| IVOD_ID |
17029 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Full/1M/17029 |
| 日期 |
2025-11-13 |
| 會議資料.會議代碼 |
委員會-11-4-26-10 |
| 會議資料.會議代碼:str |
第11屆第4會期社會福利及衛生環境委員會第10次全體委員會議 |
| 會議資料.屆 |
11 |
| 會議資料.會期 |
4 |
| 會議資料.會次 |
10 |
| 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4會期社會福利及衛生環境委員會第10次全體委員會議 |
| 影片種類 |
Full |
| 開始時間 |
2025-11-13T08:32:53+08:00 |
| 結束時間 |
2025-11-13T14:08:00+08:00 |
| 影片長度 |
05:35:07 |
| 支援功能[0] |
ai-transcript |
| video_url |
https://h264media01.ly.gov.tw:443/vod_1/_definst_/mp4:1M/bfaf9b39ac01a6859bd2a7f32a503ebb2a193970ec28db5a914d0d15f34b2c023fd85d24e81201735ea18f28b6918d91.mp4/playlist.m3u8 |
| 會議時間 |
2025-11-13T09:00:00+08:00 |
| 會議名稱 |
立法院第11屆第4會期社會福利及衛生環境委員會第10次全體委員會議（事由：邀請衛生福利部部長及行政院主計總處就「癌症新藥暫時性支付及罕見疾病藥物專款預算運用成效及政策檢討」進行專題報告，並備質詢。
(討論事項)
審查
一、委員羅廷瑋等16人擬具「癌症防治法第十三條及第十六條條文修正草案」案。
二、委員陳菁徽等16人擬具「癌症防治法第十六條條文修正草案」案。
三、委員邱鎮軍等19人擬具「癌症防治法第五條及第十六條條文修正草案」案。
四、委員劉建國等17人擬具「癌症防治法第十六條條文修正草案」案。
五、委員王正旭等17人擬具「癌症防治法第十六條條文修正草案」案。
六、委員顏寬恒等21人擬具「癌症防治法第十三條條文修正草案」案。
七、委員林淑芬等20人擬具「癌症防治法第十六條條文修正草案」案。
八、委員盧縣一等17人擬具「癌症防治法第八條及第十六條條文修正草案」案。
九、委員顏寬恒等24人擬具「癌症防治法第十六條條文修正草案」案。
十、委員蘇巧慧等30人擬具「癌症防治法修正草案」案。
十一、委員林月琴等16人擬具「癌症防治法第十六條條文修正草案」案。
十二、委員邱議瑩等16人擬具「癌症防治法第十六條條文修正草案」案。
十三、委員羅智強等18人擬具「癌症防治法第十六條條文修正草案」案。
十四、台灣民眾黨黨團擬具「癌症防治法第一條、第十三條及第十六條條文修正草案」案。
十五、委員陳亭妃等17人擬具「癌症防治法第十六條條文修正草案」案。
十六、委員黃秀芳等21人擬具「癌症防治法第十六條條文修正草案」案。
十七、委員馬文君等16人擬具「癌症防治法第十六條條文修正草案」案。
【專題報告及討論事項綜合詢答；討論事項僅詢答】） |
| 委員名稱 |
完整會議 |
| 委員發言時間 |
08:32:53 - 14:08:00 |
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好現在開會報告委員會初期委員人數已足法定人數請主席宣布開會好現在開會請議事人員宣讀上次會議議事錄立法院第十一屆第四會期社會福利及衛生環境委員會第九次全體委員會議議事錄時間114年11月12日星期三9時至14時7分 |
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地点群贤楼801会议室出席委员陈委员赵姿等14人列席委员林委员德福等18人请假委员杨耀英凤黄台风停班停课航班取消列席官员劳动部部长洪生翰等相关人员主席刘兆吉委员建国报告事项宣读上次会议议事录决定确定邀请劳动部部长列席报告业务概况并被质询 |
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本日會議由勞動部部長報告後委員陳昭芝等二十二人提出質詢均經勞動部部長及各相關主管等及其答覆委員楊耀 林德福及翁曉琳所提書面質詢列入紀錄刊登公報決定一 報告及詢答完畢二 委員質詢未及答覆或請補充資料者請相關機關於二週內書面答覆委員令要求期限者從期鎖定通過臨時提案一項宣讀完畢 |
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好 請問委員會上市議事錄有錯誤或疑惑之處沒有 謝謝 那我們議事錄確定那本日會議議程為第一 邀請衛生福利部部長及行政院主計總署就癌症診療暫時性支付及罕見疾病藥物專款預算運用成效及政策檢討進行專題報告並備諮詢 |
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第二 審查委員黨團分別凝聚癌症防治法修正草案G17案以上專題報告及討論事項採綜合詢答現在來介紹在場委員及列席官員我們第一位是王振旭王委員第二位是林月琴林委員第三位是羅廷偉羅委員第四位是蘇巧慧蘇委員 |
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然後列席官員是衛護部部長施崇良我們健保署署長陳亮瑜還有國健署署長沈靜芬洗手間好食品藥物管理署署長江志剛謝謝社會保險師代理市長陳珍惠謝謝行政院主計總署基金預算處專門委員戴群芳謝謝 |
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1824.504 |
| transcript.whisperx[6].text |
好 公務預算處專門委員陳淑萍好 華澳部參事汪蘭君好 謝謝那接著請提案委員說明提案要職 每位委員兩分鐘那第一位請羅廷偉委員來做說明 |
| transcript.whisperx[7].start |
1832.039 |
| transcript.whisperx[7].end |
1861.702 |
| transcript.whisperx[7].text |
好 謝謝主席癌症已經連續43年位居國人的十大死因之首其相關的一個療程跟抗癌的藥物我們都知道費用是非常高昂雖然我國已經實施了全民健康保險的制度但健保在新型藥物跟抗癌的療程納入給付的速度已經明顯趕不上整個醫療發展的進度許多的病友必須要自己承擔高額的費用這就是我們所擔心的 |
| transcript.whisperx[8].start |
1862.102 |
| transcript.whisperx[8].end |
1883.881 |
| transcript.whisperx[8].text |
所以我提案的癌症防治法第13條跟第16條的條文修正主要有三大的重點第一為減輕病友醫療的一個健康負擔我們政府應該設置癌症新藥多元基金的支持方案作為癌症新藥納入健保給付前的一個過渡措施第二 |
| transcript.whisperx[9].start |
1884.742 |
| transcript.whisperx[9].end |
1904.105 |
| transcript.whisperx[9].text |
除了藥品之外 針對全民健康保險為給付之檢查醫療器材也應該一併納入第三 針對經濟弱勢的癌症病人給予適當的醫療費用補助目前雖然已經有了癌症心要暫時性的支付 |
| transcript.whisperx[10].start |
1905.246 |
| transcript.whisperx[10].end |
1931.174 |
| transcript.whisperx[10].text |
這樣的制度但這對我們現在所屬的過渡性措施並非長遠之計所以為確保制度的穩定跟裁員能夠有來源的一個明確規定仍有必要透過立法院加以規範確立我們建立的法源依據的一個長期支持體系最後我要提感謝這個召委今日排審 |
| transcript.whisperx[11].start |
1931.994 |
| transcript.whisperx[11].end |
1960.396 |
| transcript.whisperx[11].text |
癌症的防治法修正草案社會各界對於癌症新藥多元基金呢已經是非常高度的關切跟支持也期盼所有的委員不分草野不分藍綠白我們大家共同來回應所有社會的期待跟病友還有他們的家屬的未來以上好 謝謝羅定偉的提案說明接下來請王振旭王委員 |
| transcript.whisperx[12].start |
1973.203 |
| transcript.whisperx[12].end |
1993.551 |
| transcript.whisperx[12].text |
謝謝主席主席還有各位同仁各位觀眾大家早針對於癌症防治法的修正我們關心的是國家如何讓癌症防治工作能夠穩定的運作如何確實來支援病友跟他的家庭我本身是一個癌症臨床的醫師在擔任立委之前也長期的投入癌症希望基金會的工作 |
| transcript.whisperx[13].start |
1994.091 |
| transcript.whisperx[13].end |
2020.746 |
| transcript.whisperx[13].text |
今天希望和各位一起来思考如何能够加速癌症新药基金的运作健全审查还有争取多元的裁员来落实病友的权益虽然台湾拥有健保制度跟优秀的医疗水平但是癌症新药从取得许可证到纳入健保平均还是需要两年以上病友往往先需要自费的购药不仅造成省重的负担而且会错失了治疗的时效 |
| transcript.whisperx[14].start |
2021.506 |
| transcript.whisperx[14].end |
2050.826 |
| transcript.whisperx[14].text |
政府自从2025年开始试行癌症新药暂时性的支付专款以公务预算来预注初中非常的良好但是还是有三个主要的问题第一个就是执行率的偏低今年虽然有50亿可是仅用到23.6亿我们希望能够尽速的来把它用到这个让病人的身上第二个就是审查的延档部分的这个药品从许可证核化到几乎剩下还需要800到2000天不等当然这是少数的部分 |
| transcript.whisperx[15].start |
2051.346 |
| transcript.whisperx[15].end |
2074.799 |
| transcript.whisperx[15].text |
那裁員其實還是不穩資金僅靠行政預算來支應缺乏法院跟長期的這個監督的機制所以這樣的情形容易導致這個病有擴大措施這個最佳的治療時機因病治平醫師也難以根據國際指引來提供治療拉大我國跟國際間的存活的差異所以具體的建議包括第一個加速基金的審核跟執行 |
| transcript.whisperx[16].start |
2075.92 |
| transcript.whisperx[16].end |
2099.162 |
| transcript.whisperx[16].text |
目前這個健保署應該公開審查跟幾乎的進度建立透明的追蹤平台定期來召開專案審查會議避免經費閒置第二個部分就是健全多元的裁員機制那研議相包括像菸酒的健康捐 碳稅等等希望能夠確定這個穩定的裁員確保不予健保的總額有排擠的作用 |
| transcript.whisperx[17].start |
2099.702 |
| transcript.whisperx[17].end |
2129.089 |
| transcript.whisperx[17].text |
第三个就是推动长期的策略蓝图以2030年癌症标准化死亡率下降三分之一为目标规划几幅蓝图确保早期治疗可及时的介入那新药的这个基金在我国癌症防治的重要的里程碑之下这不不仅是单纯的修法而是督促行政机关加速来实行健全制度保障病友希望各位能够透过这些方式来保障我们癌友的权益 |
| transcript.whisperx[18].start |
2135.063 |
| transcript.whisperx[18].end |
2138.891 |
| transcript.whisperx[18].text |
好 謝謝王委員的提案說明 接下來請林月琴委員來做提案說明 |
| transcript.whisperx[19].start |
2147.925 |
| transcript.whisperx[19].end |
2171.781 |
| transcript.whisperx[19].text |
主席部長還有各位同仁那這個法案雖然是我去年的提案但是根據衛福部113年的最新死因統計癌症冷居我們國人的首位死因去年共有將近五萬五千人因癌症過世其中約八成集中在55歲以上的族群這不是單一的疾病問題而是國家整體公共衛生體系的壓力 |
| transcript.whisperx[20].start |
2172.862 |
| transcript.whisperx[20].end |
2200.368 |
| transcript.whisperx[20].text |
目前癌症用藥呢價格昂貴在健保總額制度下常被排擠導致新藥給付的延拓病人等不到治療行政院雖然已經提出來癌症新藥的基金政策將編列40億到50億元建立暫時性支付的制度但此制度機制呢僅以行政命令為依據缺乏法律授權跟永續性制度能否 |
| transcript.whisperx[21].start |
2201.471 |
| transcript.whisperx[21].end |
2218.473 |
| transcript.whisperx[21].text |
延續能存在疑慮因此本次修正第16條明定國家有責任籌措並支付癌症用藥的費用經費來源包括政府的預算補充跟捐贈基金的支息跟其他收入並授權主管機關訂定 |
| transcript.whisperx[22].start |
2220.434 |
| transcript.whisperx[22].end |
2247.161 |
| transcript.whisperx[22].text |
經費運用及補助辦法這項修法的精神是要讓癌症新藥取得不再依賴行政彈性而是上升為國家的法定義務我要請各位委員支持這項修法讓國家以法律明定責任確保病人能公平及時的用到有效的新藥讓生命不再被預算跟程序所耽誤 謝謝好 謝謝林委員的提案說明接下來請蘇巧慧委員來做提案說明 |
| transcript.whisperx[23].start |
2257.346 |
| transcript.whisperx[23].end |
2272.78 |
| transcript.whisperx[23].text |
謝謝 主席 各位官員 各位同仁1982年起 癌症為我國十大死因之首在許多前輩努力下2003年我國催生了癌症防治法施行迄今滿20年該法也未有大幅度的盤整修正 |
| transcript.whisperx[24].start |
2273.34 |
| transcript.whisperx[24].end |
2294.945 |
| transcript.whisperx[24].text |
然而癌症仍持续蝉联于我国十大死因之首已是连续41年居于首位这样的趋势并未因我国立了癌症防治法而有所逆转因此本席认为癌症防治法已有必要通盘检讨加入新观念并将癌症新药基金法制化 |
| transcript.whisperx[25].start |
2295.865 |
| transcript.whisperx[25].end |
2312.315 |
| transcript.whisperx[25].text |
故本席提出癌症防治法的修正草案其重點如下第一將癌症防治的工作範圍定義擴大從醫療保健擴大到教育社政勞政環保等領域相互協調合作確保癌症防治策略能平等落實 |
| transcript.whisperx[26].start |
2313.436 |
| transcript.whisperx[26].end |
2329.595 |
| transcript.whisperx[26].text |
二建構癌症病患及其家人能安心生活於社會除了提供適當的癌症治療及照護外也應該提供相關支持服務包含心理支持及社會支持等事項使其能與疾病共存降低癌症死亡率 |
| transcript.whisperx[27].start |
2330.256 |
| transcript.whisperx[27].end |
2344.994 |
| transcript.whisperx[27].text |
第三鼓勵民間參與癌症防治工作或相關研究且民間捐贈有關癌症預防篩檢之經費及捐贈癌症診斷及治療基金準用所得稅負減免的相關規定 |
| transcript.whisperx[28].start |
2346.235 |
| transcript.whisperx[28].end |
2369.986 |
| transcript.whisperx[28].text |
第四本席提案中有設置基金為癌症防治基金與多數委員提案的癌症新藥基金並不相同我們認為補助的項目不僅應該有健保未給付的癌症新藥也應該補助相關的醫療服務如手術費用等此外這筆基金也應補助相關開發教育訓練學術研究及國際交流等 |
| transcript.whisperx[29].start |
2370.606 |
| transcript.whisperx[29].end |
2379.392 |
| transcript.whisperx[29].text |
其目的是為了加速癌症新興科技的發展期待使更多病人受惠以上為本席的提案請各位委員支持指教 謝謝好 謝謝蘇委員的提案說明接下來請陳清輝委員來做提案說明謝謝主席 謝謝各位官員還有以及立法院的同事 |
| transcript.whisperx[30].start |
2399.383 |
| transcript.whisperx[30].end |
2416.792 |
| transcript.whisperx[30].text |
癌症并非远在天边它可能发生在我们最亲近的家人朋友还有一起奋斗的伙伴身上我相信身边许多人都有同样的经验因此我要特别感谢招委安排本次的修法其实我本人是后生会的副会长 |
| transcript.whisperx[31].start |
2417.432 |
| transcript.whisperx[31].end |
2439.38 |
| transcript.whisperx[31].text |
在11月4日立法院後生會很多官員也同參加了召開提升台灣癌症新藥可進行相關會議在會中呢專家學者理事長們並有團體以及朝野立委都有提出寶貴的建言來檢視台灣癌症治療還有新藥可進行的挑戰以及未來的方向 |
| transcript.whisperx[32].start |
2440.12 |
| transcript.whisperx[32].end |
2454.566 |
| transcript.whisperx[32].text |
如何讓癌症新藥基金走向法治化 制度化 永續化是立法院跨黨派的高度共識從本次提案的委員也能夠看出這是人民所期盼而且朝野共同努力的目標 |
| transcript.whisperx[33].start |
2455.846 |
| transcript.whisperx[33].end |
2471.266 |
| transcript.whisperx[33].text |
當然這條路上不只有立法委員在努力更要謝謝一路以來醫護專業團體並有家屬還有所有關心台灣醫療健康的夥伴們始終站在同一個陣線為改變而努力然而讓我們回望現況 |
| transcript.whisperx[34].start |
2473.108 |
| transcript.whisperx[34].end |
2487.136 |
| transcript.whisperx[34].text |
40年這是癌症高居國人十大死因之首的時間它是全民必須共同面對的課題我們不能只是接受現狀而是要思考制度如何革新讓政策可以真正的永續 |
| transcript.whisperx[35].start |
2488.217 |
| transcript.whisperx[35].end |
2514.837 |
| transcript.whisperx[35].text |
更令人憂心的是今年已經有47項新藥退出台灣市場明年更可能超過百種藥品選擇不再進入或撤出台灣市場目前暫行性的癌症新藥基金面臨三大挑戰第一是法源的基礎不足二是財務穩定性缺乏第三資訊的透明度還有病友參與的機制不足 |
| transcript.whisperx[36].start |
2515.638 |
| transcript.whisperx[36].end |
2539.466 |
| transcript.whisperx[36].text |
面對賴清德總統提出2030年癌症死亡率下降三分之一的目標我們必須認清如果新藥沒有辦法及時穩定還有可負擔這個目標終將難以實現最後我也期盼衛福部長官這次的修法過程中能夠明確的回應國人到底衛福部的立場為何這才是至關重要還有人民最關心的核心問題謝謝 |
| transcript.whisperx[37].start |
2543.851 |
| transcript.whisperx[37].end |
2547.425 |
| transcript.whisperx[37].text |
好 謝謝陳委員的提案說明接下來請陳昭志委員來代表台灣民眾黨黨團說明 |
| transcript.whisperx[38].start |
2554.581 |
| transcript.whisperx[38].end |
2580.744 |
| transcript.whisperx[38].text |
謝謝昭緯的排審那我還在藥界就知道這個昭緯長期關心癌症病跟病友團體一起努力那我也非常認同您說的百益癌症新藥其實是不只百益意思說不是只有百益就可以解決的那我代表民眾說明我們這次癌症防治法修正草案那同時我目前也是這個後生會提升新藥台灣新藥癌症 |
| transcript.whisperx[39].start |
2581.445 |
| transcript.whisperx[39].end |
2602.306 |
| transcript.whisperx[39].text |
可敬信的委員會的召集人之一那我們修法的核心目的就是希望能夠讓創新的藥物能夠更快的更穩定的納入整個我們的醫療體系讓病友不要再因為健保制度的局限而失去了治療的時機健保本身當然是這個全民醫療安全網但是 |
| transcript.whisperx[40].start |
2602.907 |
| transcript.whisperx[40].end |
2628.65 |
| transcript.whisperx[40].text |
他也应该兼顾这个永续但目前的制度过于强调这个财务的平衡跟总额控制导致有创新价值的这个新药跟科技往往无法及时纳入那这不但影响病人的这个治疗机会也让许多家庭面对疾病时候感到制度冷漠跟无力那今年国会的论坛郑索夏教授也指出政府应该把创新疗法的支出独立成常态化的一个预算池 |
| transcript.whisperx[41].start |
2629.591 |
| transcript.whisperx[41].end |
2644.669 |
| transcript.whisperx[41].text |
那为了实现2030年让更多癌症病人活得更久活得更好我们需要的不是临时方案而是一个有稳定机缘稳定根基能够长久陪伴病友的基金那目前这个款项是靠公共预算临时拨补没有法源基础 |
| transcript.whisperx[42].start |
2645.249 |
| transcript.whisperx[42].end |
2668.03 |
| transcript.whisperx[42].text |
所以也让很多病友担心要是哪一天他终止呢不见了呢所以我觉得这个议题是朝野的共识癌症不只是公共卫生议题更关心社会公平跟人权为什么我这样说呢尤其我们现在知道癌症的成因很复杂有基因的有病毒的还有环境污染的因素比例越来越重所以我们希望透过这次的修法再不增加 |
| transcript.whisperx[43].start |
2668.55 |
| transcript.whisperx[43].end |
2695.677 |
| transcript.whisperx[43].text |
健保的負擔前提下設立基金補償制度的缺口讓每一個癌症病人都能夠得到及時的醫療那這次修法不只是回應病友的期待我希望每一個面對疾病的人他們會知道國家沒有忘掉他們最後我要說的是大家都說癌症很多醫療人員鼓勵病人說癌症不是絕症但是如果你沒有及時提供創新有價值的治療跟機會癌症就會變成絕症謝謝 |
| transcript.whisperx[44].start |
2702.947 |
| transcript.whisperx[44].end |
2727.796 |
| transcript.whisperx[44].text |
好謝謝陳昭志委員的提案說明那我的提案說明可能在這邊就簡略一下第一個補充昭志委員剛剛特別提到的當時跟我們的同仁幾位同仁還有這些癌症病友然後積極來推動了他的正確名稱叫做這個台灣癌症新藥多元支持基金證明是這樣 證明是這樣 |
| transcript.whisperx[45].start |
2729.854 |
| transcript.whisperx[45].end |
2755.65 |
| transcript.whisperx[45].text |
但是我不曉得後來為什麼會有一個叫百億癌症新藥多元基金這個不曉得是誰生出來的後來相關的媒體也用這樣做處理我再次證明我們要推動叫做台灣癌症新藥多元支持基金它的預算絕對不會亞於百億這第一件事情那第二件事情我要在這邊特別感謝我們這個健保署這個時署長 |
| transcript.whisperx[46].start |
2758.365 |
| transcript.whisperx[46].end |
2773.292 |
| transcript.whisperx[46].text |
在他的任內坦白講真的對這個癌症新藥對相關的癌症病友的積極的這樣的一個協助然後很多的期程縮短然後有更多元的這些新藥 |
| transcript.whisperx[47].start |
2773.992 |
| transcript.whisperx[47].end |
2790.523 |
| transcript.whisperx[47].text |
都可以來幫助這些癌症的病患我記得那個2022年到現在很短的時間內收費將近有應該有三四千的這個癌友然後讓每個癌友幾乎可以減輕的這個平均的醫療費用一個人應該有將近100多萬 |
| transcript.whisperx[48].start |
2795.166 |
| transcript.whisperx[48].end |
2823.128 |
| transcript.whisperx[48].text |
我想讓癌友可以看到這個曙光那現在感謝之前的石署長特別期望現在的石部長因為署長變部長之後那個power會更大所以應該未來我們可能短短一兩年之內不只是3300的病患不只是三到四千的癌症病友可以收尾應該有更大的power更大的這個癌症病友都可以 |
| transcript.whisperx[49].start |
2825.966 |
| transcript.whisperx[49].end |
2845.505 |
| transcript.whisperx[49].text |
來這個新藥的這樣一個支持甚至以減少更多這樣的一個醫療費用的支出那各位剛剛特別提到賴總統一直宣示 早已宣示就是希望這個2031年癌症的死亡要降低到三分之一所以讓這個癌症新藥可以法制化 |
| transcript.whisperx[50].start |
2846.266 |
| transcript.whisperx[50].end |
2861.466 |
| transcript.whisperx[50].text |
我想這是一個必須要走的一個步驟而且我們也必須要加快速度所以今天也特別感謝很多的委員都可以來這樣的一個提案共同要來把這件事情完整也讓我們的癌症病友可以看到這樣的曙光 |
| transcript.whisperx[51].start |
2861.946 |
| transcript.whisperx[51].end |
2879.143 |
| transcript.whisperx[51].text |
也讓我們的癌藥可以有用然後看得到一定要用得到不要再錯失這個黃金治療的這樣的一個時機好簡單做這樣說明謝謝那我們接下來就來請衛福部時務部長就本日會議議程專題報告及討論事項並案報告及說明 |
| transcript.whisperx[52].start |
2889.216 |
| transcript.whisperx[52].end |
2914.228 |
| transcript.whisperx[52].text |
趙偉還有各位委員大家早很感謝趙偉安排今天的專題報告讓本部可就癌症新藥暫時性支付及罕見疾病藥物專款的運用這個成效跟政策的檢討那麼來做這個專題的報告那麼請各位委員來不吝指教那麼癌症 |
| transcript.whisperx[53].start |
2916.209 |
| transcript.whisperx[53].end |
2940.651 |
| transcript.whisperx[53].text |
已經連續43年了是我國的十大死因之首那為了這個減少國人因癌症的死亡那麼我們積極的在按照癌症防治法的相關規定持續的推動有關於預防篩檢治療研究等等那麼癌症的防治政策來希望落實 |
| transcript.whisperx[54].start |
2942.933 |
| transcript.whisperx[54].end |
2957.047 |
| transcript.whisperx[54].text |
這個總統所倡議的健康台灣的願景在2030年之前可以讓癌症的標準化死亡率下降三分之一那麼事實上我國整體的癌症的標準化死亡率已經從96年 |
| transcript.whisperx[55].start |
2958.909 |
| transcript.whisperx[55].end |
2980.448 |
| transcript.whisperx[55].text |
的每10萬人口142.6人下降到了113年的113.3人所以整個長期趨勢來講呢那麼是呈現下降的趨勢但是為了去強化這個癌症的治療讓這個新藥可進性可以提升讓更多的 |
| transcript.whisperx[56].start |
2981.629 |
