| IVOD_ID |
160849 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Clip/1M/160849 |
| 日期 |
2025-05-01 |
| 會議資料.會議代碼 |
委員會-11-3-26-9 |
| 會議資料.會議代碼:str |
第11屆第3會期社會福利及衛生環境委員會第9次全體委員會議 |
| 會議資料.屆 |
11 |
| 會議資料.會期 |
3 |
| 會議資料.會次 |
9 |
| 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3會期社會福利及衛生環境委員會第9次全體委員會議 |
| 影片種類 |
Clip |
| 開始時間 |
2025-05-01T09:12:42+08:00 |
| 結束時間 |
2025-05-01T09:29:36+08:00 |
| 影片長度 |
00:16:54 |
| 支援功能[0] |
ai-transcript |
| video_url |
https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/872e8bbe37846fc0ebe473c19aa2c61bf84b180731b6d64105daebae4db85f917aee9c616f299ce85ea18f28b6918d91.mp4/playlist.m3u8 |
| 委員名稱 |
陳昭姿 |
| 委員發言時間 |
09:12:42 - 09:29:36 |
| 會議時間 |
2025-05-01T09:00:00+08:00 |
| 會議名稱 |
立法院第11屆第3會期社會福利及衛生環境委員會第9次全體委員會議（事由：審查
一、委員王育敏等18人擬具「病人自主權利法部分條文修正草案」案。
二、委員劉建國等16人擬具「病人自主權利法部分條文修正草案」案。
三、委員邱志偉等19人擬具「病人自主權利法第八條、第九條及第十五條條文修正草案」案。
【僅詢答】
【4月30日及5月1日二天一次會】） |
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謝謝主席,麻煩邱部長 |
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10.703 |
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吳院長今天是五一勞動節所以我還是想跟部長您討論一下醫護這個勞動權益的問題龍頭醫院台大醫院你我都服務過的醫院吳院長他還蠻喜歡公開評論時事所以我想以他帶領龍頭醫院加上他這個特質我認為他應該要對自己要求這個自我要求是要更高的你同意吧龍頭醫院嘛然後他也會關心其他的事情 |
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40.501 |
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但是台大工業企業工會剛會這個禮拜四月二十八號揭露台大院的荒唐行徑他在這個五月一號的這個假班別的一個議院調查表他只給護理人員兩個選項喔柏俊這都很清楚你有看過嗎 |
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60.599 |
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你現在看兩個選項而已,同意到院工作後調一,國定假日,第二個同意到院工作後領加班費,否定這是依法要休假一整天,當天不上班的選項沒了,不見了,它只有兩個選項,我先跟你說,因為這個是 |
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79.75 |
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94.911 |
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一個非常清楚的事實台大醫院看似在徵詢醫院事實上是已經徵詢就是同仁的意願但事實上已經設計好了不管你勾哪一項你那天就是得來一定要出勤部長你覺得這樣做可以嗎 |
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95.874 |
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114.2 |
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謝謝委員,非常關心我們這種勞動的權益,我想也不只台大,全國所有的醫療業,台大是龍頭,我們先聽著台大這點台大有解說,這是針對來五一那天上班的人,給他們簽你是要選擇 |
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117.282 |
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130.861 |
