注200億請問這200億什麼時候才會撥補下來 |
| transcript.whisperx[117].start |
4599.387 |
| transcript.whisperx[117].end |
4612.614 |
| transcript.whisperx[117].text |
我想這件事情我應該算很清楚的過去一年來非常努力在去年從第二季開始也就是說26號宣布以後的確點子整個都 |
| transcript.whisperx[118].start |
4622.72 |
| transcript.whisperx[118].end |
4648.795 |
| transcript.whisperx[118].text |
所以我們也做了各方面的努力那所以大概去年總共補的大概將近100億來達到點值0.9那這個部分說實在的醫院方面大概也佔了應該有七成那其他西醫基層大概也有一部分那我想這個部分今年看起來 |
| transcript.whisperx[119].start |
4650.804 |
| transcript.whisperx[119].end |
4677.401 |
| transcript.whisperx[119].text |
第一季也是跟去年一樣相當的低所以這個問題我想會再出現上週五我們後生會有舉辦了一個後疫情時代應該要如何因應而且衛福部其實今年10月11月也要開始打新的變種的COVID疫苗表示全世界都知道這件事情沒有終止所以你們的後疫情的這些編列也不應該終止 |
| transcript.whisperx[120].start |
4679.181 |
| transcript.whisperx[120].end |
4700.706 |
| transcript.whisperx[120].text |
你們不能像是好像COVID快結束了所以我們再把它納回到納回到健保因為這些人也有Long COVID也有一些後遺症需要處理所以其實你是很確定的是他們就是會佔我們未來的醫療很大一塊跟你一直提到的這些新藥基金科技一樣啊一樣的意思啊 |
| transcript.whisperx[121].start |
4701.9 |
| transcript.whisperx[121].end |
4716.127 |
| transcript.whisperx[121].text |
是 我想這個部分應該 如果他因為一個嚴重的疫情所產生的一個醫療的負擔我覺得不能全部由醫療院所來承擔這樣點子會太低所以可能要來爭取相關的意向 |
| transcript.whisperx[122].start |
4719.529 |
| transcript.whisperx[122].end |
4742.035 |
| transcript.whisperx[122].text |
會再追蹤 最後只是跟部長稍微提醒因為那次我總諮詢沒有聲音所以沒有辦法很完整的表達今年2月衛福部承諾白班護理津貼會撥下來但是5月的時候又說可能要到明年我覺得這個對於護理師也是是個打擊啊 士氣的打擊所以如果可以加快的話我們也希望大家可以盡快的加快 謝謝 |
| transcript.whisperx[123].start |
4743.446 |
| transcript.whisperx[123].end |
4743.907 |
| transcript.whisperx[123].text |
接下來請邱振軍委員發言 |
| transcript.whisperx[124].start |
4776.662 |
| transcript.whisperx[124].end |
4782.133 |
| transcript.whisperx[124].text |
主席好 我們一樣請我們的部長請邱部長要不要先喝個水 |
| transcript.whisperx[125].start |
4787.981 |
| transcript.whisperx[125].end |
4810.573 |
| transcript.whisperx[125].text |
我請問一下我最近看了這個報導我們賴總統他設了三個委員會那也一直強調這些委員會的任務必須以國家整體的角度來推動所以他是會設在總統府那麼其中有一個委員會就和我們衛福部的業務相關我想請問部長 |
| transcript.whisperx[126].start |
4811.997 |
| transcript.whisperx[126].end |
4822.948 |
| transcript.whisperx[126].text |
那未來您是聽這個委員會的指揮嗎我想因為總統他本身是一個很 |
| transcript.whisperx[127].start |
4825.292 |
| transcript.whisperx[127].end |
4843.351 |
| transcript.whisperx[127].text |
德高可以說是相當優秀的一個醫師那他長期也關心醫療的發展所以他擔任總統以後他很希望所以這個委員會就是凌駕在我們行政院之上了不會因為我們的政策絕對是完全的溝通不管是總統府、行政院以及衛福部 |
| transcript.whisperx[128].start |
4846.735 |
| transcript.whisperx[128].end |
4857.429 |
| transcript.whisperx[128].text |
這個委員會包含全民健保、智慧醫療還有癌症新藥及防治我看到部長今天的報告跟這個範圍是差不多的 |
| transcript.whisperx[129].start |
4859.488 |
| transcript.whisperx[129].end |
4884.22 |
| transcript.whisperx[129].text |
您覺得以後這樣子在您辦事情的時候您在施政的時候在推展你的業務的時候會不會受到影響?如果站在我的角度我是非常感恩感恩到在新政府就任之前前台灣有一千多個醫療專業的同仁開了六次的大會研討出一個國家現在目前 |
| transcript.whisperx[130].start |
4885.16 |
| transcript.whisperx[130].end |
4886.961 |
| transcript.whisperx[130].text |
那要行政院幹什麼呢? |
| transcript.whisperx[131].start |
4906.798 |
| transcript.whisperx[131].end |
4911.382 |
| transcript.whisperx[131].text |
我希望你還是要堅持表現你自己這個衛福部是我們台灣我們所有衛福部的業務你是最高的一個執行者 |
| transcript.whisperx[132].start |
4928.541 |
| transcript.whisperx[132].end |
4940.919 |
| transcript.whisperx[132].text |
應該如果說我這樣講應該是說如果是賴總統他有他的想法當然可以跟你們直接溝通我這樣覺得因為他成立這個委員會我怎麼感覺我們部長只是個傀儡 |
| transcript.whisperx[133].start |
4944.38 |
| transcript.whisperx[133].end |
4969.135 |
| transcript.whisperx[133].text |
應該不至於啦 因為在籌備的過程當中我是有完全的參與我是有完絕的參與所以那個包括那我再請教 我再請教我們的部長就是說這個委員會涉及全民健保的預算醫療體系跟生技醫藥產業的發展這涉及龐大的預算跟產業的這個重大的發展的關係這個都不需要被監督嗎都不用有法源依據 |
| transcript.whisperx[134].start |
4971.721 |
| transcript.whisperx[134].end |
4994.344 |
| transcript.whisperx[134].text |
我想這個委員會大概會比較屬於專家的一個方向的一個討論然後行政院當然就要落實到國家希望的工程整體來運作那我們衛福部就是以健康台灣相關的議題來落實所以我想這樣的一個結合是應該是相當的順暢 |
| transcript.whisperx[135].start |
4995.748 |
| transcript.whisperx[135].end |
5014.096 |
| transcript.whisperx[135].text |
那我也請委員放心,衛福部絕對會贊助你我很懷疑我們賴總統的動機他是不是要把行政院架空還是想要廢掉衛福部所以部長你要小心請委員放心,應該不會有這種事情 |
| transcript.whisperx[136].start |
5015.956 |
| transcript.whisperx[136].end |
5036.424 |
| transcript.whisperx[136].text |
本席之前就說過政府也說過一直強調醫療平權但在臺灣新藥科技變成一種階級門檻有錢的才有活命的機會臺灣平均4分19秒就有一人得到癌症去年平均9分53秒就有一人死於癌症 |
| transcript.whisperx[137].start |
5038.064 |
| transcript.whisperx[137].end |
5058.718 |
| transcript.whisperx[137].text |
指望比前年快轉了14秒那設置百億癌症基金在合理可被監督檢視的情況下我相信大家都會支持我們國民黨的幾位立委也有提到要修癌症防治法你們的報告裡也說過要修癌症防治法請問部長什麼時候會提 |
| transcript.whisperx[138].start |
5060.474 |
| transcript.whisperx[138].end |
5078.504 |
| transcript.whisperx[138].text |
跟委員報告因為癌症的治療真的站在我們醫師的立場我們感覺上一天都不能等了所以能夠越快上路越快幫助這些癌症病人越好所以像今年就有一個部長你只要講什麼時候就好那個我們明年 |
| transcript.whisperx[139].start |
5085.29 |
| transcript.whisperx[139].end |
5095.538 |
| transcript.whisperx[139].text |
致以修法,我想我也,我也當過那個立法委員發言,我也清楚,當你一個法提出來的話,尤其癌症法是一個大法 |
| transcript.whisperx[140].start |
5096.818 |
| transcript.whisperx[140].end |
5123.905 |
| transcript.whisperx[140].text |
所以我們希望部裡面盡快提出來不要只有在野版的版本好沒問題沒問題那另外就是說你剛剛提到百億基金是要用公務預算支出這跟我們的健保總額有沒有關係沒有關係沒有關係啦應該可以減輕健保總額的壓力那我想問一下這些專款是到時候是在便利預算還是怎麼樣 |
| transcript.whisperx[141].start |
5125.066 |
| transcript.whisperx[141].end |
5141.129 |
| transcript.whisperx[141].text |
當然是公務預算新的公務預算那這些部分哪些新藥可以用哪些患者符合癌症的新藥專款作業的要點我們什麼時候會訂定好 這個部分我想請健保署具體檢調回答一下 |
| transcript.whisperx[142].start |
5141.75 |
| transcript.whisperx[142].end |
5168.29 |
| transcript.whisperx[142].text |
跟委員報告目前的規劃方向呢那主要就是針對在臨床效益跟這個財務衝擊比較不確定性多數就是沒有完成三期臨床試驗的癌症新藥為目標啦但是確實在臨床上病人有這樣的需求那才會納入這個討論那這個整個的運作方式呢我們會定出一個作業要點在年底前就會發布 |
| transcript.whisperx[143].start |
5170.192 |
| transcript.whisperx[143].end |
5186.104 |
| transcript.whisperx[143].text |
關於我們國人的健康也是大家的一個利益我想希望我們的部長不得不盡快那我想加速癌症新藥還有新科技納入健保這個問題是一樣你要走哪一個部分呢你要納入健保嗎 |
| transcript.whisperx[144].start |
5196.018 |
| transcript.whisperx[144].end |
5211.077 |
| transcript.whisperx[144].text |
這個已經有多年的經驗我們怎麼樣來在不影響健保的總額之下然後慢慢的開放什麼叫做不影響健保總額就是說因為如果我們開放的太快一下子 |
| transcript.whisperx[145].start |
5213.002 |
| transcript.whisperx[145].end |
5224.667 |
| transcript.whisperx[145].text |
對健保總和的一個衝擊影響我知道大家可能還沒準備好啦沒關係啦那我還是那句話我們盡快啦好不好不要說我們到時候又大家聽了一頭霧水好不好 |
| transcript.whisperx[146].start |
5225.936 |
| transcript.whisperx[146].end |
5246.445 |
| transcript.whisperx[146].text |
那我再想就是說最近我們食藥署我們吳署長辭職的事件引發我們社會的關注部長與吳前署長的說法有存在矛盾但是外界傳聞他辭職是因為對政策和方向內部管理的不滿並與輸液的事件發生派系鬥爭有關部長是不是這樣子 |
| transcript.whisperx[147].start |
5250.799 |
| transcript.whisperx[147].end |
5272.144 |
| transcript.whisperx[147].text |
我想衛福部那個過去多年來應應了多少醫療跟防疫的困境都成為國際的驕傲我想衛福部的團結是沒有問題所以也沒有任何派系之爭我知道你會這樣回答那我再問你我們專署長的這個 |
| transcript.whisperx[148].start |
5275.825 |
| transcript.whisperx[148].end |
5302.162 |
| transcript.whisperx[148].text |
下接任新樂莊署長可是他半年後就要退休了那我想請問部長您有沒有對於說新樂部長他只有來半年那未來有沒有再尋找新樂人選跟委員報告其實我們因為食藥署的工作相當的繁重也非常重要其實這幾個月大概也增刑了很多 |
| transcript.whisperx[149].start |
5303.343 |
| transcript.whisperx[149].end |
5331.473 |
| transcript.whisperx[149].text |
各大醫學院的學院院長幾乎都被徵刑大部分都是季節我還是要建議部長就是說他來半年我不是說他能力不夠我只是說他擔心他時間不夠請委員放心以他的能力我們是一個AI的團隊他一天會比用三天來做我相信一定可以給我們很多的一個貢獻 |
| transcript.whisperx[150].start |
5332.993 |
| transcript.whisperx[150].end |
5350.434 |
| transcript.whisperx[150].text |
最後一個就是說我們苗栗縣基層的醫師嚴重不足我們本席對於優化偏鄉醫療精進的這個計畫非常的期待那第一期我們已經補助全台灣補助104名偏鄉的醫生可是苗栗還是 |
| transcript.whisperx[151].start |
5351.315 |
| transcript.whisperx[151].end |
5369.097 |
| transcript.whisperx[151].text |
有許多衛生所還在缺醫生那第二期我看幾乎都是重在我們的牙醫的培訓花了20幾億都是用在培訓的外國學歷的牙醫學員那我要講的就是說其實我們不在乎是不是 |
| transcript.whisperx[152].start |
5370.981 |
| transcript.whisperx[152].end |
5399.637 |
| transcript.whisperx[152].text |
他是哪一邊的因為現在這個牙醫是不是國外是不是本地的那我們要的是尤其是偏鄉我們要的是要有一個醫師來解決他們的一個問題部長怎麼看這個事情我想偏鄉的醫療人力不只是西醫啦牙醫也是非常缺乏很多的鄉都是從還是幾十年那個老牙醫所以我想衛福部在過去能夠注重到偏鄉有多少牙醫不足部長知道嗎 |
| transcript.whisperx[153].start |
5404.269 |
| transcript.whisperx[153].end |
5407.292 |
| transcript.whisperx[153].text |
全國上有157個牙醫醫療資源不足地區其中54個鄉鎮區五牙醫施執照 |
| transcript.whisperx[154].start |
5414.463 |
| transcript.whisperx[154].end |
5438.345 |
| transcript.whisperx[154].text |
對阿所以我請部長盡快幫忙好不好一定一定這個我們越短的時間來把它完成當然我想我們要幫忙的計畫原意都是好的但是其中的實行的內容大家都可以再討論因為大家都講很久了我想部長新的部長我希望我也期待部長有一個新的作為新的一個成績好不好好一定努力謝謝部長好謝謝 |
| transcript.whisperx[155].start |
5441.325 |
| transcript.whisperx[155].end |
5441.345 |
| transcript.whisperx[155].text |
委員長 |
| transcript.whisperx[156].start |
5462.918 |
| transcript.whisperx[156].end |
5492.095 |
| transcript.whisperx[156].text |
部長長,部長本席想請教你,就任到現在,你覺得你的職權可不可以完全的發揮?就是作為一個衛福部部長,你可不可以很多事情都是自己拍板定案做主?我覺得到現在,所有衛政、醫政相關各方面的一個實行,都是按照我們原來的規劃跟我們的理想在努力,應該好像還沒有碰到自愛燃省的地方 |
| transcript.whisperx[157].start |
5492.506 |
| transcript.whisperx[157].end |
5495.05 |
| transcript.whisperx[157].text |
沒有自然難行那我就直接請教你現在總統府我們賴總統這個他要當大總統所以呢 |
| transcript.whisperx[158].start |
5502.486 |
| transcript.whisperx[158].end |
5529.89 |
| transcript.whisperx[158].text |
他其實創設了一個健康臺灣促進委員會召集人是陳志宏那這樣子的一個委員會會不會去架空了原來衛福部的執掌而作為一個部長您是不是同時又多了很多個老闆您除了要跟行政院院長報告之外總統府又多了一個陳志宏召集人還有兩個副召集人你會不會覺得你的老闆好多 |
| transcript.whisperx[159].start |
5531.601 |
| transcript.whisperx[159].end |
5558.767 |
| transcript.whisperx[159].text |
我沒有這種感覺啦,因為我覺得應該要做的,只要跟行政院或相關的前輩,包括我在台大的老師陳志宏教授那我問你一個問題齁,健康臺灣促進委員會所做的決議,衛福部是不是要照單全收?你有沒有說不的空間?這委員會裡面開會所決議的事項,衛福部有沒有說不的空間?部長有沒有說不的空間? |
| transcript.whisperx[160].start |
5560.007 |
| transcript.whisperx[160].end |
5571.532 |
| transcript.whisperx[160].text |
應該是沒有吧?因為它是總統府層級啊,對不對?那如果跟你的意見不合的時候怎麼辦?部長跟召委的意見不合的時候,召集人意見不合的時候聽誰的?聽部長的還是聽陳志宏的? |
| transcript.whisperx[161].start |
5575.083 |
| transcript.whisperx[161].end |
5594.031 |
| transcript.whisperx[161].text |
我想那個總統也是一個非常優秀的醫師出身那陳志榮老師他也是非常有行政經驗我覺得我們過去幾年來在醫療政策防疫政策的溝通無礙而且你認為他會尊重你嗎?我覺得他們都會尊重我 |
| transcript.whisperx[162].start |
5594.974 |
| transcript.whisperx[162].end |
5616.749 |
| transcript.whisperx[162].text |
那你在這個委員會扮演什麼角色?開會的時候你去嗎?那開委員會的時候部長會收邀出席?你在是不是?但你不是召集人也不是副召集人,你是列席?我知道,你就是幕僚嗎?所以決策主持人是陳志宏醫師嗎?對不對? |
| transcript.whisperx[163].start |
5618.553 |
| transcript.whisperx[163].end |
5623.777 |
| transcript.whisperx[163].text |
但是前委員放心我想我們過去的合作經驗我希望是溝通無礙因為這個是過去所未見你也擔任過委員我們擔任委員我在未還第三屆了我從來沒有看到說在部長之上在架設一個委員會然後可以來指揮這個衛福部的過去從來都沒有所以 |
| transcript.whisperx[164].start |
5640.948 |
| transcript.whisperx[164].end |
5659.625 |
| transcript.whisperx[164].text |
坦白講我為你有點抱屈就是說這樣子的一個組織架構對衛福部做一個部長他想要做很多事情來講的話難免會有點自走當理念不一致的時候所以這個部分我真的希望賴總統也要看見今天我們邀請任何人是人才來擔任部長就應該要授權 |
| transcript.whisperx[165].start |
5661.046 |
| transcript.whisperx[165].end |
5686.093 |
| transcript.whisperx[165].text |
應該給你最大決策空間我覺得這個才是信任你的專業啦照道理來講應該是這樣運作會比較恰當另外一個我要問的是有關於吳秀美前署長你剛剛在回答詢答的時候就說你們其實已經徵詢很久了所以是不是其實吳秀美署長早就應該要下台了就是你們早就在尋覓適當的人選要替換掉他了嘛對不對 |
| transcript.whisperx[166].start |
5687.423 |
| transcript.whisperx[166].end |
5710.486 |
| transcript.whisperx[166].text |
也沒有說替換因為誰來擔任我們幫國家找到最適當的人在那個時候做最適當的我們支持越換越好但是今天本席很納悶為什麼新上任的署長他是7月1號報到吧是的那今天怎麼沒有來委員會不好意思他現在在交接還沒有11點左右交接這樣子 |
| transcript.whisperx[167].start |
5710.933 |
| transcript.whisperx[167].end |
5737.74 |
| transcript.whisperx[167].text |
早上11點交接因為我想對委員會對委員來講很想會會這位新的署長沒有問題沒有問題我也請莊署長新的署長跟大家請教對我們很想知道因為食藥署在部裡面是大署他對於食安對於這一些藥品的管理他到底有什麼新的想法他是不是會展現比過去吳秀美更強的一個行政能力跟解決問題的能力接下來我們要看的就是輸液的問題到目前為止 |
| transcript.whisperx[168].start |
5740.961 |
| transcript.whisperx[168].end |
5768.586 |
| transcript.whisperx[168].text |
問題還沒有完全的解決那我們可以看到永豐他的產能真的是非常的大過去一個月是196萬袋佔了將近八成左右到目前為止你們一方面要求國內增產但是你們現在告訴本協是你們一個月能增產的只有46萬袋對不對所以量能非常的有限才增加46萬袋然後你多數都是要靠進口 |
| transcript.whisperx[169].start |
5769.446 |
| transcript.whisperx[169].end |
5797.044 |
| transcript.whisperx[169].text |
那我要問部長的就是這個情況會持續多久?就是現在的情況什麼時候會解決?我們國內的產能什麼時候可以完全跟上?有跟上的一切嗎?還是只要永豐沒有恢復產能?事實上這是遙遙無期因為你們還講說8月的時候也只能到一個月50萬袋還差很遠,差得非常遠我們現在每週可以供應的數量是每週是49萬 |
| transcript.whisperx[170].start |
5800.021 |
| transcript.whisperx[170].end |
5816.724 |
| transcript.whisperx[170].text |
所以應該現在剛好是都是進口啊,都是靠多數靠進口我們當然也鼓勵我們我是要問你說我們國內的產能什麼時候可以追上來因為過去我們是靠國內自行生產就可以那你現在等於是將近八成都是靠進口 |
| transcript.whisperx[171].start |
5817.705 |
| transcript.whisperx[171].end |
5842.506 |
| transcript.whisperx[171].text |
那你這樣子的一個比例結構你什麼時候可以國內產能跟上還是只要永豐沒有恢復產能事實上這是做不到的那些小廠怎麼樣最高上限大概一個月就是50萬袋你們有沒有評估過大家比較在乎的剛剛陳新輝委員有問的那個兩公升的那個永豐大概應該我們恢復到大概在年底應該是可以 |
| transcript.whisperx[172].start |
5843.117 |
| transcript.whisperx[172].end |
5869.326 |
| transcript.whisperx[172].text |
他就可以符合你們的標準他就可以恢復生產了那這個這個應該就會很大宗的來改善所以年底才有可能改善現在的一個量穩定供應是沒有問題但是國內生產有問題嘛就是要到國內的要到年底永豐恢復產能之後才會穩定下來是不是這樣可以這樣講嗎可以說是不是石宥史講一下說現在進口跟國內的一個輔導狀況是跟委員報告 |
| transcript.whisperx[173].start |
5872.607 |
| transcript.whisperx[173].end |
5888.04 |
| transcript.whisperx[173].text |
那國內目前其實另外有6家這個生理實驗水的藥廠有在協助增加生產那因為他們同時還要生產其他的各項的這種輸注液的藥品所以他們目前能夠協助增加出來的產能就是剛如委員所說的大約一個月可以增加大概45到50萬之間的這個量 |
| transcript.whisperx[174].start |
5890.422 |
| transcript.whisperx[174].end |
5906.414 |
| transcript.whisperx[174].text |
這已經是最上限了我們在持續的希望在跟這些藥廠溝通看他們是不是能夠再增加那目前有幾家藥廠還在評估或許還可以再增加人力的方式去增加一個生產的班次那如果是這樣的話或許可以到達大概一個月50萬袋 |
| transcript.whisperx[175].start |
5907.679 |
| transcript.whisperx[175].end |
5908.199 |
| transcript.whisperx[175].text |
最後我問你百億癌藥基金的問題 |
| transcript.whisperx[176].start |
5933.777 |
| transcript.whisperx[176].end |
5961.295 |
| transcript.whisperx[176].text |
你剛剛在報告裡面呢提到的這個你說你要去訂定癌症新藥專藥的作業要點什麼時候要訂定因為你現在沒有法源你要有法源才可以做這個要點作業要點你們自己報告提的什麼時候要完成年底年底就會完成因為明年就要開始去落實這個那你現在的基金規模你一直號稱百億到底是多少 |
| transcript.whisperx[177].start |
5962.213 |
| transcript.whisperx[177].end |
5984.264 |
| transcript.whisperx[177].text |
明年大概,因為一下子也不可能進來那麼多,像今年我們用健保是24億然後明年我們估算起來大概60億的規模所以我們會補到公務預算會補到60億,這個部分就沒有明年才60億也不到百億啊因為需求性可能沒有那麼高,然後第三年應該就會達到百億 |
| transcript.whisperx[178].start |
5986.205 |
| transcript.whisperx[178].end |
6008.63 |
| transcript.whisperx[178].text |
這個部長我覺得在有關於醫藥的部分其實衛福部爭取到的資源真的是太少你們的進度也太慢了我們政府不是沒有錢我們政府的錢是有一些誤用的沒有真的花在刀口上而關乎人民健康的無論是全民健保或是你要設的這個癌藥基金這個都是關乎全國人民的健康 |
| transcript.whisperx[179].start |
6009.25 |
| transcript.whisperx[179].end |
6036.487 |
| transcript.whisperx[179].text |
政府應該要更大刀闊斧而且更有效率的就是挹注才對以你們現在的進程坦白講我覺得是太慢然後金額也太少我們都還有一個健康台灣的促進委員會這個委員會就應該要發揮這樣的功能從總統這邊就應該要做具體的政策的宣示應該是要一步到位而不是號稱百億基金結果就是用喊的啦就是明年還沒有百億了 |
| transcript.whisperx[180].start |
6038.908 |
| transcript.whisperx[180].end |
6061.656 |
| transcript.whisperx[180].text |
三年內達到百億三年內真的是太慢了部長你可以把這個議題丟給委員會讓他來幫你解決問題就是立法院代表民意我們要求這個應該要一步到位而不是緩步的到位好不好這個總統府竟然成立委員會他是要幫你解決問題不是要架空你的職權這個很重要啦是的好謝謝好謝謝委員謝謝 |
| transcript.whisperx[181].start |
6065.558 |
| transcript.whisperx[181].end |
6085.723 |
| transcript.whisperx[181].text |
好 謝謝王育民委員的發言在這邊做以下宣告 等一下在舒清泉委員質詢結束休息10分鐘 現在請圖泉吉委員發言好 謝謝主席 請問邱部長委員好 |
| transcript.whisperx[182].start |
6092.959 |
| transcript.whisperx[182].end |
6119.87 |
| transcript.whisperx[182].text |
邱部長我請問一下最近這個新聞滿天飛針對我們護理人員缺人這個問題衛福部應該有瞭解吧當然瞭解那我有看一下你們的專案報告那我們針對三班互變比這比例的新制我們也是希望能夠改善現在護理的職場環境對不對是的那現在施行的成效如何 |
| transcript.whisperx[183].start |
6122.877 |
| transcript.whisperx[183].end |
6126.598 |
| transcript.whisperx[183].text |
那現在施行的成效好嗎?有沒有解決這個我們缺人的問題? |
| transcript.whisperx[184].start |
6147.666 |
| transcript.whisperx[184].end |
6161.742 |
| transcript.whisperx[184].text |
因為大家大院委員的關心以及政府的努力,其實你會發現各個議院他們現在回報都說,像最近的一個就回任例 |
| transcript.whisperx[185].start |
6163.228 |
| transcript.whisperx[185].end |
6189.164 |
| transcript.whisperx[185].text |
那個都有提高啦所以我想當然我們要再仔細去評估但是只要有我們有努力我相信就會一直改善好 我們也希望能夠改善啦那從我們衛福部112年這分級醫療整體成效進度追蹤來看我們看起來地區醫院這整體就醫的建樹好像成長率比醫學中心區域醫院來更顯著 |
| transcript.whisperx[186].start |
6189.804 |
| transcript.whisperx[186].end |
6218.473 |
| transcript.whisperx[186].text |
對﹖對﹖對 |
| transcript.whisperx[187].start |
6219.019 |
| transcript.whisperx[187].end |
6234.108 |