| transcript.whisperx[56].end |
2998.539 |
| transcript.whisperx[56].text |
病人可以受惠於新藥的療效減輕經濟的負擔因此本部在114年開始就以公務預算挹注全民健康保險基金50億來成立癌症新藥暫時性支付專款 |
| transcript.whisperx[57].start |
2999.58 |
| transcript.whisperx[57].end |
3024.506 |
| transcript.whisperx[57].text |
那么先就这个疗效已经明确但是受到总而限制无法纳入收载的癌症新药或新适应症那么来先给付那么直到这个今年的10月呢那么114年到10月间呢已经收载了7项的癌症新药跟扩充3项的扩增给付 |
| transcript.whisperx[58].start |
3025.286 |
| transcript.whisperx[58].end |
3043.811 |
| transcript.whisperx[58].text |
這裡面也包含了標靶新藥標靶藥物跟免疫治療的藥物受惠的人數超過3500人那麼預估已經支付的是21.94億左右那明年的預算會再持續挹注50億那麼來逐步累積 |
| transcript.whisperx[59].start |
3044.811 |
| transcript.whisperx[59].end |
3070.538 |
| transcript.whisperx[59].text |
那麼按照病人的需要來使用那為了讓這一筆的專款那麼有法源的依據我們也修訂了全民健康保險基金收支保管及運用辦法那麼讓他有所依據專款專用於癌症的新藥給付那麼此外呢為了加快這個健保的治療藥品可與國際治療的指引 |
| transcript.whisperx[60].start |
3071.238 |
| transcript.whisperx[60].end |
3084.922 |
| transcript.whisperx[60].text |
那麼接軌那麼同時就其成本效益做有效率的評估因此我們在去年的1月1號也成立了健康政策與醫療科技評估中心的專責辦公室來推動 |
| transcript.whisperx[61].start |
3087.643 |
| transcript.whisperx[61].end |
3107.018 |
| transcript.whisperx[61].text |
新藥的平行審查 暫時性支付等業務另外今年我們也提送了行政法人國家醫療科技評估中心的設置條例草案目前在行政院審理中 後續希望能夠得到大院的支持 |
| transcript.whisperx[62].start |
3109.801 |
| transcript.whisperx[62].end |
3126.702 |
| transcript.whisperx[62].text |
那麼至於在罕見疾病的照顧部分呢那麼本部健保署逐年也編列了罕見疾病學有病跟罕見疾病特採的專款也就是在我們的總額的一般服務之外 |
| transcript.whisperx[63].start |
3127.202 |
| transcript.whisperx[63].end |
3134.947 |
| transcript.whisperx[63].text |
統計110年到114年 近5年的預算的成長率是11.3%在114年已經達到181億 那明年的預算持續成長我們目前編列的是192.21億再加上公務預算 預注20億 就會超過到212億 |
| transcript.whisperx[64].start |
3153.277 |
| transcript.whisperx[64].end |
3168.255 |
| transcript.whisperx[64].text |
那麼執行率呢這近年的執行率大概都有九成以上113年的執行率更達到99%那麼共收窄了六項新藥跟兩項的擴增那麼主要是 |
| transcript.whisperx[65].start |
3168.735 |
| transcript.whisperx[65].end |
3196.195 |
| transcript.whisperx[65].text |
SMA 那麼神經肌肉萎縮症的藥品給付那麼今年呢 到10月底也已經新增收載了8項的這個新藥那麼包含了這個法布瑞氏症等等的這個罕見疾病預計加會了630人以上那麼公務預算也有預注20億元也已經全數的用氣那麼明年呢 我們持續的預注 |
| transcript.whisperx[66].start |
3196.815 |
| transcript.whisperx[66].end |
3213.122 |
| transcript.whisperx[66].text |
那麼希望讓罕病病友都能夠得到相關的這個幫助那至於這個羅廷維等委員所拟據的癌症防治法部分條文的修正草案那麼特別是修正在第13條及第16條 |
| transcript.whisperx[67].start |
3215.603 |
| transcript.whisperx[67].end |
3226.968 |
| transcript.whisperx[67].text |
那麼要補助癌友的這個全民健保未給付的醫療費用那麼研議修法設立癌症新藥多元支持基金那麼這個為了這個讓這個癌藥的 |
| transcript.whisperx[68].start |
3231.73 |
| transcript.whisperx[68].end |
3251.733 |
| transcript.whisperx[68].text |
这个使用的可进性可以提高事实上我们读前面的报告那么已经有由政府拨款那么专款专用于癌症新药的收载那么至于设立新设基金的部分那么以目前财政纪律法第八条的规定那么必须要有 |
| transcript.whisperx[69].start |
3252.634 |
| transcript.whisperx[69].end |
3264.774 |
| transcript.whisperx[69].text |
政府既有收入或國庫撥補以外的新增財源那因此我們會積極的嚴厲那麼尋求新的財源支持再來這個成立這個 |
| transcript.whisperx[70].start |
3267.309 |
| transcript.whisperx[70].end |
3282.834 |
| transcript.whisperx[70].text |
這個專這個癌症的多元這個支持基金那以上的報告那麼懇請各位委員的支持跟協助那麼也感謝各位委員對於癌症防治業務上那麼諸多的指教跟支持那麼謝謝好 謝謝部長的報告 |
| transcript.whisperx[71].start |
3292.406 |
| transcript.whisperx[71].end |
3313.489 |
| transcript.whisperx[71].text |
有關本次會議各項說明資料均列入紀錄刊登公報現在開始審討作為以下宣告第一本會委員宣導時間6加5分鐘列席委員4加1分鐘10點半截止發言登記委員如果有順便質詢請以上意見提出預期不受理暫定10點半休息10分鐘那本日不處理臨時提案現在請登記第一位委員陳昭芝來做發言 |
| transcript.whisperx[72].start |
3318.192 |
| transcript.whisperx[72].end |
3342.019 |
| transcript.whisperx[72].text |
謝謝部長有請部長謝謝主席有請史部長我先幫您升官了我比部長陳委員早我們在談今天主席之前我想先跟你談一下這個藥品政策那我們兩個都在醫藥界耕耘的非常久我想請問你當一個國際的新藥成功研發上市的時候您覺得台灣都是第幾波引進的 |
| transcript.whisperx[73].start |
3344.825 |
| transcript.whisperx[73].end |
3361.576 |
| transcript.whisperx[73].text |
過去大概都在第三波第三波但是最近我們有一些藥已經可以趕上第二波甚至第一波了答案是第三波沒有錯但是總共也只有四波這個是很遺憾根據台美生技協會的研究台灣是全球GDP第14大經濟體但卻不是國際藥廠他們的首選這個原因當然很多包括市場小新藥價格偏低而且是綁還綁了緩緩協議 |
| transcript.whisperx[74].start |
3374.224 |
| transcript.whisperx[74].end |
3391.939 |
| transcript.whisperx[74].text |
那全國的這個全球的這個參考價格會有連鎖效應還有冗長的核價過程我想這些我過去也都質詢過那市場角色既定的事實但是我們應該把可以掌握的變數把它做好那國際普遍都有所謂的溢價還有要價差問題但是台灣的要價差連年擴大我想請問部長這兩年的要價差是多少 |
| transcript.whisperx[75].start |
3397.456 |
| transcript.whisperx[75].end |
3407.578 |
| transcript.whisperx[75].text |
現在有在縮小大概差不多在500億左右對 部長至少這兩年都700億我們可以再去是很佔藥費很龐大的比率那對新藥引進是莫大的不穩定性雖然說今天我們談到狠藥跟癌藥有公務預算來預注但是就是說對引進的廠商還是有顧慮 |
| transcript.whisperx[76].start |
3420.001 |
| transcript.whisperx[76].end |
3423.626 |
| transcript.whisperx[76].text |
這個前端價格即便看似合理那中間我們其實還要經過這個還款協議 很多的溢價過程後端還有一個要價差所以健保署說我們增加了預算那其實對他們不是很有感因為那個錢不會變成一個實收啦 |
| transcript.whisperx[77].start |
3435.683 |
| transcript.whisperx[77].end |
3450.692 |
| transcript.whisperx[77].text |
這是為什麼臺灣要進到第二波很難啊因為那個部長大概不能拿一兩個案子來處理更別說第一波那我知道這個已經啟動藥品改革政策會議那我想請陳書長你簡單用幾句話說你目前的進度跟方向是什麼 |
| transcript.whisperx[78].start |
3452.833 |
| transcript.whisperx[78].end |
3474.198 |
| transcript.whisperx[78].text |
委員報告我上任的時候也拜會過委員在這個藥品政策關於drug price gap就藥品政策的藥價差的部分在做縮小那目前也依循時部長在署長任內的政策在今年4月份我們事實上修了兩個法那第二個部分是關於這個醫院跟這個藥品的這個drug price gap藥價差的部分目前還是 |
| transcript.whisperx[79].start |
3475.138 |
| transcript.whisperx[79].end |
3492.524 |
| transcript.whisperx[79].text |
謝謝署長因為我很謝謝健保署總算承認有這三個字叫要價差那要價差面對他就有金額真的非常龐大700億然後超過700億而且一直在增高不管你怎麼砍要價越來越高那這個是一個很大的問題那網路上也有部長那先暫時先謝謝署長部長前兩週對於補充保費網路上有很多討論其實我覺得健保長期存在一個問題是民眾 |
| transcript.whisperx[80].start |
3500.966 |
| transcript.whisperx[80].end |
3522.134 |
| transcript.whisperx[80].text |
醫藥界還有政府三方對政策的理解有很大落差所以很多民眾提出了什麼呢政府不該給付罕病藥物的話等一下我會講為什麼你們每天都說是天價了另外就是說應該提高部分負擔還有政治人物我先不說他的名字他說部分分擔要提高到200%那就是完全不懂的人才會講出這個話嘛部分哪有200% |
| transcript.whisperx[81].start |
3523.334 |
| transcript.whisperx[81].end |
3541.531 |
| transcript.whisperx[81].text |
所以不是講我們都清楚政策的怎麼設定但是民眾不見得理解所以我要講的說新聞常常看到健保納入天價藥品這個標題有點像健保署的大內宣那民眾人家不會有疑問既然健保都要破產那你為什麼這麼貴的藥要納進來呢但事實上健保署會跟廠商進行什麼 |
| transcript.whisperx[82].start |
3546.696 |
| transcript.whisperx[82].end |
3569.099 |
| transcript.whisperx[82].text |
價量協議嘛 分期支付嘛等等而且像圖上這個含要這個已經這個新聞跑出來說這個排價大概是1億但是我們知道經過這個這個價量協議呀 分期支付甚至有效果財富嘛這個最終的支付價格其實沒這麼高上次那個第一個基因藥品想說 |
| transcript.whisperx[83].start |
3571.84 |
| transcript.whisperx[83].end |
3589.785 |
| transcript.whisperx[83].text |
4900萬 其實不太多我們大家都心知肚明但是民眾不知情啊民眾不知情也不會知道這個是由另外一個基金喊要的一個上次我們通過那兩個就所謂天價都是喊要事實上是專款支付啊不會影響其他病人的疾病的這個治療的權益嘛 |
| transcript.whisperx[84].start |
3591.005 |
| transcript.whisperx[84].end |
3607.339 |
| transcript.whisperx[84].text |
所以我是認同部長您講的說全臺灣每個人捐五塊錢不到就可以救一個小朋友 寒病小朋友這些都絕對值得但是我們要讓民眾瞭解健保的價值這需要社會溝通所以我在跟部長在提醒前健保署李博張署長也指出這個個別總額 醫院個別總額實施以後 |
| transcript.whisperx[85].start |
3612.823 |
| transcript.whisperx[85].end |
3633.862 |
| transcript.whisperx[85].text |
醫院可能不願意禁藥我們知道罕藥是專款我們知道可是對個別醫院總額是可以排除在這不是一般的這個服務費但是因為罕藥價我們又回到藥價差了藥價差有限因為它的管理保存跟處理可能相對是比較更多的精力跟時間那對醫院而言利潤不夠 |
| transcript.whisperx[86].start |
3635.223 |
| transcript.whisperx[86].end |
3639.245 |
| transcript.whisperx[86].text |
所以他不願意進藥所以現在已經傳出中部大型醫院我想你聽過已經用我們藥局沒有備這個藥為由拒絕罕病病人然後把他推到其他醫學中心表示他也是醫學中心所以我想請問署長或部長兩個問題請問你有沒有監控使用高價罕藥救的個案把它轉到別的醫院就診的情況那第二個問題是你有去做各個醫院 |
| transcript.whisperx[87].start |
3662.795 |
| transcript.whisperx[87].end |
3683.319 |
| transcript.whisperx[87].text |
收治新確診的個案自然的成長跟它歷史的資料比較嗎這兩點就請回答 謝謝好 謝謝委員對我們這個藥品政策相當的熟悉那我三點的補充說明第一個我們剛剛提到這些很高價的罕藥事實上我們也都是經過這個醫療科技評估去評估它確實有這個價值那我們才納入所以這並不是說這個 |
| transcript.whisperx[88].start |
3692.021 |
| transcript.whisperx[88].end |
3710.94 |
| transcript.whisperx[88].text |
為了要宣傳或什麼但是那個價格出來說會怕死人啊那至於在這個但這不是事實啊這個到底我們的這個實際上的藥費是多少這個我們跟廠商當然你會說機密但我們很清楚對 我們是不好對外去說明我想必須讓民眾知道因為你這樣會嚇到民眾然後又會覺得很困惑說不準 還在乎 |
| transcript.whisperx[89].start |
3712.581 |
| transcript.whisperx[89].end |
3735.754 |
| transcript.whisperx[89].text |
但是因為這個有這個需要其實是在商業上的努力嘛那廠商也妥協嘛所以最後離那個很遙遠我很清楚離那個數字很遙遠那第二個呢要跟也是趁這個機會說明的就是含藥的這個是在我們的健保總額裡面支付沒有錯 |
| transcript.whisperx[90].start |
3736.835 |
| transcript.whisperx[90].end |
3760.767 |
| transcript.whisperx[90].text |
但是它不是在我們現在所說的一般服務費也就是現在的個別醫院總額它是排除在外面喊藥的藥費是排除到我們現在做的醫院個別總額之外所以不影響其他的照顧其他的病人至於剛剛您特別關切有沒有因為我們實施醫院個別總額之後而造成被病人的排擠這個我們有在監測 |
| transcript.whisperx[91].start |
3761.687 |
| transcript.whisperx[91].end |
3789.032 |
| transcript.whisperx[91].text |
我們有在監測我們統計的今年的四月到八月間藥傷朋友最清楚他們的藥整個被送走了喊病的病人他的這個各個醫院的消長情形我們都有在監測這個是很重要的監測嘛對不對有有有有解決一個問題要跑出別的問題有的我們就會看到說他可能有的是因為醫師轉了醫院之後病人會跟著他走醫師轉那是另外一個所以每一個這個因為 |
| transcript.whisperx[92].start |
3791.752 |
| transcript.whisperx[92].end |
3810.565 |
| transcript.whisperx[92].text |
我們這四到八個月大概是一萬多個罕病的病我們都有在追蹤你繼續追蹤好不好我很關心這個問題那未來健保署是不是可以用白話跟大家說明啊包括這個擠負罕病的那個理由嘛那提高部分負擔的這些理論依據相關配套可以優先用電視跟這個醫療院所因為 |
| transcript.whisperx[93].start |
3813.568 |
| transcript.whisperx[93].end |
3828.479 |
| transcript.whisperx[93].text |
來檢明圖卡來對外溝通我跟你講圖卡不是用來攻擊在野黨的圖卡是這個時候政策是非常重要的使用了才能被這個理解那個信任因為為什麼呢因為現在民眾的資料都來自電視 |
| transcript.whisperx[94].start |
3829.56 |
| transcript.whisperx[94].end |
3845.359 |
| transcript.whisperx[94].text |
跟醫院但是事實上很多這不是在你們的官網嗎或是政治冗長的會議記錄可是他們不看那個啊所以當你在說明的時候你要用非常容易讓民眾明白的方式圖卡來用圖卡用的正圖是要這樣子的我們會加強這個說明 |
| transcript.whisperx[95].start |
3847.601 |
| transcript.whisperx[95].end |
3872.154 |
| transcript.whisperx[95].text |
不然大家覺得很矛盾啊你弟弟附最高要但是事實上我很清楚事情不是這樣很嚴謹的評估謝謝部長那我10月13號有質詢永豐生理鹹水的後續我還要追問請問部長到底你對永豐的裁罰總金額是多少部長你都發了多少錢我們有去了解那這個案子是最後由新北市衛生局裁處了60萬元法院依據 |
| transcript.whisperx[96].start |
3874.717 |
| transcript.whisperx[96].end |
3891.111 |
| transcript.whisperx[96].text |
這是根據違反藥事法裡面的GMP規定我要講的就是說為了這件事去年用了多了三四億以上今年又編了10億要穩定生理食鹽水的供應以至於不要讓準備手術的病人延後治療 耽誤治療我要請問當然署長您上來了您覺得這個裁罰基準合理嗎 |
| transcript.whisperx[97].start |
3897.738 |
| transcript.whisperx[97].end |
3913.417 |
| transcript.whisperx[97].text |
結果他造成去年月年中發生嘛就多了三四億就今年又補了11億署長您覺得這個裁罰基準合理嗎要不要修罰報告委員這部分我們特別有注意到對於因為這樣子特定的廠商 |
| transcript.whisperx[98].start |
3914.338 |
| transcript.whisperx[98].end |
3934.213 |
| transcript.whisperx[98].text |
他的供應的我們也希望能夠供應的範圍跟平衡能夠稍微有分攤第二個他的財閥部分我們會不是這個是先有這個問題才從外引進沒有證照的藥品這個問題就是很大這是一個非常大的一個疏失那當然署長你要就是讓你再概括承受一下雖然不在你任內監察院報告指出 |
| transcript.whisperx[99].start |
3934.733 |
| transcript.whisperx[99].end |
3958.756 |
| transcript.whisperx[99].text |
指出食藥署接貨不良品通報卻鮮少啟動無預警的查核以及在整個案件中多處缺失這個我想你看到了也就是說他認為食藥署監察院食藥署監督不力包庇廠商的意思納稅人應該多花11億來做善後署長那你接貨不良品的你現在的SOP是什麼你的改進重點是什麼有通報至少72案 |
| transcript.whisperx[100].start |
3960.552 |
| transcript.whisperx[100].end |
3977.314 |
| transcript.whisperx[100].text |
生理食鹽水謝謝委員生理食鹽水因為我們的監察院報告我有看過很清楚的針對那個細節每一次的你的SOP你都清楚嗎那要改進的呢因為過去就發生了那你要改進的重點是什麼針對這部分我們監管組去做查場之後後續的 |
| transcript.whisperx[101].start |
3978.055 |
| transcript.whisperx[101].end |
4005.253 |
| transcript.whisperx[101].text |
平次跟重新去掉他積極的調整的部分我們這邊已經在做了那署長今天我就是兩個問題第一個你裁罰他60萬事實上已經被檢舉很多次了就是通報了很多次不良品然後那個有感染注意又有雜物在那個那個等於是無菌的這個注射水裡面那第二個就是說你未來接到通報如果不反應不處理這就再釀成一次大禍啊所以這兩件事情我會繼續追蹤 |
| transcript.whisperx[102].start |
4007.214 |
| transcript.whisperx[102].end |
4013.159 |
| transcript.whisperx[102].text |
那也請 請署長部長多多留意好 謝謝 謝謝兩位謝謝主席好 謝謝接下來請陳慶輝委員來做選擇謝謝主席 請外部部長還有食藥署署長來請部長 請江署長陳委員長 |
| transcript.whisperx[103].start |
4036.29 |
| transcript.whisperx[103].end |
4055.463 |
| transcript.whisperx[103].text |
謝謝 首先當然是要關心一下署長但身為也是家長 全國的家長還有國人現在是蠻緊張的針對這個芬普尼的雞蛋事件所以我也拜讀了非常多署長以前擔任醫師的時候所撰寫的文章當時你有提到說超標不等於中毒 |
| transcript.whisperx[104].start |
4056.323 |
| transcript.whisperx[104].end |
4079.778 |
| transcript.whisperx[104].text |
但是確實對孩童有超標的危險對民眾也有但是分譜你的超標不是急性中毒是慢性中毒至於長期攝入對人體會造成何種長期慢性的危害還需要長期的追蹤並且您建議要有病理學的研究政府單位應該要做好的是風險溝通平常就應該要有宣傳並且教育民眾有這樣子的基礎 |
| transcript.whisperx[105].start |
4080.898 |
| transcript.whisperx[105].end |
4096.407 |
| transcript.whisperx[105].text |
那個時候當時的官員他是跟你講一模一樣的話就是超標不等於中毒可能要吃幾顆才有風險等等的但是您以醫師的角度說同樣身為人民也是醫師 |
| transcript.whisperx[106].start |
4097.648 |
| transcript.whisperx[106].end |
4118.173 |
| transcript.whisperx[106].text |
政府這樣子說會有點像是推卸責任可是這幾天你也知道說引起大家爭議的是你沒有辦法告訴大家要吃還是不要吃你只有說不安心就別吃吃一百顆才有風險你會覺得對於你以前給政府的建議你現在是不是也應該要有所修正呢委員這邊就由我來簡單跟委員做進一步說明 |
| transcript.whisperx[107].start |
4125.1 |
| transcript.whisperx[107].end |
4130.292 |
| transcript.whisperx[107].text |
那對於分譜米的雞蛋的部分那才源頭上面其實是在我們 |
| transcript.whisperx[108].start |
4133.815 |
| transcript.whisperx[108].end |
4159.328 |
| transcript.whisperx[108].text |
長期以來我們的監測的計畫向下那監測現在是對於我們的蛋品 禽肉以及水產品的監測那監測的過程中呢我們蛋品呢從107年到現在已經監測4282次那我們看到的是這一次我們在11月4號的時候在彰化縣衛生局彰化縣衛生局局長非常非常棒他們去監測之後 |
| transcript.whisperx[109].start |
4161.027 |
| transcript.whisperx[109].end |
4188.563 |
| transcript.whisperx[109].text |
有相關的數據到中央續產所去因為這個檢驗的過程中其實就好像我們平常在醫院檢驗需要一點時間因為它就是常態檢驗整個續產所它幫忙協助了許多所以11月4號確立之後那也激動的我們就告訴他們要主動下架那我對於這個部分特別跟委員說明了因為要主動下架這件事情是要精準的我們的蛋品的需求量相當的大我們也高度的關注 |
| transcript.whisperx[110].start |
4190.264 |
| transcript.whisperx[110].end |
4203.818 |
| transcript.whisperx[110].text |
部長提醒我們我們針對中間檢驗之後只要是檢驗到什麼證據到哪我就應該要公布到哪裡這個我們一定會虛心的進一步的檢討我們這次4號確立之後彰化圈衛生局做5號確立的當批的 |
| transcript.whisperx[111].start |
4207.742 |
| transcript.whisperx[111].end |
4234.118 |
| transcript.whisperx[111].text |
能夠下架 接下來就是當場的讓它能夠控制下架所以到10月6號重新去抽這次的檢驗就短了因為緊急事件就要掛急診檢驗不可能那麼久所以就8號出來所以我們9號就確立的確是這個確立之後我們更擴大的是說針對I47這個場文雅畜牧場全面要讓它做下架 不能再吃了 |
| transcript.whisperx[112].start |
4234.818 |
| transcript.whisperx[112].end |
4259.67 |
| transcript.whisperx[112].text |
那民眾還是會很擔心所以我就希望能夠有點擔心當然是有點學者的概念那個基因裡面 學U裡面還有我覺得當然是在急性中毒跟慢性中毒裡面讓民眾去了解那這個過程中 或許這個傳達訊息有些可能要更精準一點點這我們可以繼續去努力但是讓大家能夠知道的是精準的去對於該下架的下架 |
| transcript.whisperx[113].start |
4260.47 |
| transcript.whisperx[113].end |
4272.862 |
| transcript.whisperx[113].text |
精準的對於我們的打接範圍到哪裡為打接範圍因為一天的彈的使用量其實我們過去也經歷過差不多是2000萬顆所以我們也很擔心造成整合所以這次是比較精準的去說明先到這邊我們等一下繼續討論 |
| transcript.whisperx[114].start |
4275.945 |
| transcript.whisperx[114].end |
4299.671 |
| transcript.whisperx[114].text |
因為大部分的家長他其實只是想知道說到什麼時候才可以安心什麼時候可以安心吃當然您剛講的都很好我也聽得懂但你要講人民可以聽得懂的語言嘛那下一個我就想問這是2017年您在農傳媒他有個專家會議所以你也是以專家的身份說你說政府應該慎重的處理國人實用到 |
| transcript.whisperx[115].start |
4300.932 |
| transcript.whisperx[115].end |
4325.287 |
| transcript.whisperx[115].text |
這個雞蛋的慢性中毒問題並且進行甲狀腺的問題檢測搭配流行病學去看發病的比例如何那你剛有講當然中間有個時間差所以15萬已經流出了你現在也自己承認可能沒辦法全數收回現在只有回收了3萬那你有覺得當時你建議說處理國人慢性中毒的應變與機制 |