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我跟您講台大企業工會 工會 他們做的調查77點多就超過四分之三的人說他們根本沒有備訓諮詢就直接排定了我給你做參考 |
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132.883 |
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154.654 |
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這個是臺大醫院說法,但事實上可能就不是如此博定還是請你要注意一下,雖然好像說臺大醫院是屬於教育部管,不過我想衛福部也是您到督導的對象博定他這個預例醫療決定推動到現在,您知道簽署率有多高嗎?簽署率有多少嗎?大概千分之1.31 |
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156.711 |
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167.899 |
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簽分之1.31 柏定拜託 高板櫃再不到百分之一 又簽分之幾統計學就是沒有嘛 等於沒有人簽嘛我大概可以這麼講 柏定你有簽嗎我有簽安寧環和醫療但病毒法沒有我覺得我們的意願都很清楚 已經可以表達了在安寧環和醫療法因為法推出以後就是鼓勵 |
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185.331 |
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鼓勵後我們還是會看一下數字這也不是對錯的問題每一個人都是這間排審的三個版本它當然主要在經費之應場域放寬還有代理人的一個限制調整也許大家不太一樣不過我覺得方向是整個是正確的那就是要尊重這個意願人他自主權但是我也要提醒這個衛福部 |
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205.964 |
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213.314 |
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就是說你們對於這個所有醫護跟相關學會的意見要稍微去多多徵詢你知道以前的爭議點在哪裡嗎你知道以前的爭議點對 爭議點在什麼地方爭議點是在哪裡 |
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226.605 |
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233.027 |
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因為他的爭議點很多,病人自治權法案那個時候當時應該是蘇昭偉那個時代在推,但是我在學界應該也對這個法有相關的隱瞞因為爭議點是醫師說進戶中一陣子轉嫁給醫師,就是醫師背負太多的責任 |
| transcript.whisperx[12].start |
249.633 |
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277.231 |
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爭議點 那這個東西就是找醫護人員找他們來一起討論嘛怎麼樣讓他們就覺得是相對是讓他們願意做這樣的事情配合這樣的政策但是又不是說你責任最後都丟給我其實爭議點就是這個啦民眾黨我們期待的是有這個病毒法還要一個尊嚴善終法才能夠完善這個善終權那因為病毒法保障的是無效醫療嘛可以拒絕無效醫療 那自然善終一個選擇 |
| transcript.whisperx[13].start |
278.132 |
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300.418 |
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但是尊嚴善終是進一步讓極度痛苦的人透過嚴謹的程序然後他可以這個做自主來選擇他比較有尊嚴有體面的方式來結束生命兩者是一個互補就是可以完善一個生命自主跟尊嚴死亡那這是一個現代的價值這個衛福部現在好像都不想面對這個問題 |
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303.906 |
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326.119 |
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我們不管是衛福部的各個單位跟學界跟相關的委員會始終在面對這個問題不是沒有面對這個問題博不丁我是要跟你提起遲早要面對因為齁所有的民調大概有七八成的民眾台灣民眾是支持這個法案的但這個法案怎麼寫我知道要很小心很謹慎但是我跟博不丁這樣說啦博不丁賴總統4月27日出席健康台灣全國論壇提了很多見解 |