| transcript.whisperx[187].text |
就是針對我們我們看這個比例嘛所以我們這個我們現在擔心的就是說他這個標準標準比較高而且他現在我們看到他這個就醫件數量能也是一直增加 |
| transcript.whisperx[188].start |
6234.788 |
| transcript.whisperx[188].end |
6262.769 |
| transcript.whisperx[188].text |
那可是我們看一下我們夜班獎勵的制度我們現在是說針對三級醫療機構他護理師所做的事情其實是幾乎完全一樣可是我們針對看那個夜班比例醫學中心跟區醫院還有地區醫院我們看得到這個對地區醫院這個獎勵就是偏低所以我們想說針對這一部分我們地區醫院你看他量能逐年增加 |
| transcript.whisperx[189].start |
6263.309 |
| transcript.whisperx[189].end |
6264.77 |
| transcript.whisperx[189].text |
C2N提出這麼一些重要的事據 |
| transcript.whisperx[190].start |
6293.194 |
| transcript.whisperx[190].end |
6309.142 |
| transcript.whisperx[190].text |
我個人覺得齁所有的醫護人員不管他在哪一個級的醫院齁或者是到診所都是盡心盡力都是有負擔的跟民眾部長我針對這部分齁我們希望第七醫院齁我覺得第七醫院的 |
| transcript.whisperx[191].start |
6309.762 |
| transcript.whisperx[191].end |
6332.956 |
| transcript.whisperx[191].text |
副與同仁我相信他們也是兼顧起很大的責任對所以你看喔他的他的就醫這個量能是提高的然後他他所負擔著這個標準又是更高所以相對反而他做的多他的獎勵反而少所以我們希望針對三班互變比還有夜間獎勵的部分我們覺得應該要盡量做到一致 |
| transcript.whisperx[192].start |
6333.376 |
| transcript.whisperx[192].end |
6352.546 |
| transcript.whisperx[192].text |
不過你看這個地區醫院它離職率越來越高這個空缺率也越來越高尤其像我們我自己這個選區大園、觀音、新屋、陽梅是我們全桃園醫療資源最匱乏的地方而且我們那時候也有去視察當然我們針對我們 |
| transcript.whisperx[193].start |
6354.967 |
| transcript.whisperx[193].end |
6383.869 |
| transcript.whisperx[193].text |
新屋分院的擴建還有大坡角長照設施我們是有規劃去做但是我們現在這個區塊只有陽梅的天成醫院還有大園的閩生醫院還有新屋的布陶新屋分院這三家地區醫院可是這三家醫院我們看得到它變成只有醫院的硬體可是招不到護理人員所以這部分我希望部長能夠重視我們這邊地區醫院這缺人的問題 |
| transcript.whisperx[194].start |
6385.219 |
| transcript.whisperx[194].end |
6410.086 |
| transcript.whisperx[194].text |
我們非常重視尤其偏鄉不管是哪一個地方找不到他的人你一定想盡辦法而且我們也絕對是一視同仁雖然可能客觀上主觀上大家會認為不同的單位會有不同的壓力但是站在醫療醫護同仁的對病人的一個同理心他們都是互出是一樣的所以你剛剛提出這些數據 |
| transcript.whisperx[195].start |
6411.386 |
| transcript.whisperx[195].end |
6432.713 |
| transcript.whisperx[195].text |
是一個很好的根據,我們會滾動試著來檢討我們今天提出真的就是希望重視我們這個桃園尤其我們這沿海南區這區域醫療資源最匱乏你看這麼大的區域它只有三家地區醫院而且重點它的護理人員是非常短缺只有硬體可是並沒有這個 |
| transcript.whisperx[196].start |
6434.013 |
| transcript.whisperx[196].end |
6434.353 |
| transcript.whisperx[196].text |
是的 是的 |
| transcript.whisperx[197].start |
6453.174 |
| transcript.whisperx[197].end |
6453.314 |
| transcript.whisperx[197].text |
我想各個醫院都有 |
| transcript.whisperx[198].start |
6483.564 |
| transcript.whisperx[198].end |
6484.229 |
| transcript.whisperx[198].text |
他們那個 |
| transcript.whisperx[199].start |
6486.528 |
| transcript.whisperx[199].end |
6513.633 |
| transcript.whisperx[199].text |
部長我覺得這部分我們今天提出真的希望能夠重視我們推這個新制的確是有一些都有達到但是達到的比例我們真的還是覺得不夠滿意而且我們看我們希望我們針對像我們醫院裡面有內科也有外科它有一般性病房也有慢性病房還有呼吸照護病房加護病房等等但是我們現在所做的好像 |
| transcript.whisperx[200].start |
6514.213 |
| transcript.whisperx[200].end |
6516.555 |
| transcript.whisperx[200].text |
是全院的總體醫護比對不對總體護病比 |
| transcript.whisperx[201].start |
6522.06 |
| transcript.whisperx[201].end |
6543.287 |
| transcript.whisperx[201].text |
我們是做全院的對不對,總體互遍比嘛這是比較可行性,我知道有護理界也有反映到不同的病房那我們只要任何人反映,我們都把他列入重要的我們希望齁,能夠針對但是在計算上可能會比較困難我們希望盡量針對 |
| transcript.whisperx[202].start |
6544.887 |
| transcript.whisperx[202].end |
6565.65 |
| transcript.whisperx[202].text |
每個病房你不要做全院不然你會變成這個數據會失真假設我們骨科病房白班1比12但是有可能內科病房只有1比8但是你整體整院做下來1比10你會覺得他是符合標準但是他其實在醫院裡面其他落差是很大的 |
| transcript.whisperx[203].start |
6566.644 |
| transcript.whisperx[203].end |
6583.359 |
| transcript.whisperx[203].text |
所以我們希望盡量針對我們能夠做每個病房的護理師比不是用全院去比而且針對各病房的護病比來調整我們床數的配置這樣子我們才能真正緩解我們基層人員護理人員的負擔 |
| transcript.whisperx[204].start |
6586.107 |
| transcript.whisperx[204].end |
6602.669 |
| transcript.whisperx[204].text |
還有我們針對這一部分我們三班互併比的新制我覺得還有我們夜間獎勵制度我覺得這應該有很大的改善空間不然為什麼會造成我們護理人員這麼短缺是不是這個制度上我覺得有很大的改善的空間 |
| transcript.whisperx[205].start |
6606.187 |
| transcript.whisperx[205].end |
6626.685 |
| transcript.whisperx[205].text |
三班戶病比還有這個獎勵制度就像我們剛剛講的你這個制度上應該有很大改善空間而且我們剛剛可以看得到很多的醫院九成的醫院並沒有落實這個心智所以我們認為應該我們要有效有力的方式去約束醫院來落實這個心智 |
| transcript.whisperx[206].start |
6627.145 |
| transcript.whisperx[206].end |
6646.712 |
| transcript.whisperx[206].text |
目前我們如果僅以獎勵的制度我們覺得會讓我們的護理人員覺得看得到吃不到然後感覺我們衛福部定定這些心智好像是跟醫院站在一起而且並沒有真正在落實是漠視我們護理人員基層的心酸 |
| transcript.whisperx[207].start |
6648.464 |
| transcript.whisperx[207].end |
6660.733 |
| transcript.whisperx[207].text |
我完全了解,我跟各位委員的心都一致的,希望趕快改善醫療現在的困境但是因為就是要多方面研議,醫院我們也要讓他能夠順利來經營醫事人員的福利要照顧,這中間怎麼樣取得一個共識 |
| transcript.whisperx[208].start |
6670.2 |
| transcript.whisperx[208].end |
6698.263 |
| transcript.whisperx[208].text |
一個大家都能夠三贏的局面我希望部長你針對我們前面這幾個數據你好好研議一下你看這地區醫院他現在整個他整個量能就醫比例這量能是一直逐年在攀升然後你這個標準比對地區醫院也是不友善而且這個獎勵制度醫學中心區醫院跟地區醫院地區醫院量能又大標準又高 |
| transcript.whisperx[209].start |
6698.963 |
| transcript.whisperx[209].end |
6710.452 |
| transcript.whisperx[209].text |
結果他的獎金、夜班獎金制度而且又是偏低所以難怪造成我們地區醫院護理人員短缺而且離職率非常高我們會滾動是一直檢討尤其我剛剛講我們這個選區本來醫療資源就很匱乏我們這邊只有三個地區醫院可是只有三個地區醫院而且重點 |
| transcript.whisperx[210].start |
6722 |
| transcript.whisperx[210].end |
6723.641 |
| transcript.whisperx[210].text |
謝謝圖權吉委員的發言接下來請廖偉祥委員發言 |
| transcript.whisperx[211].start |
6761.73 |
| transcript.whisperx[211].end |
6781.146 |
| transcript.whisperx[211].text |
主席好 有請我們部長請邱部長委員好 部長好部長 那個賴總統提出這個健康台灣的願景然後 抱歉特別提到癌症死亡率要在2030年的時候 |
| transcript.whisperx[212].start |
6785.683 |
| transcript.whisperx[212].end |
6804.365 |
| transcript.whisperx[212].text |
2030年的時候減少三分之一所以具體的做法有三項第一個就是提升早期癌症篩檢第二個是聚焦基因檢測還有成立百億癌症型藥基金那請教部長現行的五癌篩檢中是否在政策上 |
| transcript.whisperx[213].start |
6805.046 |
| transcript.whisperx[213].end |
6823.736 |
| transcript.whisperx[213].text |
也要達到提升早期癌症篩檢的要求也就是在據成本效益、臨床上考量等等的長期追蹤的考量下可不可以將現行的五癌篩檢年齡層再往下降因為我們可以看到剛剛那一頁我們可以看到現在這個 |
| transcript.whisperx[214].start |
6825.157 |
| transcript.whisperx[214].end |
6847.102 |
| transcript.whisperx[214].text |
肺癌、肝癌、大腸癌都是前三名的標準化死亡率最高的,對好,謝謝委員和指教,我想您的關心這些癌症的狀況令人感佩那我想我三四年來也都是照顧癌症的病人那在四癌篩檢的時候,那個時候的國健實在推得很痛苦 |
| transcript.whisperx[215].start |
6847.842 |
| transcript.whisperx[215].end |
6866.411 |
| transcript.whisperx[215].text |
我強迫臺大醫院一定要去成立一個單位軟硬體來做所以我們共同往這些方面當然也救了不少人的命跟他的家庭所以這是一個很得正的所以我們要繼續把它擴大 |
| transcript.whisperx[216].start |
6869.013 |
| transcript.whisperx[216].end |
6885.083 |
| transcript.whisperx[216].text |
臺灣也有這樣的專家們也有這樣的討論那委員也很關心是所以部長您覺得可以把年齡層下降那個我們因為這牽涉到成本效益各方面的問題還有就是說你今天要要把它降低是不是會增加到 |
| transcript.whisperx[217].start |
6886.144 |
| transcript.whisperx[217].end |
6895.594 |
| transcript.whisperx[217].text |
醫師們的loading,因為我自己也常常在推,如果有必要,當然我們都可以往下降往上延伸,都是應該要對全民有幫助的一定潛力以赴,只是說這個可能都是要專家評估啦。 |
| transcript.whisperx[218].start |
6908.387 |
| transcript.whisperx[218].end |
6924.353 |
| transcript.whisperx[218].text |
好部長從這次最新的這個第5期的國家癌症防治計畫裡面的數據可以看到有幾個癌別的年齡層有發現有降低的趨勢尤其這個大腸癌的部分不僅年齡發生率降低在死亡的這個年齡層也往下探 |
| transcript.whisperx[219].start |
6924.973 |
| transcript.whisperx[219].end |
6944.531 |
| transcript.whisperx[219].text |
那從這個圖表可以來看到40歲從40歲以後整個曲線圖就直線上升那所以這代表現行的大腸癌的篩檢資格50歲以上現在是兩年一次的這個定量免疫法的糞便前血檢查那是不是應該要往下調整到40歲 |
| transcript.whisperx[220].start |
6946.533 |
| transcript.whisperx[220].end |
6970.28 |
| transcript.whisperx[220].text |
我覺得如果說這個部分我想要爭取說請部長回去是不是可以研議因為我覺得早期篩檢早期治療這個增加存活率跟降低健保的支出我覺得都可以有機會達到所謂賴總統健康台灣的癌症死亡率降低三分之一的目標這部分可不可以請部長回去好好的研議一下報告我當立委的時候就是一直在爭取這個預算 |
| transcript.whisperx[221].start |
6971.56 |
| transcript.whisperx[221].end |
6977.287 |
| transcript.whisperx[221].text |
太好了但是就是說我要尊重那個專業的評估嘛不曉得署長有沒有要回應一下 |
| transcript.whisperx[222].start |
6978.573 |
| transcript.whisperx[222].end |
6979.894 |
| transcript.whisperx[222].text |
過去癌症篩檢的追陽率僅8成 |
| transcript.whisperx[223].start |
7002.485 |
| transcript.whisperx[223].end |
7031.259 |
| transcript.whisperx[223].text |
所以陽性割胺跑掉未能回診追蹤然後在未來也變成晚期的癌症所以如果能夠及早治療手術就能切除的話我想這個成本費用也會遠低於標靶啦重粒子直指等晚期治療所以在健保裡面總而裡面有一個癌症治療品質改善計畫對不對那這個專款今年共總共是5.17億那也就是用來提高這個五癌篩檢的後續追蹤管理 |
| transcript.whisperx[224].start |
7032.329 |
| transcript.whisperx[224].end |
7033.77 |
| transcript.whisperx[224].text |
目前還沒有用目前變得5.17還沒有用還過用所以明年還是會變 |
| transcript.whisperx[225].start |
7061.894 |
| transcript.whisperx[225].end |
7078.236 |
| transcript.whisperx[225].text |
我想這個一定要編,那是不是要擴編或怎麼樣可能要再演繹,但是我覺得這個非常重要,因為我們把它篩檢出來結果沒有來追蹤,這是很可惜的事情。 |
| transcript.whisperx[226].start |
7078.696 |
| transcript.whisperx[226].end |
7102.293 |
| transcript.whisperx[226].text |
所以我們要從醫院方面跟基層診所方面給他們最好的一個鼓勵那因為有時候還有就是在軟體比如說在臺大醫院的電腦我們都會出現這個人的狀況然後要提醒他要來做等等的那是不是基層方面我們也可以在基層診所也可以來努力這個方面我相信這樣的天羅地網 |
| transcript.whisperx[227].start |
7103.414 |
| transcript.whisperx[227].end |
7105.836 |
| transcript.whisperx[227].text |
部長美國癌症醫學會已經在2021年公布的指引建議需要開始篩檢大腸癌的年齡從50歲下調到45歲 |
| transcript.whisperx[228].start |
7133.177 |
| transcript.whisperx[228].end |
7145.353 |
| transcript.whisperx[228].text |
那我國部分的大部分的這個這個部分的大腸癌長年是癌症十大死因的前三名那並且國際研究也顯示因為年輕人是沒有定期的篩檢的保護所以從有這個症狀到 |
| transcript.whisperx[229].start |
7148.377 |
| transcript.whisperx[229].end |
7148.497 |
| transcript.whisperx[229].text |
好。好。 |
| transcript.whisperx[230].start |
7177.126 |
| transcript.whisperx[230].end |
7180.427 |
| transcript.whisperx[230].text |
我相信三個月可以把研議要怎麼做提供給委員好那再來就是一樣喔這個 |
| transcript.whisperx[231].start |
7191.96 |
| transcript.whisperx[231].end |
7211.318 |
| transcript.whisperx[231].text |
部長今年以來流感疫情和腸病毒也都進到這個流行的週期那再加上新冠所以整個各醫療院所也都塞爆上週的健保門診急診這個診斷新冠陽性約9萬人次預計高峰在7月中那每週的這個確診 |
| transcript.whisperx[232].start |
7214.128 |
| transcript.whisperx[232].end |
7241.17 |
| transcript.whisperx[232].text |
這個門診也可能突破10萬人那部長按照這個趨勢來看其實剛剛好像也有委員有問到這第二季第三季的點值可能會掉到0.9以下很多這個今年會針對這個部分來做額外的補點值嗎?我想現在11屆已經在反映了所以我想我們會尊重11屆的反映權利來爭取相關的預算來補助跟去年一樣 |
| transcript.whisperx[233].start |
7242.386 |
| transcript.whisperx[233].end |
7261.751 |
| transcript.whisperx[233].text |
OK 跟去年一樣好那健保總額制度在這個醫療供給我想這個部分喔我們也可以看到最近在公衛之前是有講到說在這公衛的部分是不是未來還是會持續的在總額之外找這個財源的撥補到我們的這個部分的缺口我想 |
| transcript.whisperx[234].start |
7266.138 |
| transcript.whisperx[234].end |
7283.084 |
| transcript.whisperx[234].text |
如果是突發性的一些尤其事實上這麼大的疫情我想我也是很期待能夠爭取額外的經費來幫忙才能穩住我們原來需要醫療治療的這些量能 |
| transcript.whisperx[235].start |
7284.687 |
| transcript.whisperx[235].end |
7309.675 |
| transcript.whisperx[235].text |
好部長我最後因為其實時間有限了我還有準備其他的題目但是我還是想問一下就是其實我們上上這最近一直在討論這個健保點值的問題喔那其實在去年的11月23號薛議員部長在這裡也說備詢的時候說0.92元的話利潤是不到5%甚至有一些虧損那其實上次我們的署長也有一直說現在要 |
| transcript.whisperx[236].start |
7310.535 |
| transcript.whisperx[236].end |
7335.42 |
| transcript.whisperx[236].text |
用各個部分去想說屬於公衛的費用是不是用公務預算來撥補那有講了很多零零總總的一些細節但是我還是想要請問一下大家還是關心說那你做你們有沒有評估過你們現在的這些做法撥補完之後會會挪出多少的財源然後以及有沒有可能浮動往哪些點子的目標去穩定比如說到底 |
| transcript.whisperx[237].start |
7335.9 |
| transcript.whisperx[237].end |
7357.561 |
| transcript.whisperx[237].text |
你們做了這些措施之後,到底你有辦法維穩在0.92、0.95嗎?或者是你只能夠在0.9或是以下?好,謝謝你給我機會齁,我具體回答齁,不要媒體又說我沒有具體回答齁第一個,我覺得我們列出來的,跟健康台灣列出來的一個幾個短中長程的 |
| transcript.whisperx[238].start |
7358.871 |
| transcript.whisperx[238].end |
7380.243 |
| transcript.whisperx[238].text |
多數應該要去做第一個我們應該政府要補助0.36%的這個部分以前有很多都把它塞進公務的補助啦或補助哪裡都把它塞進來這影響到會影響到那個36%其實是健保的費用這個大概可以平估到挪出一百三十幾億 |
| transcript.whisperx[239].start |
7381.804 |
| transcript.whisperx[239].end |
7399.07 |
| transcript.whisperx[239].text |
那接下來就是過去在很多 其實在各個部門裡面我們這兩天會計開個會來清理 其實是應該由公務預算來支出的就由公務預算來支出 不要把它塞進來健保 |
| transcript.whisperx[240].start |
7400.27 |
| transcript.whisperx[240].end |
7415.622 |
| transcript.whisperx[240].text |
對 這個挪出去的一個部分當然我不可能一年全部挪出去這樣恐怕會亂的正腳一年一年的挪出去大概也會挪了應該一年應該會有100多億三年應該有300多億可以出去那這樣的話這個就是 |
| transcript.whisperx[241].start |
7417.423 |
| transcript.whisperx[241].end |
7431.321 |
| transcript.whisperx[241].text |
都是用在健保,如果這些,你想想看我們去年補0.9的時候,那個我們,我當立委我也拚得要死,那個連醫院連基層,臺大醫院的無名小院長跟我講說,喔,好幾次有報這個 |
| transcript.whisperx[242].start |
7432.603 |
| transcript.whisperx[242].end |
7450.233 |
| transcript.whisperx[242].text |
他們第二季賺的錢就賺那個點子的補而已,所以醫療院所真的很難經營,大家不要以為他們很好賺,也就是我們那個幸福有補,他可能他也能做一些事情,所以我想那個 |
| transcript.whisperx[243].start |
7453.756 |
| transcript.whisperx[243].end |
7464.228 |
| transcript.whisperx[243].text |
反正把這些挪出來還有就是說比較要去動到修法的比如說我們是不是婦人可以多出一點點像那個 |
| transcript.whisperx[244].start |
7468.533 |
| transcript.whisperx[244].end |
7482.904 |
| transcript.whisperx[244].text |
補充保惠這個處理當然補充保惠過去在立法院也是爭爭議議但是我是覺得我們盡量健保的意義就是照顧弱勢就是說我們如果真的比較好比較能夠 |
| transcript.whisperx[245].start |
7486.526 |
| transcript.whisperx[245].end |
7499.271 |
| transcript.whisperx[245].text |
就是比較可以挪出來的一些補充保衛我們這個部分做處理的話這是忠誠啦那我們一步一步的來我相信如果第一步我們這樣做的補充幾百億的話大概 |
| transcript.whisperx[246].start |
7500.547 |
| transcript.whisperx[246].end |
7523.481 |
| transcript.whisperx[246].text |
點子應該是會到0.923應該是沒有問題0.92或0.93那我想請問你這一年內有辦法達成嗎而且這個是實際上在進行喔是那部長請問你這個多久可以達成因為我的意思是說現在看起來醫療體系已經面臨崩潰那需要強新增啦不管你長期怎麼樣但是短期好像需要強新增那你有沒有辦法說 |
| transcript.whisperx[247].start |
7528.843 |
| transcript.whisperx[247].end |
7541.187 |
| transcript.whisperx[247].text |
現在目前一直在跟行政院溝通那就是明年的預算如果這些我們所提出的訴求都能夠達到的話我相信明年開始的點子就會達到這樣的目標了 |
| transcript.whisperx[248].start |
7541.747 |
| transcript.whisperx[248].end |
7569.996 |
| transcript.whisperx[248].text |
部長我覺得我也建議你一個爭取的方向好不好我覺得用特別條例特別預算的方式短期內先打一機強心針短期內可能是一到三年三年以內我建議因為你們的所謂健保改革的時間很長你剛剛所有東西都非常的長那我覺得這個東西已經緩不濟急那現在這個我想醫界也哀鴻遍野了所以我建議這個方向那另外其實我年初本席在這個本席在提出這個健全醫療特別發展條例的時候其實在6月5號的質詢也有說 |
| transcript.whisperx[249].start |
7571.836 |
| transcript.whisperx[249].end |
7588.315 |
| transcript.whisperx[249].text |
跟你們質詢的時候也有說這個新要國際醫療的指引權給付的政策按你們也說這是國家應該做的方向那其實當天也有很多的醫師啊並有團體有來電到我們的辦公室說這是造福國人的醫療的好政策所以今天要 |
| transcript.whisperx[250].start |
7588.894 |
| transcript.whisperx[250].end |
7611.566 |
| transcript.whisperx[250].text |
就這個百億癌症新藥基金和這個新藥國際指引全給付的關係向您請教其實這個是我們整理出來的圖你可以看到這是幾個癌症包含就是前面兩頁前面兩頁是我們的肺癌後面有這個乳癌、大腸癌等等其實後面有這個給付與指引的差異幾乎都是為給付很多是為給付的那但是沒關係我今天是想要先問 |
| transcript.whisperx[251].start |
7613.098 |
| transcript.whisperx[251].end |
7635.299 |
| transcript.whisperx[251].text |
上次有提到這個暫時性給付那今年總額也匡列20幾億加上原本的新藥專款大概40幾億總共60幾億那我想要請問百億癌症新藥基金成立以後原本總額中的暫時性給付跟新藥專款甚至是罕病專款當然它已經超過150幾億了它是會繼續留在總額內呢還是你會把它撥到百億癌症新藥基金裡面 |
| transcript.whisperx[252].start |
7636.482 |
| transcript.whisperx[252].end |
7661.71 |
| transcript.whisperx[252].text |
或是只有暫時性給付過去或是未來能進入基金的這個候選的藥物是新藥還是限於癌症新藥?大概百億基金應該現在的訴求是希望讓民眾多一點救命的機會所以那個比較療效還要再確認啊等等也就是說今年20幾億那個部分我們明年會把它用公務預算擴充到60那 |
| transcript.whisperx[253].start |
7664.031 |
| transcript.whisperx[253].end |
7665.091 |
| transcript.whisperx[253].text |
好 謝謝亮偉祥委員的發言接下來請蘇清泉委員發言 |
| transcript.whisperx[254].start |
7702.287 |
| transcript.whisperx[254].end |
7706.19 |
| transcript.whisperx[254].text |
謝謝主席,我請部長請邱部長法定人數不足 |
| transcript.whisperx[255].start |
7730.595 |
| transcript.whisperx[255].end |
7755.67 |
| transcript.whisperx[255].text |
的王振旭是不是醫療人員的隊員比我們還要緊張比我們還要緊張還要緊張啊你這次的回答這麼好剛才剛才回答到哪裡那裡的錢那裡的36%的公務預算的今天你在說得比較清楚而已昨天我不知道你在說什麼空洞烏烏啦我看你繼續做立委好了啦你這樣做立委比較適合啦 |
| transcript.whisperx[256].start |
7757.728 |
| transcript.whisperx[256].end |
7780.516 |
| transcript.whisperx[256].text |
我跟大家報告上個禮拜八大醫事團體來拜訪韓國瑜院長還有江啟臣那大家講得非常深入那是我安排的那我聽江啟臣講的我聽得很痛心他說你們去WHA去瑞士去日內瓦那我有去過三次 |
| transcript.whisperx[257].start |
7782.537 |
| transcript.whisperx[257].end |
7804.83 |
| transcript.whisperx[257].text |
我跟你們一直講台灣can help非常的驕傲我們的健保世界第一名但是不到一個月變成台灣need help因為我們那個點滴都搞不定點滴就是食鹽水葡萄糖水什麼書藝講得那麼有水準為什麼 |
| transcript.whisperx[258].start |
7809.324 |
| transcript.whisperx[258].end |
7832.756 |
| transcript.whisperx[258].text |
沙頭的生意有人做,培本的生意沒人要做嘛那一個永豐,這樣出一個紙路,台灣居然是停擺,然後永豐就擺爛,擺爛他到底有沒有在更新設備,有沒有在解決他的缺失那再來的問題就是,你人家合價合得這麼兇,5百CC的人25點 |
| transcript.whisperx[259].start |
7838.892 |
| transcript.whisperx[259].end |
7843.175 |
| transcript.whisperx[259].text |
1,000cc的放35點3,000cc的65點皮礦潛水都在秀現在要買的怕死人58cc的新加坡的56元73元1,000cc的100元73,000cc的246元這要買的下去那也是要買的 |
| transcript.whisperx[260].start |
7869.816 |