| transcript.whisperx[116].start |
4327.59 |
| transcript.whisperx[116].end |
4329.258 |
| transcript.whisperx[116].text |
這個提議應該要啟動 應該要制定了嗎 |
| transcript.whisperx[117].start |
4332.078 |
| transcript.whisperx[117].end |
4357.359 |
| transcript.whisperx[117].text |
這邊跟委員進一步說明我們針對說假如芬普尼持續存在我們要做這件事情那因為我們驗了從107到現在4282次沒有驗到一次表示它的風險它出現的次數並不是常態的那這一次呢其實也很感謝跨部會的合作之下那也有檢調的介入能夠知道呢 |
| transcript.whisperx[118].start |
4357.899 |
| transcript.whisperx[118].end |
4372.656 |
| transcript.whisperx[118].text |
是在雞的羽毛身上經過皮膚等等或者著食之後進入體內所以這個很清楚的其實是在應該是潘撒伊爾的一個觀察這樣子的過程中它是突發的事件對於芬普尼來講是突發事件 |
| transcript.whisperx[119].start |
4372.776 |
| transcript.whisperx[119].end |
4389.606 |
| transcript.whisperx[119].text |
所以我們會繼續去針對突發事件的進行的方式所以現在的話其實您是認為不用啟動當時您身為專家的一個建議這個我也聽懂了再來我們來看一下你也寫過一篇文章叫做台灣應該立即穿上防彈衣 |
| transcript.whisperx[120].start |
4390.586 |
| transcript.whisperx[120].end |
4417.881 |
| transcript.whisperx[120].text |
提出四個重點本席也非常認同第一個我們討論完了超標並非中毒第二個是提高檢查密度追查超標原因四加強用藥的管制加強用藥管制這可能是農業部的事情但您當時說政府應該要釐清其原因為何現階段要找出超標的原因安定民心接著要提高檢查密度你說短期內一定要提高檢驗的密度和強度 |
| transcript.whisperx[121].start |
4419.262 |
| transcript.whisperx[121].end |
4445.133 |
| transcript.whisperx[121].text |
阻断流通的预防性下架您认为你这次没有办法全数回收回来算是一个成功的预防性下架吗这边跟委员说明一下那就如同部长提醒我们一定要检验到哪里我们做到哪里那这一次它的特性是这样部长提示一定要做到的是这个厂的蛋一颗都不能让它再进市场了 |
| transcript.whisperx[122].start |
4446.041 |
| transcript.whisperx[122].end |
4468.313 |
| transcript.whisperx[122].text |
前面的蛋它的確有一段時間這裡面的使用我們確立之後呢能夠把它給擋住那這邊稍微說明一下因為在畜牧場裡面那畜牧場動物用藥的管理辦法裡面如果檢驗沒有確立也沒有檢出它的蛋是有異常跟環境異常等等它們就要流動了 |
| transcript.whisperx[123].start |
4469.554 |
| transcript.whisperx[123].end |
4485.734 |
| transcript.whisperx[123].text |
部長非常堅持的在跨部會的協議當下我們把它擋下來了所以只要我們確立8號 9號我們公佈之後我們就全力的把它擋住了所以我們看到今天的新聞還持續是擋住了幾十萬顆的彈在彈機場裡面 |
| transcript.whisperx[124].start |
4487.456 |
| transcript.whisperx[124].end |
4506.874 |
| transcript.whisperx[124].text |
因為這樣的堅持我想我們國人針對特定彈廠裡面畜牧場裡面其實是另外跨部會的一個這邊我想跟你討論一件事情這也是一般人看到新聞會有點害怕的昨天檢調已經抓到了這是基農違法使用農藥嘛違法使用農藥 |
| transcript.whisperx[125].start |
4507.975 |
| transcript.whisperx[125].end |
4528.657 |
| transcript.whisperx[125].text |
後來呢我們有接獲一些情資還有我們自己的實際上網事實上這個東西不會很難取得不會很難取得但是您在這個案件爆出來的第一天你就已經定調為個案現在大家想聽你說你是用什麼證據去定調這個東西是個案 |
| transcript.whisperx[126].start |
4530.413 |
| transcript.whisperx[126].end |
4553.349 |
| transcript.whisperx[126].text |
這邊跟委員報告一下因為抽樣是隨機的這麼多年來4282件的隨機鏈今年以前都是百分百合格所以random去找出來的是合格所以你要推論它是相對是合格所以你是推論它是個案對 推論那昨天看完新聞以後您會不會改變您的想法 |
| transcript.whisperx[127].start |
4553.891 |
| transcript.whisperx[127].end |
4578.725 |
| transcript.whisperx[127].text |
我其實是支持委員的一些想法那對於這個東西其實我們要主決在源頭所以源頭在跨部會裡面的環境部跟農業部對於畜牧場內的權責我們其實是互相協作的食藥署 衛福部在整個指導之下我們做的是什麼後市場端我們有任何風吹草動我們一定未來會修正在什麼關鍵的時刻 |
| transcript.whisperx[128].start |
4581.287 |
| transcript.whisperx[128].end |
4609.668 |
| transcript.whisperx[128].text |
來讓國人最先能夠知道但是我們又要避免國人的恐慌那這是我們努力的需要一點智慧也讓我們一起共同去研究那你現在會不會覺得有可能它不是隔岸了這個看了昨天的新聞之後跟委員報告農方在農場裡面的管理有他們的智慧我其實沒有辦法替他們去回答這件事情但我個人覺得需要進一步研議它是必要的好 這邊這也是您 |
| transcript.whisperx[129].start |
4610.288 |
| transcript.whisperx[129].end |
4623.622 |
| transcript.whisperx[129].text |
之前曾經說過的你教政府怎麼做事嗎你說在污染影響不明污染源不明的情況之下政府因為無法給出相關的保證所以應該誠實的向國人表明要先釐清檢驗那 |
| transcript.whisperx[130].start |
4626.405 |
| transcript.whisperx[130].end |
4650.541 |
| transcript.whisperx[130].text |
我在這邊是具體想要求衛福部食藥署你們是不是去跟檢調還有農業部做溝通他們現在有可能查到上游就這個農藥的上游那這個農藥是不是有可能也有給其他的基農這個是你們應該做橫向溝通的不是嗎這就是你當初寫的文章提高檢查密度 追查真相 |
| transcript.whisperx[131].start |
4651.55 |
| transcript.whisperx[131].end |
4677.907 |
| transcript.whisperx[131].text |
報告委員 這個其實已經在做了 已經做了確定是已經在做 也在溝通所以這部分是已經在做了那你剛剛為什麼不說是不是個案剛剛我們就是一直在問你有沒有可能它不是個案啊因為目前看到是個案但是我們絕對不放棄有可能是橫向更多的但是以我的目前的證據我只能說現在是個案所以最後有可能不是 對吧 |
| transcript.whisperx[132].start |
4678.716 |
| transcript.whisperx[132].end |
4691.945 |
| transcript.whisperx[132].text |
這個部分其實農業部在努力的時候我們跨部會裡面他們研議最後一定我想會有答案來跟各位我希望可以如同您之前的文章一樣可以及時的去做預防性下架好嗎我們不希望再看到蛋回收不回來的狀況 |
| transcript.whisperx[133].start |
4693.503 |
| transcript.whisperx[133].end |
4710.591 |
| transcript.whisperx[133].text |
這部分我們會特別盡力加強最後問部長最後一個問題而已早上在做提案說明的時候有跟部長講到說非常感謝昭緯安排這次的審查法案是因為真的跨黨派的委員都非常的關心以及藥物 |
| transcript.whisperx[134].start |
4711.471 |
| transcript.whisperx[134].end |
4732.924 |
| transcript.whisperx[134].text |
今年有退出的明年可能有更多會退出的但唯一沒有提案也沒有表明立場的就是衛福部雖然您剛有做一個口頭報告但是我們還是要問如果我們開始做這個審查的話衛福部的立場到底會是什麼我們之前上禮拜已經經歷過了很多委員包括民進黨團都提出了外送員專法 |
| transcript.whisperx[135].start |
4734.105 |
| transcript.whisperx[135].end |
4760.496 |
| transcript.whisperx[135].text |
那勞動部始終沒有版本但是在隨著我們審查的過程他們就說他們12月以前要端出版本所以我想知道衛福部的態度到底是什麼這個跟委員報告就是說對於這種癌藥新藥的這個可敬性我們是現在有專款那按照這個需求在增加中啦那至於說要不要成立一個在這個癌症防治法裡面有一個癌藥基金多元基金這個事情 |
| transcript.whisperx[136].start |
4760.976 |
| transcript.whisperx[136].end |
4783.931 |
| transcript.whisperx[136].text |
因為剛剛我在報告裡面有特別提到按照這個政府財政紀律法的規定我們一定要去找到以國庫撥補我們目前是國庫在撥補我們要去找到國庫撥補以外的財源才有辦法新設基金你可以找你找你編我們一定OK我們繼續再找因為這個也要找財源所以你的意思是說昭緯一邊審你會一邊跟昭緯做滾動性的溝通 |
| transcript.whisperx[137].start |
4789.635 |
| transcript.whisperx[137].end |
4816.696 |
| transcript.whisperx[137].text |
我們一直都在溝通 我跟昭緯一直在溝通因為昭緯一向就是很在意的這個癌友的權益昭緯是我們後生會的交集人對對對 他非常關心癌友所以我們一直都在各項的癌症議題上都有在討論好 謝謝昭緯 謝謝部長 謝謝署長謝謝好 謝謝陳委員 謝謝部長來 署長請委接下來請林月琴委員來做選答 |
| transcript.whisperx[138].start |
4819.931 |
| transcript.whisperx[138].end |
4821.958 |
| transcript.whisperx[138].text |
好 麻煩我們的指部長 請部長 |
| transcript.whisperx[139].start |
4828.207 |
| transcript.whisperx[139].end |
4853.735 |
| transcript.whisperx[139].text |
昨天一個長照悲歌的宣判我相信你有看真的讓人覺得很心痛一個80歲的母親照顧腦麻的兒子超過半個世紀最後在身心俱疲下親手結束孩子生命法院認為這個狀況非常的特殊甚至見請總統是不是可以特赦法官在判決書裡邊寫出最沉重的現實就是一個母親她含辛茹苦的一生照顧 |
| transcript.whisperx[140].start |
4854.435 |
| transcript.whisperx[140].end |
4878.231 |
| transcript.whisperx[140].text |
孩子最后却被照顾压垮了部长我知道这个量刑是司法的事情但长照是您的责任请问部长你怎么看这个案子你知不支持总统特赦我支持总统特赦是那这个案子呢我们的了解它是发生在2023年就是在疫情期间那因为这位老妈妈 |
| transcript.whisperx[141].start |
4879.538 |
| transcript.whisperx[141].end |
4894.384 |
| transcript.whisperx[141].text |
染疫的關係他要去隔離那因為他沒有辦法繼續照顧他的孩子所以產生這樣的悲劇所以反映一件事情就是對於這個照顧者的支持這些替代方案 |
| transcript.whisperx[142].start |
4894.684 |
| transcript.whisperx[142].end |
4912.2 |
| transcript.whisperx[142].text |
我们要做的更多可是部长你看根据媒体统计我们只看媒体的就是说近7年代62起的长照人人悲剧我手上这张表只是其中的几起而已每一个案子都让人家心碎一年平均8起这不是个案是制度的破口 |
| transcript.whisperx[143].start |
4912.82 |
| transcript.whisperx[143].end |
4938.611 |
| transcript.whisperx[143].text |
长照要升级到3.0这个漏洞不能不补刚刚的案例其实事实上它是有外籍看护的看似有资源却还是撑不下去部长你认为他们需要什么样的支持呢为什么我这样问因为社区照顾据点的基层团体也来跟我反映说有些长照家庭不愿意找资源或者是有的是他们自己请看护然后自己扛 |
| transcript.whisperx[144].start |
4939.133 |
| transcript.whisperx[144].end |
4967.345 |
| transcript.whisperx[144].text |
反而變得事實上是更隱形也就是說我們根本不知道他在哪邊他們就是在我們的制度的那個縫隙裡邊越來越孤單所以我不知道政府有沒有辦法去定期調查長照家庭然後有沒有像有一些更新家庭的名冊讓公部門的合作團體或者是據點能夠主動關心來協助我們都可以要去找萃家那這些也是我覺得也是萃家的一環所以不知道能不能這樣子做 |
| transcript.whisperx[145].start |
4968.306 |
| transcript.whisperx[145].end |
4980.859 |
| transcript.whisperx[145].text |
我想從兩個部分來看第一個就是說以這個個案來講他是有這個外籍的幫手那我們現在也已經讓即使你是自聘的這個 |
| transcript.whisperx[146].start |
4983.802 |
| transcript.whisperx[146].end |
5008.895 |
| transcript.whisperx[146].text |
這個照護的幫手也可以使用喘息服務就是他也是 可是他如果他不知道資源呢所以這個資源我們要做得更多讓大家知道他也可以利用喘息服務那第二個是對照顧者本身的支持因為這些路經常很漫長所以長期以來會產生壓力的累積所以我們就這幾年特別著重在 |
| transcript.whisperx[147].start |
5009.735 |
| transcript.whisperx[147].end |
5025 |
| transcript.whisperx[147].text |
家庭照顾者的支持据点包含他的心理的协谈 咨询还有照顾技巧的指导那是找得到的吗有些人可能不知道所以部长可不可以我们再多广宣目前大概已经 |
| transcript.whisperx[148].start |
5027.181 |
| transcript.whisperx[148].end |
5054.955 |
| transcript.whisperx[148].text |
是不是可以定期调查主动关怀的作业请卫福部在两周内给我一个回复我们现在把它纳入在我们服务员就是我们去做这个长照服务员也同时去筛检出它有没有高风险我接着要问这个是昨天我也对家庭照顾价制度去问劳动部长他明确的说需要卫福部来协助做处理评估不同的照顾者不同的家庭合理的照顾时间跟需求到底是什么所以想问部长 |
| transcript.whisperx[149].start |
5055.995 |
| transcript.whisperx[149].end |
5069.864 |
| transcript.whisperx[149].text |
針對各類長照跟家庭照顧長照跟照顧家庭的一個需求去做評估衛福部有沒有做有沒有定期的是給勞動部甚至有沒有跟勞動部之間有橫向的一個聯繫 |
| transcript.whisperx[150].start |
5072.026 |
| transcript.whisperx[150].end |
5088.586 |
| transcript.whisperx[150].text |
這個部分我們再來做這個詳細的評估所以要麻煩部長因為他昨天因為要完整的照顧體系的價這個價我覺得關鍵在於是兩部會的一個合作那因為 |
| transcript.whisperx[151].start |
5090.047 |
| transcript.whisperx[151].end |
5116.837 |
| transcript.whisperx[151].text |
從我們看到這個從慌亂到穩定就長照家庭他去找資源然後長輩住院找資源然後返家使用長照要聘僱移工這些這大概都要20到30天那不同的照顧者可能會有不同的需求在所以我們希望說衛福部在這邊可能要把這一塊能夠清楚的讓我們的勞動部知道那以方便我們未來再推長照 |
| transcript.whisperx[152].start |
5117.874 |
| transcript.whisperx[152].end |
5134.692 |
| transcript.whisperx[152].text |
假的时候那才有办法去定出来跟委员说明当然目前这个在公务机关是有这个家庭照顾假它是并入在市假里可是那7天当中还不够我们刚看到是20到30天那到底这个 |
| transcript.whisperx[153].start |
5135.593 |
| transcript.whisperx[153].end |
5159.136 |
| transcript.whisperx[153].text |
怎么去设计它那么我们来研究不过我们现在积极在加强的就是无缝转衔把它无缝衔接不论是出院的准备缩短它那个长照资源可以进来的时间我知道你们很努力部长昨天我接到一通罕病儿的家长的求助电话孩子罹患 |
| transcript.whisperx[154].start |
5160.231 |
| transcript.whisperx[154].end |
5176.002 |
| transcript.whisperx[154].text |
球形式的肌肉萎縮症加上知道美國的基因藥太貴了現在只能用副作用比較低的類固醇治療他跟我說在中國治療比台灣更便宜50萬台幣問我該怎麼辦那部長你建議我怎麼回答 |
| transcript.whisperx[155].start |
5177.75 |
| transcript.whisperx[155].end |
5194.672 |
| transcript.whisperx[155].text |
這個當然是這樣就是說以現在這個球星是肌肉萎縮症而言我們查了一下是目前當然還沒有藥證目前台灣是沒有藥證那我們來這個搜尋看看所以我就想這個看其他的 |
| transcript.whisperx[156].start |
5195.693 |
| transcript.whisperx[156].end |
5222.648 |
| transcript.whisperx[156].text |
就是我们要找比较具有这个HTA就是医药科技评估的这个国际组织的报告比如说像英国的NICE或者是加拿大澳洲等等这些国家的报告我们来看看这个科技评估的报告如何那么它的效果因为这高价的药我刚刚提过也是要经过严谨的这个医药科技评估的那你们预估只要是有明确的效果像 |
| transcript.whisperx[157].start |
5224.289 |
| transcript.whisperx[157].end |
5247.794 |
| transcript.whisperx[157].text |
之前这个陈昭寺委员也秀出了一个AADC那个基因治疗那个也是个罕病那么那个药这个药价也是在1亿后来我们也是会纳入是主要也是要完整的评估它的效果115年预估115年还能够纳入多少新药还有里边有没有针对神经退化性疾病的药 |
| transcript.whisperx[158].start |
5250.131 |
| transcript.whisperx[158].end |
5277.688 |
| transcript.whisperx[158].text |
我們115年 今年是大概180億那明年的話呢 健保這邊是192億在外加這個公務預算還有20億大概也是200多億所以又比今年又會再成長差不多30億左右那我們過去大概5年的成長率大概是10%所以以這樣的規模我們是覺得應該是足以來納入更多的這個罕病的新藥 |
| transcript.whisperx[159].start |
5278.348 |
| transcript.whisperx[159].end |
5297.789 |
| transcript.whisperx[159].text |
因為如果不會真的需要補這個20億的公務預算我相信跨黨派都會支持最後就是想問一個兒童篩檢的問題這幾天看到一個新聞讓人家非常難過一個父親同時要面對妻子罹癌 孩子罹病那那個孩子到一歲多才因為基因篩檢才知道他罹患罹患罹病 |
| transcript.whisperx[160].start |
5298.63 |
| transcript.whisperx[160].end |
5323.409 |
| transcript.whisperx[160].text |
所以我想問衛福部有沒有規劃要納入公費新生兒的篩檢項目因為科技都進步了我們是不是要與時俱進的能不能把健保先把健保給這些寒病的孩子來做新生兒篩檢新生兒篩檢我們目前21項公費裡面18項都是屬於寒病那至於還要不要再擴大那也都是要經過醫療科技評估像這個剛剛提的SMA這個 |
| transcript.whisperx[161].start |
5326.191 |
| transcript.whisperx[161].end |
5347.261 |
| transcript.whisperx[161].text |
脊髓神經萎縮肌肉萎縮症的這個已經評估完了所以明年會納入在這個我覺得應該要考慮增加對那其他我們都是一步一步會去檢討部長謝謝謝謝好謝謝委員好謝謝部長謝謝林委員接下來請林署委員來做詢問 |
| transcript.whisperx[162].start |
5357.227 |
| transcript.whisperx[162].end |
5385.159 |
| transcript.whisperx[162].text |
謝謝主席 是不是請我們 石部長部長林委員長部長這個數萬顆芬普尼雞蛋流入市面那你們定調說本起事件是散發個案不會擴大到百分之百的稽查這個市售所有的雞蛋那你們判斷為個案的依據是什麼 |
| transcript.whisperx[163].start |
5386.574 |
| transcript.whisperx[163].end |
5397.948 |
| transcript.whisperx[163].text |
跟委員說明因為這個過去這七年間其實每年都是列為例行性的後市場的檢驗你們例行性的後市場檢驗的計畫叫什麼名稱 |
| transcript.whisperx[164].start |
5403.305 |
| transcript.whisperx[164].end |
5411.527 |
| transcript.whisperx[164].text |
委員這邊跟您進一步報告我們叫做情緒水產品藥物殘留監測計畫這個計畫已經執行幾年了我們從107年到現在107年報告整顧的數量在整體讓委員了解107年到114年11月12號107年之前有沒有監測計畫後市場 |
| transcript.whisperx[165].start |
5431.852 |
| transcript.whisperx[165].end |
5446.728 |
| transcript.whisperx[165].text |
尤其社會市場監測計畫一直都有我們特別是說含有分普尼的監測裡面的這些殘留所以107年以前沒有監測嗎以前也有監測 也有107年監測的時候因為這是分普尼所以特別把分普尼的監測 |
| transcript.whisperx[166].start |
5447.949 |
| transcript.whisperx[166].end |
5466.534 |
| transcript.whisperx[166].text |
納進去有4282件每一年大概是400件到800件近年來 像去年是561件所以107到113年總共有的件數裡面大概合格率是百分之百那今年度是461件有一件是違規的 |
| transcript.whisperx[167].start |
5469.37 |
| transcript.whisperx[167].end |
5490.342 |
| transcript.whisperx[167].text |
你們是說過去的抽測百分之百都合格所以你們判斷這是一個個案那署長你回覆說你們抽驗一路走來都是用科學randomizerandom的方法去抽驗出來的結果所以你不會把它變成百分之百的這個抽查 |
| transcript.whisperx[168].start |
5491.883 |
| transcript.whisperx[168].end |
5506.288 |
| transcript.whisperx[168].text |
因為事實上你們用隨機抽樣去抽都沒問題嘛你是這樣講的嘛所以這件事情如果變成百分之百去抽查這件事情在科學上其實是對不起科學 |
| transcript.whisperx[169].start |
5507.902 |
| transcript.whisperx[169].end |
5534.001 |
| transcript.whisperx[169].text |
對不起科學 你的意思是這樣子嗎不科學的嗎不是不對不起科學 跟委員報告一下就是說按照現在科學的因為按照現在的基準證據這樣子的抽查的結果你認為全面抽查是不科學的所以能夠確保風險被控制就好了那我現在要討論就是不是這個樣子那我現在要問你是說上一次的芬普尼事件是什麼時候 |
| transcript.whisperx[170].start |
5535.546 |
| transcript.whisperx[170].end |
5556.143 |
| transcript.whisperx[170].text |
上次是106年代那一次的106年對106年它的發生的來龍去脈你清楚嗎那一次的整個調查因為當初是以學者的身份大概有一些些略知一二不是那麼完全清楚但是你知道監察院有調查報告嗎監察院 |
| transcript.whisperx[171].start |
5559.406 |
| transcript.whisperx[171].end |
5581.197 |
| transcript.whisperx[171].text |
我沒有特別看過那份報告但我知道監察院有特別講好 那我就跟你講我現在以下所講的全部都是來自於監察院的講法好了我先講背景2017年歐洲很多個國家包括德國 比利時 荷蘭歐盟發現28個會員國裡面有26個國家受到 雞蛋受到分普尼的污染 |
| transcript.whisperx[172].start |
5581.877 |
| transcript.whisperx[172].end |
5601.926 |
| transcript.whisperx[172].text |
然後呢後來擴散到發現美國俄羅斯南韓瑞士香港等等然後發現很多國家連亞洲國家都有了那所以食藥署跟農委會也開始進行監測了也監測了喔調查有沒有受到芬普尼污染然後呢 |
| transcript.whisperx[173].start |
5603.206 |
| transcript.whisperx[173].end |
5625.26 |
| transcript.whisperx[173].text |
根據監察院發布的調查報告食藥署只抽驗了10件雞蛋樣品而且都是在超市裡面賣場販售的盒裝雞蛋那沒有包含傳統市場也沒有包含零售廠商所以食藥署在2017年的7月8月18號發布新聞 |
| transcript.whisperx[174].start |
5627.742 |
| transcript.whisperx[174].end |
5637.923 |
| transcript.whisperx[174].text |
宣稱市售蛋品沒有檢出分譜尼告訴大家雞蛋都很安全 這是8月18號的新聞結果隔了兩天 因為只抽查了10件 |
| transcript.whisperx[175].start |
5639.973 |
| transcript.whisperx[175].end |
5665.346 |
| transcript.whisperx[175].text |
農委會就發現國內蛋機有分譜尼這個污染後續更擴大檢驗發現有44件不合格樣品顯示當時食藥署最初的抽驗過於草率所以後來發現這大問題是去抽查然後不合格率這麼高以後他就開始抽查全國的蛋廠然後8月25號一個禮拜後公佈結果 |
| transcript.whisperx[176].start |
5667.186 |
| transcript.whisperx[176].end |