| transcript.whisperx[15].start |
331.122 |
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351.81 |
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當天也在場,所以我想你應該都很清楚那我賴總統有表達,政府提出這個癌藥基金100億元那他先編列50億元但並不是100億元用完就結束,不夠了就補上去,隔年再補這樣讓這個水庫可以保持一定水平那我想提醒部長 |
| transcript.whisperx[16].start |
353.371 |
| transcript.whisperx[16].end |
371.278 |
| transcript.whisperx[16].text |
百億癌藥基金是個中繼站的概念我對你講中繼站過去的意思就是病人要團體期待然後去參觀其他國家的做法就是有一些加速審查的藥品他可能還沒有完全確定但是有些病人他有需求所以他讓這個中繼站 |
| transcript.whisperx[17].start |
372.859 |
| transcript.whisperx[17].end |
399.259 |
| transcript.whisperx[17].text |
能夠暫時性的支付這類的藥品目前健保署還沒有改口雖然我們有很多已經確定療效的安全性的都沒有附滿附足但是這一塊本來是要做這個部分它是一個中繼站的概念你看賴總統也是用水庫的概念水庫本來水就是進進出出的那就是要加速通過藥來用那既然是中繼站的話真正的問題是新藥經過開放性使用用這筆錢 |
| transcript.whisperx[18].start |
401.04 |
| transcript.whisperx[18].end |
420.787 |
| transcript.whisperx[18].text |
那之後要評估嘛 因為你暫時性使用那目前大概都兩年嘛 署長沒有改變 大概兩年後評估嘛那兩年後評估有三個結果 柏中你要聽得很清楚你日理千機 賴總統日理萬機 你日理千機百機 你也是要清楚這件事那時署長要非常清楚 因為他在執行這件事情 |
| transcript.whisperx[19].start |
421.747 |
| transcript.whisperx[19].end |
439.142 |
| transcript.whisperx[19].text |
你現在兩年後,結果會有三個評估以後,一個淘汰出局就這個有在加速生產那個經不起考驗淘汰第二個我們覺得時間不夠要繼續觀察第三個他同意了,我們覺得他的療程安全都確定了所以我們要把它回歸到正常的使用 |
| transcript.whisperx[20].start |
441.103 |
| transcript.whisperx[20].end |
463.591 |
| transcript.whisperx[20].text |
這有三條路可以走不然我是要說的癌藥不斷的在研發需求也會增加百億如何分配我到現在看不到用完怎麼辦因為賴總統我覺得他不能理解很深入的是ok的因為日理萬機賴總統意思好像好像預期會有勝他先用多少不夠我再補他預期會有勝那部長你也會認為有勝嗎 |
| transcript.whisperx[21].start |
468.092 |
| transcript.whisperx[21].end |
493.638 |
| transcript.whisperx[21].text |
我有我的資深專業的那個經驗30年前告訴你 保留癌症病人絕對會面臨另外一個噩夢因為錢是不夠用的不夠用大概要讓這個滿足這一塊 幾百億都不夠那最後會怎麼樣呢 維持現況現況是什麼 就是不人道的方式你限制癌症病人使用的對象變得很小很窄然後限制他使用次數跟時間 |
| transcript.whisperx[22].start |
495.398 |
| transcript.whisperx[22].end |
515.711 |
| transcript.whisperx[22].text |
那這個這麼多先生這是第一個到最後回到現在的噩夢這個事情我可以確定是這樣第二個當剛剛我跟你說明過當挑選後經過評估因為要評估暫時中繼站那你要進進出出到哪個地方去根據美國的經驗繼續使用就確定療效大概有六成他沒有經驗所以我們先用美國的經驗有兩成大概淘汰還有兩成他大概說我們要更長時間的觀察那有這兩個事情在前提那我請問部長 |
| transcript.whisperx[23].start |
524.717 |
| transcript.whisperx[23].end |
530.782 |
| transcript.whisperx[23].text |
這個衛福部有規劃那個中長期的裁員嗎還是說你想說先擋個兩年拖個兩年再說呢好 |
| transcript.whisperx[24].start |
532.933 |
| transcript.whisperx[24].end |
547.46 |
| transcript.whisperx[24].text |
包委員真的非常敬佩您指教這麼多專業的一個做法我相信對未來在處理心療癌症這個預算能夠有很大的幫助但是我必須要講賴總統絕對存著就是希望希望說真的病人需要癌藥的時候我們就是想盡辦法 |