| transcript.whisperx[260].end |
7872.659 |
| transcript.whisperx[260].text |
有問題的進口商,你也要賺你不要像基隆這樣,一個超市這樣40萬的營業額的公司,進口幾十億的基隆你如果再這樣付,你會被關耶,沒錯嗎?是你會看什麼? |
| transcript.whisperx[261].start |
7892.3 |
| transcript.whisperx[261].end |
7899.305 |
| transcript.whisperx[261].text |
我相信,謝謝委員的指教,你會擔心我們,大家都在打拚,所以目前當然量可以維持很平,你說,我們社會公司其實都在一間過程中,副市長有說 |
| transcript.whisperx[262].start |
7919.64 |
| transcript.whisperx[262].end |
7929.467 |
| transcript.whisperx[262].text |
每一家我們是非常小心那我們的次長在主持這些相關的工作非常的辛苦他會特別跟我提醒說 |
| transcript.whisperx[263].start |
7930.968 |
| transcript.whisperx[263].end |
7933.309 |
| transcript.whisperx[263].text |
你一間公司的點滴的產量如果超過50% 超過10萬 那就有可能會壟斷啦 有可能會超重啦 |
| transcript.whisperx[264].start |
7957.015 |
| transcript.whisperx[264].end |
7984.538 |
| transcript.whisperx[264].text |
當然前陣子負是要嫁,所以沒人要走,沒人要逃出。現在這間讓他持到這麼大隻,然後你不是每一季都有在data都要送上來嗎?那個實驗室的data,他們自己檢測的data,你們食藥署都沒在monitor,然後又說出事了,去年就發現他的點滴裡面有pyrotin,有一些雜質,有沒有這回事啊? |
| transcript.whisperx[265].start |
7987.077 |
| transcript.whisperx[265].end |
7991.022 |
| transcript.whisperx[265].text |
現在出事了,查查沒過,我們要停場,停場我也要做,停一停就要出事了,出包啊,開花啊 |
| transcript.whisperx[266].start |
7998.197 |
| transcript.whisperx[266].end |
8012.046 |
| transcript.whisperx[266].text |
我相信食藥署都按照規定去做事情當然配套措施的顆粒後面可以再來加強不要發生這種事情這是應該我們未來要檢討以前只有一間獨佔,這也是有它的背景因為這間永豐你很了解醫療,它的服務很好 |
| transcript.whisperx[267].start |
8020.794 |
| transcript.whisperx[267].end |
8035.184 |
| transcript.whisperx[267].text |
你都把你送到你的房子要整個合不好,所以大家醫生醫療院所用的比較主人,這有時候也是一種競爭之下的產物,但是我覺得站在政府的立場要注意這個問題,這是國安問題,未來我們這個一定會去檢討 |
| transcript.whisperx[268].start |
8039.787 |
| transcript.whisperx[268].end |
8054.254 |
| transcript.whisperx[268].text |
我跟大家報告喔,這電梯是很可怕的東西啦,抽抽噹噹,抽抽咻咻,現在卡車把你載到你旁邊,啊下來,他還要走那裡,要走走走走走走走走走走走走走走走走走走走走走走走走走走走走走走走走走 |
| transcript.whisperx[269].start |
8055.094 |
| transcript.whisperx[269].end |
8069.82 |
| transcript.whisperx[269].text |
很痛苦耶!那天索性叫護士來的時候,我說你要出事嗎?你要不要就直接傷害啊?所以就在國府就都要拜託他們,用車上去到北邦,每次北邦的station就都放在那裏,因為要叫護理人員,只要一聲一聲的叫他就好了,你也要整個板子,整六百公斤,只有甘武的人我住, |
| transcript.whisperx[270].start |
8079.918 |
| transcript.whisperx[270].end |
8096.555 |
| transcript.whisperx[270].text |
所以都叫支付商把我們送到北方,再加錢給他,錢再加下去就超過你們支付的點數了嘛,所以注點在現在,現在每間也叫健保的合理點數給你設置,現在都這樣了,如果要再把你送到樓上 |
| transcript.whisperx[271].start |
8100.495 |
| transcript.whisperx[271].end |
8117.828 |
| transcript.whisperx[271].text |
有的叫你加錢,否定有,這種投入有人在做嘛,你那點滴給人這麼兇,根本做不出,沙頭的生意有人做,培培的生意絕對沒有人做。如果你今天把它合到,我們有四五十個,我看另外五六間就都擴廠了。 |
| transcript.whisperx[272].start |
8122.677 |
| transcript.whisperx[272].end |
8126.741 |
| transcript.whisperx[272].text |
這就是我們專門要了解醫療真正面對很大的困境所以專門也要來幫忙大家看到施中良文鴻上班 |
| transcript.whisperx[273].start |
8145.055 |
| transcript.whisperx[273].end |
8156.819 |
| transcript.whisperx[273].text |
沒有啦,這樣一個行業混不下去,這個絕對出皮肉我今天出這個,我不知道當時出什麼問題,對吧?所以要轉播科量啦,那個健保的每一項的點數,施主任你曾經做住院醫師的時候,那些點數從老闆過來,還沒蓋,現在還在亂蓋 |
| transcript.whisperx[274].start |
8173.564 |
| transcript.whisperx[274].end |
8201.057 |
| transcript.whisperx[274].text |
全盤既然要好好的做既然要福利出身就好好的都點所該改我們今天做的行動多好跟我說接三條會計我幾萬點我說我的差異高了十五倍所以他就每天都要趕走我好好的每天放電話每天就在那邊那真的要用便宜的有理想有保護即使扶傷 |
| transcript.whisperx[275].start |
8202.425 |
| transcript.whisperx[275].end |
8221.674 |
| transcript.whisperx[275].text |
現在社長沒在聽你這一套你可能有我可能有啦現在都沒在聽你這一套所以我跟大家報告自然要好好做第二個那個百億基金欸 那個百億基金是什麼意思啊愛鎮我聽不懂我聽不懂你在說什麼什麼今年20幾個月、每年60幾個月那些沒你的錢、沒在贏的啊你不贏了如果出眾兩中開發就兩個月就給你開了啊啊 再過了 |
| transcript.whisperx[276].start |
8235.821 |
| transcript.whisperx[276].end |
8256.794 |
| transcript.whisperx[276].text |
跟委員說明這個百億基金的概念它是這樣就是說呢它對於有一些還有不確定性沒有馬上進入健保的癌症新藥先放在這個基金裡面是新藥對癌症的新藥所以它跟我們的健保總額是切開它是一個獨立的公務預算來支應 |
| transcript.whisperx[277].start |
8257.774 |
| transcript.whisperx[277].end |
8273.863 |
| transcript.whisperx[277].text |
但是這個費用還是要控管所以EA停留時間我們規劃是最長不超過三年所以用三年來做規劃那在這個三年內來做評估一方面可以作為我們健保要納入的時候的財務衝擊的確實評估 |
| transcript.whisperx[278].start |
8275.964 |
| transcript.whisperx[278].end |
8277.724 |
| transcript.whisperx[278].text |
我每次報告美國FDA批准澳洲的來到台海的點子 |
| transcript.whisperx[279].start |
8305.441 |
| transcript.whisperx[279].end |
8306.422 |
| transcript.whisperx[279].text |
我去鄉黨看他們的衛生署 |
| transcript.whisperx[280].start |
8333.562 |
| transcript.whisperx[280].end |
8352.52 |
| transcript.whisperx[280].text |
香港衛生署主要美國跟歐盟有通過,他們就馬上可以用了,不管是藥,不管是特殊材料。跟委員報告,他們有很高的部分負擔,他的支付有很高的。對,我們現在就是我們的新藥要500多天,所以你要用這個癌症基金來應付這個要新藥的,還要等很久的,或是說健保的負擔不會去的,這要先讓他先應付,所以這裡有要移住嗎? |
| transcript.whisperx[281].start |
8359.537 |
| transcript.whisperx[281].end |
8360.978 |
| transcript.whisperx[281].text |
規劃是3年達100億之後每年都會維持100億維持100億 |
| transcript.whisperx[282].start |
8386.068 |
| transcript.whisperx[282].end |
8393.053 |
| transcript.whisperx[282].text |
目前的規劃都是用公務預算我應該不會幹這種事吧健保的費用是維持醫療院所跟照顧人民基本的糧草 |
| transcript.whisperx[283].start |
8408.024 |
| transcript.whisperx[283].end |
8417.687 |
| transcript.whisperx[283].text |
臺台議長林賢大哥臺台議長也會跟我說他說今年剛才有撥稍長的不然一段五十年來臺台便宜虧損的院長他真的要去撞牆跳樓無緣面對說剛才你撥稍長一點所以一切的滿意度你看這一張 |
| transcript.whisperx[284].start |
8433.611 |
| transcript.whisperx[284].end |
8443.558 |
| transcript.whisperx[284].text |
全世界可能沒有一個公共政策說百姓滿意度89.7,要90%啦!結果醫護人員的滿意度都30%啦!這樣你來沾沾自喜,大家四個在噴雞骨,我聽你們在噴雞骨,我聽到很恐怖的!所以,你要做什麼我都要給你支持,只要有意見我還得得啦! |
| transcript.whisperx[285].start |
8458.988 |
| transcript.whisperx[285].end |
8469.471 |
| transcript.whisperx[285].text |
好 部長 署長 署長 我很尊重你我們大家坐在一起 阿 先不說了 癌症篩檢我跟大家報告 韓國他現在的健保匯率是6.47 對不對好像對吧 6.47 我們才5.17他們的佔GDP已經佔到7 8點多了 |
| transcript.whisperx[286].start |
8484.938 |
| transcript.whisperx[286].end |
8503.266 |
| transcript.whisperx[286].text |
所以韓國的所有指標都贏我們啊平均壽命也贏我們啊我們台灣的平均壽命現在比不上韓國、日本、香港、澳門、新加坡哇 每一行都輸我們的平均壽命已經減10倍 現在剩70多倍而已這樣國健署你的錢是要拿來的你的錢如果沒有健保或是都有一些冤姦什麼的我們再來起冤姦、再來起冤稅好不好 |
| transcript.whisperx[287].start |
8512.202 |
| transcript.whisperx[287].end |
8519.016 |
| transcript.whisperx[287].text |
我們的錢大概跟委員報告,除了公務預算就是菸金來支援,那篩檢的錢目前是用菸金 |
| transcript.whisperx[288].start |
8520.055 |
| transcript.whisperx[288].end |
8540.132 |
| transcript.whisperx[288].text |
我們只有大長海篩檢力高一點點,其他都不及格,那有什麼補?他們剛才有很多人問,想不想說這個就好了。我想我們如何去提高整體的篩檢力跟涵蓋力,對於早期癌症病毒是非常重要的。我們幼兒園怎麼獎勵?錢有嗎?錢夠嗎?國健所基金不是很多錢嗎? |
| transcript.whisperx[289].start |
8548.157 |
| transcript.whisperx[289].end |
8552.099 |
| transcript.whisperx[289].text |
好 謝謝蘇清泉委員的發言 我們現在先休息10分鐘 |
| transcript.whisperx[290].start |
9168.986 |
| transcript.whisperx[290].end |
9172.609 |
| transcript.whisperx[290].text |
我們休息結束就繼續選答下一位我們請黃秀安委員謝謝主席我們請邱部長請邱部長 |
| transcript.whisperx[291].start |
9190.441 |
| transcript.whisperx[291].end |
9201.689 |
| transcript.whisperx[291].text |
部長好部長我從早上聽到剛剛我想請教就是說大家關心這個輸液的這個問題那我其實是還蠻納悶的就是說從輸液發生這個永豐發生這個問題到現在也好幾個月了那我是覺得說這個變輸液好像是只有這一家永豐在做 |
| transcript.whisperx[292].start |
9218.359 |
| transcript.whisperx[292].end |
9240.553 |
| transcript.whisperx[292].text |
那其他的是,變成說它是獨佔市場是不是?就永豐這一家?永豐如果以,因為它有做那個兩公升的啦,兩公升的在洗腎啦,在可能在沖洗上面齁,有它的用途,所以它的,大人比較沒作用,它一沾到齁 |
| transcript.whisperx[293].start |
9242.034 |
| transcript.whisperx[293].end |
9242.934 |
| transcript.whisperx[293].text |
部長我想請教就是說我覺得食藥署這方面應該也要去做一個盤點到底我們臺灣全國 |
| transcript.whisperx[294].start |
9258.618 |
| transcript.whisperx[294].end |
9284.298 |
| transcript.whisperx[294].text |
到底有幾家可以做這樣的一個輸液那這個我是想聽到未來你們要怎麼做啦而不是說你剛剛講的是說這個輸液這一家永豐生產可能要到年底嘛那其他的部分可能就是用進口的我覺得這樣不太對應該要去扶植我們臺灣這個國內的這些廠商可以自己製作 |
| transcript.whisperx[295].start |
9285.759 |
| transcript.whisperx[295].end |
9312.271 |
| transcript.whisperx[295].text |
我覺得應該是要朝著這個方向那既然就可以從國外進口的這些輸易這個費用還要花好幾億來進口我覺得為什麼不能讓國內的這些廠商一方面你也是要有一些誘因讓他們願意來生產這樣子比較大瓶裝的這些輸易是不是我可以聽到那個部長您一些具體的回答 |
| transcript.whisperx[296].start |
9313.851 |
| transcript.whisperx[296].end |
9339.719 |
| transcript.whisperx[296].text |
好我想這個方向絕對要經過這次的經驗我相信一定要往這方面來做所以我們除了緊急在方面專案進口以外還一直協助國內的可以製造的齁能夠加線啦齁當然因為要給人給什麼還要加班所以我們要給錢會比較高啦齁那我們過去是不是都用太低價齁 |
| transcript.whisperx[297].start |
9341.119 |
| transcript.whisperx[297].end |
9367.368 |
| transcript.whisperx[297].text |
讓很多廠商也不願意去做那永豐因為量大嘛什麼因為這樣可能它在廠的品質的要求是不是也會受到影響這我們都說實在話這個就是我們食藥署要做的工作所以食藥署這一次也很負責就是檢查到有問題的確就是按照規定處理 |
| transcript.whisperx[298].start |
9368.708 |
| transcript.whisperx[298].end |
9388.217 |
| transcript.whisperx[298].text |
那在之前當然就是說發現問題之後整個停產我覺得說造成全台灣這個輸液是短缺這個是讓我嚇一跳耶就是全台灣好像就只有這一家這一家停產之後全部這個輸液全部都沒有了沒有人在做所以我覺得你們未來要怎麼做 |
| transcript.whisperx[299].start |
9388.797 |
| transcript.whisperx[299].end |
9407.833 |
| transcript.whisperx[299].text |
如果萬一又發生這個事情怎麼辦所以你們要總是要想個辦法不能只有這一家來做嗎那是不是要有什麼樣的誘因我們未來一定訂定相關的辦法不能讓獨家佔這麼多所以你們現在有這樣的規劃已經有請其他廠商在補修的過程當中在未來的時候有把這個列為非常重要的一點是 |
| transcript.whisperx[300].start |
9415.519 |
| transcript.whisperx[300].end |
9427.722 |
| transcript.whisperx[300].text |
所以未來我們一定要扶持國內更多的那可能未來的核價可能要讓人家做下去所以你現在這個核價是讓人家做不下去所以就只有一間在做就對了是這樣子嗎我是不是請那個石署長 |
| transcript.whisperx[301].start |
9442.91 |
| transcript.whisperx[301].end |
9445.538 |
| transcript.whisperx[301].text |
是跟委員報告其實應該是這麼講就是說這個 |
| transcript.whisperx[302].start |
9449.5 |
| transcript.whisperx[302].end |
9472.632 |
| transcript.whisperx[302].text |
短期間要讓這些國內的 這個技術並不困難但是短時間它要馬上增量它有一些產線的問題還有它的人力的需求一下子是沒有辦法所以短期還是需要靠這個國外的進口國外的進口因為它又有時效的限制因為我們需要很快的補足所以它相對的成本會比較高 |
| transcript.whisperx[303].start |
9473.172 |
| transcript.whisperx[303].end |
9473.452 |
| transcript.whisperx[303].text |
委員會主席委員會主席 |
| transcript.whisperx[304].start |
9498.215 |
| transcript.whisperx[304].end |
9526.769 |
| transcript.whisperx[304].text |
當然就剛剛講的如果說價格讓人家做不下去當然就沒有人要做啊就是要有一些誘因嘛跟委員報告就是說這些輸液我們過去幾乎這個過去好長一段至少6年的時間都沒有再砍價了已經一段時間了那之所以沒有提高也是因為沒有廠商來提從我們的要價調查就是醫院的進價還低於健保的合價所以 |
| transcript.whisperx[305].start |
9527.529 |
| transcript.whisperx[305].end |
9540.434 |
| transcript.whisperx[305].text |
一方面沒有廠商來提出要申請提高健保合價一方面調價調查的結果還低於健保的合價所以才沒有調整不過經過這個事件之後我們會全盤來檢討 |
| transcript.whisperx[306].start |
9543.755 |
| transcript.whisperx[306].end |
9567.748 |
| transcript.whisperx[306].text |
那除了輸液之外剛剛也有委員提到可能國內常用的一些藥品我覺得應該也要一併去討論就是說你不能讓這個可能是只有一兩家的藥廠在製作可能也是要去盤點到底這樣的藥品這樣的輸液有幾家在做那會不會有類似這樣的 |
| transcript.whisperx[307].start |
9568.809 |
| transcript.whisperx[307].end |
9594.983 |
| transcript.whisperx[307].text |
今天發生的這樣的一個問題我覺得真的要去盤點不要說到時候又發生哪個藥又短缺然後又要從國外又緊急進口我覺得我們不樂見這樣的事情再次發生所以我希望說衛福部那食藥署健保署我覺得真的要去通盤做一個檢討可不可以剛講的那個比較大公升的那種可能要到年底就是可能永豐 |
| transcript.whisperx[308].start |
9595.823 |
| transcript.whisperx[308].end |
9595.963 |
| transcript.whisperx[308].text |
主席 |
| transcript.whisperx[309].start |
9609.708 |
| transcript.whisperx[309].end |
9626.838 |
| transcript.whisperx[309].text |
當然當然,這個要朝方最後面來努力,而且我們會,本來其實都有重要藥品醫材的一個管理,我想這個我們要去落實,依委員的指導,一定要去確實,而且要平均化,不要變成被獨家所佔用。 |
| transcript.whisperx[310].start |
9630.7 |
| transcript.whisperx[310].end |
9655.359 |
| transcript.whisperx[310].text |
好,部長我今天為什麼會排一個就是有關這個健保合理支付那保障醫護人員的收入還有設置百億癌症基金及健保這個健康投資這些議題是希望就是說這個健保的這個合理支付其實在這個醫院也好或診所也好很多醫師一直在提到就是說我們現在的這個健保的這個 |
| transcript.whisperx[311].start |
9656.46 |
| transcript.whisperx[311].end |
9684.811 |
| transcript.whisperx[311].text |
支付其實是不太合理啦就剛剛講的我碰到可能就是有的人在做這個肺癌的篩檢那有的可能到這個區域醫院那因為可能要接受這樣的一個檢查那這個醫院他可能就覺得說以這個可能這個儀器故障啊那他們也不太想修理因為他的這個支付的這個健保給付的 |
| transcript.whisperx[312].start |
9685.111 |
| transcript.whisperx[312].end |
9685.131 |
| transcript.whisperx[312].text |
委員長 |
| transcript.whisperx[313].start |
9710.573 |
| transcript.whisperx[313].end |
9727.03 |
| transcript.whisperx[313].text |
致富多少,要支付多少才合理的,我覺得健保署這邊應該要去好好的去做盤點,要不然大家說你這個所有的這個檢查也好,或者是藥品也好,真的是 |
| transcript.whisperx[314].start |
9728.174 |
| transcript.whisperx[314].end |
9746.086 |
| transcript.whisperx[314].text |
這件事是很傷害的,給的這個點值,這個一點也不到0.9,確實是讓所有的醫護人員覺得說,這個真的是蠻委屈的,所以我是不是可以請教就是說,我們這個 |
| transcript.whisperx[315].start |
9748.027 |
| transcript.whisperx[315].end |
9768.322 |
| transcript.whisperx[315].text |
衛福部在這幾年當中針對健保的合理支付我覺得你們要去做一個盤點另外醫護人員的收入雖然我們在前陣子有針對夜班的護理人員有做一些補助也造成很大的反彈 |
| transcript.whisperx[316].start |
9769.602 |
| transcript.whisperx[316].end |
9785.372 |
| transcript.whisperx[316].text |
白班的護理人員也是非常的辛苦為什麼是只有夜班的護理人員有補這個又造成醫院內有一些蠻奇怪的氛圍所以我想請教就是說部長未來針對這樣子的 |
| transcript.whisperx[317].start |
9788.574 |
| transcript.whisperx[317].end |
9792.636 |
| transcript.whisperx[317].text |
這點委員的行論有兩部分一個怎麼樣健保合理的支付我想這個大家放心說 |
| transcript.whisperx[318].start |
9810.41 |
| transcript.whisperx[318].end |
9825.359 |
| transcript.whisperx[318].text |
做一個手術或怎麼樣都比人家幾乎的少很多嘛那其實當然是跟整個健康的投資跟健保的 |
| transcript.whisperx[319].start |
9826.499 |
| transcript.whisperx[319].end |
9840.932 |
| transcript.whisperx[319].text |
的額度裡面都有相關的關係,而且醫療的需求越來越多所以這的確是會面對很大的困境,我想不管是政府或者是專業團體也都為這個絞盡腦汁,也謝謝委員的關心那其實目前健保治療項目有4800多項 |
| transcript.whisperx[320].start |
9848.803 |
| transcript.whisperx[320].end |
9856.387 |
| transcript.whisperx[320].text |
我想衛福部已經健保水在113年6月成立支付標準恆平性平良規劃專家小組來看各個學會有什麼支付偏低的專科學會 |
| transcript.whisperx[321].start |
9864.191 |
| transcript.whisperx[321].end |
9889.746 |
| transcript.whisperx[321].text |
我們來討論通盤來調整支付標準我做醫師公會醫師做六檔外我也知道說大家說政策會要調要調但是你總部就會這麼多所以我們要針對說人民需要的重要的有一個順序不然你就居候增加健康投資這個部分所以在有限的 |
| transcript.whisperx[322].start |
9890.546 |
| transcript.whisperx[322].end |
9896.231 |
| transcript.whisperx[322].text |
我認為可能你們要在這個短時間內也要趕快去做一個盤點另外就是說我們在這個上禮拜有關我們這個健保這個點子我們這個一點 |
| transcript.whisperx[323].start |
9913.646 |
| transcript.whisperx[323].end |
9937.593 |
| transcript.whisperx[323].text |
國民黨委員有提到點值1.1元或者是0.95元我是覺得說未來我們要面對的到底有沒有這麼多的預算因為現在已經送大院會去要做協商我想請教就是說未來如果在表決通過之後 |
| transcript.whisperx[324].start |
9939.318 |
| transcript.whisperx[324].end |
9953.438 |
| transcript.whisperx[324].text |
我想請教衛福部你們這邊要怎麼去處理這件事因為勢必會增加一些預算那我想請教就是說你們要最後要做什麼樣的努力那如果通過之後你們要怎麼去處理 |
| transcript.whisperx[325].start |
9954.924 |
| transcript.whisperx[325].end |
9981.617 |
| transcript.whisperx[325].text |
首先有關法案我們當然尊重大院的一個決議然後還有行政部門我們會討論怎麼樣來應應因為這滿整體性的那我們現在能做我剛剛其實有報告過我們就盡量來增加健保應該是屬於健保費用的要移住進來 不能移住出去就是說我剛才說的健保 政府要你健保出36% |
| transcript.whisperx[326].start |
9983.078 |
| transcript.whisperx[326].end |
9984.539 |
| transcript.whisperx[326].text |
這個清出來就可以多一百多億 |
| transcript.whisperx[327].start |
9994.397 |
| transcript.whisperx[327].end |
10020.497 |
| transcript.whisperx[327].text |
在過去有的,你可以用其他的公務項目來出的,我們都把30多個健保來出,這個我們現在也慢慢清除,清除一年就清一百多億,其實這樣子,這個才是真正在做事,說實在的,我不是定了一個目標,可是就是很難達到,或者是也不合乎那個一個財政的一個 |
| transcript.whisperx[328].start |
10023.219 |
| transcript.whisperx[328].end |
10041.54 |
| transcript.whisperx[328].text |
的方式,那不是唯一的辦法,我們更重要的辦法是把很具體的把健保費用增加,還有另外一個大家比如說各位醫療院所比較在意的,我們這次也把最低推在健保總和才是 |
| transcript.whisperx[329].start |
10042.361 |
| transcript.whisperx[329].end |
10066.502 |
| transcript.whisperx[329].text |
建保總和的成長力才是醫療單位需要的而在這個部分我們也做最努力譬如說把低退估弄到最高高退估也移到最高希望成長力能夠多這才是真正醫療對我們一步很踏實的做我相信應該很快的會讓醫療界感受到我們執政黨在這方面的努力 |
| transcript.whisperx[330].start |
10068.362 |
| transcript.whisperx[330].end |
10093.497 |
| transcript.whisperx[330].text |
其實真的衛福部的事情真的是非常的多從出生到死亡從這個醫療福利真的是非常的多所以我希望說部長你從5月份5月20上任到現在確實還有很多需要去了解那也有很多需要你去解決的我們說可以更具體然後希望真的未來可以看到就是我們 |
| transcript.whisperx[331].start |
10094.578 |
| transcript.whisperx[331].end |
10094.978 |
| transcript.whisperx[331].text |
防洩當委員發言 |
| transcript.whisperx[332].start |
10126.616 |
| transcript.whisperx[332].end |
10133.727 |
| transcript.whisperx[332].text |
好謝謝請王振旭委員發言好謝謝主席有請邱部長請邱部長 |
| transcript.whisperx[333].start |
10142.504 |
| transcript.whisperx[333].end |
10157.642 |
| transcript.whisperx[333].text |
部長好委員好是剛剛我們事情前委員說目前今天至少會有三位醫療相關醫師的委員來跟你請教相關的問題那也很謝謝趙偉今天特別安排這個專題報告 |
| transcript.whisperx[334].start |
10160.165 |
| transcript.whisperx[334].end |
10181.501 |