5688.696 |
| transcript.whisperx[176].text |
對污染場域的那個氧機場 氮機場進行了移動管制但是到9月14號仍然還有受污染的雞蛋流出農委會的全面抽檢還有後續處理沒有完全的圍堵住那署長 部長你聽清楚食藥署抽驗的件數過少 |
| transcript.whisperx[177].start |
5691.977 |
| transcript.whisperx[177].end |
5718.335 |
| transcript.whisperx[177].text |
然後就發布說這個市面上雞蛋安全無虞請問你們這一次抽驗了幾件跟委員這邊報告這次其實我們抽的第一波其實是我們委託張大學衛生局例行性的抽驗以外你們這個事件發生以後有沒有再去抽驗這個抽驗的時候當初是抽五件中了一件在這一家廠這個是例行性的抽驗對 |
| transcript.whisperx[178].start |
5720.376 |
| transcript.whisperx[178].end |
5738.179 |
| transcript.whisperx[178].text |
那事發之後然後大家都發現這家廠有問題你在後市場裡面有沒有再去抽過至少抽個看看其他廠有沒有其他問題因為你也是隨機抽的嘛然後文雅之後有沒有在後市場再抽其他的 |
| transcript.whisperx[179].start |
5738.82 |
| transcript.whisperx[179].end |
5758.517 |
| transcript.whisperx[179].text |
我們這個抽菸其實持續在進行當中以今年的 你知道在2017年發生的時候其實他們在也有例行性的抽菸2017年之前 不是你講你的計畫2018年開始但2017 2016 2015其實都有後市場的各種食品安全的抽菸也都有 |
| transcript.whisperx[180].start |
5759.5 |
| transcript.whisperx[180].end |
5774.465 |
| transcript.whisperx[180].text |
但整個事件發生以後當國家採取這個這個安全措施的時候當時2017年食藥署也在再去抽驗例行性的抽驗之後有再去抽驗抽了10次然後就說安全無虞 |
| transcript.whisperx[181].start |
5776.326 |
| transcript.whisperx[181].end |
5792.766 |
| transcript.whisperx[181].text |
所以後來這邊跟委員稍微一點點的報告其實我們已經確定在養雞場內部的畜牧場內部的所以我們跨部會裡面提到的是在所有還沒有出來之前就要驗我們後市場我們會積極的持續的來去做不是啦 |
| transcript.whisperx[182].start |
5793.506 |
| transcript.whisperx[182].end |
5818.422 |
| transcript.whisperx[182].text |
還沒出來以前要驗這個是源頭把關還沒有出來以前要驗是農業部的責任跟你無關但我現在問你是當整個事件發生以後你到底有沒有去針對市面上到底這個問題是不是一個個案還是有沒有比較大的嚴重的擴散你有沒有進行任何的後市場抽驗 |
| transcript.whisperx[183].start |
5820.598 |
| transcript.whisperx[183].end |
5842.165 |
| transcript.whisperx[183].text |
跟委員報告一下 我剛才提到的是 整體的107年的時候其實是沒有長期先前的抽驗可是我們現在的政績是從107到現在有四千多次的追驗我現在要告訴你是 你回答我你整個事情發生以後 你有沒有做出任何的後市場再抽驗一次 |
| transcript.whisperx[184].start |
5844.246 |
| transcript.whisperx[184].end |
5865.723 |
| transcript.whisperx[184].text |
我們今年度已經整個驗了461件所以就今年度所以我們在這個樣子的情形之下其實是應該是精準的知道是哪裡那在畜牧場端我們其實是持續在跨部會裡面就合作針對這部分那我再把監察院當時報告再講一次 |
| transcript.whisperx[185].start |
5867.565 |
| transcript.whisperx[185].end |
5876.449 |
| transcript.whisperx[185].text |
當時發生以後去抽驗的實踐然後被認為說這個就宣稱安全無虞監察院約詢的時候副署長林金富告知統計學上原則採樣至少要30件這個是發生事情發生之後然後去抽驗的然後呢第一波檢驗完以後三個部會決議要由農委會主政從源頭全面檢測所以 |
| transcript.whisperx[186].start |
5897.701 |
| transcript.whisperx[186].end |
5912.838 |
| transcript.whisperx[186].text |
這個食藥署就不再去做這個抽驗但是監察院認為重點就是當時為什麼實踐以後就作為依據對外宣布結果實有不當在那時候呢如果看一下當年的新聞一定會覺得如果 |
| transcript.whisperx[187].start |
5917.318 |
| transcript.whisperx[187].end |
5940.407 |
| transcript.whisperx[187].text |
當時農委會就組了跨部會小組決議啟動24小時全台大抽檢然後一共有15個機場驗出分普尼殘留然後抽檢數量達到1451件當時的新聞如果是食藥署你現在署長你去看你一定覺得說怎麼一點也不科學還驗到這個1000多件 |
| transcript.whisperx[188].start |
5942.168 |
| transcript.whisperx[188].end |
5946.003 |
| transcript.whisperx[188].text |
但是如果當年沒有全台大抽檢 抽檢了一千多件 |
| transcript.whisperx[189].start |
5947.711 |
| transcript.whisperx[189].end |
5973.901 |
| transcript.whisperx[189].text |
它就沒有後來後續的比較完善的管理的機制那我現在要告訴你說你認為我們例行性的檢查今年已經檢了幾百件了應該是沒問題了然後你要告訴大家說一天要吃這個100顆才會急性中毒然後每天吃7到8顆才會慢性中毒所以理論上安人民的心是對的但是不能夠只是這樣子講 |
| transcript.whisperx[190].start |
5975.262 |
| transcript.whisperx[190].end |
5997.203 |
| transcript.whisperx[190].text |
你應該不要再用學者的身份把自己學者的身份拋棄掉不要再高舉著這部科學的說法拒絕更多的管制的手段因為十安五環最重要的上游的這個源頭管制管控的項目源頭的管控重建生產管理加強查驗 |
| transcript.whisperx[191].start |
5998.704 |
| transcript.whisperx[191].end |
6016.081 |
| transcript.whisperx[191].text |
這都是食藥署責務判斷最該執行的項目然後你動不動就說你叫我再去檢測更擴大檢測這不科學然後你們只針對現在的文雅牧場單一個案加強管理人家會覺得說這個真的是安全的嗎人家也會質疑你說這是不是鴕鳥心態那還有媒體指出 |
| transcript.whisperx[192].start |
6024.181 |
| transcript.whisperx[192].end |
6048.32 |
| transcript.whisperx[192].text |
你們試圖以歷年抽驗4000多例只有一次出問題來化解疑慮然後你剛剛我講的你要吃100多顆才能夠即興中毒所以另外一個不具名的毒物專家他們知道署長是毒物專家他講說民眾擔心食安的議題不是只有你講科不科學科學的理論抽驗還需要風險溝通 |
| transcript.whisperx[193].start |
6051.602 |
| transcript.whisperx[193].end |
6070.357 |
| transcript.whisperx[193].text |
所以風險的溝通這一件事情很重要然後盡快的釐清真相才能安定民心嘛而不是說你看你們歷次發生這種事件的時候都便以形式然後屢屢被後續發生的案例打臉打到臉都腫了打到臉都紅了 |
| transcript.whisperx[194].start |
6072.901 |
| transcript.whisperx[194].end |
6093.52 |
| transcript.whisperx[194].text |
這個過去都是這樣子好那我現在告訴你你認為今年都已經檢驗了幾百件了就最近有問題所以你認為都沒問題了最好如此喔我是認為說你說的最好如此如果還有其他的樣品被其他地方政府抽檢出來 |
| transcript.whisperx[195].start |
6094.941 |
| transcript.whisperx[195].end |
6123.675 |
| transcript.whisperx[195].text |
那恐怕臉還會更腫所以當時2017年就抽了全抽 抽了1000多批你這個案例你要清楚報告委員的提醒我謹記在心但是我這邊要特別提一下所有的風險溝通其實風險溝通來自風險分析因為你關心我現在是全民關心一定要風險評估Risk Assessment為基礎所以我們會有這麼大的底氣 |
| transcript.whisperx[196].start |
6124.975 |
| transcript.whisperx[196].end |
6136.925 |
| transcript.whisperx[196].text |
去相信希望能夠去穩定是一個單一的個案以外我們也會積極的去了解因為後續是不是有你們話都不要講得太早部長 一開始你說該事件不是飼料殘留飼養過程中的添加應該是環境污染現在證明對啦 也是環境污染因為被一送法辦了人家認為是直接分譜你就噴在機織上面啦對 目前的證據是這樣 |
| transcript.whisperx[197].start |
6153.078 |
| transcript.whisperx[197].end |
6161.565 |
| transcript.whisperx[197].text |
在機織上面叫做環境污染嗎我想這部分應該農業部會積極的去懲處跟你們無關 所以你可以這樣講所以我要跟你講話不要講太快你們也不是你們業務所管所以你不要去講說應該是環境污染不是飼料殘留 不是添加當然不能添加當然不可能是飼料殘留因為咱都知道隔子農機的問題是什麼隔子農機的飼養環境是什麼 |
| transcript.whisperx[198].start |
6180.02 |
| transcript.whisperx[198].end |
6191.317 |
| transcript.whisperx[198].text |
而他真的就是需要因為葛齒龍雞他能夠生活的環境多大你知道嗎一隻雞終其一生他的一輩子一隻蛋雞他能夠生存的空間有多大你知道嗎比這一張還要小 |
| transcript.whisperx[199].start |
6195.808 |
| transcript.whisperx[199].end |
6223.398 |
| transcript.whisperx[199].text |
雞隻連要清羽毛連要清除牠身上的寄生蟲都沒有辦法連轉身都沒有辦法中期牠的一生只能吃飼料下蛋吃飼料下蛋而牠的大便就直接在下面骯髒的大便堆了多高就是在那裡蟲業的養殖的人員年紀有多高如果你去看了你就知道你不訝異為什麼他們一直使用分譜尼 |
| transcript.whisperx[200].start |
6224.793 |
| transcript.whisperx[200].end |
6244.7 |
| transcript.whisperx[200].text |
然後為什麼只有環境傾銷還不夠因為雞隻上面很多跳蚤害蟲牠走到要死去嘛所以雞都不健康嘛然後所以才會直接噴在上面但是我告訴你全台灣蛋90%都是格子龍雞難道只有一個文雅牧場會這樣子做嗎 |
| transcript.whisperx[201].start |
6246.775 |
| transcript.whisperx[201].end |
6265.6 |
| transcript.whisperx[201].text |
你相信只有無氧牧場會這麼的離譜嗎老實說我們不知道但是我們相信你還是要科學的方法但科學不是你講說要100顆蛋才會急性中毒我們要的食品安全標準絕對不是急性中毒 |
| transcript.whisperx[202].start |
6266.46 |
| transcript.whisperx[202].end |
6271.064 |
| transcript.whisperx[202].text |
我們要的食品安全的標準我已經跟你講過也不是說要不會慢性中毒我們為什麼要你來跟我們講說不會慢性中毒不會急性中毒我們要的是你好好的管源頭的管而且政府的管是真的有用有效的 |
| transcript.whisperx[203].start |
6286.82 |
| transcript.whisperx[203].end |
6303.672 |
| transcript.whisperx[203].text |
而不是你在用學者身分說學院在抽查不科學這樣的講法都不是溝通風險的溝通不是這樣子我一定悉心的去檢討我們的食農教育都告訴我們食品是怎麼來的 |
| transcript.whisperx[204].start |
6304.901 |
| transcript.whisperx[204].end |
6328.528 |
| transcript.whisperx[204].text |
如果我們知道我們的食物你的格子籠雞的雞蛋的飼養環境是那樣子那麼你就不會覺得很安心所以這是一個機會教育也是一個食品的安全教育也是一個食農教育你要去了解格子籠雞場是怎麼養雞的你就會知道風險高還是低 |
| transcript.whisperx[205].start |
6330.503 |
| transcript.whisperx[205].end |
6358.544 |
| transcript.whisperx[205].text |
我一定會把相關意見跟農業部做進一步的協調溝通謝謝委員這個姿態也很重要就不要動不動用學者的姿態然後認為我們閱聽人認為立委認為人民認為一般的人都不科學只有你最科學是這樣子報告委員我們會繼續查下去的查到哪裡我們就驗到哪裡謝謝部長 謝謝署長 謝謝林委員接下來請邱政軍委員來做詢問 |
| transcript.whisperx[206].start |
6367.903 |
| transcript.whisperx[206].end |
6375.944 |
| transcript.whisperx[206].text |
主席好我還是請一下我們的安心署長上來一下安心署長請江署長 |
| transcript.whisperx[207].start |
6386.621 |
| transcript.whisperx[207].end |
6413.062 |
| transcript.whisperx[207].text |
好 署長好這個每次食安出問題我們食藥署長都告訴大家這個劑量吃了不會死然後不會中毒我幫你回顧一下就從你上任開始不管是食安疑慮還是已經發生的食安問題你怎麼跟大家說的第一次取消日本福島食品進口限制我們江署長說在日本吃得很開心 |
| transcript.whisperx[208].start |
6414.028 |
| transcript.whisperx[208].end |
6415.397 |
| transcript.whisperx[208].text |
那第二次呢驗出這個萊劑的株 |
| transcript.whisperx[209].start |
6419.186 |
| transcript.whisperx[209].end |
6446.891 |
| transcript.whisperx[209].text |
我們江署長又說每天吃也健康無虞從沒有見過人吃萊克多巴胺中毒因為知識缺乏才會擔心那第三次是黑心大腸為了破案食藥署6月已經接到通報卻拖到10個月才下架讓民眾多吃了4個月的黑心大腸那現在分埔泥雞蛋署長你又說60公斤這個重成人 |
| transcript.whisperx[210].start |
6448.371 |
| transcript.whisperx[210].end |
6469.131 |
| transcript.whisperx[210].text |
一天要吃100顆雞蛋慢性風險是一天7至8顆持續吃一輩子才會有問題如果擔心可以這幾天先不吃蛋署長我想請問你人民吃下肚的東西要靠食藥署把關但是你每一次一而再再而三的挑戰人民的信任 |
| transcript.whisperx[211].start |
6469.952 |
| transcript.whisperx[211].end |
6494.097 |
| transcript.whisperx[211].text |
我再提醒你一次 沒有人想要吃到有毒的東西實際上就是0跟1的關係 沒有其他的關係身為署長 如果你都有容許模糊 有灰色地帶那整個體系就會爛掉 你知道嗎那現在我們芬普尼的雞蛋問題2017年你自己有分析過 2017年的時候你接受天下雜誌的訪問 當時你是台大的醫師 |
| transcript.whisperx[212].start |
6497.362 |
| transcript.whisperx[212].end |
6516.677 |
| transcript.whisperx[212].text |
讀理學副教授你自己說過超過每顆每日容許值不會急性中毒但健康風險提高設施不允許發生的那8年前是不容許發生的為什麼到了2025年你卻用了要吃100顆才中毒來合理這個違法殘留 |
| transcript.whisperx[213].start |
6518.342 |
| transcript.whisperx[213].end |
6531.238 |
| transcript.whisperx[213].text |
報告委員 這邊跟您整體一併的說明先從蛋的部分來做說明分普尼雞蛋的時候當初了解的情況下其實是整個還沒有背景的調查 |
| transcript.whisperx[214].start |
6532.81 |
| transcript.whisperx[214].end |
6552.506 |
| transcript.whisperx[214].text |
不知道狀況怎麼樣調查之後發現整個的狀況是長期的 暴露了所以在這種情形之下是全面性的跟現在這個我們經過七年來107年一路以來持續努力4282次裡面 驗裡面有一次前面現在是做所謂的 |
| transcript.whisperx[215].start |
6554.252 |
| transcript.whisperx[215].end |
6574.102 |
| transcript.whisperx[215].text |
隨機抽樣出來的結果要告訴我們所有的機場應該是隨機抽樣出來的結果為我們施政的依據在這樣的前提之下我們認為現在的可能的我們精準的知道在這一個場裡面所以在這個場裡面我們必須要做風險評估為基礎之下這個科學證據之下 |
| transcript.whisperx[216].start |
6576.303 |
| transcript.whisperx[216].end |
6589.838 |
| transcript.whisperx[216].text |
你昨天公布的這個檢驗數據雞蛋檢出這個芬普尼代謝物是0.03ppm那羽毛更高是這個0.27ppm那代謝物是0.13那目前你跟農業部研判的問題是什麼 |
| transcript.whisperx[217].start |
6591.7 |
| transcript.whisperx[217].end |
6608.146 |
| transcript.whisperx[217].text |
是環境還是殺蟲劑我其實難以跟幫忙就是說農業部但是以我的專業來去判斷這個應該是噴灑在雞隻的身上羽毛經過皮膚或者著食之後吸收到體內產蛋的時候就出現我們規定的是0.01ppm以下你怎麼去研判的呢 |
| transcript.whisperx[218].start |
6611.287 |
| transcript.whisperx[218].end |
6632.733 |
| transcript.whisperx[218].text |
這就是我的專業所在所以有時候這個部分其實要去了解的是因為飼料裡面要進來很困難環境用藥它其實凝膠劑因為它關在鎖起來飼料你怎麼確定它很困難因為其實這件事情之後其實農業部有些部分他們我們跨部會裡面他其實有驗過那你有去抽查其他的地方嗎 |
| transcript.whisperx[219].start |
6633.874 |
| transcript.whisperx[219].end |
6642.946 |
| transcript.whisperx[219].text |
這個現在就是因為抽查在機場的部分會是在2017年的時候2017年的時候就已經查過全國為什麼到你這邊就不行了 |
| transcript.whisperx[220].start |
6643.669 |
| transcript.whisperx[220].end |
6663.029 |
| transcript.whisperx[220].text |
那時候的查過前果是歷年來我們今年度就已經查了460件不是今年都沒有記住我是說你發生之後為什麼不查重點是整個的全體的現在隨機查出來的結果告訴我們的證據是你為什麼要隨機你為什麼不要全面清查我現在講這件事情你為什麼你要隨機呢 |
| transcript.whisperx[221].start |
6665.672 |
| transcript.whisperx[221].end |
6688.672 |
| transcript.whisperx[221].text |
這件事情特別跟委員做說明是不敢查還是怎麼樣還是怕查出來沒辦法應付現在查的時候呢 必須要在全面性的機場的在前端就要查了所以我們現在在跟農業部這邊能夠協調怎麼樣前端的要去查我們後端的是持續今年度400多批今年這個月呢 持續還是有我們的計畫向下還是有批數要來增加你飼料業有幾件 |
| transcript.whisperx[222].start |
6689.773 |
| transcript.whisperx[222].end |
6706.126 |
| transcript.whisperx[222].text |
我們今年 只驗了兩件對不對我們今年總共驗了461件這個月彰化其實驗了44件除了這以外你現在就是因為我說你飼料驗不出來才要頭痛那是因為目前看起來是噴在身上 |
| transcript.whisperx[223].start |
6707.046 |
| transcript.whisperx[223].end |
6728.956 |
| transcript.whisperx[223].text |
飼料上面有這件事情它怎麼會噴到牠身上為什麼要噴到牠身上剛才林委員其實非常專業的有說明了因為雞隻是龍雞 住得很小所以牠連轉身都很難去把自己的身上的雞屍感染清乾淨所以有些可能這個雞農用年紀我不知道特別是幾歲所以林委員剛才提示得非常精準的說這個因為牠都癢 |
| transcript.whisperx[224].start |
6731.937 |
| transcript.whisperx[224].end |
6752.966 |
| transcript.whisperx[224].text |
因為養就會影響下蛋所以就影響產量所以在這種情形之下呢他們就想辦法能夠解決問題可是解決問題是用錯的方法其實是有核准的相關的用藥的這個都是農業部在管理底下的所以是農業部在負責嘛 對不對我當然知道不是完全不是食藥署的這個責任但是農業部的問題確實也大只是說你2017年發生這個問題的時候你們把全國雞蛋這個蛋機廠都掃了一遍為什麼現在不做 |
| transcript.whisperx[225].start |
6759.909 |
| transcript.whisperx[225].end |
6786.452 |
| transcript.whisperx[225].text |
蛋機場少 蛋機場只要進入廠裡面都是農業部在管所以現在我們是要主決在食安五環2.0在主環在最前面那一段你現在講說百分之百機場它不是科學就對了這件事情容我說一下這個抽查是要精準的跟經過規劃的如果每一顆蛋都抽查完之後呢那顆蛋就不能吃了 |
| transcript.whisperx[226].start |
6788.499 |
| transcript.whisperx[226].end |
6799.892 |
| transcript.whisperx[226].text |
那我們要用批次來抽查跟能夠地點來抽查這個部分我們一定會繼續在按照規劃裡面持續做不會讓這個努力的要去做的那你現在有確認你現在有確認這些雞這些污染的雞蛋它確實是噴了農藥才感染的 |
| transcript.whisperx[227].start |
6806.96 |
| transcript.whisperx[227].end |
6824.976 |
| transcript.whisperx[227].text |
是誰噴的 為什麼噴有抓到源頭嗎 有沒有源頭這個是檢調 有沒有源頭我在這邊一定讓我講一下我要非常非常感謝彰化縣衛生局的局長葉彥博業局長非常機警的也感謝食安辦我們在10月5號通報之後立刻啟動了檢調進去機場裡面 |
| transcript.whisperx[228].start |
6827.998 |
| transcript.whisperx[228].end |
6855.439 |
| transcript.whisperx[228].text |
也在很專業的選擇哪邊的雞比較可能有問題去那邊的雞因為四萬顆雞五萬隻雞四萬顆蛋五萬隻雞你要抽中一定是一眼望過去哪邊是高風險的在這麼專業而且檢調協助農業方衛生方去檢雞毛拔出來雞蛋拿出來食品環境全部都我還是問你你不要講那麼多那到底查到源頭了沒有 |
| transcript.whisperx[229].start |
6856.809 |
| transcript.whisperx[229].end |
6866.523 |
| transcript.whisperx[229].text |
查到了沒有嘛雖然說是檢調不公開但是已經公開說就是大家想像的那樣應該是推論是噴在雞的身上對 誰噴的嘛 |
| transcript.whisperx[230].start |
6868.655 |
| transcript.whisperx[230].end |
6889.274 |
| transcript.whisperx[230].text |
一定要問機場的人他們目前那個後面的筆錄我就沒辦法問了所以你們現在已經確定是這樣就對了我沒辦法確定啦但是後面筆錄的部分應該是檢察官他們會問問完之後最後起訴所以你現在答的你現在講的是就是說他就是在現場人家噴的你現在說法是這樣嘛對不對那如果不是呢分譜尼呢會有 |
| transcript.whisperx[231].start |
6891.195 |
| transcript.whisperx[231].end |
6908.343 |
| transcript.whisperx[231].text |
這一次如果驗出來不是呢因為又沒抓到咧報告 報告委員因為這部分在檢調在調查其實他們很努力證據明確 方向正確我相信檢調跟農政跟衛生因為我們已經相信你很多次了嘛對不對 可是一直都出狀況不是嗎 |
| transcript.whisperx[232].start |
6910.766 |
| transcript.whisperx[232].end |
6929.044 |
| transcript.whisperx[232].text |
這個只說明了芬芙尼蛋其他的我可以一併的說明一下對於管理的部分我們持續會以最高標準的來管理對於食品安全我們會用風險評估為基礎不是 署長我這樣講如果今天查出來不是的話你要不要負責 |
| transcript.whisperx[233].start |
6931.003 |
| transcript.whisperx[233].end |
6955.982 |
| transcript.whisperx[233].text |
我想噴雞蛋你要不要嘛要不要負責我說噴雞蛋噴在雞身上是農政單位我這邊後市場端我們想盡辦法該抽的4282次我們從這麼多年來所有農衛政單位的同仁們齊心合力去做了這麼多把關去確定有異常就告訴全國的國人我希望你們這邊繼續追蹤下去一定的 |
| transcript.whisperx[234].start |
6959.145 |
| transcript.whisperx[234].end |
6973.825 |
| transcript.whisperx[234].text |
你浪費我時間太多了我最後問一個簡單的主席不好意思 部長關於我們提的癌症防治法的修正草案我看你們整體都不是很支持 |
| transcript.whisperx[235].start |
6976.709 |
| transcript.whisperx[235].end |
6995.603 |
| transcript.whisperx[235].text |
應該是這樣講我們很支持的就是加速讓這個癌症的新藥可以讓病人用到為了讓他加速可以用到我們就還沒有修法我們就已經先在健保基金裡面現有的健保基金裡面因為我們行政的第五條是一個政策宣示也可以說是一個行政機關的自我期許 |
| transcript.whisperx[236].start |
6996.323 |
| transcript.whisperx[236].end |
7015.32 |
| transcript.whisperx[236].text |
那但是法律條文才會有約束力啦你之前所以我們才會提出那第16條我們希望建立的是癌症心要多元的支持基金核心很簡單就是要有穩定的裁員明確的用途但你們的意思是說現在有癌症心要暫時性的支付專款就夠了 |