| transcript.whisperx[25].start |
557.845 |
| transcript.whisperx[25].end |
569.413 |
| transcript.whisperx[25].text |
給他充分 足夠及時那這個部分後面他立定了一個很這麼關懷我們前骨癌症的病人的方向以後原則我沒有問題那我們怎麼來把它做法嘛就是我們必須要來把它落實但是他有總統也特別強調說要多少就補多少 |
| transcript.whisperx[26].start |
587.725 |
| transcript.whisperx[26].end |
613.547 |
| transcript.whisperx[26].text |
就是要把我們的癌症的病人幫他照顧好 降低死亡率那署長我剛剛講的那些問題 你有瞭解嗎你也知道問題在哪裡嘛 對不對 加速的通過那你現在怎麼辦 你準備好了沒有 大概已經這個很快 你準備了這個要解決的問題 就是這個癌症新藥基金這個等於是讓我們在財務預估上可以算準確 |
| transcript.whisperx[27].start |
615.008 |
| transcript.whisperx[27].end |
637.469 |
| transcript.whisperx[27].text |
我們現在有的時候還不知道到底使用會有多少所以未來還是會回到健保基金一樣的它回到健保所以在這健保裡面去編列這個新藥預算的時候讓它可以等你有一個庫讓你先了解那我告訴你說美國大概六成人會回來你六成人回來錢都準備好了那你這樣病人怎麼辦我治療有效結果你不讓我繼續用惡夢出現 |
| transcript.whisperx[28].start |
640.452 |
| transcript.whisperx[28].end |
643.794 |
| transcript.whisperx[28].text |
無縫的接軌啦你今天也談不出這個100億怎麼分啦怎麼 allocation 怎麼分配啦這個還有很大的問題還是不夠因為賴總統他以為夠他還說不夠我就補回去不夠就補回去不夠的啦賴總統也覺得不夠啦不夠的話問題就來那你就開始要壓縮使用嘛壓縮就開始分配嘛 |
| transcript.whisperx[29].start |
661.303 |
| transcript.whisperx[29].end |
676.521 |
| transcript.whisperx[29].text |
分配就開始你誰先用這個就涉及每一個人的觀點主審的最大這個就是我跟你講很多人他不是真的要去圖利誰可是他有他自己的想法這個是很難處理的所以我也一直很關心這件事情然後現在我就回到說現在你的這個分區共管你知道這個有後遺症嗎不管署長或部長 |
| transcript.whisperx[30].start |
681.607 |
| transcript.whisperx[30].end |
700.107 |
| transcript.whisperx[30].text |
不同區域之一人之人本來就不均勻啦你分區共管那會不會惡化那個城鄉的差距呢而且如果地方管理適當齁那健保這個費用運用適當民眾群會不會受損那衛福部跟健保署是否已經有事辦範圍啊標準配套監督機制你就等於說幫他去管啊 |
| transcript.whisperx[31].start |
701.488 |
| transcript.whisperx[31].end |
711.513 |
| transcript.whisperx[31].text |
那每個醫院就管 你在這個情況下如果你在等於在自生自滅喔你不把總額這個大帽子拿掉你等於讓各地區各醫院自己去自生自滅喔 |
| transcript.whisperx[32].start |
713.206 |
| transcript.whisperx[32].end |
726.877 |
| transcript.whisperx[32].text |
現在已經發生了你看好我看下一張好了就是我告訴你這個現象你們大家知道你看現在醫院怎麼存活南部的醫學中心就在醫生的處方的螢光幕上跟你說跟你說我建議你開這個藥因為這個要打圈圈兩個圈圈為什麼呢因為利潤最高 |
| transcript.whisperx[33].start |
731.661 |
| transcript.whisperx[33].end |
734.982 |
| transcript.whisperx[33].text |
你難免逼著人家去做這件事嘛而且就是說還寫說敬請開立藥品時同時考慮醫療經濟學的成本效益其實藥品價格不代表醫療成本效益經濟學的但是它就是一個簡化的方式那他們的醫師自己說這些提示雖然沒有強制但是在這個院務會這個每一季的討論的時候你就科別業績沒搞 |
| transcript.whisperx[34].start |
758.05 |
| transcript.whisperx[34].end |
772.642 |
| transcript.whisperx[34].text |
你這個要被檢討 績效不好啊這個情況下醫師就被迫去勾那個藥啊已經出現了啦 部長署長 我想你們都知道吧醫院會建議你醫生怎麼藥 病人聽聽看我的意思是醫院建議他用哪一個藥那我的感覺呢 我的權益呢病醫生的專業權 自主權怎麼辦後遺症都出現 所以我才說 |