| transcript.whisperx[334].text |
讓所有委員也更清楚的知道目前衛福部針對這些重大的議題做了哪一些的努力那也期待未來能夠迅速的回應民眾的需求能夠針對於作實這個健康台灣有更多好的發展的方向那我們先看一下到底目前這些挑戰 |
| transcript.whisperx[335].start |
10182.722 |
| transcript.whisperx[335].end |
10196.209 |
| transcript.whisperx[335].text |
透過今天的報告我們能夠做哪一些的延伸跟進步的機會包括不管是護理師的急診的最近好多好多急診這些量的滿載部分 |
| transcript.whisperx[336].start |
10198.21 |
| transcript.whisperx[336].end |
10220.128 |
| transcript.whisperx[336].text |
藥品供應不足還有因為護理人力不足相關因素之下這個病床數的開床無法滿足這些醫療需求那另外一個比較少被提到的就是藥師人力的不足的部分那這部分希望透過今天的詢問來請教我們有如何因應的對策我們再往下看就會發現 |
| transcript.whisperx[337].start |
10221.389 |
| transcript.whisperx[337].end |
10237.422 |
| transcript.whisperx[337].text |
其實這個醫療院所缺藥師是一個進行式它已經不是未來才會面臨的問題那我們也發現不管這個醫院或者是生技藥廠診所都很需要藥師的幫忙 |
| transcript.whisperx[338].start |
10238.183 |
| transcript.whisperx[338].end |
10252.159 |
| transcript.whisperx[338].text |
那藥師尤其在COVID-19那段時間協助發放口罩或等等的幫助針對於我們對於COVID-19造成的影響真的很感謝藥師能夠提供非常多的協助讓民眾 |
| transcript.whisperx[339].start |
10253.3 |
| transcript.whisperx[339].end |
10275.524 |
| transcript.whisperx[339].text |
這方面得到很大的安慰跟好的服務可是越來越多的藥師前往社區藥局發展這個是可以理解的因為如果我是藥師或者是我家人有藥師的話我相信做這樣的選擇是非常自然的事情可是我們也擔心往下看我們發現說藥師這種目前的狀況 |
| transcript.whisperx[340].start |
10281.072 |
| transcript.whisperx[340].end |
10282.213 |
| transcript.whisperx[340].text |
在藥師方面嗎是藥師人力的部分 |
| transcript.whisperx[341].start |
10308.342 |
| transcript.whisperx[341].end |
10328.744 |
| transcript.whisperx[341].text |
好我先提這個剛剛你現在放這一張我們很期待既然慢慢的要朝向醫藥分裂那社區的藥局大概所有的藥物都能夠盡量備齊那也盡量符合民眾的需要那特別是小孩子的尤其急性病 |
| transcript.whisperx[342].start |
10329.505 |
| transcript.whisperx[342].end |
10332.187 |
| transcript.whisperx[342].text |
有關健保合理支付、保障醫護人員收入及健康投資等事項 |
| transcript.whisperx[343].start |
10351.579 |
| transcript.whisperx[343].end |
10379.984 |
| transcript.whisperx[343].text |
我們醫生也是一樣,大家一定找一個,那時候我們做病就要離家近,緊張到那個當然我們的醫學教育,我們很用心,百年來台灣今天能夠駐守到第一線,去守護偏鄉能夠肯在加護病房面對彼此的病人,肯在安寧病房面對即將過世的病人 |
| transcript.whisperx[344].start |
10381.164 |
| transcript.whisperx[344].end |
10386.685 |
| transcript.whisperx[344].text |
我相信所有的醫事人員的教育都是這樣子那至於說怎麼樣改善一個更好的環境或者是說讓可能有一些考試的及格率 |
| transcript.whisperx[345].start |
10409.059 |
| transcript.whisperx[345].end |
10427.289 |
| transcript.whisperx[345].text |
我認為也都應該要考量,因為有的人很忙,就不一定考試得很好。部長我請教你,就是說如果針對於偏鄉的醫師人力需要做適度的補充,或者是需要去解決這樣的問題, |
| transcript.whisperx[346].start |
10428.49 |
| transcript.whisperx[346].end |
10449.637 |
| transcript.whisperx[346].text |
那不知道藥師未來在這方面有沒有相關的問題也要同步去克服最近像慈濟慈濟他們在花蓮偏鄉所以就經過努力的爭取以後他們就這個要學習這個他的偵測的機會那未來在偏鄉的部分如果藥師短缺怎麼辦 |
| transcript.whisperx[347].start |
10450.757 |
| transcript.whisperx[347].end |
10473.545 |
| transcript.whisperx[347].text |
有沒有像工會醫學生一樣將來會有工會藥學生類似的這些要因應的措施因為未來不管是要如何去處理醫藥分業單軌制的情形要落實的話那萬一這個人力不足的時候我們不希望看到像今天一樣好像問題出現以後才開始解決的一些方案 |
| transcript.whisperx[348].start |
10474.537 |
| transcript.whisperx[348].end |
10492.13 |
| transcript.whisperx[348].text |
我想這個部分可以分全國性跟地區域性啦齁全國性你就是要有這個量大嘛阿合理的學到不錯的你就讓他出來來社會服務沒一個去念大學科相關科系的都是父母的寶貝阿齁你能讓 |
| transcript.whisperx[349].start |
10493.291 |
| transcript.whisperx[349].end |
10511.148 |
| transcript.whisperx[349].text |
如果能夠多多輔導他能夠有工作做而且是能夠工作他的專業不管哪一個醫事人員我覺得我們都真的要去協助啦這個部分就會在考選部跟各位專科的團體能夠去重新站在國家的立場來思考 |
| transcript.whisperx[350].start |
10512.149 |
| transcript.whisperx[350].end |
10534.775 |
| transcript.whisperx[350].text |
那我覺得把量,整個國家的量充實起來以後,然後再開始鼓勵偏鄉的一個醫事人力,包括美根醫生,都要鼓勵。以前不可以保障像花蓮慈濟這樣保障在地的醫生,現在我個人過去幾年來是非常支持 |
| transcript.whisperx[351].start |
10535.976 |
| transcript.whisperx[351].end |
10556.041 |
| transcript.whisperx[351].text |
自己原鄉培養的一個自己培養醫師人力因為那個留任率可能可以到七成那你用光輝的去齁那如果時間夠都照那背的啦可能就沒30%啦所以我覺得這些都要...而且我還要提一個意見就是說老歸於下鄉啦齁 |
| transcript.whisperx[352].start |
10563.562 |
| transcript.whisperx[352].end |
10579.482 |
| transcript.whisperx[352].text |
臺北企業醫療資源非常豐富,臺北市那些以前的專家,現在看病看得很少,是不是我們也可以安排說那個給他鼓勵,反正孩子也不要理他,空巢期嘛,你兩個帶他去台東去花蓮去做這樣 |
| transcript.whisperx[353].start |
10581.283 |
| transcript.whisperx[353].end |
10582.484 |
| transcript.whisperx[353].text |
衛生福利部長 |
| transcript.whisperx[354].start |
10599.654 |
| transcript.whisperx[354].end |
10600.475 |
| transcript.whisperx[354].text |
大家可以做好事 |
| transcript.whisperx[355].start |
10619.992 |
| transcript.whisperx[355].end |
10642.209 |
| transcript.whisperx[355].text |
那我們也知道護理師的部分剛剛部長也說明了非常多我們也希望醫療院所有更好的彈線工時的安排等等讓我們的護理師們可以有一點話我自我了解醫療院所包括都講一句話你只要跟我講說這個要給護理他們怎麼會去跟你要拿去呢所以將來只要說要給護理的 |
| transcript.whisperx[356].start |
10645.27 |
| transcript.whisperx[356].end |
10672.366 |
| transcript.whisperx[356].text |
我覺得醫院一毛錢都不會跟你拿不要誤解到醫院會去拿這些錢我個人是從很多醫療院所的領導人他們的意見是這樣子好 那再來看這個瑞士洛杉磯管理學院他在2024年最近公佈的這個國家競爭力的部分那和醫療相關的就是有一個基礎建設基礎建設部分其實我們的成績非常好 |
| transcript.whisperx[357].start |
10673.526 |
| transcript.whisperx[357].end |
10696.163 |
| transcript.whisperx[357].text |
其實名列前三這個部分就是醫療保健基礎設施符合社會需要意思就是說我們的硬體設備其實是很有競爭力的那這個也剛剛反映出萬一對於這些在已經很充分的硬體設施包括醫院的設置之下新增人口需要床數增加的時候 |
| transcript.whisperx[358].start |
10697.163 |
| transcript.whisperx[358].end |
10712.752 |
| transcript.whisperx[358].text |
分布上要怎麼樣去讓這些需求能夠在已經這麼好的基礎上去做特別的處理另外我們也看到這個醫療保健支出佔GDP的比例相對來講就是差很多才佔了41名 |
| transcript.whisperx[359].start |
10714.393 |
| transcript.whisperx[359].end |
10736.359 |
| transcript.whisperx[359].text |
這一部分其實反映出來就是我們真的很需要有更多的醫療資源的投入那這一部分也需要請邱部長繼續努力的來做相關的處理那其實我們也看到下一張就是有關於這些公共衛生支出的項目剛才你也已經說明得很清楚 |
| transcript.whisperx[360].start |
10737.479 |
| transcript.whisperx[360].end |
10757.635 |
| transcript.whisperx[360].text |
再來,如果有辦法把這個相關的項目做適當的盤整以後讓它回歸到這個醫療需求你想想看,剛才這樣算對GDP的占比會有效提升到多少百分比有沒有這樣的一個預估或者是盤算 |
| transcript.whisperx[361].start |
10759.914 |
| transcript.whisperx[361].end |
10788.974 |
| transcript.whisperx[361].text |
我想我們這個部分應該是王委員長期在關注而且你才是專家我們衛務部應該也必須要來盤算因為現在都還在盤算當中但是我相信只要公務預算都投入到公共衛生、傳染病防治、預防保健的話我們相信我們的LDP應該就自然而然就會提升到相當不錯的水準 |
| transcript.whisperx[362].start |
10790.014 |
| transcript.whisperx[362].end |
10813.242 |
| transcript.whisperx[362].text |
好,很期待能夠看到這個數字的具體呈現那還有兩個問題想要請部長這邊幫忙確認就是通訊診療其實今天就要正式實施那對於這個基層機構診所可能會有一些擔心的部分那能不能夠更有效的去提供相關的誘因協助 |
| transcript.whisperx[363].start |
10814.162 |
| transcript.whisperx[363].end |
10840.316 |
| transcript.whisperx[363].text |
讓我們的基層診所也比較安心的去知道怎麼去配合這個需要讓這個受惠的民眾可以到達274萬人的過程當中醫療診所是可以扮演重要的角色這個部分王委員提到這個部分我必須要感謝我們基層醫療其實你們是大家用通訊診察用的最多的 |
| transcript.whisperx[364].start |
10841.587 |
| transcript.whisperx[364].end |
10853.007 |
| transcript.whisperx[364].text |
在我們最困難的疫情COVID的疫情最困難的時候即台北市一天最高曾經到達1萬個infected COVID新北市2萬個 |
| transcript.whisperx[365].start |
10855.194 |
| transcript.whisperx[365].end |
10872.122 |
| transcript.whisperx[365].text |
這是如果只要有其中一少部分的人因為他擔心他的小孩子發燒或者自己不舒服就衝到急診只要百分之一每一個急診都爆掉但是我們政府這個時候的政策應該是從兩個當時也是推動這個通訊診療用視訊就會來看他家裡的這個小孩子的發燒狀況生病狀況 |
| transcript.whisperx[366].start |
10882.182 |
| transcript.whisperx[366].end |
10908.951 |
| transcript.whisperx[366].text |
那有什麼問題可以隨時來解決那這個也直擊以過去我們20年來臺灣推動社區醫療群、家庭醫師制度就大家都有一個合作所以我鼓勵你,你鼓勵我金獸才肯來做相關的一個居家甚至到居家通訊的診療穩住了國家的一個疫情所以以前你不用煩惱,你做這麼多 |
| transcript.whisperx[367].start |
10911.553 |
| transcript.whisperx[367].end |
10916.378 |
| transcript.whisperx[367].text |
現在通信的整條辦法那個我想意思是很清楚都是會站在 |
| transcript.whisperx[368].start |
10917.438 |
| transcript.whisperx[368].end |
10942.809 |
| transcript.whisperx[368].text |
以病人為中心然後協助讓基層醫療能夠很方便的來照顧他原來的病人而醫院方面他只是在照顧他原來他用的通訊設備會比較屬於照顧他原來的病人或者是比較離島、外島等等的偏鄉特殊任務的大致上不至於影響到基層 |
| transcript.whisperx[369].start |
10943.789 |
| transcript.whisperx[369].end |
10959.978 |
| transcript.whisperx[369].text |
他究竟在看病人這也是我們臺灣醫療體系必須要堅持的基層醫療就是要原則上要face to face你就是要去瞭解你社區的狀況你就是瞭解他甚至他們家有養幾隻貓幾隻狗你都知道 |
| transcript.whisperx[370].start |
10960.698 |
| transcript.whisperx[370].end |
10981.947 |
| transcript.whisperx[370].text |
你才能夠知道他的疾病嘛這是基層醫療的價值所在那如果能夠配合有些為高齡化的社會或機構那也給基層醫療來做那也可以應應剛剛COVID的那個時候的狀況我覺得這是這是這一個進步的我們把這樣的一個辦法弄到更進步更符合人民的需要 |
| transcript.whisperx[371].start |
10983.788 |
| transcript.whisperx[371].end |
10999.643 |
| transcript.whisperx[371].text |
最後就是一個有關於公費流感、客流感使用的這個部分因為在6月26號突然就宣布說又可以回歸到這個公費使用所以讓很多基層診所挫折不及 |
| transcript.whisperx[372].start |
11000.263 |
| transcript.whisperx[372].end |
11017.353 |
| transcript.whisperx[372].text |
那這次的這個流感或類流感它的在夏天還這麼樣的猖獗的確是令人無法去預估不過依照我們所看到的這個重症數並沒有緩和下來我們最後一張可以看到的就是 |
| transcript.whisperx[373].start |
11020.154 |
| transcript.whisperx[373].end |
11046.001 |
| transcript.whisperx[373].text |
接管署把這個試用期間從6月26號一直延伸到7月31號那我們期待的是說如果是這樣公費持續來適應這個需求的話那到7月31號截止之前萬一這個疫情沒有真的緩和下來的時候那要公佈這樣的延續或者是要取消是不是能夠再提前一個禮拜就能夠事先一個預告之類的否則的話 |
| transcript.whisperx[374].start |
11048.401 |
| transcript.whisperx[374].end |
11049.382 |
| transcript.whisperx[374].text |
這部分再麻煩邱部長有一個好的準備 |
| transcript.whisperx[375].start |
11066.102 |
| transcript.whisperx[375].end |
11086.568 |
| transcript.whisperx[375].text |
各位委員報告,我們這次因應疫情所以把擴大客流感的用藥從6月26日延長到7月底主要的原因是我們認為說這次流感的疫情大概是7月中左右會到尖峰可是後面可能會逐漸下降不過我們會持續的來評估 |
| transcript.whisperx[376].start |
11090.009 |
| transcript.whisperx[376].end |
11112.79 |
| transcript.whisperx[376].text |
響鐘 |
| transcript.whisperx[377].start |
11115.114 |
| transcript.whisperx[377].end |
11122.498 |
| transcript.whisperx[377].text |
好那我先做一下宣告等一下再鄭天才委員質詢結束處理臨時提案現在請鄭天才委員發言 |
| transcript.whisperx[378].start |
11142.951 |
| transcript.whisperx[378].end |
11158.712 |
| transcript.whisperx[378].text |
主席、各位委員、有請部長。請邱部長。委員好。部長辛苦了。謝謝。今天衛福部的報告裡面特別提到 |
| transcript.whisperx[379].start |
11160.204 |
| transcript.whisperx[379].end |
11183.835 |
| transcript.whisperx[379].text |
本部將配合行政院人事行政總署研議調整公立醫院醫事人員待遇以利羅制及留任醫事人員請問部長這個打算怎麼去進行呢?我想這個部分是那個從 |
| transcript.whisperx[380].start |
11188.007 |
| transcript.whisperx[380].end |
11196.097 |
| transcript.whisperx[380].text |
這幾年來一直在努力的方向,當然各個醫院都有他的一個努力必須要去突破的 |
| transcript.whisperx[381].start |
11205.843 |
| transcript.whisperx[381].end |
11208.666 |
| transcript.whisperx[381].text |
這個部分我要特別請衛福部,因為你這邊寫說配合行政院和行政總署 |
| transcript.whisperx[382].start |
11230.566 |
| transcript.whisperx[382].end |
11243.303 |
| transcript.whisperx[382].text |
他絕對不會主動,所以你們要主動而且這個醫事人員人事條例按照第4條的話,這裡面還涉及到你要調整的話 |
| transcript.whisperx[383].start |
11244.568 |
| transcript.whisperx[383].end |
11272.496 |
| transcript.whisperx[383].text |
考試院會同行政院定資所以我的建議賴總統既然要在總統府成立健康臺灣推動委員會我們要擋也擋不住了他這裡面特別提到願景就是要讓人民活得長壽又健康而且還要通過健康憲章 |
| transcript.whisperx[384].start |
11273.837 |
| transcript.whisperx[384].end |
11293.682 |
| transcript.whisperx[384].text |
中華民國的法例的條文裡面有提到憲章的只有兩個憲章一個是聯合國憲章我們很多法律都有提到另外一個是奧林匹克憲章表示這個憲章的高度很高 |
| transcript.whisperx[385].start |
11295.151 |
| transcript.whisperx[385].end |
11314.89 |
| transcript.whisperx[385].text |
然後要推動健康臺灣生根計畫我的建議剛才我講的醫事人員、護理人員尤其是偏鄉原住民族地區的部分你要增加他的專業家籍剛剛的方向是這樣就提報這個 |
| transcript.whisperx[386].start |
11317.522 |
| transcript.whisperx[386].end |
11343.341 |
| transcript.whisperx[386].text |
總統所主持的《健康台灣推動委員會》因為這裡面就會涉及到這已經跨院了而且還要涉及到行政院跟考試院所以這個部分建議部長往這個提報到這邊可以嗎?沒問題沒問題我們在健康台灣的論壇六場論壇裡面都有談到原住民方面的一個怎麼樣來照顧所以這個是重點 |
| transcript.whisperx[387].start |
11344.822 |
| transcript.whisperx[387].end |
11373.365 |
| transcript.whisperx[387].text |
提到原住民謝謝你主動提到原住民族健康法第一條這是去年112年6月21號公布施行的這裡面很重要的就是改善原住民族健康不平等這個已經是中華民國法律認證了原住民族健康不平等所以要改善所以很多要改善的地方 |
| transcript.whisperx[388].start |
11375.718 |
| transcript.whisperx[388].end |
11376.699 |
| transcript.whisperx[388].text |
衛生福利部的處規程裡面 |
| transcript.whisperx[389].start |
11404.226 |
| transcript.whisperx[389].end |
11414.962 |
| transcript.whisperx[389].text |
護理及健康照護師就是負責嚴肅民主第七醫事人力及服務體系之發展與推動 |
| transcript.whisperx[390].start |
11416.67 |
| transcript.whisperx[390].end |
11442.813 |
| transcript.whisperx[390].text |
一個護理及健康照護師他其實是沒有辦法去達成整個原住民族健康不平等的改善是沒有辦法他絕對不是護理及健康照護師所可以去支撐的因為原住民族健康不平等的改善涉及到衛福部的整個10個師 |
| transcript.whisperx[391].start |
11445.134 |
| transcript.whisperx[391].end |
11470.281 |
| transcript.whisperx[391].text |
十個師都有關係到所以這個部分部長這個部分要怎麼去推動我的建議我的建議因為其實還有涉及到各部會我的建議就是提到總統所主持的總統所主持的健康台灣推動委員會 |
| transcript.whisperx[392].start |
11471.687 |
| transcript.whisperx[392].end |
11493.42 |
| transcript.whisperx[392].text |
我相信這個健康台灣推動委員會一定會討論這個主題所以這個部分要把整個原住民族健康不平等的改善的因應的措施包括相關的這些從人力到經費到各個層級包括也有涉及到別的部會可以嗎 |
| transcript.whisperx[393].start |
11495.604 |
| transcript.whisperx[393].end |
11520.776 |
| transcript.whisperx[393].text |
過去多年來我在這個地方也聆聽到很多關心原住民的立法委員們都教導很多所以我也知道大家的訴求跟努力的方向那我相信會把它而且健康台灣的確也是這個內委重點那雖然現在目前可能沒有剛剛您提到那個滿意的一個設置但是在我們在那個健康 |
| transcript.whisperx[394].start |
11522.297 |
| transcript.whisperx[394].end |
11536.586 |
| transcript.whisperx[394].text |
會有一個除了一個健康政策會來跨部會以外在這個司裡面也會想要來申請一個科來專門照顧這樣的一個工作這樣子好這個加油好謝謝好謝謝 |
| transcript.whisperx[395].start |
11540.337 |
| transcript.whisperx[395].end |
11565.78 |
| transcript.whisperx[395].text |
好謝謝鄭天才委員的發言現在處理臨時提案總共有五案請一併宣讀臨時提案第一案新竹臺大生醫醫院二期工程涉及新竹地區集中症照護能量的提升以及涉及臨床轉譯研究和產學合作等效益的落實原要求衛福部積極予以協助提供行政及預算支持必立醫療大樓如期如之啟用 |
| transcript.whisperx[396].start |
11566.28 |
| transcript.whisperx[396].end |
11590.347 |
| transcript.whisperx[396].text |
提案人委員．邱振鈞、陳金輝、廖偉翔、徐欣盈第二案考量目前大容量生理食鹽水因嚴重缺貨致使第一線醫療現場正常運作受到衝擊原決議衛福部應限期於一週內向立法院社會福利及衛生環境委員會委員提交恢復國內生理食鹽水正常供應之預期時程及行政準備規劃書面報告 |
| transcript.whisperx[397].start |
11591.887 |
| transcript.whisperx[397].end |
11598.893 |
| transcript.whisperx[397].text |
提案人委員陳金輝、陳昭芝、邱振鈞第三案有鑒於優化兒童醫療照護計劃於113年到期考量持續挹注經費、優化兒童醫療環境仍有必要原請衛生福利部針對未來相關預算給予寬裂 |
| transcript.whisperx[398].start |
11609.241 |
| transcript.whisperx[398].end |
11615.927 |
| transcript.whisperx[398].text |
積極啟動優化兒童醫療照護計畫2.0規劃作業．並於一個月內向立法院社會福利及衛生環境委員會提交規劃書面報告提案人委員陳金輝、陳昭芝、邱振鈞第4案有鑒於當前國內醫事機關在深受生理實驗水輸液缺貨的影響下連帶至第一線對病患從事治療等相關業務接受衝擊原要求衛福部限期 |
| transcript.whisperx[399].start |
11639.267 |
| transcript.whisperx[399].end |
11654.902 |
| transcript.whisperx[399].text |
與一週內針對國內藥品、藥材及醫材供應韌性不足之重點項目進行檢討與準備作業之盤點．後並於一個月內向立法院社會福利及衛生環境委員會提交書面報告提案人委員陳金輝、陳昭芝、邱振鈞第5案 |
| transcript.whisperx[400].start |
11655.382 |
| transcript.whisperx[400].end |
11656.543 |
| transcript.whisperx[400].text |
好請問第一案行政單位有沒有意見 |
| transcript.whisperx[401].start |
11685.674 |
| transcript.whisperx[401].end |
11702.225 |
| transcript.whisperx[401].text |
主席衛福部議事是因為台大醫院是教育部體系下的醫院我們是建議在倒數第二行裡面就是原提案要求加列教育部及衛福部 |
| transcript.whisperx[402].start |
11703.326 |
| transcript.whisperx[402].end |
11731.084 |
| transcript.whisperx[402].text |
是就是及衛福部積極那個予以協助及提供行政及預算支持就加一個教育部嗎那教育部及衛福部OK好那委員有沒有意見提案委員有沒有意見可以齁好可以齁好那就照文資修正通過 |
| transcript.whisperx[403].start |
11732.233 |
| transcript.whisperx[403].end |
11761.61 |
| transcript.whisperx[403].text |
那請問第二案行政單位有沒有意見報告主席第二案是衛福部食藥署那因為這個委員這邊是要求就倒數第三場開始原決議應限期於一週內向本委員會提交書面報告這部分是不是可以請委員讓我們寬限到一個月因為整個我們要查核員下去查核業者提供他的矯正報告我們要再下去確認所以這是一個很攘查的過程就可以請委員同意是不是可以把這個期限改為一個月內 |
| transcript.whisperx[404].start |
11762.09 |
| transcript.whisperx[404].end |
11764.031 |
| transcript.whisperx[404].text |
第三案第三案遵照辦理第四案 |
| transcript.whisperx[405].start |
11781.477 |
| transcript.whisperx[405].end |
11799.694 |
| transcript.whisperx[405].text |
報告主席,第4案是衛福部食藥署,食藥署這邊會遵照辦理,當然要跟委員報告一下,就是藥品醫療器材這邊是由食藥署會完成盤點比提出報告,那至於藥材的部分我們會協請中醫藥師那邊協助提供,因為那是他們所負責的。所以沒有文字上的修正,沒有嗎?好,那就第4案召案通過,第5案,謝謝,第5案 |
| transcript.whisperx[406].start |
11805.034 |
| transcript.whisperx[406].end |
11828.372 |
| transcript.whisperx[406].text |
好 先召委還有先委員的提案那是不是可以請求委員同意在倒數第三行 委員要求衛福部就提供臺中市居民會來篩檢補治的可行性那就提供三個字改成嚴厲好不好衛福部來嚴厲臺中市居民會來篩檢補治的可行性 |
| transcript.whisperx[407].start |
11829.723 |
| transcript.whisperx[407].end |
11842.279 |
| transcript.whisperx[407].text |
請問提案委員有沒有意見並以委員的提報第5案就照文字修正通過臨時提案全部處理完畢接下來請葉元之委員發言 |
| transcript.whisperx[408].start |
11860.926 |