| transcript.whisperx[237].start |
7016.121 |
| transcript.whisperx[237].end |
7043.585 |
| transcript.whisperx[237].text |
那問題是這筆錢是公務預算的挹注沒有明確的法源沒有穩定的機制也就是說今天可以編明年又可以不要了所以這種不定期的挹注根本是支撐不起來的所以我希望你們趕快把這個東西定案因為我們常常看到我們賴總統很多政策喊得也很漂亮喊一喊然後又沒有了 對不對所以我也不希望說我們這個變成一個口號能夠有實際的作為可以嗎 |
| transcript.whisperx[238].start |
7044.464 |
| transcript.whisperx[238].end |
7062.527 |
| transcript.whisperx[238].text |
會 我們會持續的爭取預算來維持一直不斷的在擴充這些癌症新藥的納入因為剛剛也報告過因為要成立一個新的基金他需要有去籌措這個裁員那我們現在目前你大概多久會弄你的期程有沒有 至於有時間表嗎 |
| transcript.whisperx[239].start |
7064.408 |
| transcript.whisperx[239].end |
7083.154 |
| transcript.whisperx[239].text |
這個難度很高啦要一線有財源以外等於就是你要新增一個什麼東西這個真的是難度很高有沒有心要做的問題而已啦對不對我們都有心在努力才會先去爭取用公務預算因為公務預算是不能夠很新的 |
| transcript.whisperx[240].start |
7084.614 |
| transcript.whisperx[240].end |
7112.497 |
| transcript.whisperx[240].text |
對不對 你那個東西不確定性那你如果實施之後今年有 明年又沒有那怎麼辦不會啦 因為總統總統說用多少我們就會再補多少所以那你就趕快把法條列出來嘛那既然總統都背書了你怕什麼以現在來講我們是有一個法源就是用這個全民健康保險基金收支保管及應用反正我不管你用什麼辦法嘛反正就是這個基金你趕快你另外提撥一個專用的專款專用的這筆才對啊 |
| transcript.whisperx[241].start |
7113.666 |
| transcript.whisperx[241].end |
7137.31 |
| transcript.whisperx[241].text |
目前這個也是專款專用不會留到其他的健保的其他用途專門就在用癌症新藥目前就是專款專用可是你那個是 等於是另外一個我認為那個東西還不太穩定啦我們大家的看法是這樣不然我們大家不會提出來啦所以部長你趕快 盡快啦 好不好我們繼續努力 繼續努力好 謝謝委員 謝謝好 謝謝邱委員 謝謝部長 |
| transcript.whisperx[242].start |
7144.602 |
| transcript.whisperx[242].end |
7163.169 |
| transcript.whisperx[242].text |
好 接下來請王議員來做詢討那我們到盧先生委員詢討結束 我們就休息十分鐘在這邊做宣告好 謝謝主席 我們有請部長那請部長王委員好 |
| transcript.whisperx[243].start |
7163.772 |
| transcript.whisperx[243].end |
7192.747 |
| transcript.whisperx[243].text |
部長好 部長這個是你上任之後遇到第二件的這個史安事件那這個芬芙妮蛋從11月4號這個就被驗出來了一直到11月9號你們發了一個新聞稿11月10號衛福部才對外開了一個記者會讓消費者知道說這一個要去注意家裡冰箱你買到的是I47這樣的一個號碼就不要吃 |
| transcript.whisperx[244].start |
7193.527 |
| transcript.whisperx[244].end |
7211.688 |
| transcript.whisperx[244].text |
你認為你們整個的處理從11月4號驗出來到11月10號才正式的開記者會讓所有的民眾都知道消費者無辜多了幾天把毒雞蛋吃下肚你們這樣的做法有沒有檢討的空間要不要檢討 |
| transcript.whisperx[245].start |
7212.783 |
| transcript.whisperx[245].end |
7226.378 |
| transcript.whisperx[245].text |
跟委員報告我們這個就如同這個這個手板上面所呈現的是每一個步驟都很積極的在進行每一天都有進度你說你很積極所以沒有改進的空間100分 |
| transcript.whisperx[246].start |
7227.839 |
| transcript.whisperx[246].end |
7249.322 |
| transcript.whisperx[246].text |
不敢说100分因为毕竟还是有国人吃下去的我们都觉得不安心你们公布的速度有没有调整的空间有空间要改善我们会去检讨我现在就告诉你应该怎么改善第一个你们11月7号就已经要求通路停止贩售了为什么没有同步 |
| transcript.whisperx[247].start |
7250.359 |
| transcript.whisperx[247].end |
7259.584 |
| transcript.whisperx[247].text |
就是告訴大家而且當你11月7號同時要通知通路的時候為什麼你不開記者會不告訴大家就默默低調進行 |
| transcript.whisperx[248].start |
7261.055 |
| transcript.whisperx[248].end |
7282.606 |
| transcript.whisperx[248].text |
是為什麼這不是應該要趕快讓消費者知道嗎因為今天除了通路下架完之外很多消費者是之前就買回來放在冰箱每天吃一顆早上吃一顆水煮蛋好健康你如果越早講他在冰箱裡面的雞蛋他可以拿出來對號碼然後不用吃下毒不是嗎 |
| transcript.whisperx[249].start |
7284.378 |
| transcript.whisperx[249].end |
7301.044 |
| transcript.whisperx[249].text |
這個要不要改進謝謝委員這知道我們部長要不要改進告訴我就好特別指示我們要在這部分要積極的去研究以後要求你們改進這個是消費者之的權利未來的話我們就是查到哪裡公佈到哪裡當然我們也要考慮到不要讓民眾恐慌 |
| transcript.whisperx[250].start |
7302.024 |
| transcript.whisperx[250].end |
7329.329 |
| transcript.whisperx[250].text |
會影響到整個所有的合法的但不是恐慌的問題是你怎麼公告的問題你可以告訴消費大眾說我現在已經查到一批那批號是什麼民眾現在如果有疑慮你可以選擇暫停使用但民眾有知的權利他自行去判斷他要不要繼續使用那你們這一次我覺得做錯的地方就是你們沒有充分告知讓民眾提早知道 |
| transcript.whisperx[251].start |
7330.109 |
| transcript.whisperx[251].end |
7358.665 |
| transcript.whisperx[251].text |
在日本 在韓國他們都是採用最快的速度因為消費者有知的權利而且他們發布的方式韓國他還用緊急通訊系統在你的手機裡面馬上就看到韓國他們的這個系統緊急災難警報系統是很厲害的馬上就會看到說什麼貨號什麼時候這一批貨品廣為周知告知消費者這個是我覺得在這次食安事件處理的時候衛福部應該還要再改進的地方這是第一點 |
| transcript.whisperx[252].start |
7359.665 |
| transcript.whisperx[252].end |
7381.78 |
| transcript.whisperx[252].text |
那第二點是這一點我認同這個委員的看法所以就是我們要精準不要傷及無辜那在精準的資訊下那麼儘快的揭露讓消費者你不是說所有雞蛋不能吃而是你告訴他哪一個批號有問題哪一個蛋場對不對那這一個我要求你們日後改進第二個是我們要料底從寬預底從嚴 |
| transcript.whisperx[253].start |
7384.742 |
| transcript.whisperx[253].end |
7407.538 |
| transcript.whisperx[253].text |
那在這一次你發現這一個批號有問題之後為什麼沒有擴大再去抽驗市場上面的散彈你們有沒有抽跟委員報告就是說這個例行性的今年度大概是查了461批那這461批裡面就包含了散彈有幾件 |
| transcript.whisperx[254].start |
7410.461 |
| transcript.whisperx[254].end |
7414.425 |
| transcript.whisperx[254].text |
我接下來要追問的就是署長有對外明確的擔保說這一次的珍普尼彈 液彈是完全沒有問題的我接下來要問的就是說 |
| transcript.whisperx[255].start |
7429.521 |
| transcript.whisperx[255].end |
7456.486 |
| transcript.whisperx[255].text |
署長你為什麼敢掛保證就是因為這個蛋廠的所有的蛋它通通都是上了這個超市通路嗎沒有留到散裝蛋嗎沒有是整批的出去嗎那如果我們現在的管理我們現在只能追蹤到超市的進到市場的它其實是整批整籃子的蛋買回去就是你真的可以百分之百保證 |
| transcript.whisperx[256].start |
7457.526 |
| transcript.whisperx[256].end |
7485.488 |
| transcript.whisperx[256].text |
沒有任何的早餐店沒有任何的其他的小吃單是買到這一家這一個畜牧場的蛋嗎這邊跟委員做一點點補充說明那這部分我們後來想辦法趕快修正所以我們把一些這個蛋散蛋上面每個框上面都有它的QR code我知道有QR code我現在在問你的問題是你怎麼知道這些蛋沒有流通到其他的市場小吃點 |
| transcript.whisperx[257].start |
7486.946 |
| transcript.whisperx[257].end |
7507.338 |
| transcript.whisperx[257].text |
你敢掛保證 你說沒有其他的液彈有問題你會不會話講太快了 署長報告委員 我們那時候其實我們的資訊裡面這家彈廠裡面沒有特別提供所謂液彈的處理的因為液彈有時候會但它有提供散彈對 它有提供散彈這部分那散彈後續的追蹤你怎麼確保它沒有進到其他的液彈市場呢 |
| transcript.whisperx[258].start |
7508.198 |
| transcript.whisperx[258].end |
7524.809 |
| transcript.whisperx[258].text |
除非你今天是已經有反向去所有的這個液氮廠去追查反向追查有沒有來源是來自這一家的畜牧廠有嗎 也沒有所以這樣的保證是沒有意義的這個署長我也是要提醒你就是說我發現你現在對外回應有些話都講得太滿 太快 |
| transcript.whisperx[259].start |
7529.707 |
| transcript.whisperx[259].end |
7541.412 |
| transcript.whisperx[259].text |
就是你可能擔負不起這樣的一個保證因為到目前為止坦白講你們能保證使用分譜你的只有彰化的這一家蛋廠嗎 |
| transcript.whisperx[260].start |
7542.867 |
| transcript.whisperx[260].end |
7564.398 |
| transcript.whisperx[260].text |
你們敢保證嗎部長 署長你們敢保證嗎報告委員這部分其實已經啟動跨部會了所以農政單位的針對蛋廠裡面的一些用藥的他們其實積極的啟動了農盟也會跟他們一起協作對啊 他現在才要去查而已但是你的保證已經掛在前面了而且前面話還講太快說我們不需要再去查其他的地方 |
| transcript.whisperx[261].start |
7566.085 |
| transcript.whisperx[261].end |
7594.181 |
| transcript.whisperx[261].text |
處理危機不是這樣子處理的所謂預敵重演就是我從這個單一的案場發現了這樣的情況之後我除了我的畜牧場我要開始啟動其他的畜牧場一樣加嚴的處理之外韓國當時爆發分譜就是這樣我全部都查查完一遍讓國人安心因為我們不放心是不是只有這單一牧場違法使用如果按照很多這種資深的基農還有動保團體他們指出來的 |
| transcript.whisperx[262].start |
7595.583 |
| transcript.whisperx[262].end |
7623.372 |
| transcript.whisperx[262].text |
分譜你還有人偷偷在用啊那偷偷在用真的只有這單一的廠嗎因為主要是他防治這個機師的效果他的效果特別好又比較便宜這個就是重點了那如果你不敢保證的時候我覺得我建議官方在說法上面不要太過於自滿你講到百分之百萬一不是呢萬一這普查下去還有另外一家廠有的時候你的保證 |
| transcript.whisperx[263].start |
7624.924 |
| transcript.whisperx[263].end |
7644.898 |
| transcript.whisperx[263].text |
變成完全沒有意義所以我覺得應該是實事求是吧欲敵從嚥吧你們今天農業部沒有來我希望你們回去在那個會議裡面我們要求的是農業部你應該即刻就要展開很快速的再去清查一遍比照2017年的分埔泥事件你這樣才能讓國人安心嘛 |
| transcript.whisperx[264].start |
7645.578 |
| transcript.whisperx[264].end |
7668.167 |
| transcript.whisperx[264].text |
他如果源頭沒有問題你後端市場你目前查驗的你才可以說因為源頭沒有問題我們查到沒有問題到目前為止才能定調是單一事件但你通通都還沒有做以前就先宣告這只是單一事件這都是錯誤的就像農業部部長他對外說這是環境污染可是隔壁的農田飄過來了是嗎現在查出來 |
| transcript.whisperx[265].start |
7669.267 |
| transcript.whisperx[265].end |
7692.081 |
| transcript.whisperx[265].text |
就是有噴灑嗎就是這麼高的一個濃度就是有噴灑所以我要求的就是你們要預底重演預底重演還有一項是你們食藥署可以做除了源頭是農業部該做的預底重演還有你們該做的是什麼就是應該還要再去散彈市場再加鹽再多抽幾個讓大家安心可不可以 |
| transcript.whisperx[266].start |
7693.057 |
| transcript.whisperx[266].end |
7712.439 |
| transcript.whisperx[266].text |
這邊跟委員說一下報告給一點點就是說針對這樣子的事件我們長期的追蹤事實上是從我知道你長期的追蹤這個話你已經講過很多遍了但是署長我提醒你因為現在就是爆發了驗到了嘛當你驗到的時候所謂預計重演就是你不要以為只有這單一 |
| transcript.whisperx[267].start |
7713.76 |
| transcript.whisperx[267].end |
7734.6 |
| transcript.whisperx[267].text |
它可能市場上面可能還有 所以你的密度再加強再多高密度的稽查 你這也是讓大家放心就是說宣示你食藥署的行動就是我展開播出了要求農業部源頭你要把關好之外後端市場 你再加密加嚴在這一陣子多查幾個 查出來也是沒有 |
| transcript.whisperx[268].start |
7735.541 |
| transcript.whisperx[268].end |
7764.981 |
| transcript.whisperx[268].text |
大家消費者就覺得很安心會更相信是單一個案在買蛋的時候可以更放心我要講一個為什麼我在建議裡面你們去研究看看我們現在有這個蔬果的質樸快篩中心有29所我們對於蔬果是高密度的檢驗而且是常態化的檢驗為什麼因為天天都要吃蔬果但是雞蛋呢雞蛋我們沒有我們對雞蛋的管理相對是比較鬆散的為什麼因為可能 |
| transcript.whisperx[269].start |
7765.681 |
| transcript.whisperx[269].end |
7791.65 |
| transcript.whisperx[269].text |
我也不知道為什麼 可能他檢驗的方法是比較困難但是後來這一些蔬果質樸儀快檢中心出來之後的確讓國人安心了很多我希望這個署長你很自豪是你是學者學者好好去研議一下怎麼樣這個蛋品的檢驗我們一定都要送到中央續產中心嗎像這樣的一個比對有沒有更好的儀器跟設備我們可以加快就是把它驗出來 |
| transcript.whisperx[270].start |
7792.17 |
| transcript.whisperx[270].end |
7807.37 |
| transcript.whisperx[270].text |
因為這一次我不曉得是你們的責任還是農業部的責任2019年農業部已經講了驗這個分譜你之前是拖拖拉拉一個禮拜後來他說要48小時就要驗出來結果這一次又沒有你們是10月27號開始驗對不對 |
| transcript.whisperx[271].start |
7809.572 |
| transcript.whisperx[271].end |
7833.583 |
| transcript.whisperx[271].text |
中央本是什麼時候因為他是常態的是彰化幫忙抽完之後送到中央續產會報告直接告訴我們我們就馬上所以花了多少天的時間他們第一波是告訴我們我們回出來的報告是在7天10月27號到16號要花7天才能出來嗎第二波其實因為是緊急個案前面是常態的嘛還有很多要驗其他的東西所以這次第二波驗他其實在48小時內就符合48小時嗎的確是有了 |
| transcript.whisperx[272].start |
7835.444 |
| transcript.whisperx[272].end |
7843.504 |
| transcript.whisperx[272].text |
好我最後建議的這個比照蔬果質樸開栽中心將蛋品檢驗常態化提高抽驗比例這個讓部長來回答 |
| transcript.whisperx[273].start |
7845.527 |
| transcript.whisperx[273].end |
7874.272 |
| transcript.whisperx[273].text |
你覺得有沒有可能去研議當然剛剛您提到幾個重點我都蠻認同就是說我們要加強這個風險的溝通當然是要讓民眾安心但是我們也要提醒民眾應該注意哪些事情這個是我們會來改善的但是要不要擴大抽菸這個事情因為今年這個情況跟2017年的時候已經不同因為2017年之前是沒有這個常態性例行性抽菸 |
| transcript.whisperx[274].start |
7875.132 |
| transcript.whisperx[274].end |
7901.19 |
| transcript.whisperx[274].text |
而且在爆發那個事件之後農業部也加強了畜牧場的管理然後我們之後每年大概都四五百件一路抽下來所以今年才抽出這一件當然我們不能夠完全放心所以我們現在也配合檢調跟農業部繼續往上再查如果有發現有橫向的情形的時候我們就會再繼續就是查到哪裡我們就驗到哪裡所以我們會持續調整這樣 |
| transcript.whisperx[275].start |
7903.311 |
| transcript.whisperx[275].end |
7915.3 |
| transcript.whisperx[275].text |
好我希望這邊其實今年就是下半年我們還沒有結束所以我們的計畫持續抽菸還在抽嘛對不對還有的我們一定會持續公告給全國人去了解你們可不可以針對龍翅的蛋C的 |
| transcript.whisperx[276].start |
7917.165 |
| transcript.whisperx[276].end |
7937.193 |
| transcript.whisperx[276].text |
強化它的頻率可以嗎現在就是我們抽菸的時候就是挑那個蜥蜴對 龍柿的作為重點好不好因為是它的飼養方式它太密集然後比較容易有這個蟲產生然後所以它的用藥的頻率可能就會比較高所以你們調整那個比例好不好針對龍柿的部分 |
| transcript.whisperx[277].start |
7939.174 |
| transcript.whisperx[277].end |
7966.103 |
| transcript.whisperx[277].text |
提高那個抽氧比例我們需要的食安是真的讓大家可以安心所以我希望這個衛福部你們也責無旁貸特別已經成立了食藥署應該在這一塊態度要更積極而不是用學術化的話語就是來回應吃一百顆雞蛋都沒有關係署長下次不要再講這種事情一百顆是有關係的不能這樣吃法對還沒中毒之前就那你怎麼會蹦出這一句呢 |
| transcript.whisperx[278].start |
7967.331 |
| transcript.whisperx[278].end |
7971.435 |
| transcript.whisperx[278].text |
那個好 其實好啦 以後我提醒你一定會注意的講話不要太滿好不好 謝謝謝謝 謝謝委員 |
| transcript.whisperx[279].start |
7995.245 |
| transcript.whisperx[279].end |
8024.036 |
| transcript.whisperx[279].text |
好謝謝主席有請部長部長好雖然有點遺憾就是說你們針對我的癌症防治法第八條修正草案是說建議維持原條文不過我還是要說明我的理由第一個就是說我們平均與命大家都知道大概在六七歲的差距第二個就是我們的基因差距大概在 |
| transcript.whisperx[280].start |
8025.097 |
| transcript.whisperx[280].end |
8040.216 |
| transcript.whisperx[280].text |
幾萬年 可能三萬年左右所以我們的疾病的形態就會不一樣那我們的因為大部分都是低射精的地位所以可能死亡率也比較高所以就總統的那個2030年你說要降低到三成的這個 |
| transcript.whisperx[281].start |
8041.717 |
| transcript.whisperx[281].end |
8066.036 |
| transcript.whisperx[281].text |
預期呢我相信這個原住民如果這個沒有所謂的專門的一個人在那邊把關的話我相信這個30%這樣的一個預期我覺得會有點質疑所以我希望部長能夠支持我這樣的一個修法也就是說希望我們這個我們的團體裡面不是把原住民變成是民間團體或者是說一般的那個類型我們是 |
| transcript.whisperx[282].start |
8067.133 |
| transcript.whisperx[282].end |
8084.474 |
| transcript.whisperx[282].text |
基因獨特然後射精地位獨特的一個族群所以希望在癌症這個防治的部分裡面我們一起努力好不好跟委員報告我們很認同這個剛剛委員所描述到這個我們原住民跟一般的這個漢民漢人之間 |
| transcript.whisperx[283].start |
8086.997 |
| transcript.whisperx[283].end |
8108.395 |
| transcript.whisperx[283].text |
在疾病特別是在我們的這個十大死因的分析裡面對比起來是不一樣的那即使是癌症的發生率也有差異所以確實應該要針對原住民族的健康要有特別的研究跟策略所以這個我們也在部裡面其實也有這個我們原住民族健康的諮議會 |
| transcript.whisperx[284].start |
8109.736 |
| transcript.whisperx[284].end |
8125.739 |
| transcript.whisperx[284].text |
那全部大概幾乎啦多數是我們都有原名背景的好 謝謝部長那我們會把這個癌症這個議題也非常非常重視好 謝謝那我念這再一次的就是我們原卷法已經通過兩年 將近要兩年半了 |
| transcript.whisperx[285].start |
8126.36 |
| transcript.whisperx[285].end |
8141.59 |
| transcript.whisperx[285].text |
那現在我們就看第二條第二項的規定就是說應該有專責單位可是我看到你們在第二頁的報告裡面有看到就是說將規劃成立行政法人國家醫療科技評估中心要請大院審議 |
| transcript.whisperx[286].start |
8142.671 |
| transcript.whisperx[286].end |
8161.936 |
| transcript.whisperx[286].text |
我們看到這樣的時候會覺得說那我們原住民的專責單位已經原紀法已經通過兩年多了是不是要像我們原紀法一樣的擺在那邊二十年都不動那我說已經成立兩年多至少在民進黨執政說是把原住民看成很重要的夥伴的時候這個專責單位為什麼遲遲沒有看到呢 |
| transcript.whisperx[287].start |
8163.097 |
| transcript.whisperx[287].end |
8189.08 |
| transcript.whisperx[287].text |
其實我們現在是有的我們有專門的這個課在處理這個我們有專責的單位在我們衛福部的就主要是我們的意思是說可能他的成績不夠高所以如果說我們就比如說要查資料比如說我們剛才所講的所謂的疾病的型態這些都沒有一個研究單位或者是一個專責單位在做的話其實我們在做這方面的一個處置的時候會覺得特別辛苦 |
| transcript.whisperx[288].start |
8189.66 |
| transcript.whisperx[288].end |
8214.331 |
| transcript.whisperx[288].text |
那我們也知道園民會也不是小型的行政院嘛他什麼都要管的話他怎麼管得到那麼多東西那我們就看我們南回醫院好了就是南回我們上次都有出席的那個追思會這是他的告別式之前我有去就是旁邊是現在的執行長就是高原醫師我是希望部長能不能承諾那裡是屬於我們 |
| transcript.whisperx[289].start |
8215.532 |
| transcript.whisperx[289].end |
8244.606 |
| transcript.whisperx[289].text |
就是等於是離台北最遠的地方那你說所有的醫療的這些當然不可能說跟都市一樣不過如果就公部門的立場來講能不能至少支援他們的急診或者是說他們這個盤點那邊的醫療資源把它整合起來不然如果說半夜有人發燒或者說半夜有人需要插管這些比較緊急的事情都沒有人可以處理的話是不是覺得那邊就變成明明不是在島外變成像一個孤島一樣 |
| transcript.whisperx[290].start |
8245.486 |
| transcript.whisperx[290].end |
8266.956 |
| transcript.whisperx[290].text |
跟委員報告對於南回的醫療我們一直在投入所以包含之前的這個大武衛生所我們把它協助它擴建變得像一個小型醫院的規模那麼這個裡面也包含我們一些新的遠距醫療的設備甚至我們也提供了這個醫學中心的服務進駐高醫的團隊會去那邊看診 |
| transcript.whisperx[291].start |
8269.577 |
| transcript.whisperx[291].end |
8287.062 |
| transcript.whisperx[291].text |
然後馬街希望有一些成效比如說你看到的使用率怎麼樣那它是24小時的急診都在運作所以急診的部分是沒有問題那我們也補助了放射檢查來協助說不用動不動都要往台東市送所以這個我們會一直在強化一直在 |
| transcript.whisperx[292].start |
8287.822 |
| transcript.whisperx[292].end |
8317.22 |
| transcript.whisperx[292].text |
那就针对癌症的部分就是我们这次的主题就是我们的癌症心要部分我们大概也都知道全世界都是Lung Cancer无论是女性男性不过在原住民地区就不一样我们看一下资料后来我很辛苦的找到是高雄市卫生局它所呈现的这个两行字我们现在我们原住民大概就是如果以死亡率来讲的话是反而是消化系的站前面几乎都是消化系甚至是口腔癌才排第三跟我们国人的 |
| transcript.whisperx[293].start |
8317.62 |
| transcript.whisperx[293].end |
8323.888 |
| transcript.whisperx[293].text |
一般國人的那個死亡的類別是不太一樣不過就新藥的來講你看如果就 |
| transcript.whisperx[294].start |
8325.015 |
| transcript.whisperx[294].end |
8354.068 |
| transcript.whisperx[294].text |
口腔癌的话反而没有它的那个只有10种的新药嘛而且是它的申请啊什么都非常的繁琐或者是说有些限制所以造成说我们的离病的状况不太一样的时候其实我们族人在申请这些新药的时候其实就遇到很大的难题甚至明明就设定地位已经很低了还要请假淡产我是觉得说这个如果是原住民发生癌症的那个类别跟大家不一样因为你们大概都补足了肺癌跟 |