| transcript.whisperx[35].start |
781.829 |
| transcript.whisperx[35].end |
787.17 |
| transcript.whisperx[35].text |
你要分區各管但是你有沒有監測的配套的機制去看看這個品質嘛對不對就像署長昨天那個林靜儀的那件事情對不對他的他提出來的那個國際要價不是那個藥品的國際要價他把它污品掉了今天的專科醫師都跑出來講了所以他裡面那個不同的那個所謂的那個封口劑喔裡面有不同還有人添加凝血因子還有人添加防沾黏的功能根本都不一樣 |
| transcript.whisperx[36].start |
811.414 |
| transcript.whisperx[36].end |
822.039 |
| transcript.whisperx[36].text |
你把它全部從分類分組一個叫grouping他們最害怕這個字你沒有廠牌之分把它放在同一組用裡面最低的價錢林靜儀次長唸出來的這邊都有公開的資料他唸的不是那個藥品的國際藥價但是你們在分組的時候可能出問題現在醫師大反彈因為那個病只有一次救命的機會對不對大動脈剝離主動脈剝離只有一次救命機會他當時沒有辦法就沒有辦法 |
| transcript.whisperx[37].start |
838.687 |
| transcript.whisperx[37].end |
851.981 |
| transcript.whisperx[37].text |
如果你把它縫好了 水還是漏出來 雪還是漏出來就要靠這個凝膠去把它黏住就像淋到水管的私力控一樣嘛 對不對那它可能是本質不一樣 我是看專科醫師在談這件事情那你要把它放在同一組以後請林次長不懂 不要亂講話 現在醫師大反彈了 |
| transcript.whisperx[38].start |
860.51 |
| transcript.whisperx[38].end |
868.615 |
| transcript.whisperx[38].text |
我簡單回應一下,第一個就是各區的公關,我相信你來行的,你是不是所有相關的委員會你都當過,其實在南區做得不錯但是這個現象都出現啊 |
| transcript.whisperx[39].start |
878.961 |
| transcript.whisperx[39].end |
897.235 |
| transcript.whisperx[39].text |
所以美國的模式,我們總是要突破嘛所以是可以用在各區也是共管,其實這樣各區也是自己共管只是方式不太一樣現在出現後遺症我們告訴你嘛我們一定是預防後遺症那像剛剛提出這個部分我們健保署去了解逼迫醫院去這樣做啊 |
| transcript.whisperx[40].start |
904.201 |
| transcript.whisperx[40].end |
916.947 |
| transcript.whisperx[40].text |
其實如果一個以,因為我也是醫師,我也非常反對影響到醫師的住宿專業錢跟一樣嘛,我們不管是醫藥都是專業的嘛,我們真的很不希望被影響但是怎麼樣慢慢的讓整個醫療的行為能夠 |
| transcript.whisperx[41].start |
922.95 |
| transcript.whisperx[41].end |
947.247 |
| transcript.whisperx[41].text |
能夠恢復健康經濟,然後對人民好我們價值理念都一樣,我現在在說就食物啦另外署長你在醫材,那個當然我在藥品太久了醫材的部分,你要grouping的時候,你要把它分類成同一組,當作你們是同一夥的同樣的東西,我只花一樣的錢去買的時候,還是要小心啊因為醫生說不同成分,裡面我一聽有磷血因子,加磷血因子當然貴啊 |
| transcript.whisperx[42].start |
949.755 |
| transcript.whisperx[42].end |
969.72 |
| transcript.whisperx[42].text |
當然我不知道,那林次長他給的那個國際要價不是他的國際要價然後大家就會以為說,就這麼貴你怎麼還要炒,炒的是醫生啊謝謝委員,我跟委員一樣都不是對所有的藥物都那麼清楚所以還是需要專家的意見為主啦所以我們會再回去,我們都有機制 |
| transcript.whisperx[43].start |
972.14 |
| transcript.whisperx[43].end |
1000.721 |
| transcript.whisperx[43].text |
我們這個過去全部都是自費啦過去都是自費現在才納入健保給付那至於一開始五月要納入健保給付他還有時間來申付他要提高價格把成本給我們看我們還是要為健保的財務把關啦所以我們要跟國際要價相比需要看他的成本合給一個合理的價格但是沒有他就隱藏他的自己的國際要價嘛你們這個共理會的表就隱藏他是空白啦只有他空白其他都有啊 |
| transcript.whisperx[44].start |
1001.682 |
| transcript.whisperx[44].end |
1010.937 |
| transcript.whisperx[44].text |
所以就是這個要出問題啦這個藥也不是最主流的藥所以其他主流的藥沒有問題所以供藥上沒有問題我以表達謝謝主席 |