| transcript.whisperx[408].end |
11884.286 |
| transcript.whisperx[408].text |
請那個麻煩請部長謝謝請邱部長部長好委員好因為我們現在新北市很多家醫院到急診室都要等非常久包括我特別去了解各家都一樣三峽恩祖宮、亞東也有、汐止國泰我不知道部長你有掌握到這個狀況嗎 |
| transcript.whisperx[409].start |
11886.263 |
| transcript.whisperx[409].end |
11911.321 |
| transcript.whisperx[409].text |
我應該很掌握啦,亞東醫院的急診部主任是我的學生沒有問說你的學生啦我是說你有沒有了解說我們在地方急診室都排很久的狀況大概排隊的狀況我們都能夠因為今天台大要好像100個病人在等長庚有180個病人在等病床兩個醫院加起來就快300個那加上我們新北到處都在等衛福部了不了解背後原因是什麼 |
| transcript.whisperx[410].start |
11915.531 |
| transcript.whisperx[410].end |
11936.723 |
| transcript.whisperx[410].text |
如果你聽那個臺大吳明璇院長講這個急診的後傳是日常的事情沒有有變嚴重了部長有變嚴重了才會來反應嘛部長不要一副事不關己這都病人每次在那邊都等很久沒有我們絕對不是你知不知道原因是什麼很重要的事情 |
| transcript.whisperx[411].start |
11939.858 |
| transcript.whisperx[411].end |
11967.301 |
| transcript.whisperx[411].text |
當然第一個我們的分級醫療是不是沒有落實不是我直接講啦部長我直接講啦因為我也我是我們也沒有很多時間護理師缺很多啦所以關床啊出現關床的狀況我想這也是一個關床狀況而且是比例是非常的高大概有的是已經接近到四分之一了等於是說他的床是在那邊但是沒有護理師嘛所以沒有開床嘛但我不曉得說這個數據外部部有嗎 |
| transcript.whisperx[412].start |
11970.014 |
| transcript.whisperx[412].end |
11972.545 |
| transcript.whisperx[412].text |
衛福部有這個數據嗎?就是說現在到底整體來說台灣的醫院關床狀況是怎樣? |
| transcript.whisperx[413].start |
11977.182 |
| transcript.whisperx[413].end |
12004.342 |
| transcript.whisperx[413].text |
我們這個是有從衛生局的通報啦所以有這個數據有時候病房做醫院的做調控的時候並沒有通報衛生局那這樣子好不好我在這邊我們掌握的好像跟看到的好像不太一樣因為為什麼呢因為他不見你掌握的是床數嘛他有多少床嘛但實際上我們現在講的是有床沒有用嘛他要把那個病房打開嘛要開嘛 |
| transcript.whisperx[414].start |
12005.183 |
| transcript.whisperx[414].end |
12031.13 |
| transcript.whisperx[414].text |
所以可不可以請衛福部去了解一下因為我要跟你說這個情況非常嚴重那問題非常嚴重就影響到一般民眾看病的權益嘛那還有一些醫院現在因為也是病房的關係所以現在他們比較喜歡叫做怎麼經辦經出病房啊今天來看完之後趕快出去那種啊現在好像比較流行啊但一些比較嚴重的就要在急診室等半天啊 |
| transcript.whisperx[415].start |
12031.75 |
| transcript.whisperx[415].end |
12052.335 |
| transcript.whisperx[415].text |
所以我希望說衛福可不可以去了解一下這個情況好不好可不可以把這個數據統計出來給本席一份資料好沒問題好不好一個禮拜我們現在跟各地的衛生局合作好那第二個齁我今天跟你講說大部分是因為護理師缺乏的問題啦好那你現在你又要好像又要提高護病比嘛請問一下護理師缺乏的問題要怎麼解決 |
| transcript.whisperx[416].start |
12054.942 |
| transcript.whisperx[416].end |
12074.756 |
| transcript.whisperx[416].text |
現在衛福部要怎麼解決這個問題我們其實在這個問題一直存在所以我們在去今年的3月1號行政院就通過有一個三大方向十二大策略在進行這個我都有看到啦但是現在很多醫院就說第一個緩不濟急第二個也沒有發揮作用 |
| transcript.whisperx[417].start |
12075.777 |
| transcript.whisperx[417].end |
12099.899 |
| transcript.whisperx[417].text |
我這邊具體喔建議兩個好不好第一個就是說可不可以針對一些特殊單位的護理師比如說像一些護病房啊一些門診啊急診的護理師給一些特殊的家籍啊第二個是有沒有可能針對護理師現在的教育訓練都是由各醫院自己辦理嘛有沒有可能用衛福部職業編預算來做這個事情有可能嗎 |
| transcript.whisperx[418].start |
12102.124 |
| transcript.whisperx[418].end |
12127.41 |
| transcript.whisperx[418].text |
這個其實都是可以研議的事情可以研議喔這是我個人建議啦但我想說部長你也是來自於我完全了解護理人員的心思你也是來自於醫界啦我相信我講的問題你可能都知道啦但是因為你現在是衛福部長你覺得講太多好像感覺有點自打臉所以不願意講出來但是我覺得現在的問題就是我們的民眾的看病的權益受損了嘛那這後面還有一個問題就是說健保點值啦你現在健保點值如果能夠提高的話這個問題都解決了嘛 |
| transcript.whisperx[419].start |
12129.431 |
| transcript.whisperx[419].end |
12155.165 |
| transcript.whisperx[419].text |
那當時賴清德總統在競選的時候自己講的阿說健保點值可以朝1.1元阿這個方向阿為什麼現在感覺做這個事情又不行了阿為什麼每次都選前講一套選後做一套政治人物可以這樣嗎我們跟委員報告齁落實真正去做比較重要所以那這樣以後大家選舉的時候隨便開空投資票就好不用做 |
| transcript.whisperx[420].start |
12156.278 |
| transcript.whisperx[420].end |
12181.577 |
| transcript.whisperx[420].text |
因為部長你也很清楚嘛你來自於醫界嘛你知道說很多都是因為資源的問題才會衍生出這些狀況嘛如果說資源夠的話何必要關床咧如果資源夠的話護理師也許不會缺乏啊所以這個是根本問題啊我們要面對那你我覺得我現在討論的已經不是說好像醫生的收入要增加當然醫生收入也會因此增加但是關鍵是這件事情影響到我們一般民眾就醫的醫學品質了 |
| transcript.whisperx[421].start |
12183.198 |
| transcript.whisperx[421].end |
12197.899 |
| transcript.whisperx[421].text |
所以他其實是一個非常嚴重的問題我們今天才來反映嘛因為他不是只有一家醫院他是以我們新北市來說各家醫院都面臨類似的狀況所以必須要大刀闊斧的提出一些辦法出來啦是不知道部長能不能解決這個問題 |
| transcript.whisperx[422].start |
12200.422 |
| transcript.whisperx[422].end |
12213.267 |
| transcript.whisperx[422].text |
在健保的費用裡面我剛剛已經有很具體的提過幾個方案第一個我們要把所有應該歸附到公務預算的出來不要佔在健保的總額裡面這樣健保自然就因為我們那個我剛剛講的那個 |
| transcript.whisperx[423].start |
12217.228 |
| transcript.whisperx[423].end |
12244.26 |
| transcript.whisperx[423].text |
有關於比如說護理師缺乏、關床率那些資料慢慢部長提供給我然後另外也要提醒你一句話因為現在COVID也增加了嘛現在整個COVID-19整個又起來嘛到時候你因為COVID-19的關係你到時候病房又又要空一些出來去處理這個病患你問題會更雪上加霜啦所以這很緊急啦好不好當一回事啦當一回事啦謝謝好謝謝葉元芝委員的發言接下來請劉許廷委員發言 |
| transcript.whisperx[424].start |
12249.818 |
| transcript.whisperx[424].end |
12251.644 |
| transcript.whisperx[424].text |
謝謝主席 部長有請請邱部長 |
| transcript.whisperx[425].start |
12255.424 |
| transcript.whisperx[425].end |
12281.653 |
| transcript.whisperx[425].text |
委員好 部長午安這個根據護理師工會的統計臺灣護理師的就職率低於60%職業壽命只有6.5年相比於日本的15年美國的20年跟英國的30年顯然這個流失的狀況很嚴重每一年護理系的畢業生都有提供充足的人力補充但是2024年卻有高達2.4萬的缺口代表產業勞動的環境不太好人員流動非常快速恐怕是留不太住的人 |
| transcript.whisperx[426].start |
12282.353 |
| transcript.whisperx[426].end |
12309.258 |
| transcript.whisperx[426].text |
有很多護理師寧願放棄所學重新開始也不願意留在本行裡面這應該是一個很嚴重的問題那麼醫護環境的尤其是基層環境的三大問題本期會診一下第一個叫人力不足的問題第二個叫待遇不合理的問題第三個叫做勞動環境惡劣的問題這我相信很多委員都有關心衛福部應該也有長期試圖的針對這些問題來做出改善但今天我們就針對一些改善的方案跟具體的執行來做一下討論 |
| transcript.whisperx[427].start |
12310.058 |
| transcript.whisperx[427].end |
12310.699 |
| transcript.whisperx[427].text |
全民健康保險強化 |
| transcript.whisperx[428].start |
12329.432 |
| transcript.whisperx[428].end |
12344.798 |
| transcript.whisperx[428].text |
住院護理照護夜班獎勵鼓勵留任但部長這些不管是達標獎勵或者是夜班津貼這個實務上來講承受承接政府預算資源的主體應該不會是基層對不對應該是醫院對不對 |
| transcript.whisperx[429].start |
12347.339 |
| transcript.whisperx[429].end |
12370.241 |
| transcript.whisperx[429].text |
也就是說我把這個錢編出來發出去是發給醫院然後你期待說醫院基於良心嗎?也許是基於政策目標嗎?我在合理的來醫院內部來做分配但顯然有一些實務上的問題嘛如果說這個機制真的那麼有效的話那也許我們這個基層護理缺工的問題都解決了嘛所以部長是不是同意說這個也許在一些細節方面有一些精進的必要 |
| transcript.whisperx[430].start |
12372.327 |
| transcript.whisperx[430].end |
12393.096 |
| transcript.whisperx[430].text |
我相信這些錢全部應該都是到護理的身上但是這樣還不夠我覺得護理人員應該更多的鼓勵跟支持這個我們就提幾個建議第一個是有關於護病比的資料因為你現在護病比的這個標準看起來好像大家都達標可是其實尤其是基層有些是透過這個 |
| transcript.whisperx[431].start |
12394.877 |
| transcript.whisperx[431].end |
12416.791 |
| transcript.whisperx[431].text |
寫和勞工的這個記者會的方式來呈現有些是透過公會來發聲那其實讓他們都若干都有反應就是說你這護病筆其實有些失真啦就是醫院不見得他有辦法做出漂亮的數據啦但是數據真的精準嗎你現在用全市護病筆的方式來計算為什麼不是用三班護病筆的方式來計算呢那第二個不管是用全市或者是三班你怎麼去避免這些醫院 |
| transcript.whisperx[432].start |
12418.052 |
| transcript.whisperx[432].end |
12442.62 |
| transcript.whisperx[432].text |
基於我要拿到更多的津貼或者是說我要規避一些監督然後我有一些數據不精準的狀況請問衛福部針對這樣的問題有沒有提出解決的方案好第一個我想回答的就是說那個醫護三班醫院三班即使我們3月1號開始說實在達到達到率也是也是參差不齊的在醫學中心譬如說在一大夜班才達到 |
| transcript.whisperx[433].start |
12443.941 |
| transcript.whisperx[433].end |
12444.962 |
| transcript.whisperx[433].text |
這個真的有嚇阻的效果嗎? |
| transcript.whisperx[434].start |
12469.003 |
| transcript.whisperx[434].end |
12479.714 |
| transcript.whisperx[434].text |
這是不是衛福部這邊針對懲罰的機制,你有沒有提出檢討跟改善的打算?懲戒的部分,如果他們不配合的話,因為我們講嘛,我資源都給醫院嘛,醫院沒有照章質疑的時候我要懲罰嗎? |
| transcript.whisperx[435].start |
12482.742 |
| transcript.whisperx[435].end |
12506.383 |
| transcript.whisperx[435].text |
然後要公開透明然後因為今天時間有限你把相關的這些資料包含我怎麼樣落實三班護病比的資料公佈第二個我的懲罰機制要怎麼樣做改進好不好留個書面資料好那再來我們也不要就只講說醫護因為醫院也很多也叫苦連天嘛說環境不好健保等等但是回到點值的問題現在點值的問題到底還有什麼好講當然就是要給他提高嘛 |
| transcript.whisperx[436].start |
12506.923 |
| transcript.whisperx[436].end |
12529.879 |
| transcript.whisperx[436].text |
你也講讓醫院的營運環境改善雙管齊下嘛我一方面改善了醫院的營運環境讓他有足夠的收入二方面我在政策的方面做細節的精進讓這些資源可以有效的到基層的這個醫護的身上而這樣才能夠解決問題嘛那點值的部分到底還有什麼好客氣呢因為賴清德總統也講啊0.9目標1.1元啊對不對難道沒有這樣子的一個宣示嗎那為什麼還不做呢我們很具體在做喔 |
| transcript.whisperx[437].start |
12531.059 |
| transcript.whisperx[437].end |
12545.804 |
| transcript.whisperx[437].text |
那包括我剛剛跟委員報告的我們把公務預算移出來健保然後健保就會比較多的稅庫然後第二個成長力我們也創造歷年來有史最大的成長力這個都是真正可以提高 |
| transcript.whisperx[438].start |
12546.909 |
| transcript.whisperx[438].end |
12550.29 |
| transcript.whisperx[438].text |
衛福部相關,你有一些政策配套的話,我也希望你會有提供書面資料,包含時間表在內,如何來做精進。最後一點點時間,我要問一下,菸方法修正已經16個月了,健康風險評估? |
| transcript.whisperx[439].start |
12567.901 |
| transcript.whisperx[439].end |
12570.323 |
| transcript.whisperx[439].text |
我想這個相關的資訊吼那個吳署長非常清楚可以跟你們剪掉報告一下 |
| transcript.whisperx[440].start |
12594.281 |
| transcript.whisperx[440].end |
12617.041 |
| transcript.whisperx[440].text |
報告委員因為健康保障評估的話我們目前大概每個月大概開3到4次的審查會那只要業者符合我們當初要求他提的資料那麼能夠說服委員的話我們最後的結果就會公布這是叫最後結果部長有一些前期的也許跟健康風險有關的已經有先有結論其實我認為可以分階段先行公布這技術上有困難嗎 |
| transcript.whisperx[441].start |
12618.617 |
| transcript.whisperx[441].end |
12632.065 |
| transcript.whisperx[441].text |
還是要尊重委員的意思好 這個我希望部長也審慎思考啦因為我講的是純粹從風險知情權的角度啦好不好這事情請衛福部委員託予言議再予回覆好嗎好 謝謝好 謝謝謝謝委員好 謝謝牛許廷委員發言接下來請林淑芬委員的發言主席是不是請我們這個邱部長請邱部長 |
| transcript.whisperx[442].start |
12652.148 |
| transcript.whisperx[442].end |
12657.34 |
| transcript.whisperx[442].text |
部長,你最近一次的就醫是什麼時候?你有沒有去診所看醫生?額外費有沒有調轉? |
| transcript.whisperx[443].start |
12661.656 |
| transcript.whisperx[443].end |
12685.012 |
| transcript.whisperx[443].text |
我不太準啦,我在台大醫院看病有優惠喔,這樣子喔,好好好對啦,所以這個大人物包括立委,大概包括我自己老實說我去這個看病,大概醫生認識他都連掛號費都不收所以我們這一些人都叫做特權人士啦但我要講的是一般人不是特權人士喔我們這麼的 |
| transcript.whisperx[444].start |
12688.154 |
| transcript.whisperx[444].end |
12690.456 |
| transcript.whisperx[444].text |
特權可是一般人其實是蠻相當的影響衝擊蠻大的那因為調漲公安費的這個醫療院所你們號稱地方衛生局可以要求他們回報 |
| transcript.whisperx[445].start |
12702.566 |
| transcript.whisperx[445].end |
12714.714 |
| transcript.whisperx[445].text |
但是呢我更想知道是中央做什麼衛福部已經委託了健保署建置系統當時王次長說這個如果要調整掛號費啊這個系統建置好的時候不需要回報地方政府該系統建置好的時候就直接把調整後的這個費用輸入系統當中然後你們就會掌握了就清楚了請問一下這個系統到底有沒有在建置 |
| transcript.whisperx[446].start |
12734.17 |
| transcript.whisperx[446].end |
12754.437 |
| transcript.whisperx[446].text |
當時的王次長說的回覆媒體跟委員報告我們現在在健保的快預通上面都有所有診所的資料那裡面現在都建制有這個掛號費的費用收取情形那你有沒有強制登載我們有統計登載率大概98%都有登載這個掛號的這個費用嗎 |
| transcript.whisperx[447].start |
12760.568 |
| transcript.whisperx[447].end |
12775.281 |
| transcript.whisperx[447].text |
你們都有掌握這個價格的趨勢嗎?我們可以進一步分析再給委員參考。顯然你有掌握嘛,那我問你一個。你知道核心特約門診要掛號費多少錢嗎?核心診所特約掛號費。我們現在馬上查。 |
| transcript.whisperx[448].start |
12788.394 |
| transcript.whisperx[448].end |
12788.795 |
| transcript.whisperx[448].text |
那現在是怎樣? |
| transcript.whisperx[449].start |
12815.928 |
| transcript.whisperx[449].end |
12820.775 |
| transcript.whisperx[449].text |
你有沒有聽過?這樣你都不食人間煙火,不接地氣 |
| transcript.whisperx[450].start |
12831.089 |
| transcript.whisperx[450].end |
12850.555 |
| transcript.whisperx[450].text |
當時你們一絲絲施掌劉月萍受訪的時候說醫療機構不會亂漲價因為貿然漲太多也會影響病人求診的意願而且已經要求院所必須明顯標示價格萬一有聯合漲價的話會有公平會把關這樣聯合漲價跟你們都無關的 日本都叫公平會去辦理我現在問你 你說到底核心特約門診官號費多少錢 |
| transcript.whisperx[451].start |
12858.183 |
| transcript.whisperx[451].end |
12873.656 |
| transcript.whisperx[451].text |
查了?上網有這麼慢慢喔?我們的AI內閣捏AI捏阿那優先排病床繳六千部長?署長有什麼看法?核心多少集?你有APP阿,你健保課一通通有阿,我就看是真要怕了 |
| transcript.whisperx[452].start |
12886.345 |
| transcript.whisperx[452].end |
12889.247 |
| transcript.whisperx[452].text |
哎呀,你要拖時間,我這幾天的時間很懶根本就沒有,不要在這裡鬼扯了核心,然後你再查一下,查到告訴我,沒關係我再問下去部長,六千塊的寡貨費,我們優先給你排病床,你作何感想這我們的立委喔,會講的立委跟我說的我不好意思說出哪個名字 |
| transcript.whisperx[453].start |
12913.888 |
| transcript.whisperx[453].end |
12935.024 |
| transcript.whisperx[453].text |
也不好意思說出哪一家醫院,你要去查給我阿?我想健保是要,我們今天台灣會全民健保就是要保護我現在講掛號費勒,取消掛號費上限是你們做的不是在講健保,現在講取消掛號費上限是你們廢止的阿現在出現這種亂象 |
| transcript.whisperx[454].start |
12940.796 |
| transcript.whisperx[454].end |
12960.214 |
| transcript.whisperx[454].text |
六千元可以優先排病床這個作何感想啊醫療現在是怎樣?有錢可以幫我優先?不然錢沒有?對嗎?還有理會的質詢?瞭解一下沒有我是問你作何感想啊不是瞭解一下作何感想 |
| transcript.whisperx[455].start |
12964.888 |
| transcript.whisperx[455].end |
12979.938 |
| transcript.whisperx[455].text |
我接受陳情,我的好朋友的老婆已經插管了,插管可以不在家戶病房裡面,可以在急診室插管,還在急診室排病床嗎? |
| transcript.whisperx[456].start |
12981.397 |
| transcript.whisperx[456].end |
12986.159 |
| transcript.whisperx[456].text |
一般如果需要插管的病人一般都會移到急診的重症區重症區但是可能不一定馬上排得到ICU所以他有分為好幾個等級但是至少是一個特別的 |
| transcript.whisperx[457].start |
13007.109 |
| transcript.whisperx[457].end |
13026.199 |
| transcript.whisperx[457].text |
我現在...不太可能在路邊,就是說那個走道邊在插管啊對啦,所以我跟你講說,但是至少他不是在ICU裡面,也是在外面特定區域然後也是一個人來人很多人的地方啦,不是在走道,但也是在擠來擠去才會卡到的,叫你委員說你幫我安排賠償一個,已經插管了我這個白天幾天才...才遇到的陳情案件咧 |
| transcript.whisperx[458].start |
13034.889 |
| transcript.whisperx[458].end |
13060.914 |
| transcript.whisperx[458].text |
好那我現在要講就是說你們取消這個上線然後有這麼多的亂象這麼多的亂象然後呢我們現在資訊公開透明健護老婆公開透明我們都很多這個社群網站我們什麼人什麼地方的社團很多最常出現的抱怨你知道 |
| transcript.whisperx[459].start |
13061.334 |
| transcript.whisperx[459].end |
13069.178 |
| transcript.whisperx[459].text |
如果兩個小孩同時感冒同時確診,一次掛號費加部分負擔,要繳多少錢嗎?除了兩個小孩就稍微啊,如果感染確診啊,掛號費加部分負擔,去診所看而已喔。診所拿藥物幾天,你知道嗎?診所給我們小孩藥物幾天的份量,你知道嗎? |
| transcript.whisperx[460].start |
13085.765 |
| transcript.whisperx[460].end |
13095.707 |
| transcript.whisperx[460].text |
沙崗嗎?沙崗,所以沙崗要再看一天,這樣一天要看兩天,那我問你,他一次,如果兩個小孩同時生病要花多少錢?現在啦,我們說接地氣的一般診所掛號費多少錢?有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有核心,有� |
| transcript.whisperx[461].start |
13116.516 |
| transcript.whisperx[461].end |
13117.719 |
| transcript.whisperx[461].text |
我告訴你他的特約門診公佈答案兩千塊 |
| transcript.whisperx[462].start |
13125.345 |
| transcript.whisperx[462].end |
13126.807 |
| transcript.whisperx[462].text |
所以你知道我是什麼人,我是什麼人的社團當然很多人在抱怨 |
| transcript.whisperx[463].start |
13149.008 |
| transcript.whisperx[463].end |
13157.991 |
| transcript.whisperx[463].text |
所以這個部長你們說叫我們看健保快易通可是呢人家民眾也自行架設了這個地圖網頁以前我們有口罩地圖現在有連那個醫療機構掛號費調漲現況人家也做了一個地圖網頁方便更多的民眾去查詢所以我們在講說衛福部現在你們 |
| transcript.whisperx[464].start |
13177.296 |
| transcript.whisperx[464].end |
13182.421 |
| transcript.whisperx[464].text |
你們就是因約費時,你把整個掛號費的上限拿掉,當然有問題,沒有完全不能調整也是有問題但是呢,你全部都拿掉,也產生問題來了,變成階級性的啦,階級性問題的來啊,優先給掛號費付6000的 |
| transcript.whisperx[465].start |
13198.237 |
| transcript.whisperx[465].end |
13199.519 |
| transcript.whisperx[465].text |
所以我們在想說你們對定期發布公告費調查調查報告的制度面你們這個系統你用健保快移通健保快移通介面兩派用你知道嗎我就要忘記我的密碼 |
| transcript.whisperx[466].start |
13213.114 |
| transcript.whisperx[466].end |
13214.915 |
| transcript.whisperx[466].text |
因為沒有強制登記,登記的也是假的,所以你們可以依據你的大數據來跟我報告什麼? |
| transcript.whisperx[467].start |
13236.909 |
| transcript.whisperx[467].end |
13245.193 |
| transcript.whisperx[467].text |
你依據錯誤的假的數據來給立法委員報告 這個報告都是失真的啦失真的啦 好啦 保證 這樣要怎麼做 |
| transcript.whisperx[468].start |
13252.665 |
| transcript.whisperx[468].end |
13254.546 |
| transcript.whisperx[468].text |
現在你不覺得整個公共醫療都要自費系統化了嗎 這才是問題啊 |
| transcript.whisperx[469].start |
13276.974 |
| transcript.whisperx[469].end |
13300.96 |
| transcript.whisperx[469].text |
把公共醫療這個餅越做越小,把自費的系統越做越大,真的排擠了醫護人員喔,自費系統的好不好,你知不知道,你現在是要把警服門診全部普遍化,各個醫院都自費化,好不好,有夠好的,有技能,對著就很好好不好 |
| transcript.whisperx[470].start |
13302.16 |
| transcript.whisperx[470].end |
13306.963 |
| transcript.whisperx[470].text |
若沒有錢就要慢慢來擺 慢慢來擺好不夠賣 又健保秘書、保護書就要再要再要陳情 插管了還在找立委陳情這是真正的問題 這個真正的問題 癥結就是在這裡而你們沒有感覺 你們還在講說還自費不在我們的管轄 你們把自費做大 把公共醫療做小 |
| transcript.whisperx[471].start |
13331.175 |
| transcript.whisperx[471].end |
13333.677 |
| transcript.whisperx[471].text |
這是整個國家醫療體制即將崩壞公共醫療要崩壞、要瓦解這才是大問題有錢一直就是很好的待遇沒錢你就越來越壞、白越久、單越久 |
| transcript.whisperx[472].start |
13350.618 |
| transcript.whisperx[472].end |
13366.106 |
| transcript.whisperx[472].text |
這樣你們作何感想?我們可以看整個全國在公告的醫療收入幾乎大部分的醫學中心都是負的 |
| transcript.whisperx[473].start |
13367.006 |
| transcript.whisperx[473].end |
13390.054 |
| transcript.whisperx[473].text |
如果不是靠那個美食街跟那個停車場,恐怕他是沒辦法養他這個醫院的教研、教學研究,或者甚至如果要蓋個大樓﹖那跟自費市場做大工﹖所以變成這個,如果以臺大醫院的自費市場就是那個美食街﹖自費市場不是美食街啊﹖ |
| transcript.whisperx[474].start |
13390.094 |
| transcript.whisperx[474].end |
13392.515 |
| transcript.whisperx[474].text |
臺大當然是不典型你怎麼不去講說這個中醫大你怎麼不去講那些私立的這些財團法人醫院長庚 |
| transcript.whisperx[475].start |
13413.346 |
| transcript.whisperx[475].end |
13417.13 |
| transcript.whisperx[475].text |
政治、社營、細胞治療、細胞治療,那這樣的話你點值就要增加囉,你在講點值喔!所以你是認為他們的掛號費上漲調漲是應該的囉? |
| transcript.whisperx[476].start |
13434.656 |
| transcript.whisperx[476].end |
13453.049 |
| transcript.whisperx[476].text |
你是這個意思嗎?你支持他,因為他的正規醫療的收入都是負的,所以你是要支持關號會再調漲,然後點值要增加嗎?你是這個意思嗎?你今天扯這個是要讓他再增加嗎?關號會還是有彼此競爭的啦,不可能說我們同一條街上,你如果是我整個就沒人要去了嘛 |