| transcript.whisperx[295].start |
8354.748 |
| transcript.whisperx[295].end |
8363.564 |
| transcript.whisperx[295].text |
那个乳癌嘛可是我们疾病类型不一样的时候可是我们在那一端呢性药的申请就特别反而会觉得国家根本就没有帮到我的忙 |
| transcript.whisperx[296].start |
8364.537 |
| transcript.whisperx[296].end |
8386.838 |
| transcript.whisperx[296].text |
跟委員報告確實我們全國的這個癌症死亡率排行的話呢這個口腔癌是第五位啦但是在這個原住民這邊的排名是比較前面那當然這個口腔癌最大的關聯性就是檳榔跟菸啦所以這個要從前頭的防治再加強用藥的部分確實它 |
| transcript.whisperx[297].start |
8387.859 |
| transcript.whisperx[297].end |
8414.009 |
| transcript.whisperx[297].text |
它現在的治療的新藥不是像前面這幾個像肺癌 肝癌不斷地推出很多標靶藥物 免疫治療那麼口腔癌的部分是比較少但是如果有藥我們一定也會對 那希望在申請的限制上面不要太苛刻尤其是對原住民的條件好不好然後我們在可能部長還記得我在3月份的時候有替一個小朋友申請也就是台中榮總的ITP |
| transcript.whisperx[298].start |
8415.57 |
| transcript.whisperx[298].end |
8435.082 |
| transcript.whisperx[298].text |
那ITB後來我昨天知道要排這個議程的時候我特別又打電話給陳情人結果回去問說到底有沒有幫忙他說到目前為止也是沒有得到幫助也就是說那個父母親都是做勞力的然後他要照顧小朋友然後還要負擔這些自費的藥品 |
| transcript.whisperx[299].start |
8437.023 |
| transcript.whisperx[299].end |
8454.333 |
| transcript.whisperx[299].text |
從3月份到現在又將近8個月過去所以我的意思是說像這種罕見疾病你們也在喊從一百一十幾億現在15年到192億已經增加了64%可是需要幫忙的人就在那邊等待可是求數無門 |
| transcript.whisperx[300].start |
8456.311 |
| transcript.whisperx[300].end |
8470.53 |
| transcript.whisperx[300].text |
跟委員說明我們也有去了解那因為一直不符合我們現在的用藥規定那我們會持續的關心那如果說這個適應症這個用藥的條件需要調整我們也請專家看一下因為這個 |
| transcript.whisperx[301].start |
8471.952 |
| transcript.whisperx[301].end |
8495.083 |
| transcript.whisperx[301].text |
就這個目前這個個案是不符合這個新藥的適應沒錯啦 就是說我們的個案少了可是如果一旦發生了還是有一些這麼多的條件明明看到這麼大的餅在那裡可是我卻分享不到的那種感覺希望部長可以體會 謝謝好 謝謝委員 我們努力好 謝謝盧委員我們現在休息十分鐘 |
| transcript.whisperx[302].start |
9177.967 |
| transcript.whisperx[302].end |
9180.389 |
| transcript.whisperx[302].text |
好 我們繼續開會接下來請蘇清泉 趙偉來做詢問謝謝 謝謝主席那我們請柏定你先休息一下 |
| transcript.whisperx[303].start |
9204.54 |
| transcript.whisperx[303].end |
9206.282 |
| transcript.whisperx[303].text |
我們看第一張的slide |
| transcript.whisperx[304].start |
9230.583 |
| transcript.whisperx[304].end |
9238.149 |
| transcript.whisperx[304].text |
首長 你先給人家告白你先跟人家說你對人家沒信心就不要吃你有說這個話嗎 |
| transcript.whisperx[305].start |
9240.335 |
| transcript.whisperx[305].end |
9262.465 |
| transcript.whisperx[305].text |
不是啊 我應該講得快了一點我覺得應該要修正啦 因為就是說現在這個彈 我們蠻精準的知道在那一家的彈廠那時候我知道那一家彈廠的部分我們先特別把它精準的能夠框住那真的是不是很確定的時候稍微停可是呢 這其實這個彈量是很大 |
| transcript.whisperx[306].start |
9264.486 |
| transcript.whisperx[306].end |
9279.915 |
| transcript.whisperx[306].text |
這就是我們台灣一年要吃五次蛋 你知道嗎一天大概一人一顆平均我們台灣一年需要的蛋82億顆 怕死人喔82億顆標示說2430萬人差不多大家都吃一顆 |
| transcript.whisperx[307].start |
9286.809 |
| transcript.whisperx[307].end |
9293.771 |
| transcript.whisperx[307].text |
乘以365差不多85億顆這石叢量很高 我也覺得很高82億顆以上 你看我們的蛋積我們的蛋積差不多有3000萬隻 3000萬隻 |
| transcript.whisperx[308].start |
9304.66 |
| transcript.whisperx[308].end |
9323.235 |
| transcript.whisperx[308].text |
因為雞一隻雞一年三八六十五天一年可以產三百顆差不多一年三八六十五天可以生三八顆育熊就第一名了到第二年差不多剩兩百多到差不多百五年就要淘汰了 |
| transcript.whisperx[309].start |
9330.695 |
| transcript.whisperx[309].end |
9349.046 |
| transcript.whisperx[309].text |
所以台北的雞丁都這樣 你有看到嗎這樣 這種品質 這種品質在融四的我問你喔 這雞兩隻 這跟你一樣的這不是我一樣的啦 這裡啊不然你是關什麼後市場在水洗淡了之後呢我們就開始管道跟市場端了 |
| transcript.whisperx[310].start |
9349.286 |
| transcript.whisperx[310].end |
9359.415 |
| transcript.whisperx[310].text |
要離開養殖場之後才算我的這就像我之前講的那台滴有沒有這間滴媽出事還是說滴媽去泡那個什麼什麼什麼雙陽水雙陽水啦還是那個符合馬鈴有人泡符合馬鈴嗎沒有啦符合馬鈴要做檢體的不行啦 |
| transcript.whisperx[311].start |
9374.728 |
| transcript.whisperx[311].end |
9388.281 |
| transcript.whisperx[311].text |
所以甲醛那一類的雙氧水雙氧水在屠宰場出屠宰場要送你的對你英文就跟中央市場會搞不清楚這都中央市場會亂部的這就基地這樣我們看到的基地 |
| transcript.whisperx[312].start |
9393.857 |
| transcript.whisperx[312].end |
9409.849 |
| transcript.whisperx[312].text |
三千萬隻的雞都這樣牠們從牠們開始的胖子到吃飼料到吃雞肉到死自己的胎都在雞裡面牠們都像雞毛、雞屎那樣我那種 這種地方我看過很多我都去那裡看這種雞屎很凸凸的去發酵做堆肥也好這種地方的品質這種地方的雞的心情 |
| transcript.whisperx[313].start |
9424.264 |
| transcript.whisperx[313].end |
9433.167 |
| transcript.whisperx[313].text |
這心情壞 生產能力才會好一點啦不然你後面癌症 寒病 都會無法解決那就是後面嘛來 你看 現在下一張這就是水蓮式的你看這這茄子這樣 厚大顆的生產能力也很棒的保證 這最重要的 這比較重要啦所以你們的輔導都做得好今天比較貴 沒關係啦 |
| transcript.whisperx[314].start |
9452.351 |
| transcript.whisperx[314].end |
9480.294 |
| transcript.whisperx[314].text |
這個大家每天都要吃的啊現在以前一斤雞蛋差不多高了幾十年嘛我們早就算好了以前一斤雞蛋差不多 之前喔之前差不多三十塊而已我家庭菜啊你如果有市民差不多五十幾塊啊以前在欠雞蛋的時候一斤一斤不到八幾塊啊現在像這種的這種的菜一斤差不多一顆差不多十一塊啦 |
| transcript.whisperx[315].start |
9482.074 |
| transcript.whisperx[315].end |
9494.467 |
| transcript.whisperx[315].text |
我比你瘦掉 比你更清楚你只叫人家不要吃 你有在吃嗎有啦 我包包裡面還有兩顆沒拿出來我每天吃兩顆水煮蛋 有吃有吃所以這個喔 來 |
| transcript.whisperx[316].start |
9496.511 |
| transcript.whisperx[316].end |
9516.338 |
| transcript.whisperx[316].text |
下一張 你看這個就水聯市的我是 我們的期待啦我們的醫療水平那麼高我們健保的做得那麼好全世界第一名那我們這個應該要改善啦是低的啦 是低的啦普天有這個比較重要啦這比什麼更重要你這個衝得好 後面就沒有病了嘛人家不歸我們兩個管你不要講了 你不要要求我看不會 我有講你應該聽 我一定接受講的 |
| transcript.whisperx[317].start |
9526.062 |
| transcript.whisperx[317].end |
9548.406 |
| transcript.whisperx[317].text |
來 這椰子 這椰子 這種吃的這個是用泡了水給它吃它吃了 它還可以當冬甘菇這當了幾年了 半年以上但是這椰子不必 那種粉朴泥 多少 幾百年你知道嗎 一百倍 |
| transcript.whisperx[318].start |
9551.33 |
| transcript.whisperx[318].end |
9561.037 |
| transcript.whisperx[318].text |
分不分是什麼 用分的啦像葡萄園那樣子 全都結在一起剛才你看到整個都亂分成一團所以像你們炒菜 結的毛它也有 它沒有長到一片 |
| transcript.whisperx[319].start |
9567.612 |
| transcript.whisperx[319].end |
9573.236 |
| transcript.whisperx[319].text |
你這種東西這麼貴 要不要把錢給雞大量使用就雞三千萬才雞雞雞雞雞雞雞雞雞雞雞雞雞雞雞雞雞雞雞 |
| transcript.whisperx[320].start |
9595.314 |
| transcript.whisperx[320].end |
9600.302 |
| transcript.whisperx[320].text |
這瓶子就提高而且不會有病要不然你的雞都整隻在裡面雞腎啊什麼的跳躁牠咬也咬就給我痛痛痛摔下去生兩隻殘疾你也放下了 |
| transcript.whisperx[321].start |
9610.261 |
| transcript.whisperx[321].end |
9630.508 |
| transcript.whisperx[321].text |
所以台灣這種市街要改變 不能再這樣了炒到現在可以做堆肥 發酵現在有很多地方在做這個就可以改善市街如果沒有到市街 它是很好賺的但是像我們長輩的就迷茫了你可以 |
| transcript.whisperx[322].start |
9635.734 |
| transcript.whisperx[322].end |
9644.982 |
| transcript.whisperx[322].text |
有啊 那塊Full Render 要給台介紹 叫大家都贏不然都會不爽爽贏啦 我都還不謹慎啊你來 標示一下 我時間要沒了喔好啊 你 寶丁來 寶丁 我要跟你們解釋一下問題解釋一下問題我給你 |
| transcript.whisperx[323].start |
9660.18 |
| transcript.whisperx[323].end |
9687.146 |
| transcript.whisperx[323].text |
來來來 保證這現金一定有大贏的你到底是有在做嗎有 有 在進行進行喔 因為我們總院長答應說年底嘛我會一直追喔好我每次都會追你好你看年輕醫師現在的住院醫師現在的那個PGY那個錢都太少了啦他們同樣年齡的住院醫師像我兒子還下去那一輪 |
| transcript.whisperx[324].start |
9689.99 |
| transcript.whisperx[324].end |
9707.461 |
| transcript.whisperx[324].text |
他說他們的同學有資工的 去也常常在讀班他在旁邊也在讀班 我在三天四天讀班他們在一個紅海裡面也在讀班他們要讀班的人年薪就250多條我們這PGY在大宅大概7、8萬8萬嘛 差不多11萬你們啊 你們10萬也才8、2萬而已 |
| transcript.whisperx[325].start |
9717.819 |
| transcript.whisperx[325].end |
9722.506 |
| transcript.whisperx[325].text |
所以你覺得很不值得嘛所以一批賣掉就糟糕了 |
| transcript.whisperx[326].start |
9723.877 |
| transcript.whisperx[326].end |
9748.859 |
| transcript.whisperx[326].text |
重症沒人要走 你沒辦法給人家加薪水你說一年多 多少 多多 真的有多邱太元很好 石崇良也很好都去要了一大堆的經費但是都是在幫醫事人員 護理人員加薪而且我們衛務部盯得很緊 健保署也盯得很緊你這個錢不能給我亂用亂用的話要追回 還要處罰 這很好 |
| transcript.whisperx[327].start |
9751.241 |
| transcript.whisperx[327].end |
9777.248 |
| transcript.whisperx[327].text |
所以醫界也很有認同說你給我錢 我都來給你調薪但是醫生不調薪 國健署的署長你都要先帶來你先帶來的薪水也不夠嘛 對不對所以醫生十五年沒加薪這樣你不重振 要捐多少錢你說值班費 加班費 要捐多少錢看財政部這樣擱擱擱 擱擱擱 要半年 |
| transcript.whisperx[328].start |
9780.501 |
| transcript.whisperx[328].end |
9806.898 |
| transcript.whisperx[328].text |
最新的結構是什麼頭部的結構是什麼跟委員報告啦我們從稅賦公平正義的角度來看因為醫師確實他的工時比一般的人長加班的收入比照我們所得稅法的規定本來就是可以免稅啦所以我們跟財政部公他們也認同現在就是執行的細節的部分 |
| transcript.whisperx[329].start |
9808.999 |
| transcript.whisperx[329].end |
9831.054 |
| transcript.whisperx[329].text |
到底是多少個小時這個時薪要怎麼計算我們再處理這個加班費 值班 值班那是代命嘛不然代命被你扔掉會很累的你現在要去看看你現在這個年紀要去看看所以川普說的加班費 值班費 消費都免稅 |
| transcript.whisperx[330].start |
9832.295 |
| transcript.whisperx[330].end |
9837.386 |
| transcript.whisperx[330].text |
人家最近要發錢 要發兩千塊美金 要發六萬我們這裡發了一萬塊 鄉鎮一定很害怕人家一塊發六萬 所以 |
| transcript.whisperx[331].start |
9844.682 |
| transcript.whisperx[331].end |
9861.197 |
| transcript.whisperx[331].text |
所以這個你沒辦法給他加薪你就給他減一點稅那個差很多你看那個產值還有一般診所的我就不好意思是K診所醫師都要用兩個半月到三個月的全薪去繳稅 |
| transcript.whisperx[332].start |
9863.378 |
| transcript.whisperx[332].end |
9876.302 |
| transcript.whisperx[332].text |
會很嚴重的事情所以這個是一定要用心馬上趕快解決年底之前所以你大慈欣台這種大型的最後一個36話 主席 |
| transcript.whisperx[333].start |
9878.303 |
| transcript.whisperx[333].end |
9898.162 |
| transcript.whisperx[333].text |
這今天我們要講這個啦這對我來說這都不重要啦這修法就是要用一個擴充有法律的效率讓那邊能夠有點保障不然的話有一餐沒一餐的每一年都用公務預算在撥補那個錢有沒有來源下一張有沒有 沒有了 |
| transcript.whisperx[334].start |
9901.443 |
| transcript.whisperx[334].end |
9928.648 |
| transcript.whisperx[334].text |
來 這寒病啊你要請他用什麼公務預算啊用什麼煙煙煙什麼的這一些那現在最近你們國電署也通過那個加熱煙嘛加熱煙加熱煙可以用的嘛隔粉幾款電子煙不行嘛不行 電子煙絕對電子煙絕對不行裡面都是化學成分 那是西人的所以加熱煙好像主席也偶爾嘛偶爾你有沒有 |
| transcript.whisperx[335].start |
9932.35 |
| transcript.whisperx[335].end |
9959.847 |
| transcript.whisperx[335].text |
不聽到啦所以你這個來源要框得清楚讓這裡有補充不然王政序因為這個癌症癌症在這裡大家都要挨挨救我們這裡創造給他們安心一點做然後能夠達到我們賴總統的健康台灣把癌症的那個是發生率還是死亡率死亡率 標準化死亡率死亡率延長下降啦下降標準化死亡率 |
| transcript.whisperx[336].start |
9960.607 |
| transcript.whisperx[336].end |
9979.302 |
| transcript.whisperx[336].text |
癌症病人活得越久 大家有一個觀念各位媒體朋友 癌症病人活得越久 花越多錢他本來在騷擾 結果不騷擾 又繼續挖 又開了很多錢所以癌症的死亡率減少 癌症的存活率越高是表示要花更多更多的錢 |
| transcript.whisperx[337].start |
9980.53 |
| transcript.whisperx[337].end |
9994.801 |
| transcript.whisperx[337].text |
所以大家觀念要改過來以為說這樣可以省錢沒有 花更多的錢年齡的老化平均壽命的延長就是要付出無窮無盡的代價啦這個是大家要了解的阿伯你很辛苦今天跟阿伯說真的沒問題 |
| transcript.whisperx[338].start |
9999.713 |
| transcript.whisperx[338].end |
10016.943 |
| transcript.whisperx[338].text |
確實像委員提到的因為隨著醫藥科技的進步現在慢慢的癌症從過去的絕症變成慢性病他確實如果能夠好好的治療他的餘命是可以延長的但是新的藥物確實是不便宜所以我們 |
| transcript.whisperx[339].start |
10018.284 |
| transcript.whisperx[339].end |
10036.218 |
| transcript.whisperx[339].text |
這個很努力的在找財源那也希望讓這個健保能夠永續下去持續的照顧民眾不要讓人民會因病而病把這個健保的精神最後一個喊病的前線這是用公務預算還是用健保 |
| transcript.whisperx[340].start |
10036.718 |
| transcript.whisperx[340].end |
10055.956 |
| transcript.whisperx[340].text |
主要還是由健保費的來源就是說我們還是編在整個總額裡面只不過它我們總額分成專款跟一般服務一般服務就是在總額分配時南京大公園醫院個別總額它是一般服務專款是另外用多少給多少的所以它不會有浮動點子的問題 |
| transcript.whisperx[341].start |
10057.29 |
| transcript.whisperx[341].end |
10074.459 |
| transcript.whisperx[341].text |
所以現在健保連愛滋病的你也自己 你也付啦對以前在第八屆的時候為了愛滋病要讓它延後納入健保給付有公務預算那個時候我跟鎖建國委員大家很努力把它延了三年 |
| transcript.whisperx[342].start |
10075.379 |
| transcript.whisperx[342].end |
10097.887 |
| transcript.whisperx[342].text |
才納入健保支付 你知道嗎我知道 其實愛滋病現在也是一個慢性病啦所以前兩年的費用是由公務預算支應之後才納入健保那現在連寒病的健保護 癌症的健保護健保的健保要怎麼可能不會到啦不會啦 健保不會到啦好 謝謝委員 謝謝 |
| transcript.whisperx[343].start |
10105.236 |
| transcript.whisperx[343].end |
10108.577 |
| transcript.whisperx[343].text |
謝謝主席剛剛我們這個蘇昭偉有提到這個癌症病人他是慢性病其實我們期待的是說他要康復 |
| transcript.whisperx[344].start |
10132.442 |
| transcript.whisperx[344].end |
10153.707 |
| transcript.whisperx[344].text |
如果是進入到需要長期治療的話我們希望你能回歸到社會就是說你治療中間其實對社會對家庭是有幫助當然它會有一些費用的產出不過基本上是希望經過大家的關心後讓他積極治療讓他有更好的對回歸到社會來謝謝我們這方面的討論 |
| transcript.whisperx[345].start |
10157.728 |
| transcript.whisperx[345].end |
10162.703 |
| transcript.whisperx[345].text |
那請時副長還有足記總署的代表是不是請群方專委 |
| transcript.whisperx[346].start |
10163.784 |
| transcript.whisperx[346].end |
10191.946 |
| transcript.whisperx[346].text |
莊委員好部長好是莊委好謝謝我們今天召委安排這樣的題目那針對於今天的部分有三個題目要來跟部長討論第一個就是癌症信鑰基金如何持續提供穩定的保障第二個就是全民健保裁員的合理調整方向那第三部分就是希望衛福部能夠研議擴增還有定期制度化來檢討公費新生兒篩檢的項目 |
| transcript.whisperx[347].start |
10193.687 |
| transcript.whisperx[347].end |
10209.355 |
| transcript.whisperx[347].text |
有關於第一部分的話剛剛其實也討論了很多最重要就是有沒有一個穩定的保障的裁員其實在2023年第十屆的第七會期的時候就有排案審查過癌症防治法 |
| transcript.whisperx[348].start |
10209.895 |
| transcript.whisperx[348].end |
10237.2 |
| transcript.whisperx[348].text |
那個時候的元凶就是我們今天的主席就是趙偉他那個時候真的就非常非常的關心所以那個時候我們主席總署也認為說需要遵守財政紀律法的相關規定反對政府既有的收入來用做基金的這個專款專有的方式來處理那請問現在主席總署對於這樣的意見有還是一樣嗎還是有其他新的想法各位請趙偉在這邊跟我們說一個說明 |
| transcript.whisperx[349].start |
10239.813 |
| transcript.whisperx[349].end |
10255.314 |
| transcript.whisperx[349].text |
主席各位委員大家好主席總書代表這邊的意見原則上主席總書不反對設立基金但是你設立基金就是要符合財政紀律法的規定的相關前提譬如說你要找到自己的政府撥補以外的一個新增氏族的一個財源 |
| transcript.whisperx[350].start |
10256.135 |
| transcript.whisperx[350].end |
10285.206 |
| transcript.whisperx[350].text |
然後還要評估說你現在納入這些基金有沒有既有的基金已經在辦理了那如果像我們這個癌症用藥現在的這個已經納入健保基金在運作了所以原則上如果說衛福部要新成立基金的話我們原則上還是請衛福部要評估你自己要有裁員第二個目前有沒有其他的基金是真的都沒有在運作的那如果符合這個條件之下你才使得設立那財政紀律法從108年這財政紀律法當初也是那個立委 |
| transcript.whisperx[351].start |
10285.906 |
| transcript.whisperx[351].end |
10309.786 |
| transcript.whisperx[351].text |
剛好那個賴世保委員在現場這個財源基地法當初也是那個賴世保委員提案的那他也是希望說政府基金應該要有那個新增4組的財源來設立比較有利於後續這個業務的穩定推作所以我們原則上主義總署是不反對設立基金但是就是要符合這個財源基地法前提之下使得設立以上說明 |
| transcript.whisperx[352].start |
10310.599 |
| transcript.whisperx[352].end |
10329.132 |
| transcript.whisperx[352].text |
所以看起來今天討論的重點兩個元兇都在這裡包括賴委員包括劉委員所以看起來好像劉兆偉之前聽到的一些論述跟今天聽到好像是沒有太大的差別麻煩兆偉請回座 謝謝 |
| transcript.whisperx[353].start |
10334.191 |
| transcript.whisperx[353].end |
10350.656 |
| transcript.whisperx[353].text |
其實國際有其他的經驗在我們就是上個月的10月30號立法院獲勝會也召開了提升癌症新藥可進行的專家會議那裡面的專家包括韓信文教授他也是第六屆的健保 |
| transcript.whisperx[354].start |
10350.956 |
| transcript.whisperx[354].end |
10378.803 |
| transcript.whisperx[354].text |
會委員他有提出一些國際經驗如何能夠來增加這個相關的費用的挹注包括說有沒有可能透過這個食品健康捐包括不健康食品稅肥胖稅等等的或者是課徵酒品健康福利捐或加徵酒稅加徵菸捐菸稅開探開徵碳稅或者是對環境造成有可能跟癌症相關的一些部分做處理 |
| transcript.whisperx[355].start |
10379.463 |
| transcript.whisperx[355].end |
10405.435 |
| transcript.whisperx[355].text |
那這個部分不知道部長有沒有一些想法好 這個根本不知道確實如同剛剛大家討論的要新增一個基金一定要有除既有稅收或者是國庫撥補以外的裁員才有辦法設立的那但是因為現在如果以這個癌症新藥而言我們在健保裡面其實就在支付所以才會在健保基金裡面先含納 |
| transcript.whisperx[356].start |
10406.295 |
| transcript.whisperx[356].end |
10422.745 |
| transcript.whisperx[356].text |
有一個專款專用的概念所以我們也去修訂了全民健康保險基金收支保管及應用辦法讓他有法源所以政府撥補的這些公務預算呢通通放在這裡專款專用所以這個部分已經初步達到那個精神 |
| transcript.whisperx[357].start |
10423.485 |
| transcript.whisperx[357].end |
10437.381 |
| transcript.whisperx[357].text |
只是說大家現在比較擔心是說會不會有時候撥多撥少我們還是得去拜託主總願意撥下來那大家如果覺得說這樣的做法上希望更穩定那我們就得找裁員 |