| transcript.whisperx[477].start |
13457.793 |
| transcript.whisperx[477].end |
13468.486 |
| transcript.whisperx[477].text |
不說那不死人間煙火的話,一星期兩個孩子生病要看病情後,其實對很多人負擔是很重的,真的 |
| transcript.whisperx[478].start |
13470.742 |
| transcript.whisperx[478].end |
13473.843 |
| transcript.whisperx[478].text |
那對有錢人來不會去那裡看啦有錢人不會這樣看好啦我看喔其實醫療的成本喔醫療的成本也相當高啦有錢人的這個自費醫療齁一開下去什麼都沒問題他們哪有那個單秘藏的問題他們哪有那個單檢測的擺落骨的問題都衰去衰走 |
| transcript.whisperx[479].start |
13493.09 |
| transcript.whisperx[479].end |
13497.092 |
| transcript.whisperx[479].text |
有錢人的自費醫療都沒問題啦自費醫療本來就沒問題,服務多好我現在再說永豐化學啦永豐化學大財團不要忘了他們當時被你們調造停止生產的原因你還記得嗎?部長 |
| transcript.whisperx[480].start |
13511.243 |
| transcript.whisperx[480].end |
13521.609 |
| transcript.whisperx[480].text |
實驗數據造假組成費有效性不足內有汙染物、懸浮汙染物大家今天講說什麼時候可以復工可以恢復生產然後你們的前署長有預知這個能力他說10月前會復工以過去永豐化學過去的不良紀錄來看我們非常不樂見政府所長因為輿論壓力所以對永豐化學查場複查放水 |
| transcript.whisperx[481].start |
13540.538 |
| transcript.whisperx[481].end |
13543.041 |
| transcript.whisperx[481].text |
而新的署長今天很聰明的要告辭都不用來我們也期許他要大破大立不要讓這種大財團永豐於集團的永豐化學當初一家數據造假 |
| transcript.whisperx[482].start |
13556.698 |
| transcript.whisperx[482].end |
13569.648 |
| transcript.whisperx[482].text |
他當初主成份感給他有效性不足當初他有汙染物、懸浮物、不怕病人死這樣做出來大家用市佔率可以達到八成這政府都沒錢人嘛所以再用對藥廠的包庇 |
| transcript.whisperx[483].start |
13573.971 |
| transcript.whisperx[483].end |
13579.255 |
| transcript.whisperx[483].text |
因尋苟且,到現在看到政府處分了,可是民眾要飽受缺藥,使用不良藥品之苦。 |
| transcript.whisperx[484].start |
13605.366 |
| transcript.whisperx[484].end |
13623.761 |
| transcript.whisperx[484].text |
6月5號質詢,今天7月1號將近1個月,您有在想嗎?您有要做嗎?報告委員,我們事實上都有一直在盤查相關的名單那目前主要是法列在這個以國內重要醫療第一線重要急需然後許可證我現在沒有在講這個本來 |
| transcript.whisperx[485].start |
13625.442 |
| transcript.whisperx[485].end |
13629.025 |
| transcript.whisperx[485].text |
依據藥事法第27條之2的規範的必要藥品481項清單你們是到去年為止有一份清單是去年的到現在像要27條之2規範的書意根本不在這個裡面 |
| transcript.whisperx[486].start |
13645.396 |
| transcript.whisperx[486].end |
13670.876 |
| transcript.whisperx[486].text |
我也不跟你談輸液 怎麼樣談 我要談制度面的管理所以我在講的兩個要點保定625號我質詢就講這兩個要點第一個 它不在27條之2的規範裡面但是藥品市佔率不均 或者是原料益生短缺那這一些藥品的管理管制方法和手段你要怎麼管 那你要怎麼處理 |
| transcript.whisperx[487].start |
13672.037 |
| transcript.whisperx[487].end |
13672.537 |
| transcript.whisperx[487].text |
報告委員我們經過這樣盤點下來有9家藥廠跟16張許可證 |
| transcript.whisperx[488].start |
13702.189 |
| transcript.whisperx[488].end |
13706.852 |
| transcript.whisperx[488].text |
9家藥廠16張許可證是什麼藥品的品名?包含石泉浮沫傳定非泥以非零點研議然後萬博梅素懸疑用粉劑 |
| transcript.whisperx[489].start |
13725.3 |
| transcript.whisperx[489].end |
13740.89 |
| transcript.whisperx[489].text |
約克康靜脈注射液、信東舒凱1.47%氯化鈣溶液、連續性血液過濾補充液甲信東、劍橋雙氰昆皮注射液2毫克毫升、二薩西磷注射劑 |
| transcript.whisperx[490].start |
13743.706 |
| transcript.whisperx[490].end |
13770.783 |
| transcript.whisperx[490].text |
信東煉霉酥注射劑1克赤芙勒素口服懸疑用顆粒25毫克毫升蘇德林西入疫2毫克毫升立刻眼用眼膏阿雷匹阿沁注射液優良優次定注射液2.5公司公錯所以不是9項喔報告委員我們講徐國泰因為他剛剛是有不同劑好沒關係那我現在問你他們市佔率有多高 |
| transcript.whisperx[491].start |
13771.889 |
| transcript.whisperx[491].end |
13781.272 |
| transcript.whisperx[491].text |
我們在當初篩的時候都是以市佔率超過60%在篩對啊這些藥都很普遍很普通都老藥都舊藥聽起來是很長輩的人所以你們盤點這幾個有可能會那個所以你要去預警然後發生問題會怎麼樣那我們現在的意思是說 |
| transcript.whisperx[492].start |
13793.596 |
| transcript.whisperx[492].end |
13798.223 |
| transcript.whisperx[492].text |
不可以事後還這樣無動於衷若是輸疫的事用風這件事看起來就是無動於衷但是保證你在6月5日我給你質詢的時候你有說因為您次長和醫界比較合 |
| transcript.whisperx[493].start |
13810.54 |
| transcript.whisperx[493].end |
13827.035 |
| transcript.whisperx[493].text |
他想要趕快安撫醫界的心啊所以都急著發臉書啦讓大家知道說要怎麼做真是用心良苦啊這是你說的嘛那我們看一下啦他的確老實說人家次長在自己的臉書講的我在這裡講他講的都沒錯 |
| transcript.whisperx[494].start |
13829.017 |
| transcript.whisperx[494].end |
13832.141 |
| transcript.whisperx[494].text |
5月20講的建立關鍵和寡占藥品的安全備援機制平衡廠商在市場的占比5月22講的要建立預警和輔導平衡機制對市占部軍會原料益生短缺的他講的都沒錯喔然後這樣子 |
| transcript.whisperx[495].start |
13847.919 |
| transcript.whisperx[495].end |
13873.698 |
| transcript.whisperx[495].text |
5月29也講要提出後續的檢討機制盤點高風險的這個問題等等然後要降低獨佔市場斷貨風險和建立調度的機制好來這個部長如果發臉書比較快那安撫大家的心講話講的都是正確這麼漂亮用心良苦那我要問你這些你們都開始做了嗎 |
| transcript.whisperx[496].start |
13875.745 |
| transcript.whisperx[496].end |
13878.888 |
| transcript.whisperx[496].text |
如果被檢視的時候,什麼都沒做呢?那我問你,這個高風險,他一直在講高風險,你們的定義裡面,講得很漂亮很漂亮的話都很會講,那你先告訴我你們定義的高風險藥品是什麼?高風險藥廠啦,有高風險的定義是什麼?你們有盤點出哪些藥廠是高風險的嗎? |
| transcript.whisperx[497].start |
13899.895 |
| transcript.whisperx[497].end |
13904.239 |
| transcript.whisperx[497].text |
報告委員我們盤點最主要是要看最近3年內他的GMP違規的狀況以及產品有沒有不良品回收通報 |
| transcript.whisperx[498].start |
13921.834 |
| transcript.whisperx[498].end |
13928.7 |
| transcript.whisperx[498].text |
你講的剛剛好捏我就講了永豐永豐他們有嚴重違反GMP的記錄嗎永豐書意報告委員永豐最近三年的話他的嚴重違反GMP就是今年我們我們對啊所以過去三年都沒有欸只有這一次欸所以你們高風險指標就以高風險指標為這最近三年嚴重違反GMP來講永豐在這一次以前的過去三年通通都沒有 |
| transcript.whisperx[499].start |
13952.613 |
| transcript.whisperx[499].end |
13955.115 |
| transcript.whisperx[499].text |
9間高風險的藥廠 這一宗市佔率超過六成的藥品你這樣未來要怎麼管理 要怎麼樣 |
| transcript.whisperx[500].start |
13981.479 |
| transcript.whisperx[500].end |
14001.288 |
| transcript.whisperx[500].text |
報告委員未來第一個我們在他就是在他的這個製造許可到期前原來是6個月以前要提出申請我們現在要求他在9個月前就要提出申請讓我們可以這樣就可以降低獨佔市場了另外我們會更其他人沒有在生產的那替代性怎麼來報告委員那個替代的部分我們會鼓勵其他的藥廠 |
| transcript.whisperx[501].start |
14002.812 |
| transcript.whisperx[501].end |
14029.149 |
| transcript.whisperx[501].text |
沒有人要做了跟這次一樣沒有人要做了若是市佔率高的都有一個共同價共同策略當初用低價的策略擴大市場的佔有率然後成為壟斷或獨佔然後政府就要記載它當初是用這種策略但是現在因為這個價格這樣競爭競爭未果其他業區都沒了你們在介紹給到這種人他才把他的有效性降低做出劣質藥 |
| transcript.whisperx[502].start |
14030.47 |
| transcript.whisperx[502].end |
14036.199 |
| transcript.whisperx[502].text |
但人們不願意做這種有聘啊：所以跟這種高風險藥材的人不願意一樣的競爭啊：所以呢,現在次長在那裡,寫臉書很快、講漂亮話、講場面話都很快,用心良苦 |
| transcript.whisperx[503].start |
14045.914 |
| transcript.whisperx[503].end |
14050.998 |
| transcript.whisperx[503].text |
我們的內閣被人家嘲笑是外星人內閣我們衛福部會不會被人家嘲笑是太空人內閣所以現在我們的意思是說引起這個很大的問題不管是我剛剛講了掛號費的問題或者是這個書我不是講書意我講的是藥品市占不均原物料一生短缺的藥品名單還有你管理這些高風險藥廠 |
| transcript.whisperx[504].start |
14074.974 |
| transcript.whisperx[504].end |
14075.174 |
| transcript.whisperx[504].text |
好啦 部長就是說齁 |
| transcript.whisperx[505].start |
14095.151 |
| transcript.whisperx[505].end |
14095.912 |
| transcript.whisperx[505].text |
接下來請李彥秀委員發言 |
| transcript.whisperx[506].start |
14121.434 |
| transcript.whisperx[506].end |
14121.594 |
| transcript.whisperx[506].text |
請出副長 |
| transcript.whisperx[507].start |
14147.45 |
| transcript.whisperx[507].end |
14153.174 |
| transcript.whisperx[507].text |
為了因應健保點值的修法我們最近有提到未來要成立癌藥的基金未來用公務預算撥補包括除了癌藥基金之外還有公共衛生性質相關的項目未來都有可能用公務預算 |
| transcript.whisperx[508].start |
14176.61 |
| transcript.whisperx[508].end |
14194.415 |
| transcript.whisperx[508].text |
那部長這個部分因為這牽涉到9月份我們馬上就要處理這個健保總額的協商還有下個會期我們就要審查預算到底這一塊你心裡有沒有去跟行政院或跟主席處溝通過未來大概要拿多少錢出來 |
| transcript.whisperx[509].start |
14196.98 |
| transcript.whisperx[509].end |
14221.818 |
| transcript.whisperx[509].text |
如果是明年的癌藥基金就大概60億60億然後那個因為第三年才會100億嘛因為一需要啦其實今年才24億嘛不是說一下子就馬上需要那明年到底多少明年就60億嘛60億那公共預算嗎公共衛生性質的公共衛生預算現在兩個第一個我再說一次我今天說很多次了第一個就是 |
| transcript.whisperx[510].start |
14223.059 |
| transcript.whisperx[510].end |
14234.085 |
| transcript.whisperx[510].text |
有些其他的補助都把它塞到應該政府要給健保36%的那個部分這個把它清出來大概可以大概130幾億應該140億左右 |
| transcript.whisperx[511].start |
14239.528 |
| transcript.whisperx[511].end |
14246.692 |
| transcript.whisperx[511].text |
所以明年從健保可以挖出140億減少140億其他用140億不要把我們算過來這是健保應該是給健保的啦這個部分那個就可以多140億然後有一些過去就是部長我問清楚140億是公共衛生性質的預算60億是癌藥基金的預算加起來200億60億所以加起來200億那個是獨立的啦那個獨立為了這個基金嘛對 |
| transcript.whisperx[512].start |
14269.304 |
| transcript.whisperx[512].end |
14271.605 |
| transcript.whisperx[512].text |
因為這個會牽涉到未來9月份我們健保協商的時候到底我們有多少錢可以拿出來再做分配 |
| transcript.whisperx[513].start |
14288.783 |
| transcript.whisperx[513].end |
14297.899 |
| transcript.whisperx[513].text |
好 現在講的都是收入要讓整個健保的大水庫嘛能夠增加嘛那...就剛才你剛才跟我說你...因為那個三條路拍這個會用八四英啦 |
| transcript.whisperx[514].start |
14302.401 |
| transcript.whisperx[514].end |
14318.686 |
| transcript.whisperx[514].text |
133億嘛然後另外就是我們開始清一些過去用健保其實應該用公務預算的這可能一年可以清出分三年把它完成一年大概可以清100出頭億應該沒有問題所以這兩個就應該有可以多200億 |
| transcript.whisperx[515].start |
14324.048 |
| transcript.whisperx[515].end |
14328.191 |
| transcript.whisperx[515].text |
部長我延續一下剛剛林淑芬委員的質詢其實這個部分也是缺藥跟缺人我們大家也都知道這個是吳署長最後下台最主要的原因 |
| transcript.whisperx[516].start |
14344.662 |
| transcript.whisperx[516].end |
14360.286 |
| transcript.whisperx[516].text |
無論在這一段時間無論這些用藥的缺藥的狀況缺人缺藥這個是醫界長期的狀況但是最近的缺藥是特別的嚴重那部長你看一下我下一張這個是在今年的一年前112年的2月27號當時缺藥所提出來的解決方案一樣是分短中長期 |
| transcript.whisperx[517].start |
14366.408 |
| transcript.whisperx[517].end |
14366.508 |
| transcript.whisperx[517].text |
主席 |
| transcript.whisperx[518].start |
14393.237 |
| transcript.whisperx[518].end |
14421.569 |
| transcript.whisperx[518].text |
廣佔市場市佔率高但是都是廣佔市場我們衛福部處理的方向是什麼你們剛剛說你們會設立高風險但是我憑良心講衛福部長期就是廣佔市場的幫兇為什麼我們會讓這些單一市場超過六成也好超過八成也好我們解決他們變單一市場的方式解決的方案到底是什麼這也是剛才林淑芬也關注的重點也是我今天要關注的方向 |
| transcript.whisperx[519].start |
14422.429 |
| transcript.whisperx[519].end |
14433.679 |
| transcript.whisperx[519].text |
我們常常在講說任性臺灣任性臺灣但是我們連一個生理食鹽水供給的方式都這麼的脆弱我們在疫情時間我們強化說我們自己臺灣can help我們現在變成臺灣needs help |
| transcript.whisperx[520].start |
14437.955 |
| transcript.whisperx[520].end |
14454.424 |
| transcript.whisperx[520].text |
所以外界才會批評我們在缺藥的狀況我們好像是太空人的內閣狀況 我不希望這個是由衛福部掛解 因為我知道你很用心 部長我知道你很用心但是解決的方法到底是什麼 不對嗎 |
| transcript.whisperx[521].start |
14458.016 |
| transcript.whisperx[521].end |
14484.628 |
| transcript.whisperx[521].text |
我想這個缺藥的原因太多了所以真的是要抽絲剝繭但是你們之前還花了3億要好好的妥善這個藥價要好好的用藥價的調整讓更多人願意進來這個市場我們還花了公務預算花了健保花了3億元來解決解決的結果等於是0所以我才會說你交了一張白券可不可以請那個健保署跟那個食藥署 |
| transcript.whisperx[522].start |
14486.3 |
| transcript.whisperx[522].end |
14511.172 |
| transcript.whisperx[522].text |
最近大家努力的一個跟委員報告過去有些缺藥他是屬於原廠藥的這個退出啦那都有國內的學名藥或者是相關的替代藥品你不用跟我講過去我剛才列一大堆藥無論是白內障的用藥柯寧優尼利普陀還有兒童的止吐止瀉藥這些東西啊連最近的這個輸液其實狀況都擺在眼前啊 |
| transcript.whisperx[523].start |
14515.461 |
| transcript.whisperx[523].end |
14527.491 |
| transcript.whisperx[523].text |
前面這些藥都是有替代藥品就是學名藥可以這些都是學名藥可以用的那麼輸液是因為短期的產線出了問題那這個已經有從這個專案的進口那麼調整這個價格去增加國內的產量這個多軌在進行 |
| transcript.whisperx[524].start |
14536.879 |
| transcript.whisperx[524].end |
14561.172 |
| transcript.whisperx[524].text |
這個市井永豐化學藥廠它寡占市占率用的這麼頻繁然後它又是寡占市場你們在停掉的時候它固然違反GMP我也覺得執行的沒錯但是你們都沒有去做完整的規劃跟處理才會造成今天的狀況平常其他的缺藥你們都有市井的狀況但是缺藥的狀況還是非常的頻繁 |
| transcript.whisperx[525].start |
14562.541 |
| transcript.whisperx[525].end |
14587.727 |
| transcript.whisperx[525].text |
這個就是今天攤在這邊問題所在所以你今天很然很顯然你沒有辦法說服所有今天來質詢這麼多的委員關注臺灣現在缺藥的問題這就是你們最大的責任跟過失在這裡所以部長我們還是期待各位說明齁我們健保一共給付的藥品超過一萬三千多項但是每年會有這樣的缺藥的情形那個數目相較之下是少的啦 |
| transcript.whisperx[526].start |
14589.616 |
| transcript.whisperx[526].end |
14595.7 |
| transcript.whisperx[526].text |
我完全瞭解到醫療驗手我很敬佩這個委員真的很瞭解醫療驗手的狀況醫療驗手很希望給人民最好最周全的藥如果缺藥他們真的也都有反應到我們這邊來這個問題還是存在的所以我們一定用心去研議 |
| transcript.whisperx[527].start |
14619.634 |
| transcript.whisperx[527].end |
14620.254 |
| transcript.whisperx[527].text |
謝謝主席 本席請邱部長 |
| transcript.whisperx[528].start |
14652 |
| transcript.whisperx[528].end |
14679.994 |
| transcript.whisperx[528].text |
委員好部長好本席知道今天因為我們在談健保合理支付以及保障醫護人員收入這個議題剛剛這個提早到也聽到前面幾位委員質詢也許有些問題可能您說您講很多次了但可能不一定每個委員這個剛好都有這樣坐著聽那首先本席想就我們今天講健保合理支付 |
| transcript.whisperx[529].start |
14680.734 |
| transcript.whisperx[529].end |
14694.803 |
| transcript.whisperx[529].text |
以及保障醫護人員收入我們召委會提這個議題我想應該就是這樣的問題在台灣我聽到很多人講我們應該這也已經如果再不解決應該會是國安問題 |
| transcript.whisperx[530].start |
14697.185 |
| transcript.whisperx[530].end |
14697.325 |
| transcript.whisperx[530].text |
委員會主席 |
| transcript.whisperx[531].start |
14716.104 |
| transcript.whisperx[531].end |
14716.284 |
| transcript.whisperx[531].text |
藍總統上任後 |
| transcript.whisperx[532].start |
14733.61 |
| transcript.whisperx[532].end |
14735.411 |
| transcript.whisperx[532].text |
臺灣邁向健康大國永續發展論壇您應該也在場吧?您主辦的好像 |
| transcript.whisperx[533].start |
14762.63 |
| transcript.whisperx[533].end |
14788.867 |
| transcript.whisperx[533].text |
我不是主辦,但是我有在場您在場那當時我們的這個現在的賴總統就說經費方面應該要有健保安定基金還有醫療支出要佔GDP的比例要提高所以呢現在我們賴總統在這個拿到40%左右的選票當選了 |
| transcript.whisperx[534].start |
14790.248 |
| transcript.whisperx[534].end |
14798.633 |
| transcript.whisperx[534].text |
所以首先本席想請教賴總統就職還有新內閣上路請問你們有就這個部分有共識嗎報告委員那個其實 |
| transcript.whisperx[535].start |
14803.772 |
| transcript.whisperx[535].end |
14828.855 |
| transcript.whisperx[535].text |
在除了在提白皮書以後當選在賴總統當選了以後馬上召開了六場全國性的那個可以說是健康臺灣的這個本席在總質詢的時候這個大概有一千兩百多位醫療方面的專家參加了這六場提供了十大策略以及十大建言 |
| transcript.whisperx[536].start |
14829.755 |
| transcript.whisperx[536].end |
14855.098 |
| transcript.whisperx[536].text |
我問的是總統跟您就我們現在健保的問題還有這個醫事人員合理的薪資的部分你們有共識怎麼解決這個長期的問題嗎包含醫界四大皆空包含現在醫護人員不夠今天很多委員都提出來然後關病床的關病房的這個問題這個全部在相關的策略裡面可能沒辦法有實驗意義 |
| transcript.whisperx[537].start |
14855.838 |
| transcript.whisperx[537].end |
14867.286 |
| transcript.whisperx[537].text |
你們有共識嗎?首先您先回答,您跟總統有共識嗎?因為這是一千多個EJ,也都是我過去幾十年來的老戰友我不是問那個論壇,我是問賴總統,他擔任一個總統,他要怎麼解決台灣現況的問題?跟您現在受命為衛福部長 |
| transcript.whisperx[538].start |
14877.233 |
| transcript.whisperx[538].end |
14878.676 |
| transcript.whisperx[538].text |
建保安定基金這個部分是賴總統提出來,現在你們打算怎麼樣? |
| transcript.whisperx[539].start |
14890.063 |
| transcript.whisperx[539].end |
14908.399 |
| transcript.whisperx[539].text |
好 健保安定基金最重要的目的其實是穩定健保的一個不是 那這樣你這樣扯我的時間已經夠少了那再來你醫療支出佔GDP的比例提高首先本席先我想你也知道本席要在這邊講 |
| transcript.whisperx[540].start |
14909.5 |
| transcript.whisperx[540].end |
14932.674 |
| transcript.whisperx[540].text |
我們台灣2021年醫療支出佔GDP的比例整個我們的健保6.5620227.52023只有6所以我們的賴總統說要提高所有的發達國家都在10%以上我相信您很了解韓國也有8%以上 |
| transcript.whisperx[541].start |
14933.354 |
| transcript.whisperx[541].end |
14933.494 |
| transcript.whisperx[541].text |
指揮官 |
| transcript.whisperx[542].start |
14953.917 |
| transcript.whisperx[542].end |
14955.438 |
| transcript.whisperx[542].text |
我相信GDP一定有相當的成長 |
| transcript.whisperx[543].start |
14980.12 |
| transcript.whisperx[543].end |
14990.409 |
| transcript.whisperx[543].text |
你不能相當啊你但是到底會提升到幾%GDP增長我們是指佔GDP的幾%你們有共識是幾%以上你要提高到多少你總要有個目標努力吧或是你們在進行的時候你說有共識可是我又問不出來 |
| transcript.whisperx[544].start |
15003.083 |
| transcript.whisperx[544].end |
15026.002 |
| transcript.whisperx[544].text |
好再來再來最後我相信您應該知道我們整個醫療八大團體他們不斷的陳情那一定有向您陳情嘛大家也講到包含我們立法院委員們這個健保的點值的問題固定點值或浮動點值的部分還有健保總額總額點值總額的部分那現在 |
| transcript.whisperx[545].start |
15026.943 |
| transcript.whisperx[545].end |
15043.421 |
| transcript.whisperx[545].text |
如果不談總額那因為你們要用這個一些公務預算各方面去補嘛那現在想請問我們是不是可以這個健保的浮動點值我們定一個下限然後讓他浮動在這個下限之上可以嗎 |
| transcript.whisperx[546].start |
15046.975 |
| transcript.whisperx[546].end |
15069.253 |
| transcript.whisperx[546].text |
大家的期望就是定底線是1嘛其實我們當時總額的一個概念就是希望就是會有點子的一個起伏啦那當然點子太低的話我問的是下限我們可不可以把下限定在1嘛下限定在1喔然後你去往上浮動 |
| transcript.whisperx[547].start |
15071.53 |
| transcript.whisperx[547].end |
15096.397 |
| transcript.whisperx[547].text |
這個這個下限定到1恐怕以現在的情況要增加很多很多的預算喔恐怕是比較困難啦那你們希望多少我看好像去年去年有在喊0.95以上下限不要低於0.95去年是這樣啦去年是補到那個0.9啦齁那個那大概那個時候要花了100將近100億齁 |
| transcript.whisperx[548].start |
15098.698 |
| transcript.whisperx[548].end |
15122.448 |
| transcript.whisperx[548].text |
所以因為那個時候第二季第三季第四季都相當的低那今年的第一季其實也是跟去年差不多所以這個部分可能一屆也要努力所以我們現在就是說天時地利就是因為我們的總統賴總統還有您也是一屆出來的所以有沒有可能我們浮動點值的下限就0.95以上或是1以上嗎 |
| transcript.whisperx[549].start |
15127.181 |
| transcript.whisperx[549].end |
15128.182 |
| transcript.whisperx[549].text |
我們希望邱部長莫忘初衷也希望我們的賴總統莫忘競選承諾 |
| transcript.whisperx[550].start |
15148.624 |
| transcript.whisperx[550].end |
15173.478 |
| transcript.whisperx[550].text |
我更期待就是在您以及整個行政院團隊特別我們賴總統領導之下我們醫界的這種各種的情況大家很憂心的我們能夠改善而且臺灣的健保能夠持續永續的讓大家有最好的醫療環境當然當然我們一起努力你們只要做 |
| transcript.whisperx[551].start |
15174.358 |
| transcript.whisperx[551].end |
15176.079 |
| transcript.whisperx[551].text |
謝謝主席以及各位先進,有請衛福部的邱部長 |
| transcript.whisperx[552].start |
15202.136 |
| transcript.whisperx[552].end |
15218.022 |
| transcript.whisperx[552].text |
主席 委員好部長你久待我第一次跟你諮詢為什麼要來跟你諮詢因為過去你8年在立法院給人家的印象就是人人好阿阿阿阿阿阿阿阿阿阿阿阿阿阿阿阿阿 |
| transcript.whisperx[553].start |
15226.026 |
| transcript.whisperx[553].end |
15235.318 |
| transcript.whisperx[553].text |
大家都覺得你真有道理那個意思言外之意就是你沒什麼魄力這次你把吳秀美開掉我跟你說讚有魄力喔所以我就覺得說 |
| transcript.whisperx[554].start |
15241.614 |
| transcript.whisperx[554].end |
15261.832 |
| transcript.whisperx[554].text |
吳秀梅這個老實講是衛福部的一個毒瘤在那裡7年了齁她不下來她犯了錯慶祝難輸啊光那個EUA過程當中一塌糊塗然後這個疫苗的問題這個完全就是意識形態在失真齁 |
| transcript.whisperx[555].start |
15263.293 |
| transcript.whisperx[555].end |
15264.934 |
| transcript.whisperx[555].text |
市長提出辭呈還是你給他就是想辦法讓他走? |
| transcript.whisperx[556].start |
15282.559 |
| transcript.whisperx[556].end |
15302.219 |
| transcript.whisperx[556].text |
這也人生規劃啦他跟你提辭成了嗎?回去那個因為要回去規定要做嘛七年還沒有到啊八年才到啊戒掉都才安捏啊一任四年啊戒掉一次四年可以八年總共可以八年啊對不對這你們應該可以不必回到我是說我是說覺得說你 |
| transcript.whisperx[557].start |
15305.682 |
| transcript.whisperx[557].end |
15332.801 |
| transcript.whisperx[557].text |
你做這個是正確的但是呢我是高度質疑的以你的個性你也不會得罪人的啊當然是一定是民進黨高層叫你動刀啊很簡單就是這樣啊對不對很簡單就是這樣啊不然的話他提詞你應該不准啊因為背後老闆要他居住現在是背後老闆不要他做對不對背後老闆不要他做他犯了太多錯誤 |
| transcript.whisperx[558].start |
15334.521 |
| transcript.whisperx[558].end |
15360.393 |
| transcript.whisperx[558].text |
這個東西今天沒有時間細講好回過來今天的主題問題這個你講健保現在0.9有多0.9嗎有些醫學中心只有0.8多勒對吧台大多少你告訴我台大台大台大一點多少錢來講一下現在嗎平均點值都超過台大多少你講基層一點台大一個點一點幾塊錢對啊都超過0.9 |
| transcript.whisperx[559].start |
15365.191 |
| transcript.whisperx[559].end |
15371.742 |
| transcript.whisperx[559].text |
醫院乳以平均點子是有超過0.9啦臺大我知道是0.8多而已,農總也0.8多沒有0.9那個是浮動點子來來來講一下講一下 |
| transcript.whisperx[560].start |
15380.781 |
| transcript.whisperx[560].end |
15385.165 |
| transcript.whisperx[560].text |
第一季台北區是平均點值0.91,北區是0.95醫院醫院的部分來來我看醫院,基層基層就對了 |
| transcript.whisperx[561].start |
15407.557 |
| transcript.whisperx[561].end |
15417.523 |
| transcript.whisperx[561].text |
這是全國啦,但是基層是比較低啦,0.86,但是有些地方比較高,有些區比較低啦所以我也不用親自說說,這樣糊弄大家,賴總統是希望一塊錢,不要什麼點,就是錢啦,萬年,萬年,今天最少一塊 |
| transcript.whisperx[562].start |
15436.906 |
| transcript.whisperx[562].end |
15440.108 |
| transcript.whisperx[562].text |
什麼時候可以達到?什麼時候可以達到?你要定一個目標,你說你要達到,你不要保障繼續做啊!保障一直做下去啊!你說三年以後,三年以內給你做保障啊!我們當然都很希望...希望繼續做保障就對了但是要考慮到整個總額的精神跟民眾的負擔你告訴我一個努力目標什麼時候你努力目標? |
| transcript.whisperx[563].start |
15465.435 |
| transcript.whisperx[563].end |
15466.055 |
| transcript.whisperx[563].text |
一塊錢不要1.1,一點點一塊就好 |
| transcript.whisperx[564].start |
15482.421 |
| transcript.whisperx[564].end |
15485.144 |
| transcript.whisperx[564].text |
那你現在看0.86那你0.9是地板什麼時候可以做到0.90.8是這樣子喔 |
| transcript.whisperx[565].start |
15507.526 |
| transcript.whisperx[565].end |
15524.905 |
| transcript.whisperx[565].text |
那是不一樣,像台北區就比較低你如果以平均點子來講的話,0.9差不多台灣六區有兩區是沒有達到其他四區是有達到什麼時候可以六區全部達到 |
| transcript.whisperx[566].start |
15526.238 |
| transcript.whisperx[566].end |
15552.354 |
| transcript.whisperx[566].text |
那這個要牽涉到那個不太一樣啦因為各有各的說辭所以你沒辦法給我答案喔零點酒都保不到你又幾塊錢聽完預談補你零點酒是用負來去補啦去補的啦補下100億齁要把所有的醫院跟基層都給他加零點酒啦所以要補加零點酒並不是困難的事情 |
| transcript.whisperx[567].start |
15553.713 |
| transcript.whisperx[567].end |
15558.534 |
| transcript.whisperx[567].text |
第二個問題喔,你剛剛有提到,我不曉得你有沒有聽錯,請你再講一遍喔,未來兩年內不會漲健保費,是不是這樣? |
| transcript.whisperx[568].start |
15576.576 |
| transcript.whisperx[568].end |
15578.477 |
| transcript.whisperx[568].text |
明年我們全力讓它不要漲 |
| transcript.whisperx[569].start |
15610.836 |
| transcript.whisperx[569].end |
15626.941 |
| transcript.whisperx[569].text |
因為我們的安全準備金還夠,大概有兩個月,所以基本上應該今年跟明年都不至於漲除非大家在健康,如果你健康投資要多一點的話,那當然又另當一回事喔 |
| transcript.whisperx[570].start |
15627.441 |
| transcript.whisperx[570].end |
15643.222 |
| transcript.whisperx[570].text |
你一年支出多少?一年的健保支出多少?今年是八千七百億,明年大概會一估九千億左右,是有成長率的 |
| transcript.whisperx[571].start |
15645.665 |
| transcript.whisperx[571].end |
15647.827 |
| transcript.whisperx[571].text |
現在不是已經要求了嗎? |
| transcript.whisperx[572].start |
15676.425 |
| transcript.whisperx[572].end |
15676.747 |
| transcript.whisperx[572].text |
委員會主席 |
| transcript.whisperx[573].start |
15679.739 |
| transcript.whisperx[573].end |
15705.534 |
| transcript.whisperx[573].text |
根據藥物優良製造以及西藥優良營銷準則,這個其實就是minimum的,全世界都這樣子,我們的再生療法沒有把這個菸皮加進來,為什麼?因為目前屬於商品類的東西、產品類的東西都是屬於要走自給那條路,那如果說目前是自提的部分的話,就是自給 |
| transcript.whisperx[574].start |
15706.414 |
| transcript.whisperx[574].end |
15707.114 |
| transcript.whisperx[574].text |
GDP是比較低的啊 |
| transcript.whisperx[575].start |
15722.044 |
| transcript.whisperx[575].end |
15732.11 |
| transcript.whisperx[575].text |
今天部長講了很多的努力目標,要不要把這個當作你未來的努力目標,未來就是通通要GMP,這樣子來講的話其實在國際跟國際接軌,國際都有GMP啊,同意嗎?努力目標可以吧? |
| transcript.whisperx[576].start |
15747.688 |
| transcript.whisperx[576].end |
15748.389 |
| transcript.whisperx[576].text |
這個要看臨床實際上的狀況,臨床就需要 |
| transcript.whisperx[577].start |
15756.315 |
| transcript.whisperx[577].end |
15782.43 |
| transcript.whisperx[577].text |
是不是會影響到他用到病人的權利?那就不要做啊!如果這樣就不要做!因為你可以想打到貓、狗、豬上面都要GMP打到人要求GMP,這就奇怪了!那個是大量的致記啦!這是客製化的基金對他的細胞提出來,還用他嘛!所以你沒有用到,基本上是沒有用到其他人的身上所以他跟致記大量的不太一樣 |
| transcript.whisperx[578].start |
15782.97 |
| transcript.whisperx[578].end |
15806.015 |
| transcript.whisperx[578].text |
可是其他國家都要求,你去主委講跟委員報告,其實日本跟我們現在的制度有點相似,也就是雙軌制有一些是比較低風險的,個人使用,自己的細胞自己回輸的,是客製化少量自己的細胞就是GDP,但是大量的就是GMP對,如果商品化,液體的使用,那個就是GMP這樣的話沒有寫進來啊 |
| transcript.whisperx[579].start |
15808.035 |
| transcript.whisperx[579].end |
15808.555 |
| transcript.whisperx[579].text |
接下來請陳穎委員發言 |
| transcript.whisperx[580].start |
15847.843 |
| transcript.whisperx[580].end |
15875.12 |
| transcript.whisperx[580].text |
謝謝主席,麻煩請部長,請邱部長委員好部長好,我們先來看一下這個TVBS的這個新聞的專題報告會不會為此也估算了一下這一項修正草案,恐怕還要多加300多億元的預算,雖然美情營銷讓有長輩需要照顧的家庭可以減輕負擔,但如果未來保費入不敷出,是不是又要調漲年輕世代的健保費? |
| transcript.whisperx[581].start |
15876.341 |
| transcript.whisperx[581].end |
15883.146 |
| transcript.whisperx[581].text |
其實在特別預算的支持再加上補充保費讓健保連續5年的赤字終於在2022年由戶轉好那個我想這樣 |
| transcript.whisperx[582].start |
15895.953 |
| transcript.whisperx[582].end |
15905.416 |
| transcript.whisperx[582].text |
本工資、軍工教條新、投保金額上限調整以及景氣回升、稅收比預期好、提高收入、擺脫負數來到103億、2023更創下了8年來新高344億,尤其是補充保費的意助 |
| transcript.whisperx[583].start |
15913.379 |
| transcript.whisperx[583].end |
15941.47 |
| transcript.whisperx[583].text |
立委提出老人福利法修正草案增訂綜合所得稅20%以下的65歲長者免繳交健保費估算要花到359億元衛福部憂心法案通過後保費短收節於右邊負數醫改會認為恐怕會加速健保破產我們的醫療資源的分布包含就醫的需求困境其實都不一樣所以你現在在談其一補助其實可能會衍生其他公平性的問題 |
| transcript.whisperx[584].start |
15942.43 |
| transcript.whisperx[584].end |
15966.169 |
| transcript.whisperx[584].text |
再來就是政策的這個正當性那倘若這個提案真的通過了那它將會併入現在的政府負擔36%裡面對於政府端而言它本來就要負擔一定的比例那所以它在政府端它其實首當其衝其實是保費的這樣的一個短收但是對於民眾端而言的話它所帶來也是疊加的負擔的這樣的一個架軸 |
| transcript.whisperx[585].start |
15967.53 |
| transcript.whisperx[585].end |
15985.206 |
| transcript.whisperx[585].text |
開辦以來主要來源都是壽星階級但漸漸的得要正視高齡社會還有少子化健保保費繳交到人變少就得進行改革只是這個要補助那個也要增加預算影響到政府負擔的36%再加上法案沒有指定用途 |
| transcript.whisperx[586].start |
15985.886 |
| transcript.whisperx[586].end |
16000.458 |
| transcript.whisperx[586].text |
財源供不應求未來都是一大問題．再加上長輩們大多是慢性疾病每一年健保費用在萬千上高達四成健保補助並不是解決高齡社會福利的解決之道 |
| transcript.whisperx[587].start |
16008.022 |
| transcript.whisperx[587].end |
16027.532 |
| transcript.whisperx[587].text |
當初在總統大選老人健保補助確實是候選人們的政見草案說要排富但銀髮族們或許才是最有能力消費的保費又要找年輕世代要專家也說把多的稅收增加就醫知識健保長照的未來投資才是長遠之計TVB新聞 |
| transcript.whisperx[588].start |
16030.727 |
| transcript.whisperx[588].end |
16040.76 |
| transcript.whisperx[588].text |
這則新聞的內容恰恰點出了在野黨提案補助老人健保費所帶來的一些問題減輕經濟弱勢的負擔我絕對是大力支持的 |
| transcript.whisperx[589].start |
16046.448 |
| transcript.whisperx[589].end |
16065.755 |
| transcript.whisperx[589].text |
本席在衛環委員會也質詢了很多次也要求衛福部應該要擴大對經濟弱勢長者的照顧可是在這個專題報告裡面講得非常清楚就是在野黨現在的提案幾乎完全是一種齊頭式的補助這對年輕人來講是一個世代正義的問題同時也是對這個年輕世代再扒一層皮 |
| transcript.whisperx[590].start |
16074.398 |
| transcript.whisperx[590].end |
16089.456 |
| transcript.whisperx[590].text |
所以我們現在對於這個低收入戶中低收入戶的認定標準依照各縣市公布的這個最低生活費的基準家庭平均收入低於最低生活費是低收入戶那麼家庭 |
| transcript.whisperx[591].start |
16090.077 |
| transcript.whisperx[591].end |
16090.237 |
| transcript.whisperx[591].text |
本會議主席 |
| transcript.whisperx[592].start |
16108.996 |
| transcript.whisperx[592].end |
16126.054 |
| transcript.whisperx[592].text |
我主要還是要強調的就是說由經濟弱勢的底層往上去檢討然後擴大補助的這個可能性才是真正這個照顧弱勢而且符合公平正義的一個正確模式不知道部長對於我剛剛的講法認不認同 |
| transcript.whisperx[593].start |
16129.245 |
| transcript.whisperx[593].end |
16146.55 |
| transcript.whisperx[593].text |
完全支持好謝謝那由下往上的這個由社會的這個最底層然後往上去檢討政府應該要幫助的對象才是正確的一個政策方向那可是呢這一檔現在提案的是這樣的一個圖我們來看一下 |
| transcript.whisperx[594].start |
16147.912 |
| transcript.whisperx[594].end |
16167.107 |
| transcript.whisperx[594].text |
他是只有去掉這個金字塔頂端的這些長者其他是無差別式的全部列入補助的對象這將會發生非常大的問題那長者在退休之後大部分他們的健保費有可能都是依附在子女上的這個頭包 |
| transcript.whisperx[595].start |
16169.028 |
| transcript.whisperx[595].end |
16179.447 |
| transcript.whisperx[595].text |
所以探討經濟的狀況可能也是我們必須要去檢視這個整個家庭的情形那依照這個主計總署公布的資料 |
| transcript.whisperx[596].start |
16180.882 |
| transcript.whisperx[596].end |
16205.534 |
| transcript.whisperx[596].text |
台灣家庭財富的中位數是894萬元那麼在在野黨的這個提案裡面呢有83%的長者是全部補助的那麼在這83%的長者的家庭當中如果家庭財富超過2000萬的我們補助他健保費部長你覺得這樣子合理嗎 |
| transcript.whisperx[597].start |
16212.384 |
| transcript.whisperx[597].end |
16226.868 |
| transcript.whisperx[597].text |
這83%的長者當中假設他的存款是有超過200萬元甚至有更多好幾百萬甚至破千萬的那他可能不只是生活無憂這樣子的長者 |
| transcript.whisperx[598].start |
16227.288 |
| transcript.whisperx[598].end |
16227.408 |
| transcript.whisperx[598].text |
應該不用 |
| transcript.whisperx[599].start |
16255.287 |
| transcript.whisperx[599].end |
16282.217 |
| transcript.whisperx[599].text |
好 那再來我想這個健保的概念是一個互助的一個制度那麼我們要擴大對弱勢長者的照顧這絕對是一個正確的方向但是在以目前這個在野黨的提案裡面不論它是不是會直接影響到健保的財政那它絕對絕對是增加未來年輕人的負擔 |
| transcript.whisperx[600].start |
16283.437 |
| transcript.whisperx[600].end |
16302.863 |
| transcript.whisperx[600].text |
所以我必須要在這裡強調那在野黨提案的內容有很多可能是政府編列預算但是拿這個有限的資源去補助到經濟優渥的家庭所以部長你認不認為說這樣是一個很大的問題 |
| transcript.whisperx[601].start |
16304.213 |
| transcript.whisperx[601].end |
16324.962 |
| transcript.whisperx[601].text |
當然是很大的問題那我們因為我上面這樣子列出來其實這些都是我提到這些都是有所本那麼這些數據也都是可以被統計出來的數據甚至還有其他這個經濟狀況的數據我很早就也跟衛福部說了 |
| transcript.whisperx[602].start |
16326.583 |
| transcript.whisperx[602].end |
16353.344 |
| transcript.whisperx[602].text |
衛福部應該要把這些統計數據全部拿出來讓在野黨讓所有的民眾知道在他們的提案當中有多少金分是去補助到這些經濟優渥的家庭那他們的提案要補助的對象有多少是擁有這個兩棟三棟房子的家庭那有多少的存款有多少的長者的存款是有好幾百萬的那這些呢 |
| transcript.whisperx[603].start |
16354.425 |
| transcript.whisperx[603].end |
16378.048 |
| transcript.whisperx[603].text |
我想以就是說在野黨這樣子提案這種濫用國家公帑的這個行為我覺得這些經濟狀況優渥的長者有可能得到補助之後甚至搞不好他們不會去感謝這些提案的委員反而會認為說為什麼不把這些錢用在更需要幫助的人身上 |
| transcript.whisperx[604].start |
16379.314 |
| transcript.whisperx[604].end |
16406.479 |
| transcript.whisperx[604].text |
那我想這些數據我希望說部長你們可以在一週內去跟相關部會整理出來那在院長協商的時候在院長主持協商的時候你們可以提出這些有力的證據作為佐證那我不希望說因為這件事情去要數據這個事情我其實在更早之前我已經有提醒你們了 |
| transcript.whisperx[605].start |
16407.179 |
| transcript.whisperx[605].end |
16415.898 |
| transcript.whisperx[605].text |
那我不曉得你們有遇到什麼樣的困難還是就是說這是沒有問題我們可以盡快來拿到這些數據來作證 |
| transcript.whisperx[606].start |
16419.025 |
| transcript.whisperx[606].end |
16431.761 |
| transcript.whisperx[606].text |
我們相關的部門其實一直在蒐集相關的數據那是不是會牽涉到個人隱私的這個我再確認一下能拿多少我們就拿多少那第二個簡單的其實我們簡單的一個數據他如果說要求要淨稅20%以上的 |
| transcript.whisperx[607].start |
16437.208 |
| transcript.whisperx[607].end |
16455.361 |
| transcript.whisperx[607].text |
那這個我們統計起來他大概他的收入的中位數可能是每個月15萬可是現在的年輕人你挑中位數差不多有3萬7千5的中來3萬7千5的要去互保會月入15萬的要去補支單其實這對世代正義是不好的 |
| transcript.whisperx[608].start |
16461.825 |
| transcript.whisperx[608].end |
16462.306 |
| transcript.whisperx[608].text |
陳穎委員的發言 |
| transcript.whisperx[609].start |
16491.946 |
| transcript.whisperx[609].end |
16494.928 |
| transcript.whisperx[609].text |
接下來請劉建國委員劉建國委員請劉建國委員發言謝謝主席有請部長請邱部長 |
| transcript.whisperx[610].start |
16518.973 |
| transcript.whisperx[610].end |
16537.995 |
| transcript.whisperx[610].text |
我要先感謝主席今天專門安排這個專報部長要來探討這個健保的合理支付還有保障醫護人員這樣的收入設置百億基金、百億癌症基金及健康的投資這每件事情都事關重大也代表部長的責任非常之重 |
| transcript.whisperx[611].start |
16539.256 |
| transcript.whisperx[611].end |
16553.583 |
| transcript.whisperx[611].text |
那我想健保要撐起這個臺灣龐大的醫療體制其實來講他已經非常吃緊了然後那要急需這個心療救命的癌症病友也非常清楚這一點所以在2022年的時候 |
| transcript.whisperx[612].start |
16555.045 |
| transcript.whisperx[612].end |
16569.105 |
| transcript.whisperx[612].text |
並有團體共同提出臺灣百億癌症診療基金的構想然後透過與健保脫鉤然後讓基金可以自主營運用更快的這樣的速度來引進國外的創新藥物不僅救急也要救命 |
| transcript.whisperx[613].start |
16571.843 |
| transcript.whisperx[613].end |
16597.358 |
| transcript.whisperx[613].text |
在這個構想提出的時候我本席立即響應也在2022年的4月12在立院的總質詢的時候向我們的行政院前蘇院長不是陳院長是蘇院長還有時任的衛福部陳前部長也同年在這5月17邀請衛福部及相關的專家學者召開臺灣癌症新藥多元支持基金的這個公聽會然後在隔年的4月20號2023 |
| transcript.whisperx[614].start |
16599.319 |
| transcript.whisperx[614].end |
16614.137 |
| transcript.whisperx[614].text |
我帶領著13個並有的團體進到總統府內面見到當時的賴清德副總統當天副總統就公開的表示要將臺灣百億癌症基金納入在競選的政見之中 |
| transcript.whisperx[615].start |
16615.578 |
| transcript.whisperx[615].end |
16641.211 |
| transcript.whisperx[615].text |
所以在去年年底總統大選時有人說賴清德總統的政見是抄襲別人的政見這是真的非常冤枉而且是天大的誤會但是我也必須要提醒當時在2023年4月20號在總統府的時候確實我們現任的總統當時的副總統有講要把這個癌症新藥的基金納入在政見裡面這是一個事實 |
| transcript.whisperx[616].start |
16642.939 |
| transcript.whisperx[616].end |
16664.705 |
| transcript.whisperx[616].text |
我是要讓部長了解到整個臺灣百億癌症新藥基金的時序也是讓部長能夠了解到說癌症病友從2022年就開始朝這個基金會因期盼的希望可以盡速的來成立當然他必須要透過法律的修正同時有更多的癌症的病友他們在等待新藥中 |
| transcript.whisperx[617].start |
16665.885 |
| transcript.whisperx[617].end |
16690.288 |
| transcript.whisperx[617].text |
是已經絕望的離去所以我在今年5月本席在與立院的後生會召開提升臺灣癌症新藥可進信的這個委員會我們的時事部長也有參加那癌症希望基金會的董事這柯醫師說了最難過的事情不是看不到希望是看到希望卻沒辦法去做 |
| transcript.whisperx[618].start |
16692.853 |
| transcript.whisperx[618].end |
16693.994 |
| transcript.whisperx[618].text |
真的非常感動,我今天才 |
| transcript.whisperx[619].start |
16713.377 |
| transcript.whisperx[619].end |
16728.184 |
| transcript.whisperx[619].text |
這麼清楚的知道這個百億基金的來源原來是這樣的這個還有很多流程部長可以過目賴基民醫師是我好朋友他也從事感謝建國委員陪著賴 |
| transcript.whisperx[620].start |
16729.764 |
| transcript.whisperx[620].end |
16756.362 |
| transcript.whisperx[620].text |
那一時去去去爭取到這樣的一件事情那這個有兩件事情如果說我們馬上癌症防治法裡面這樣寫啊大家有共識很快的通過那馬上來落實齁最好這是最好的事情但是沒關係在這之前我們現在就齁剛剛時事長今天也報告了我們用暫暫時支付的方式20今年24億在處理這個部分讓一些癌症的新藥 |
| transcript.whisperx[621].start |
16757.142 |
| transcript.whisperx[621].end |
16785.237 |
| transcript.whisperx[621].text |
可以用到病人的身上明年政府會用60億的公務預算60億因為不用那麼多啦所以剩下的266就可以了第三年就變百億至少這三年我們這樣做那癌症防治法裡面如果修法能夠順利完成就接上這個癌症防治法的一個看基金的設立啦或是怎麼樣我想這樣的運作我們就不會讓病人去等啦 |
| transcript.whisperx[622].start |
16785.757 |
| transcript.whisperx[622].end |
16798.266 |
| transcript.whisperx[622].text |
部長講出兩個點,第一個點要有共識,馬上就可以修,現在有什麼地方沒有共識的?還是哪一個委員有不一樣的意見?你不用講委員的名字,有沒有這樣的因素存在? |
| transcript.whisperx[623].start |
16801.541 |
| transcript.whisperx[623].end |
16822.143 |
| transcript.whisperx[623].text |
如果沒有你這麼講是有點奇怪哪一個委員有不一樣的意見跟想法大家都可以來討論嘛因為坦白講今天如果不是召委排這樣的一個專案報告我想...可不可以我們同時來進行就是我們錢已經先拿出...申請比較...拿出來沒有沒有但是...但是...我剛才講的第一個點你還沒有答覆嘛第二點 |
| transcript.whisperx[624].start |
16822.944 |
| transcript.whisperx[624].end |
16823.764 |
| transcript.whisperx[624].text |
這個要分清楚如果是補助 |
| transcript.whisperx[625].start |
16848.699 |
| transcript.whisperx[625].end |
16870.912 |
| transcript.whisperx[625].text |