| transcript.whisperx[358].start |
10439.623 |
| transcript.whisperx[358].end |
10464.542 |
| transcript.whisperx[358].text |
這些財源也都要考慮到能不能夠支撐我們現在是以公務預算在撥補這個規模呢那麼這個其實如果按照我們的設計可能一年也會達到百億甚至更多那其他這個新增的這個財源能不能夠支應到那麼能不能抽得到這個我們都會再研議這個都在我們的評估範圍內 |
| transcript.whisperx[359].start |
10466.513 |
| transcript.whisperx[359].end |
10490.732 |
| transcript.whisperx[359].text |
好 那我們希望在早時間多來了解這部分那再過來就是有關於針對國家醫療科技評估中心設置條例這也是非常重要的一環那早上部長在報告的時候也說已經進到這個行政院在審查當中那有沒有比較可預估的這個期程或者是什麼時候有預計會進到立法院來做審查 |
| transcript.whisperx[360].start |
10491.754 |
| transcript.whisperx[360].end |
10512.507 |
| transcript.whisperx[360].text |
因為因為我們同時有兩個行政法人一個是那個中醫藥研究所我們要改設成為中醫藥研究院的行政法人那另外一個就是國家醫療科技評估中心設置條例這個也是一個行政法人所以我們是兩個法人的設置條例現在都在行政院一併審查因為都是 |
| transcript.whisperx[361].start |
10513.167 |
| transcript.whisperx[361].end |
10538.421 |
| transcript.whisperx[361].text |
衛福部主管所以我們這兩個案子行政院也會一同的審查所以快的話我覺得也是會很快年底前可能就會送到大院來到時候再請衛院來協助再過來就是我們也了解2023年為了要讓癌症信號基金在成立過程裡面有更好的一個學習過程所以也去英國包括去參訪NICE跟他們NHS |
| transcript.whisperx[362].start |
10539.301 |
| transcript.whisperx[362].end |
10556.118 |
| transcript.whisperx[362].text |
那其實我們也了解當初的英國設立這個NICE設立這個癌症新藥基金CDFUN的時候他們後來又改變也增加了所謂的IMF就是有關於這個新藥相關的這個基金有點雙軌並行那將來台灣會有什麼樣的一些方式來做處置嗎 |
| transcript.whisperx[363].start |
10562.384 |
| transcript.whisperx[363].end |
10578.197 |
| transcript.whisperx[363].text |
跟委員報告 事實上我們在113年我們就在健保總額裡面有一個暫時性支付的專款就是conditional listing那時候就是在先等於是我們現在癌症信藥基金的前身 |
| transcript.whisperx[364].start |
10579.998 |
| transcript.whisperx[364].end |
10604.444 |
| transcript.whisperx[364].text |
現在有了這個癌藥基金之後其實在健保的總額裡面還是有保留一個專款屬於叫做這個除了癌症新藥以外的這個這個condition暫時性支付的專款在它的概念就是對於其他的新藥不是癌症的新藥也可以用這個機制類似像英國的IMF這樣的方式來收窄 |
| transcript.whisperx[365].start |
10604.724 |
| transcript.whisperx[365].end |
10628.386 |
| transcript.whisperx[365].text |
所以這個是目前有這樣的機制所以其實我們已經有點雙軌制在進行對 我們現在是雙軌制一個是用公務預算一個是在總額裡面的專款那未來是不是要再成立另外一個基金也是同樣的問題OK 好 謝謝再過來就是有關於如何能夠針對於健保裁員合理調整 |
| transcript.whisperx[366].start |
10630.851 |
| transcript.whisperx[366].end |
10650.016 |
| transcript.whisperx[366].text |
好像不止700億的缺口啦其實我們的這個整個規模已經到1兆了已經到達千億嘛那個前兩天有看到這個媒體是 所以讓這個我們部長都睡不好是睡不好還是睡不著不知道不過至少這個三道破口是大家要值得關心那我們的這個中華經濟研究院的 |
| transcript.whisperx[367].start |
10650.716 |
| transcript.whisperx[367].end |
10672.927 |
| transcript.whisperx[367].text |
連憲民院長也認為這三道破口包括勞動人口的萎縮還有世代負擔的失衡還有少子化的人力荒造成了這一個很嚴重的破口所以他提出了三項建議包括建立全民基礎的保費然後將資產納入課徵還有善用AI來補強醫療的人力這個是他的一個建議 |
| transcript.whisperx[368].start |
10673.607 |
| transcript.whisperx[368].end |
10695.993 |
| transcript.whisperx[368].text |
那另外呢我們的這個前衛生署的副署長張宏仁張副署長他有提出說如果真的無法這個調漲健保費用的話那能不能夠用商保不為健保的模式由政府來擔任最終風險的承擔者設計具有商業保險特性的政策性附加險來解決相關的問題 |
| transcript.whisperx[369].start |
10698.474 |
| transcript.whisperx[369].end |
10725.123 |
| transcript.whisperx[369].text |
其實這個禮拜金管會彭主委他也有在財政委員會質詢的時候 備詢的時候針對健保財務改革也有討論到以資產取代股利來收保費同時彭主委也有提到可以考慮商保協同健保的模式這個想法其實有慢慢的大家會進入到討論的階段針對健保的裁員其實我也非常的關心 |
| transcript.whisperx[370].start |
10725.623 |
| transcript.whisperx[370].end |
10739.97 |
| transcript.whisperx[370].text |
那這次在總諮詢的時候也請教了院長問的補充保費調整的情形那個時候卓院長的答覆是說應該有能力者來多負擔的方向來調整所以目前 |
| transcript.whisperx[371].start |
10741.371 |
| transcript.whisperx[371].end |
10756.26 |
| transcript.whisperx[371].text |
根據這個左院長的指示還有綜合大家最近的一些意見想要請這個部長來多從這個相關的方向來調整第一個就是是否考量以資產為課程的基礎第二個是否能夠考慮推動 |
| transcript.whisperx[372].start |
10757.421 |
| transcript.whisperx[372].end |
10781.114 |
| transcript.whisperx[372].text |
商保協同健保那第三個是能否打開這個補充保費的上限這是另外一個議題是不是要包括五千萬以上都還可以更高那最後是不是能夠考慮從相關的稅捐來補充那因為時間的關係我們是不是可以請部長在兩個月裡面提供書面的報告讓委員會跟我們辦公室來做參考 |
| transcript.whisperx[373].start |
10782.471 |
| transcript.whisperx[373].end |
10804.731 |
| transcript.whisperx[373].text |
謝謝委員確實因為隨著高齡人口的增加我們的醫療的支出越來越成長但是收入上相對的沒有辦法跟得上以這個我們明年的健保的總額支出大概會來到9883億但是以我們今年的推估今年的收入大概 |
| transcript.whisperx[374].start |
10805.973 |
| transcript.whisperx[374].end |
10827.306 |
| transcript.whisperx[374].text |
只是近9000億沒有辦法超過9000億所以馬上明年的缺口馬上就會呈現有八九百億的年度缺口但是因為我們有過去的累積節餘所以明年的保費還可以維持在安全準備金是一到三個月的範圍裡面所以明年的保費是不會調整但是再往後這個還是會成長 |
| transcript.whisperx[375].start |
10830.248 |
| transcript.whisperx[375].end |
10846.183 |
| transcript.whisperx[375].text |
支出一定還會成長所以整個健保的財務的這個問題呢還是必須持續的來討論所以剛剛您提的這些方向我們都會納入一起來評估好希望這樣可以讓部長好睡一點那最後一點點時間就是針對於這些 |
| transcript.whisperx[376].start |
10849.466 |
| transcript.whisperx[376].end |
10871.314 |
| transcript.whisperx[376].text |
新生兒篩檢的部分含病是大家一直非常關心其實我們很期待說現在有一些是屬於法定的補助項目有些是智慧項目像SMA其實也都有要務是不是可以請衛部來研議擴增含病公費新生兒篩檢的項目另外可以定期的來用制度化的方式來檢討新生的項目 |
| transcript.whisperx[377].start |
10871.94 |
| transcript.whisperx[377].end |
10891.267 |
| transcript.whisperx[377].text |
好跟委員報告我們現在大概有像您提到的有21項的新生兒公費篩檢大概18項都跟罕病相關那這些篩檢的一個大原則是第一個他要有藥可以治療篩檢才會有意義就後面要有治療啦但是隨著這個科技的進步這些藥也不便宜 |
| transcript.whisperx[378].start |
10891.707 |
| transcript.whisperx[378].end |
10911.688 |
| transcript.whisperx[378].text |
所以這個藥要怎麼樣支付我們也需要做嚴謹的醫療科技評估這些基因治療的藥都很貴所以像您提到的SMA經過了大概一年的討論跟HTA的評估已經確定明年會納入公費篩檢因為現在也有藥物對應的治療 |
| transcript.whisperx[379].start |
10912.389 |
| transcript.whisperx[379].end |
10915.351 |
| transcript.whisperx[379].text |
好 謝謝 謝謝部長謝謝主席 謝謝好 謝謝委員好 謝謝 謝謝主席是不是請石部長來 請部長 |
| transcript.whisperx[380].start |
10935.792 |
| transcript.whisperx[380].end |
10949.593 |
| transcript.whisperx[380].text |
來 部長 林委員好我長話短說我想健保擴大補充保惠新制引發爭議那衛福部沒有跨部會討論就片面的釋放健保補充保惠來調整訊息 |
| transcript.whisperx[381].start |
10951.536 |
| transcript.whisperx[381].end |
10972.042 |
| transcript.whisperx[381].text |
拔草測風向也引發整個股市的動盪那本席是希望說衛福部跟行政院要考慮這些退休族上班族小資族生活不易不要亂放消息引起民心恐慌還是狼來了很久了擴大補充保費政策就會變真的嗎 |
| transcript.whisperx[382].start |
10973.602 |
| transcript.whisperx[382].end |
11002.349 |
| transcript.whisperx[382].text |
你有什么看法跟委员报告这整个健保的财务确实需要全盘的讨论不会只针对某一项或某一类的人那对于这个付费的公平性都是一项的健保的精神所以我们一定会考虑到量能付费的问题你这个横向的一定要找这些人来研究不是只有你一个人擅自发表那会出很大的问题人家说你在炒作股票 |
| transcript.whisperx[383].start |
11003.209 |
| transcript.whisperx[383].end |
11030.794 |
| transcript.whisperx[383].text |
對不對 我本身都沒有股票高血壓疾病位居113年國人的死大死因第六名死亡人數達到8928人死大死因中的心臟疾病腦血管疾病 腎臟疾病還有糖尿病也都跟高血壓有直接關係那這些死因人數相加起來已經超過了第一名的癌症俗話說預防剩餘治療 |
| transcript.whisperx[384].start |
11032.754 |
| transcript.whisperx[384].end |
11054.209 |
| transcript.whisperx[384].text |
也就是說健保節流的方法之一代謝症候群防治的計畫自1111年的7月期推動到今天已經滿三週年那累計協助超過42萬人那我請問部長估計已省下多少健保的醫療費用你們有沒有統計過 |
| transcript.whisperx[385].start |
11055.57 |
| transcript.whisperx[385].end |
11082.487 |
| transcript.whisperx[385].text |
這個我們倒沒有很精確的統計不過就誠如這個委員提的能夠在疾病的前期或早期趕快控制住甚至把它逆轉減少後面的重病的發生這個是確實是我們的要多宣傳然後預防剩餘治療讓大家有那種健康的嘗試我認為這個很重要很重要所以剛剛您提的那個代謝症候群我們會持續的推廣現在人數也在增加 |
| transcript.whisperx[386].start |
11082.887 |
| transcript.whisperx[386].end |
11098.437 |
| transcript.whisperx[386].text |
那個 那個 石部長賴清德總統近日拜託工業界來幫員工加薪加薪會促進消費讓台灣整個社會更穩定那根據衛福部刊登在求職網 |
| transcript.whisperx[387].start |
11100.518 |
| transcript.whisperx[387].end |
11115.461 |
| transcript.whisperx[387].text |
上面的工作許多職缺普遍月薪跟最低工資差不多譬如說衛福部豐原醫院趙胡源月薪只有29860元起彰化醫院趙胡源是28590元 |
| transcript.whisperx[388].start |
11124.043 |
| transcript.whisperx[388].end |
11135.875 |
| transcript.whisperx[388].text |
本期是希望說衛福部響應賴總統的呼籲將造福園增財的月薪予以調整提高部長你有什麼看法我們來檢討確實是我們這兩年健保的總額成長 |
| transcript.whisperx[389].start |
11140.66 |
| transcript.whisperx[389].end |
11156.713 |
| transcript.whisperx[389].text |
是歷年最高啦像今年較去年的成長率是這個實質加進來是近8%的那明年又是高成長對啊 因為我們會來檢討讓所有的醫事人員的薪資包含照服員都一樣 |
| transcript.whisperx[390].start |
11157.093 |
| transcript.whisperx[390].end |
11174.83 |
| transcript.whisperx[390].text |
对啊 因为部长现在已经步入高龄化社会那你当然很多长者需要照护员来配合那你又薪资搞得那么低那我认为这个都要去做通牌性的检讨啦好地法院在今年八月通过包装无糖饮品 |
| transcript.whisperx[391].start |
11175.53 |
| transcript.whisperx[391].end |
11190.284 |
| transcript.whisperx[391].text |
的免稅那台北市公共衛生公會特別提醒說無糖飲料多以人工甜味劑來替代長期健康的風險能具爭議那政府有責任長期來監測 |
| transcript.whisperx[392].start |
11193.067 |
| transcript.whisperx[392].end |
11206.263 |
| transcript.whisperx[392].text |
國際的癌症研究機構已將田味劑就是阿斯巴田這個列入可能致癌物建立因審慎來評估等於是暴露的風險 |
| transcript.whisperx[393].start |
11207.785 |
| transcript.whisperx[393].end |
11227.571 |
| transcript.whisperx[393].text |
那台北醫學大學營養學院研究發現甜味劑蔗糖素吃多了可能損害男性的生育率像那個精子的數量恐怕大減25%本期是希望說衛福部啟動相關研究監測的計畫 |
| transcript.whisperx[394].start |
11229.612 |
| transcript.whisperx[394].end |
11254.223 |
| transcript.whisperx[394].text |
來瞭解人體食用甜味劑後有哪些可能的危害風險那個部長你的看法跟委員報告我們對於這個食品安全標準的設計設定我們一向是跟隨國際的接軌然後實證的依據這個我們會來評估這個很重要最後一題台灣已經步入高齡化的社會政府鼓勵長者多走 |
| transcript.whisperx[395].start |
11255.043 |
| transcript.whisperx[395].end |
11275.712 |
| transcript.whisperx[395].text |
多走出來 就出門走走來增進體能 情緒的健康但某些縣市 鄉鎮大眾運輸不足那部分高齡駕駛只能自駕以滿足日常外出的需求若政府希望長者不要自己騎車 開車方便的公共運輸就很重要 |
| transcript.whisperx[396].start |
11277.973 |
| transcript.whisperx[396].end |
11292.645 |
| transcript.whisperx[396].text |
先前本席也向交通部建議要與衛福部共同來檢討長照交通車使用方式增加醫院以外的停靠點以加會高齡長者出外的需求交通部也回覆本席說 |
| transcript.whisperx[397].start |
11293.966 |
| transcript.whisperx[397].end |
11307.524 |
| transcript.whisperx[397].text |
長照交通車由衛福部主政因此希望衛福部把本席的建議帶回去研究怎麼樣跟委員說明為了協助長者就醫其實我們在南區有試辦小房計程車還有公車站 |
| transcript.whisperx[398].start |
11311.388 |
| transcript.whisperx[398].end |
11335.246 |
| transcript.whisperx[398].text |
有协调跟地方有协调过我们有这个经验那我们把过去在健保做这个协助到医疗院所去就医这个以前我们过去已经在做的在南区都在这样做那我们会考虑到地方上的需要你来评估看一下再找交通部来帮忙对对对好谢谢好谢谢林德文委员发言谢谢部长答询下一位请赖世保委员发言 |
| transcript.whisperx[399].start |
11343.166 |
| transcript.whisperx[399].end |
11362.626 |
| transcript.whisperx[399].text |
謝謝主席以及各位先進有請這個衛福部的司部長相關的長官要幫忙可以喔可以去幫忙好 部長你當初當市長的時候我就看好你我記得我跟你講過一句話我說你要給我做保定喔 |
| transcript.whisperx[400].start |
11364.216 |
| transcript.whisperx[400].end |
11389.252 |
| transcript.whisperx[400].text |
你要跟我客氣 不信比我嚴重不過最近表現就突切突切這個什麼突然來一個什麼鼓勵加利息加房租超過兩萬的就要什麼什麼等等好啦 我先回來第一題今天就談到癌症了還有一個罕見疾病了我的看法是這樣子的沒有人希望得到癌症但是費用這麼高 |
| transcript.whisperx[401].start |
11391.129 |
| transcript.whisperx[401].end |
11413.909 |
| transcript.whisperx[401].text |
健保能夠cover盡量cover罕見疾病也是這樣我們民意代表出來的第一線的看到那個得到癌症的真的傾家蕩產都有所以這一部分我覺得請問你現在癌症的支出費用包括藥物包括其他治療的佔我們的健保比例多高 |
| transcript.whisperx[402].start |
11414.269 |
| transcript.whisperx[402].end |
11425.294 |
| transcript.whisperx[402].text |
跟委員報告大概是這樣我們以前一年因為今年還沒統計完我們用去年的話一年的癌症接受治療的大概90萬支出大概1400多億 |
| transcript.whisperx[403].start |
11428.273 |
| transcript.whisperx[403].end |
11451.614 |
| transcript.whisperx[403].text |
幾% 差不多六分之一我們健保差不多16%左右六分之一啦六分之一就16 16.6667我那個第一個我的訴求就是盡量可以盡量救啦特別一些這個很辛苦的人第二點 |
| transcript.whisperx[404].start |
11452.782 |
| transcript.whisperx[404].end |
11481.649 |
| transcript.whisperx[404].text |
我來不是像主計總署的長官說這個財政距離而已啦我來帶紅包給你啦你現在說一千億啊找不到錢對不對我替你找錢讓你睡得著你是睡不著還是睡不好 睡不好睡不好喔 但那續續還有睡的不錯 還有睡的如果是你睡不著我現在來這裡今天來這裡特別跟你講 |
| transcript.whisperx[405].start |
11483.584 |
| transcript.whisperx[405].end |
11504.229 |
| transcript.whisperx[405].text |
你出一招 進帳四千多億什麼意思 那個一千萬上限補充保費啊拿掉 無上限有錢人 大家都了解有錢人賺這麼多當然多幫忙一點啊 |
| transcript.whisperx[406].start |
11506.38 |
| transcript.whisperx[406].end |
11534.011 |
| transcript.whisperx[406].text |
你知道現金鼓勵最多的人可以 都說你知道嗎現金鼓勵 你不知道喔現金鼓勵乘以2.11%就是我們的補充包圍對不對小資本額為什麼大家反彈這麼大那些退休的存款組五張十張 也被你課當然就XXX對不對但是那個大老闆你知道高到多少現金鼓勵喔 |
| transcript.whisperx[407].start |
11535.356 |
| transcript.whisperx[407].end |
11554.204 |
| transcript.whisperx[407].text |
我就知道有一兩位喔 超過一百億一年喔 一年喔 一年喔 一年喔 一年喔One year only有人超過一百億 超過十億的一槓子為什麼我們只有課到一千萬呢 |
| transcript.whisperx[408].start |
11555.407 |
| transcript.whisperx[408].end |
11576.162 |
| transcript.whisperx[408].text |
你把一千萬的屋頂拿掉你原來還在講說怎麼變五千萬我說這幹什麼加一個你來差不多怎麼變五千萬變五億或者變十億上限到這裡你敢不敢這得罪有權人我敢得罪有權人你敢不敢剛剛我聽到委員這樣講我眼睛都亮起來 |
| transcript.whisperx[409].start |
11577.363 |
| transcript.whisperx[409].end |
11594.014 |
| transcript.whisperx[409].text |
那我就告訴你 我跟你讓眼睛更亮 晚上就睡了還打呼 我跟你說來 我跟你講 去年2024年現金股利總發放多少你知道嗎你不知道啊 2.3兆啊2.3兆乘以2.11%是多少 4850億 |
| transcript.whisperx[410].start |
11602.216 |
| transcript.whisperx[410].end |
11620.747 |
| transcript.whisperx[410].text |
我今天來這裡就帶這個紅包給你你敢不敢提這個東西你前面講的那個我們現在這個主席啊 王委員太客氣了啦還有什麼總資產都漏漏洞一堆不用 一行就好了改得很簡單的 只要改一條一千萬拿掉就好了所有的都扣2.1% |
| transcript.whisperx[411].start |
11623.263 |
| transcript.whisperx[411].end |
11638.353 |
| transcript.whisperx[411].text |
小資族不會罵你有錢人心裡想罵你也不敢罵他領一百億多交個2.11%就多交個兩億算什麼對不對 必要的時候你給他匯台灣兩多給他一個獎牌 |
| transcript.whisperx[412].start |
11641.84 |
| transcript.whisperx[412].end |
11663.979 |
| transcript.whisperx[412].text |
對不對 他可能不敢拿 說不定不過這個報紙都有寫 你算一下就知道你注意看 那些大老闆持股多少公開資料 算一算就知道我不能點名了 媒體都有點名了我這個資料是工商時報的資料 今年五月份的資料現金股率 Cash Dividend |
| transcript.whisperx[413].start |
11666.101 |
| transcript.whisperx[413].end |
11686.01 |
| transcript.whisperx[413].text |
2.3兆乘以2.1% 4850億今天我就帶這個禮物給你謝謝委員今天帶這麼大的紅包你敢不敢 你敢不敢做這個晚上一定很好睡你敢不敢 我問你 你敢不敢還是要跟我這次學會了要先跟跨部會協調一下 |
| transcript.whisperx[414].start |
11689.548 |
| transcript.whisperx[414].end |
11708.705 |
| transcript.whisperx[414].text |
你不要講說明年還補多少什麼100億200億300億把有錢人的毛他也不肯挨你小資族去挨我跟你講這些有錢人你看 |
| transcript.whisperx[415].start |
11710.55 |
| transcript.whisperx[415].end |
11736.759 |
| transcript.whisperx[415].text |
我一看啦 媒體順便一翻啦哪一家什麼科技公司23億就是去年的這個鼓勵現金鼓勵喔現金喔Cash Dividend喔還有17億還有30幾億的一缸子啦因為補充保費的時候那時候國民黨還是執政黨參與補充保費的時候我在裡面很清楚我記得 |
| transcript.whisperx[416].start |
11737.239 |
| transcript.whisperx[416].end |
11755.889 |
| transcript.whisperx[416].text |
到一千萬我就低估了我說為什麼這麼低我那時候就主張要五千萬那時候我就主張五千萬你知道嗎因為現在發現五千萬不夠那時候因為最高最高的現金孤立那時候33億現在呢超過100億的我已經看到兩個人了對不對從這裡下手 |
| transcript.whisperx[417].start |
11760.749 |
| transcript.whisperx[417].end |
11779.051 |
| transcript.whisperx[417].text |
好不好我們希望讓這個越有能力的人可以負擔一些他也覺得很光榮啊 他有錢啊一年而已耶他一年的現金鼓勵是一百億耶天啊 我想說我們把錢可能一輩子不要說一百億 幾億啊 |
| transcript.whisperx[418].start |
11781.073 |
| transcript.whisperx[418].end |
11809.691 |
| transcript.whisperx[418].text |
我们再细算一下看看这些是到现金鼓励到哪一些到底到哪边去的你没有100亿你有上限最少10亿你现在1000万把它加两个0我们下次提出修法的时候我一定支持第三个我要讲的你不要把什么鼓励利息帮助什么把它加总这个你等于抢估税期的生意我们现在是救援课税 |
| transcript.whisperx[419].start |
11810.936 |