補助癌症的用藥只要合乎indication其實基本上這部分就是健保給付的嘛這沒有問題那現在問題是說一些新藥好像它的效果還沒有確認有沒有完成三期或怎麼樣可是我們就醫生還是覺得有用啦啊這個你們有一個機會去用啊這個用過去算起來是二十幾億 |
| transcript.whisperx[626].start |
16871.952 |
| transcript.whisperx[626].end |
16891.829 |
| transcript.whisperx[626].text |
阿這是根據那個他們藥商提出來的所以補兌你要說你應該把你阿伯這位先你先把阿伯這位公帝討錢這去公帝阿伯那不用那麼多錢啦OK沒問題你如果要把不用那麼多錢扣在討錢阿伯這該算幾百萬你這樣想到健保通通是你如果做生意書啦看你這種說法下去跟你求情阿說你這個生意但沒那麼怪怪你這樣會發生危險 |
| transcript.whisperx[627].start |
16901.492 |
| transcript.whisperx[627].end |
16903.114 |
| transcript.whisperx[627].text |
你的屬於裡面,會去搜判,這不好啦,你現在是沒中喔 |
| transcript.whisperx[628].start |
16909.244 |
| transcript.whisperx[628].end |
16935.727 |
| transcript.whisperx[628].text |
今天說清楚啊,委員你跟他說,你要回去做委員才好,我是聽覺得很不滿的,對嗎?你就不知道做,所以也苦恥啊,不會是醫師啊,他又開便宜啊,你是家醫師,你做不對啊,他開便宜的醫師就對了,做得這麼大就對了,他又沒辦法做不對,不管你國民黨在內沒辦法做不對,你民眾在內警察沒辦法做不對,啊你是家醫師,背景的啦,你可以做不對,所以也苦恥啊,不知道跟你說這樣,啊所以你的表演就要更更更 |
| transcript.whisperx[629].start |
16936.167 |
| transcript.whisperx[629].end |
16962.939 |
| transcript.whisperx[629].text |
更視頻八文,所以有些話可能先後順序排序你要清楚一點,不然你會傷到啦好不好,那我現在在講齁,你們不只這個部長你剛才講的先後順序已經是有衝突矛盾的你們連這個報告裡面,你們在那邊亂七八糟的修改我不曉得是哪一個幕僚提供這樣的訊息給你還是說誰給你的指令怎麼會你們的報告一下子寫這樣,一下子寫這樣你知道這個改過嗎? |
| transcript.whisperx[630].start |
16964.793 |
| transcript.whisperx[630].end |
16979.311 |
| transcript.whisperx[630].text |
本部將朝修正癌症防治法設立癌症診療基金這是最早給我們的報告現在這幾個字不見了本部優先規劃爭取公務預算撥入全民健康保險基金 |
| transcript.whisperx[631].start |
16985.765 |
| transcript.whisperx[631].end |
16998.218 |
| transcript.whisperx[631].text |
你是要怎麼解釋?委員報告,這在行政院裡面,大家經過大家認真的討論,當然...所以你的意思是說,你的意思是說你行政院認真討論,所以你原本的報告出來,你補來的就是不夠認真討論嘛? |
| transcript.whisperx[632].start |
17002.026 |
| transcript.whisperx[632].end |
17025.556 |
| transcript.whisperx[632].text |
本來就是要那個風雄,但是覺得那個風雄可能走時間太短就失敗了不是啦,不是說你講話,我覺得你要洗衣啦,你這樣講很奇怪就對了因為,因為你在上禮拜,你對媒體講什麼話,跟你現在在報告裡面,它又太誇張,又是衝突,又是衝突有沒有,你很清楚,不然你的幕僚就是不清楚 |
| transcript.whisperx[633].start |
17026.928 |
| transcript.whisperx[633].end |
17042.128 |
| transcript.whisperx[633].text |
然後你的報告禮拜五的時候委員會已經收到這個本部將朝向修正癌症防治法設立癌症診療基金這是你們的報告阿為什麼現在這個報告不見了然後你跟我講是行政院你們被 |
| transcript.whisperx[634].start |
17044.673 |
| transcript.whisperx[634].end |
17068.495 |
| transcript.whisperx[634].text |
打開謝愛心的確是有寫到癌症防治法那我們禮拜六禮拜天也都沒有休息嘛就可能要講清楚一點齁我們還是先以那個先進到健保基金專款專用馬上明年就可以來做齁這個優先啦啊這個癌症防治法是等於是說同時來後面來做啦 |
| transcript.whisperx[635].start |
17070.777 |
| transcript.whisperx[635].end |
17079.673 |
| transcript.whisperx[635].text |
那個言委員原本就要講久一點,因為他到了我就沒辦法講很久了,所以我開始要講重點的。我簡單讓部長答覆,不然這樣答覆還是有很大的問題。 |
| transcript.whisperx[636].start |
17081.557 |
| transcript.whisperx[636].end |
17086.16 |
| transcript.whisperx[636].text |
為什麼還要來到健保這個塊然後再從這邊出去然後叫做專款專用 |
| transcript.whisperx[637].start |
17110.337 |
| transcript.whisperx[637].end |
17113.159 |
| transcript.whisperx[637].text |
這個邏輯你這樣說不受怕,你問我比較沒理由我聽得懂,我聽不懂,不然你去請教一下。 |
| transcript.whisperx[638].start |
17118.462 |
| transcript.whisperx[638].end |
17136.767 |
| transcript.whisperx[638].text |
這也是一個風雄啊,但是...你這個風雄,你用這筆錢用公務預算來處理癌症新藥嘛,對不對?好,那你暫沒有成立基金,你覺得現在來用這些經費是夠的嗎?你講的是60億嘛,對不對?號稱60億嘛你暫時,對明年喔,你暫時現在支付是24.29億嘛,對不對?你這個還包括涵蓋寒病還有其他疾病的新藥暫時是有經費的你扣掉,那你扣掉到底是多少? |
| transcript.whisperx[639].start |
17146.269 |
| transcript.whisperx[639].end |
17149.45 |
| transcript.whisperx[639].text |
二十四億你就覺得夠了?二十四億的暫時性幾乎今年,署長你跟我講這樣就夠了?二十四億今年夠用?很明確? |
| transcript.whisperx[640].start |
17161.001 |
| transcript.whisperx[640].end |
17188.051 |
| transcript.whisperx[640].text |
跟委員報告我們現在訂的不是把健保裡面就不再支付癌藥新藥癌藥新藥還是健保裡面有所以他療效如果明確我們的評估財務衝擊都很明確還是會進到健保那這個專款的部分只是對一些療效或財務評估不確定的讓他可以先用那個才是用這個專款所以並不是全部合起來的癌藥只有這個24億 |
| transcript.whisperx[641].start |
17189.491 |
| transcript.whisperx[641].end |
17216.832 |
| transcript.whisperx[641].text |
市長,我們那天有講得很清楚,公聽委你有參加嘛,對不對?那其實是要分流出來的,如果是重疊在一塊,那意義就不大嘛,對不對?他現在就是分開他現在分開?那你已經把他分開之後,為什麼不能去修防治法趕快成立基金?跟委員報告,因為依據這個財政紀律法,你現在要訂一個獨立的基金,你要另密財源 |
| transcript.whisperx[642].start |
17217.712 |
| transcript.whisperx[642].end |
17229.196 |
| transcript.whisperx[642].text |
不能用現有財源或公務預算挹注,所以為了讓這個癌症...這句話已經聽過N次以上了對...所以為了要快進度,我們現在用現有的基金沒有新的財源沒有新的財源,那你20幾億是從哪邊跑出來的?這是用公務預算在現有的基金裡面先來執行你的公務預算就可以跑出20幾億出來 |
| transcript.whisperx[643].start |
17240.74 |
| transcript.whisperx[643].end |
17260.258 |
| transcript.whisperx[643].text |
所以你的公寓算是沒有辦法沒有辦法跑出100億出來就對了嗎?你要跟我表達是這樣即使有100億有有未來一定有100億但是沒有辦法新設一個基金啊為什麼有100億沒辦法新設一個基金這是財政紀律法的規定財政紀律法有跟你規定有100億然後你們已經找出財源 |
| transcript.whisperx[644].start |
17261.619 |
| transcript.whisperx[644].end |
17263 |
| transcript.whisperx[644].text |
你現在這個是用現有的預算嗎?不是嗎? |
| transcript.whisperx[645].start |
17289.391 |
| transcript.whisperx[645].end |
17315.414 |
| transcript.whisperx[645].text |
這個現在是放到現有的基金不是啊 你的預算你現在這個公務預算是現有的預算嗎不是新的基金必須要另謀新的財源我們現在做法上是現用健保基金是既有基金所以不受限於那一個所謂要新籌財源的限制我可以坦白你也很清楚你有參加他們都知道我們 |
| transcript.whisperx[646].start |
17316.014 |
| transcript.whisperx[646].end |
17316.816 |
| transcript.whisperx[646].text |
才會來請託你們,才會來請託總統,才會請託院長嘛,對不對? |
| transcript.whisperx[647].start |
17331.516 |
| transcript.whisperx[647].end |
17352.001 |
| transcript.whisperx[647].text |
要去成立這個基金嘛那你現在要從健保基金裡面去融資29億多不是又不是是由公務預算預支到健保基金專款專用啦對嘛你就從公務預算預支到健保基金才從健保基金再融資出來嘛我這樣講不對嗎就是在健保基金裡面來操作啊專款專用你的公務預算給自己整個是對台來的 |
| transcript.whisperx[648].start |
17358.034 |
| transcript.whisperx[648].end |
17385.138 |
| transcript.whisperx[648].text |
這個國家的國家的預算裡面撥進來是嘛國家的預算撥進來阿所以他這樣沒有委婉財政機率沒有阿但是如果你是立法要新設一個基金的話就要另某財源要新的財源阿不能用這個財源去成立一個基金不可以阿所以到目前為止是上面沒有跟你講說有新的財源所以你們不可以去修這個法是這樣對阿這樣你就是把 |
| transcript.whisperx[649].start |
17385.698 |
| transcript.whisperx[649].end |
17398.401 |
| transcript.whisperx[649].text |
邱部長嘴巴打得非常大了因為他是說要有共識嘛委員會要有共識嘛他剛剛開慘白就講的第一點就這樣嘛所以還需要時間去研議研議是你們先去研議找新的裁員嘛不是委員會沒有共識嘛你剛剛坐底下有沒有聽到嗎很清楚啊邱部長是這麼講的他講的第一點啊 |
| transcript.whisperx[650].start |
17412.216 |
| transcript.whisperx[650].end |
17438.902 |
| transcript.whisperx[650].text |
我應該沒有聽錯阿 主席應該也沒有聽錯阿如果修正癌症防治法裡面設一個基金是不是裡面要寫另闢財源對 要有新的財源你是要寫另闢財源才有辦法嗎對 要有基金的來源所以這一個我們來努力嘛但是在努力可能有一段時間之前我們這個公務預算馬上用就直接可以用到健保基金專款專案來用到病人的身上 |
| transcript.whisperx[651].start |
17439.962 |
| transcript.whisperx[651].end |
17459.027 |
| transcript.whisperx[651].text |
這是最短數趕快做到然後癌症防治法這個基金我們再來談看看設了以後然後我們怎麼樣有哪一個財源來那這個的確是可能會第二步需要一點時間啦但是大家不要忘記了你今天所有的癌症現在的治療還是健保在幾戶啊 |
| transcript.whisperx[652].start |
17460.186 |
| transcript.whisperx[652].end |
17485.132 |
| transcript.whisperx[652].text |
並沒有影響到健保應該要治療的,絕對不會影響啊。沒有啦,你講這個我不是不清楚嘛,這件事情不是現在這麼說,我來講時序是2022年就開始的,一直到現在。署長應該非常清楚吧,你到底什麼地方去卡到,不然你那一天怎麼會對媒體講,對這個百億基金你的看法跟你的做法。 |
| transcript.whisperx[653].start |
17485.712 |
| transcript.whisperx[653].end |
17487.074 |
| transcript.whisperx[653].text |
那我覺得說你如果用這樣來處理的話我覺得這個有點在蒙混啊 |
| transcript.whisperx[654].start |
17492.813 |
| transcript.whisperx[654].end |
17519.9 |
| transcript.whisperx[654].text |
就好像你們不打算要成立這個基金要門戶然後門鈕再多你們的意思就是這樣嘛你對健保的中央來講你號稱的60億其實這36億裡面就是原本今年就已經核定過的核富的新藥你的30多億元本就是這樣你的暫時性資金是4點以下高的其實也是我剛才說的你敢說沒有有涵蓋韓病還有其他的你說沒有那可能也差了幾億而已啦也差了幾億而已啦不然你給民視拿給我看啊 |
| transcript.whisperx[655].start |
17520.72 |
| transcript.whisperx[655].end |
17529.629 |
| transcript.whisperx[655].text |
你把民事拿出來啊,讓所有人看啊。你要跟我假假告告喔,在那一天兩天、三天、四天就對了。啊你心理上我們在這裡的生活比較清楚勒?我可以讓你這樣告訴我嗎?你不就是當初我今天才來的?一個...一個... |
| transcript.whisperx[656].start |
17542.279 |
| transcript.whisperx[656].end |
17556.851 |
| transcript.whisperx[656].text |
新藥要等多少?平均782天這些癌友、團體訴求這個事情衛生部去年還派去英國考察我們到現在這個基金還沒辦法成立現在來跟我講財政紀律我們快點來修這個癌症防治法這個部 |
| transcript.whisperx[657].start |
17568.871 |
| transcript.whisperx[657].end |
17580.554 |
| transcript.whisperx[657].text |
你要跟我說委員有不同意見我們都可以去溝通你衛福部也應該去溝通那到底有哪一個11個版本有哪一個委員的意見是不同的我不清楚所以我就教於你嘛 |
| transcript.whisperx[658].start |
17585.42 |
| transcript.whisperx[658].end |
17610.771 |
| transcript.whisperx[658].text |
癌症防治法的部分我們趕快來整理看大家的意見現在因為行政院希望趕快落實總統的政見所以就是明年會用公務預算60億那專款專料來幫助這個癌症的診療後年會100億那這一邊我相信這一邊如果越快癌症防治法這一邊如果通過的話我想整個會shift到這邊來做來運作 |
| transcript.whisperx[659].start |
17612.752 |
| transcript.whisperx[659].end |
17637.628 |
| transcript.whisperx[659].text |
部長我再強調一次最後一句話就好了總統的政見就是要成立癌症新藥百億基金嘛就這樣而已嘛好那個衛福部是不是那個剛剛劉委員提出來的是不是有一些新的資料或者是你們可以提供給劉委員做講考接下來請楊耀委員發言 |
| transcript.whisperx[660].start |
17641.099 |
| transcript.whisperx[660].end |
17646.942 |
| transcript.whisperx[660].text |
陳冠廷委員陳冠廷委員陳冠廷委員陳冠廷委員不在接下來請楊耀委員謝謝主席主席我請一下邱部長請邱部長委員好部長好 |
| transcript.whisperx[661].start |
17664.639 |
| transcript.whisperx[661].end |
17688.113 |
| transcript.whisperx[661].text |
部長我今天沒有帶任何資料我們就是赤手空拳討論幾個問題今天的專案報告的題目就是開頭第一個就是健保合理支付也就是健保合理給付那部長本身 |
| transcript.whisperx[662].start |
17689.668 |
| transcript.whisperx[662].end |
17719.368 |
| transcript.whisperx[662].text |
是一個名醫師、名教授也曾經是醫師前年會理事長也在這個委員會跟我共事了8年現在是部長所以由你來認定我覺得應該還不錯那當然這個沒有絕對的答案我第一個問題請教部長你覺得什麼叫合理健保怎麼給付叫合理 |
| transcript.whisperx[663].start |
17724.285 |
| transcript.whisperx[663].end |
17740.578 |
| transcript.whisperx[663].text |
這個是因為要依據每一個國家的消費水準至少現在比較起來是偏低部長覺得現在是偏低應該是偏低是從哪裡看 |
| transcript.whisperx[664].start |
17749.882 |
| transcript.whisperx[664].end |
17769.727 |
| transcript.whisperx[664].text |
就是部長剛剛有講到消費水準也是一個那就是說現在健保給醫療院所的讓他們發出去的薪資是真的有比台灣一般性的職業低嗎? |
| transcript.whisperx[665].start |
17771.789 |
| transcript.whisperx[665].end |
17783.031 |
| transcript.whisperx[665].text |
我現在不是說醫護人員的薪資應該這麼低,我是就部長剛剛講的就是舉了一個消費水準,那就跟薪資有關嗎?柏中你覺得太低啦,好,那我就直接再請教部長,你覺得 |
| transcript.whisperx[666].start |
17800.765 |
| transcript.whisperx[666].end |
17825.703 |
| transcript.whisperx[666].text |
怎麼做才能夠讓他的給付增加?因為我們如果比其他國家的醫事人員的收入的確是比較低然後來使用開一個刀比如說開個房廠我們這邊可能給付兩千塊好了那可能美國就給付那個多少可能是有十倍 |
| transcript.whisperx[667].start |
17827.032 |
| transcript.whisperx[667].end |
17849.88 |
| transcript.whisperx[667].text |
難道我們的消費水準差這麼多嗎?那個是不是這樣將來會擠壓到醫療發展的空間?不是我現在其實合不合理呢?光是我就有兩個答案所以這個我們今天就是純粹探討探討他的合理性假如說部長覺得偏低 |
| transcript.whisperx[668].start |
17851.124 |
| transcript.whisperx[668].end |
17868.457 |
| transcript.whisperx[668].text |
那部長覺得應該用什麼方法讓它比較不低?所以我們其實我們已經有公告從113年7月其實一直在修訂這個支付標準因為有臨床的需要要去專業團體說所以總共有168次的公告調整超過3000次的診察項目 |
| transcript.whisperx[669].start |
17884.188 |
| transcript.whisperx[669].end |
17905.055 |
| transcript.whisperx[669].text |
那個都是在水庫裡面挪動而已嘛,像是說你假如說給付偏低,就是你支出面覺得收到的人太少表示支出、收入跟支出之間,收入是少於支出的嘛,我這樣子講對不對? |
| transcript.whisperx[670].start |
17906.929 |
| transcript.whisperx[670].end |
17933.376 |
| transcript.whisperx[670].text |
所以收入面也要擴大啦收入面擴大你才有辦法給付更高一點的給付那收入面怎麼擴大擴大就是我剛剛有做一些報告比如說我們要增加公務預算的投資或者是說不應該給健保的一個費用用其他的補助來 |
| transcript.whisperx[671].start |
17935.096 |
| transcript.whisperx[671].end |
17957.504 |
| transcript.whisperx[671].text |
來填補這個其實政府應該給健保的36%這個就差了一百三十幾億了政府應該給的就是法定應該給的本來就應該給啊對但是他有時候會把算說他補助什麼補助什麼都跟健保沒有關也算進去這裡面 |
| transcript.whisperx[672].start |
17958.804 |
| transcript.whisperx[672].end |
17975.624 |
| transcript.whisperx[672].text |
這個我覺得你們行政團隊必須要自己去做處理是就是政府應該每年應該給健保多少這個一定要這個到位了以後還有沒有給付偏低的問題這個到位了應該是還不夠還不夠所以 |
| transcript.whisperx[673].start |
17980.151 |
| transcript.whisperx[673].end |
18005.712 |
| transcript.whisperx[673].text |
部長剛剛的意思就是還是要用公務預算撥補對不對先把公務預算釐清就是比較屬於公共衛生的或者是其他不是在健保法裡面可以來支持的統統把它移出去的話那大概除了說36%以外可以多100億多億那其實再把 |
| transcript.whisperx[674].start |
18006.974 |
| transcript.whisperx[674].end |
18008.695 |
| transcript.whisperx[674].text |
這個我們都是支持的所以必須要先水庫做大嘛 |
| transcript.whisperx[675].start |
18035.911 |
| transcript.whisperx[675].end |
18038.733 |
| transcript.whisperx[675].text |
因為現在有很多黨團也好委員版本也好都是要保障點子的這個是要從公務預算來撥對不對 |
| transcript.whisperx[676].start |
18066.614 |
| transcript.whisperx[676].end |
18089.968 |
| transcript.whisperx[676].text |
因為你提的太高,第一個也破壞到總和的精神,總和其實就是當時想控制啦控制在一定的,不然一直報一直報到最後人民的增加還是多嘛那當然這個總和的控制會的確是會擠壓到醫療院所的權益啦,說實在還是讓他們還是會比較幸福不然我沒有反對 |
| transcript.whisperx[677].start |
18095.136 |
| transcript.whisperx[677].end |
18120.023 |
| transcript.whisperx[677].text |
讓醫療院所的收入增加然後來提高我們今天專案裡面的提高醫護人員的待遇這個我想大家都很贊成的只是說用什麼方法來達成這個目的才是重要的像我我就比較傾向從整體的保險制度來看 |
| transcript.whisperx[678].start |
18121.297 |
| transcript.whisperx[678].end |
18125.512 |
| transcript.whisperx[678].text |
就是說為什麼為什麼大家那麼抗拒抗拒 |
| transcript.whisperx[679].start |
18128.14 |
| transcript.whisperx[679].end |
18152.494 |
| transcript.whisperx[679].text |
提高保費我們現在的費率也還沒有到法定我們提高然後在六類的被保險對象裡面政府應該補貼的我們從這裡來做公務預算的支出這個我覺得很合理因為我一直覺得一個制度要建立很困難 |
| transcript.whisperx[680].start |
18153.885 |
| transcript.whisperx[680].end |
18181.572 |
| transcript.whisperx[680].text |
可是要打破呢很容易因為大家大家都知道點子保障到1保障到0.95保障到0.9一屆會很歡迎所以我呢我是很堅持不破壞制度那假如要破壞制度呢 |
| transcript.whisperx[681].start |
18182.659 |
| transcript.whisperx[681].end |
18208.661 |
| transcript.whisperx[681].text |
我的點子保障我的主張是1.1到1.2為什麼呢因為假如說大家提案最高限制保障1.1元那真的要再鼓勵醫療院所投資設備然後提高其他的醫事人員的薪資結構那當然必須要超過 |
| transcript.whisperx[682].start |
18210.649 |
| transcript.whisperx[682].end |
18210.669 |
| transcript.whisperx[682].text |
臺電長期虧損 |
| transcript.whisperx[683].start |
18240.933 |
| transcript.whisperx[683].end |
18264.742 |
| transcript.whisperx[683].text |
都是由政府的公務預算來補貼然後電價明顯低於國際你覺得這個合理嗎?沒有,你覺得這個合理嗎?我講過今天我們就是沒有任何的對錯所以我也沒有帶資料我們就只是看你覺得這個合理嗎? |
| transcript.whisperx[684].start |
18266.725 |
| transcript.whisperx[684].end |
18294.567 |
| transcript.whisperx[684].text |
那假如說這個不合理,其實,不好意思說,假如說這個不合理,那為什麼不合理?因為選票嘛。講到最簡單的就是,就是大家怕漲電價,影響選票,失去政權嘛。所以才會一直用政府補貼嘛。我剛才舉台電這個例子,有沒有很像即將要來臨的健保? |
| transcript.whisperx[685].start |
18296.363 |
| transcript.whisperx[685].end |
18310.8 |
| transcript.whisperx[685].text |
有啦!很像啦!真的很像啦!我知道我以一己之力並沒有辦法阻擋這個法案的通過那我要聲明 |
| transcript.whisperx[686].start |
18312.247 |
| transcript.whisperx[686].end |
18330.416 |
| transcript.whisperx[686].text |
我並不是不想讓醫界的待遇整體可以提高醫療的水準可以提高而我覺得假如有其他的方式譬如說我們補充保費也是從五千元就課後來提高調高到兩萬這個也都可以檢討 |
| transcript.whisperx[687].start |
18333.317 |
| transcript.whisperx[687].end |
18359.637 |
| transcript.whisperx[687].text |
為什麼大家就是非得要破壞整體的制度然後不就真正的問題來做解決這個我不懂那我最後除了合理的健保以外我今天剛好看了一則新聞所以也跟部長講一下是不是你們從現在開始 |
| transcript.whisperx[688].start |
18363.151 |
| transcript.whisperx[688].end |
18385.581 |
| transcript.whisperx[688].text |
不要再做醫學中心的醫院評鑑因為醫學中心不用做啊醫學中心只升不降的啊何必為難大家呢醫學中心花了那麼多的時間、人力然後做書面、寫故事 |
| transcript.whisperx[689].start |
18392.642 |
| transcript.whisperx[689].end |
18410.608 |
| transcript.whisperx[689].text |
然後讓這些委員看啊看一看呢從1988年到現在沒有任何一家醫學中心是降級的然後更好笑的是我們原本是200萬人一間醫學中心現在我們2300萬人口已經22家了 |
| transcript.whisperx[690].start |
18421.67 |
| transcript.whisperx[690].end |
18444.74 |
| transcript.whisperx[690].text |
我 我 我覺得這個可以取消避免浪費大家的 你們就只要去評阿其實 欸 也額滿了啦醫學中心在 你看喔 在回到我們剛才講的健保支出一個 一個醫院 從7億醫院升級到 到醫學中心 |
| transcript.whisperx[691].start |
18445.759 |
| transcript.whisperx[691].end |
18456.807 |
| transcript.whisperx[691].text |
我只是覺得不可思議陳時中部長任內我一樣在這個執行台四年我問了他不下五次 |
| transcript.whisperx[692].start |
18476.341 |
| transcript.whisperx[692].end |
18497.31 |
| transcript.whisperx[692].text |
醫學中心是不是有升有降?他跟我出了事,他走了薛部長上來,一下子沒有任何一家降的,一下子新增了三間,就剛好勉強快要達到一百萬人口一家醫學中心。 |
| transcript.whisperx[693].start |
18499.415 |
| transcript.whisperx[693].end |
18521.175 |
| transcript.whisperx[693].text |
部長這樣啦!這件不要讓你回答啦!但是我強烈建議把醫學中心的評鑑取消啦!讓他們不用再花費那麼多無謂的人力、財力、物力來寫一些書面說一些故事給你們聽啦!因為他升上去的就不會降了嘛!對不對? |
| transcript.whisperx[694].start |
18523.834 |
| transcript.whisperx[694].end |
18525.015 |
| transcript.whisperx[694].text |
好 謝謝楊耀委員的發言 |
| transcript.whisperx[695].start |
18547.745 |
| transcript.whisperx[695].end |
18568.834 |
| transcript.whisperx[695].text |
本日會議詢答全部結束委員林益君、盧憲一、陳冠廷委員所提書面質詢列入記錄刊登公報現在做以下決定報告及詢答完畢委員質詢未及答覆或請補充資料者請相關機關於兩週內以書面答覆委員另要求期限者從其所定本日會議到此結束現在散會 |
| transcript.whisperx[696].start |
18586.659 |
| transcript.whisperx[696].end |
18588.38 |
| transcript.whisperx[696].text |
臺灣的陽性臺灣的陽性 |