| transcript.whisperx[419].end |
11840.223 |
| transcript.whisperx[419].text |
救援課費所以你能一課就到你要加總那等於第二國稅局喔你要一缸子的人去處理你股率多少啦 利息多少啦我們主席賺很多錢他的房租賺多少啦他房子比較多比如這樣講 隨便講齁對不對那個是財政部的事情喔財政部他不一定他地盤你要清他的地盤 不可以啊所以只有一條路就我剛剛講的一千萬的上限拿掉 |
| transcript.whisperx[420].start |
11841.533 |
| transcript.whisperx[420].end |
11870.306 |
| transcript.whisperx[420].text |
對不對你稍微客氣一點把他加到10億這個故事就不一樣了我告訴你你是好歹最少2000億金賬這樣可以嗎謝謝委員我們會去再跟相關單位確認一下這個金額到底其他單位都不會有人講話啦只有大老闆他心裡面說不定會怎麼樣但是他不敢講出來啦因為講出來他就說他就知道錢太多我們所有的考慮都是說讓大家付費公平啦 |
| transcript.whisperx[421].start |
11871.566 |
| transcript.whisperx[421].end |
11890.911 |
| transcript.whisperx[421].text |
這個很公平啦 這個有錢人多交一點你鼓勵拿個十億好了十億 然後你交個兩千萬算什麼我們朝這個方向來 對不對這個東西很簡單的事情所以我除了剛才那個長官講說我財政紀律之外我要來帶紅包給你 好 謝謝好 謝謝賴委員 謝謝賴志寶聖誕委員 |
| transcript.whisperx[422].start |
11899.174 |
| transcript.whisperx[422].end |
11916.506 |
| transcript.whisperx[422].text |
加持跟發言謝謝 也謝謝部長的答詢下一位請陳碧雲發言好謝謝主席那有請衛福部石部長謝謝有請石部長 |
| transcript.whisperx[423].start |
11920.923 |
| transcript.whisperx[423].end |
11945.738 |
| transcript.whisperx[423].text |
陳委員好部長我今天要來問的其實是跟兒少世代的自殺率有關我從一上任就一直關心這個議題所以我們確實跟衛福部做了很多討論我們來看一下相關數字我相信部長應該非常清楚左手邊這個比較簡單的表格蓄意自我傷害就是我們一般人所認知的自殺在112年它的排名順位死亡的原因裡面排第二個 |
| transcript.whisperx[424].start |
11946.718 |
| transcript.whisperx[424].end |
11963.259 |
| transcript.whisperx[424].text |
也就是除了事故傷害之外12年你們的統計數字是這樣排第二個可是如果我們來看從113年到112年都是這個狀況也就是自殺人口占12到17歲死亡原因 |
| transcript.whisperx[425].start |
11963.479 |
| transcript.whisperx[425].end |
11988.062 |
| transcript.whisperx[425].text |
第二名而且已經連續兩年都這樣我不希望下一年也還是這樣可是如果我們來看另外右邊這個統計表每10萬人口0到24歲死亡率從103年的2.5到113年變成5.8翻身了一倍也就是說確實其實衛福部早早有意識到兒少的自殺這件事情確實越來越嚴重所以我要先感謝衛福部 |
| transcript.whisperx[426].start |
11988.723 |
| transcript.whisperx[426].end |
12016.246 |
| transcript.whisperx[426].text |
之前有提供15歲到45歲的心理諮商方案每一個人一年內有它總共三次我要感謝這個數字確實在相關第一線的回報是很好的意思就是說其實很多孩子們意識到自己有這個需求他們會去求助可是在這個困境底下我們要看見的是那我們政府端到底還能夠多做什麼事情接住這些孩子這個是你們剛剛前面那一張投影片是你們衛福部的數字接下來這一張是兒少 |
| transcript.whisperx[427].start |
12018.067 |
| transcript.whisperx[427].end |
12037.934 |
| transcript.whisperx[427].text |
青少年兒童青少年精神醫學會他們做了一個統計同時他們在今年4月跟少年報導者做了一個報告報告指出這個問卷裡面有100個兒童心智科的醫生他們填寫的問卷他們告訴少年報導者其實是要告訴台灣社會孩子們去求助的原因的樣貌越來越多 |
| transcript.whisperx[428].start |
12038.975 |
| transcript.whisperx[428].end |
12052.79 |
| transcript.whisperx[428].text |
從過往的大人比較容易看出來的自閉症跟ADHD這確實要走入這個門診但是呢包含網路過度使用或者是其他的焦慮症跟憂鬱症其實在第一線的診間發現情況比例越來越高 |
| transcript.whisperx[429].start |
12053.511 |
| transcript.whisperx[429].end |
12071.86 |
| transcript.whisperx[429].text |
那醫生們其實提出警訊孩子們在面對憂鬱症跟焦慮症的時候他們到底接下來除了去醫院就診之外我們整個醫療體系可以為這些孩子做什麼另外有一個更可怕的數字但我沒有投我沒有放在這個投影片裡面是什麼呢就是這幾年我們發現 |
| transcript.whisperx[430].start |
12073.041 |
| transcript.whisperx[430].end |
12092.856 |
| transcript.whisperx[430].text |
我們一直以來都會有自殺通報對不對可能我陳培瑜要自殺一次兩次三次被通報但是我可能都沒有自殺成功所以在陳培瑜身上這個案例可能累積了三次的自殺通報可是這幾年有一個數字非常可怕有越來越多孩子們他們首次的自殺通報就正是他死亡那一天 |
| transcript.whisperx[431].start |
12093.957 |
| transcript.whisperx[431].end |
12114.886 |
| transcript.whisperx[431].text |
也就是說在這之前他可能已經有一些身心狀態但是他沒有出口或是他找不到方法求救或者是他不敢求救原因當然非常複雜跟多元但是等到他發出求救訊號正是他死意堅決那一天然後他就找了一個百分之百會讓自己成功的方法結束了生命離開了這個世界 |
| transcript.whisperx[432].start |
12116.267 |
| transcript.whisperx[432].end |
12131.249 |
| transcript.whisperx[432].text |
所以把這兩個線上合在一起看12歲到17歲也好0到24歲也好都是我們關注生命經驗還沒有開展的孩子們他們就決定走上絕路但是確實有越來越多的孩子也知道自己需要求救所以回過來看 |
| transcript.whisperx[433].start |
12132.871 |
| transcript.whisperx[433].end |
12159.792 |
| transcript.whisperx[433].text |
除了剛剛賴氏寶委員送那個大紅包真的有希望解決健保的一些困境之外我知道其實一直以來衛福部都有被要求增加不同科別的點數對不對但我其實今天不想跟部長您談點數因為點數怎麼樣都不夠真的我只是想要跟部長您討論一下到底我們在第一線的精神醫療人員他們所面臨的困境其實會投射到孩子們接受服務的困境 |
| transcript.whisperx[434].start |
12160.572 |
| transcript.whisperx[434].end |
12189.217 |
| transcript.whisperx[434].text |
那孩子們接受服務有一個比較特別的地方我相信部長你一定非常清楚或是您後方的署長一定非常清楚孩子們在初次就診的時候甚至在二次三次回診的時候都不會是自己一個人他一定會伴隨著老師家長社工甚至是有關係的親朋好友可能在幾次的諮商過後就診之後這個對話的團體跟人會越來越多因為我們想要積極的協助這個小孩所以他方方面面周邊的關係人都被放進來 |
| transcript.whisperx[435].start |
12190.257 |
| transcript.whisperx[435].end |
12202.366 |
| transcript.whisperx[435].text |
那一直以來這個時間我知道你們有努力在增加健保點數非常感謝但是相關困境還是在喔那我說我今天很務實我不想只談健保點數我認為是我們整體的醫療環境在這一端 |
| transcript.whisperx[436].start |
12205.348 |
| transcript.whisperx[436].end |
12233.948 |
| transcript.whisperx[436].text |
我們在協助兒少的同時我們也去支持並且感謝所有這些兒童青少年精神專科醫師尤其是我知道我們現在在台灣有相關專科次專科醫師是300多位可是實際上在第一線服務的大概只有200多位而這200多位其實要cover全台灣我剛剛說大概300多位兒少的需求我相信他們的工作量絕對無比龐大難以想像宇宙無敵的厲害我非常感謝這些兒少精神專科醫師 |
| transcript.whisperx[437].start |
12235.209 |
| transcript.whisperx[437].end |
12250.577 |
| transcript.whisperx[437].text |
但我覺得我們今天聊完之後我們辦公室希望積極的找衛福部開會我們如何再協助兒少精神專科醫師同時接觸更多的孩子也許之後我們的社安網也要積極同步跟上好嗎沒有跟你時間說話 |
| transcript.whisperx[438].start |
12251.638 |
| transcript.whisperx[438].end |
12275.519 |
| transcript.whisperx[438].text |
跟委員報告還是謝謝委員對於孩子的這個關心這個很重要那我們也已經也意識到雖然我們的這個出生率下降孩子的數目變少但是不能夠因為孩子數變少之後我們的服務就沒有辦法到位因為我們的服務是跟著人走所以我們明年的健保總額特別去鎖定這個0到6歲的孩子 |
| transcript.whisperx[439].start |
12275.819 |
| transcript.whisperx[439].end |
12297.507 |
| transcript.whisperx[439].text |
那当然我们有能力的话会再往后那至于这个精神方这个心理的这个照顾的部分因为我们现在健保署的署长就是精神科的专家对对所以我特地挑今天来讲给两位听对对对所以接下来我们会按照跟委员来讨论那看怎么样来强化对孩子的支持 |
| transcript.whisperx[440].start |
12298.007 |
| transcript.whisperx[440].end |
12313.975 |
| transcript.whisperx[440].text |
所以我部長跟署長我跟你們分享一個案例但我相信你們都知道來下一張台北榮總有向日葵學員這十年以來他們自掏腰包賠了很多錢但是他們做了一件非常重要的事情而且我們問了很多相關專業的人都告訴我們這個模式是好的 |
| transcript.whisperx[441].start |
12314.855 |
| transcript.whisperx[441].end |
12334.127 |
| transcript.whisperx[441].text |
一 他們這十年來收了兩千多位在現場拒學的青少年拒學之後到醫院去是所謂在醫院就學把特教老師請進去把外聘的老師請進去然後結合心理師結合社工師當然我們第一線的相關精神科的醫師也都在現場協助這些小孩 |
| transcript.whisperx[442].start |
12334.767 |
| transcript.whisperx[442].end |
12359.476 |
| transcript.whisperx[442].text |
在醫院現場完成這些學業然後慢慢去解決他拒學的困境而這25年來服務超過2000位拒學的孩子後續的成效非常明顯7成以上的孩子繼續升學然後返回學校回歸日常正常生活我非常感謝台北榮總感謝退輔會給予支持我相信衛福部也給予支持我相信你們都知道這個case這case實在太棒了 |
| transcript.whisperx[443].start |
12360.516 |
| transcript.whisperx[443].end |
12383.108 |
| transcript.whisperx[443].text |
先感謝台北榮總撩這麼多錢每年虧一千四百多萬做這個事情他是一個很好的model但是我們不能都讓醫院賠錢那當然也感謝新北市政府跟台北市政府在這件事情上因為必須有教育的資源一起進來所以確實是中央加地方加所有第一線工作人員的努力跟願意協助這些孩子們的大人們 |
| transcript.whisperx[444].start |
12383.988 |
| transcript.whisperx[444].end |
12404.705 |
| transcript.whisperx[444].text |
感謝這些大人我們有了一個很好的典範我認為這樣的需求可能會越來越高我甚至預估台北榮總可能未來收的孩子會越來越多當然在病床數可允許的情況下但這個模式我們衛福部還可以給予台北榮總什麼樣的支持我們會後再來討論好嗎好謝謝部長謝謝署長謝謝主席好謝謝陳平委員的發言謝謝部長的答詢下一位請劉建國召委發言 |
| transcript.whisperx[445].start |
12415.764 |
| transcript.whisperx[445].end |
12418.539 |
| transcript.whisperx[445].text |
謝主席 有請部長有請施部長 |
| transcript.whisperx[446].start |
12422.955 |
| transcript.whisperx[446].end |
12450.094 |
| transcript.whisperx[446].text |
部長好部長我還是再次感謝你啦因為剛剛在這個提案說明的時候我就特別提到我還是再強調一次那這個強調一次還是再感謝你因為在你當任健保署長任內確實對這個癌症病患有諸多的這樣的一個積極的這樣的一個協助啦也讓很多癌症病有看到新的一個曙光嘛這個絕對是惠服之眼但是坦白講我今天看到看到你們這樣的一個報告裡面 |
| transcript.whisperx[447].start |
12452.235 |
| transcript.whisperx[447].end |
12468.629 |
| transcript.whisperx[447].text |
我是有一點 我還是感謝的話我還是不會收回啦不過等一下如果講到之後可能會有一些也讓你做更深層的一個參考因為畢竟你現在已經從署長上來當部長了 |
| transcript.whisperx[448].start |
12471.051 |
| transcript.whisperx[448].end |
12487.453 |
| transcript.whisperx[448].text |
那個角度高度是應該是完全不一樣的思維跟思考然後互出要對全部的這樣的一個在衛生醫療領域的患者裡面你的思考要更多但是 |
| transcript.whisperx[449].start |
12488.274 |
| transcript.whisperx[449].end |
12510.078 |
| transcript.whisperx[449].text |
不能講說顧慮要更多啦是要更精準更精細嘛那你現在看啦剛剛我聽你在答詢很多文的時候我們特別提到今天是講癌症跟講這個寒病那寒病的部分你講平均這五年對健保在幾戶寒病的這些患者裡面平均是 |
| transcript.whisperx[450].start |
12511.338 |
| transcript.whisperx[450].end |
12538.384 |
| transcript.whisperx[450].text |
每年增加4%以上11%好 你跟我計較1%那我就好好跟你計較了我們要精準 要精算部長來看一下這個表格你看既然5年平均 正如部長所講的就是平均增加11%對不對明年為什麼低於11%你要跟我講是114年它就高於11% |
| transcript.whisperx[451].start |
12540.438 |
| transcript.whisperx[451].end |
12568.073 |
| transcript.whisperx[451].text |
但是你看平均這三年在2014年前三年通通不到11%但你要跟我講一個邏輯啊2014年高於11%2015年為什麼又距降於快燃腰折半了才6.6%這個對罕見疾病的病友而言你是要釋放出什麼樣的訊息 |
| transcript.whisperx[452].start |
12569.198 |
| transcript.whisperx[452].end |
12593.793 |
| transcript.whisperx[452].text |
而且是你當任部長獲得第一年的針對罕見疾病 血友病的這個藥會啦相關的一些特採來做一個處理在成長率裡面我們看到這樣的一個數據你到底要施放什麼訊息還是你在政策上去做什麼樣的一個調整跟修正這個你要說清楚啊不然我不能理解平均就11.1%為什麼115 |
| transcript.whisperx[453].start |
12598.12 |
| transcript.whisperx[453].end |
12615.045 |
| transcript.whisperx[453].text |
你的第一年的部長任內的這個成長率是降至到6.6跟委員說明大概他有兩塊啦這個是屬於在健保裡面的192億那另外還有公務預算20億啦那20億先不談嘛我就先講這個嘛 對不對那第二個呢 |
| transcript.whisperx[454].start |
12619.287 |
| transcript.whisperx[454].end |
12646.742 |
| transcript.whisperx[454].text |
這個都經過我們業務單位去算過因為我們不斷地在提高這個幾副的藥品進來進來的時候通常啦在第一年的時候會比較多因為有累積的那些病人啦然後之後新增了他就會穩定下來那所以算過他們按照這個已經有來listing說可能會在未來一年通過的去推估出來那大概是這些預算啦 |
| transcript.whisperx[455].start |
12647.262 |
| transcript.whisperx[455].end |
12674.38 |
| transcript.whisperx[455].text |
我們這個今年會特別高是因為我們給付了幾個很高昂貴的藥物所以他才會 他還會成長的比較高啦所以你是預估明年就是沒有預估沒有會給付到很高的藥物大概是這樣是OK啦因為還有一個20億以來之後你覺得這樣是OK你的供應預算撲普20億你覺得20億就夠了你不會明年的時候可能在年中還是在年尾的時候 |
| transcript.whisperx[456].start |
12675.629 |
| transcript.whisperx[456].end |
12683.945 |
| transcript.whisperx[456].text |
又有不一樣的變化又需要跟行政院要求請求要再多增加供預算來支付這個罕病的部分 |
| transcript.whisperx[457].start |
12685.915 |
| transcript.whisperx[457].end |
12711.895 |
| transcript.whisperx[457].text |
應該沒有辦法現在就可以馬上下定論嘛應該是這樣嘛對不對那我是講說我現在跟你講一個基礎面嘛因為我們講平均嘛11.1嘛對不對為什麼為什麼唯獨你明年剛開始又是你當部長的第一年這算是第二年了啦但是這預算來講是第一年嘛為什麼就居降到百分之百分之四十幾啦不到百分之五十啦依照均值喔依照均值喔那如果你對照前一年那更可怕了 |
| transcript.whisperx[458].start |
12713.237 |
| transcript.whisperx[458].end |
12740.684 |
| transcript.whisperx[458].text |
聚降7成你6.6除以19.1嘛其實應該這麼說啦這個成長率因為隨著你那個base越來越大那個成長率就不一樣啦因為你那個已經到達200億規模的10%跟100億之後的10%那是不一樣沒有 你還沒有達到你還沒有達到200億啊你的200億是增加20億的撥補工預算才有達到200億喔 對不對那你這中間還有包含許有病喔 |
| transcript.whisperx[459].start |
12742.414 |
| transcript.whisperx[459].end |
12746.618 |
| transcript.whisperx[459].text |
對你把他吸入出來才多少所以那一天為什麼創辦人會當場流下眼淚他為什麼要哭他為什麼要列薩利華院 |
| transcript.whisperx[460].start |
12755.151 |
| transcript.whisperx[460].end |
12783.731 |
| transcript.whisperx[460].text |
有其原因嘛我想部長在過去的什麼職位裡面跟他們的互動也都算是密切平緩的嘛也應該知道他們的這樣的一個訴求基本上不為過啦不為過啦當然每一個團體站在自己的角度自己遇到的狀況反射出來的當部長的人都是要面面俱到要去做相關的一些回應嘛但是另外一個角度因為你不是一來就當部長了嘛你是從 |
| transcript.whisperx[461].start |
12785.312 |
| transcript.whisperx[461].end |
12805.789 |
| transcript.whisperx[461].text |
建保署吧 意思是等相關的單位一直上來的一個部長嘛所以當他們會覺得這樣對他們是不公平他們會覺得這樣是有期待上的落差這個我不曉得部長你要怎麼做這個回應但如果你剛剛對我這樣的回應我想他們可能也聽不太進去 |
| transcript.whisperx[462].start |
12806.789 |
| transcript.whisperx[462].end |
12818.545 |
| transcript.whisperx[462].text |
不會啦 我們對所有的這個罕病的病友都會全力的去照顧那該給的藥我們也都持續的在編列所以請大家放心啦 |
| transcript.whisperx[463].start |
12821.406 |
| transcript.whisperx[463].end |
12839.728 |
| transcript.whisperx[463].text |
你講這句話我是可以放心但其他的這個這個對象是不是會放心我不清楚不過部長部長這個21公的預算要公務預算要報補沒問題嘛對不對那未來如果還不足的情況之下還是要還是要積極爭取嘛是沒問題嘛對不對好我是我是請 |
| transcript.whisperx[464].start |
12840.689 |
| transcript.whisperx[464].end |
12862.063 |
| transcript.whisperx[464].text |
部長是不是可以針對這個罕病的藥物專款然後必須提出一個具體的計算公式然後通報人數這個新舊罕藥的價格一般用藥期治療等等這每年應該都應該是計算出來然後應該是何時去編列才是一個對 這個都是何時去編列 |
| transcript.whisperx[465].start |
12863.104 |
| transcript.whisperx[465].end |
12883.184 |
| transcript.whisperx[465].text |
不要再讓韓病的病人擔心啦好不好 不然就煩惱啊 每一年 甚至那還不夠 還要再拜託你如果繼續做 我才不用煩惱啦沒有啦 這我講這是會有之言嘛 他們要自己比別人清楚啊 對不對但是 但是 但是已經找一個苦沒中了啊這外國要換一個沒中我們不知道啊 |
| transcript.whisperx[466].start |
12885.612 |
| transcript.whisperx[466].end |
12914.171 |
| transcript.whisperx[466].text |
我講這是實在話 我也希望你做過 也能把這件事進一屆開會就是讓他可以去制度化嘛對不對 尤其在你的任內裡面這是最好不過的嘛好 那我現在就來我就要講癌症新藥 為什麼今天要排審然後你們從今年的4月份的答覆的東西今天再重複一次如果你這個答覆是有其道理你這個答覆是可以讓癌症病患覺得 |
| transcript.whisperx[467].start |
12915.992 |
| transcript.whisperx[467].end |
12937.153 |
| transcript.whisperx[467].text |
不用去成立一個基金這樣就可以把他們因應期盼的這個新藥的多元的支持的這新藥的患者裡面都可以去去有所期待解決我們今天也不需要排審我們當然知道主計總署當時已經講過的話了你就是這個預算撥補除外你就是要找新的裁員那找新的裁員對 |
| transcript.whisperx[468].start |
12940.229 |
| transcript.whisperx[468].end |
12966.232 |
| transcript.whisperx[468].text |
對可能衛務部底下所屬機關的首長可能會有所困難對石部長而言 我覺得一點困難都沒有絕對一點困難都沒有 剛剛王振興委員還特別把可以找新的裁員都把他們挪列出來的請你才一屌都能聽我出力啦不然 你回想一下嘛長照基金 長照當時還沒有成立基金的時候一年多少錢 |
| transcript.whisperx[469].start |
12968.12 |
| transcript.whisperx[469].end |
12987.305 |
| transcript.whisperx[469].text |
我自己這個委員會 跟居府 跟長照的相關團體在這裡不知道欺騙誰 害勝敗一雙嘛一百五千人疫情 平均不到四十億那五十億是騙人的對吧 還有一年是二十幾億而且都是用那個特別預算去做處理 預備金去處理的 |
| transcript.whisperx[470].start |
12990.698 |
| transcript.whisperx[470].end |
13016.962 |
| transcript.whisperx[470].text |
很難拖就對了所以當時你跟中央市內政部社會事管機構然後當時的衛生署 照護師去管居股兩個單位要給的錢這些團體是政府的夥伴要申請的那些錢經常在那邊拖一拖是幾個月 甚至半年所以當時是怎樣 把倫理倫理100隻載起來50隻就去派你來進補社會事務門口 |
| transcript.whisperx[471].start |
13020.222 |
| transcript.whisperx[471].end |
13041.91 |
| transcript.whisperx[471].text |
另外五十隻準備要去衛生署的門口啊要拖錢啊 要拖長照的錢啊對喔 曾經何時這十年過了106年成立基金之後馬上變成多少320億捏那不是假白白捏 那是白白衣裳捏現在多少千億了對啊 幾年而已106 現在114啊 |
| transcript.whisperx[472].start |
13046.434 |
| transcript.whisperx[472].end |
13058.13 |
| transcript.whisperx[472].text |
那是外國的速度 外國的速度比國體還要快15列車的速度在趕要應付全國長照的需求者還有照顧的對象啊 |
| transcript.whisperx[473].start |
13060.077 |
| transcript.whisperx[473].end |
13080.573 |
| transcript.whisperx[473].text |
你不可以做 現在不可以做那如果在你原本的健保在幾乎這個癌症新藥這個整個期程剛剛文委員都提供這個數據就是八八幾天啊就是要不足夠的啊所以我們希望在依照仿造因果的模式在成立一個基金然後透過法律的制定 |
| transcript.whisperx[474].start |
13081.758 |
| transcript.whisperx[474].end |
13098.121 |
| transcript.whisperx[474].text |
我覺得這個應該對部長而言 你應該會全力的支持而且我們一直在那邊推 一直在那邊推你要跟行政院講 你要跟總統講我覺得它不是一個問題啊我最後再用數據來講 時間到了啦你看那個數據我們現在報一個50億嘛 今年50億對不對叫做愛中心要暫時性自負我給你提到暫時性自負就感覺很麻煩就對了你要暫時性到什麼時候 |
| transcript.whisperx[475].start |
13107.463 |
| transcript.whisperx[475].end |
13131.474 |
| transcript.whisperx[475].text |
現在收債 債益的薪料 預估23億多你剛剛答覆其他委員 那有的時候一年一百億就不夠了 對不對所以你說什麼百億 要做薪料 那歐北說啊這個錢 有人現在不敢這樣暗算啦 讓人家拿比較高的嘛所以超過一百億也是不在剛才你大埔所委員說的餵嘛 你看現在呢 這幾十三億多了 |
| transcript.whisperx[476].start |
13136.256 |
| transcript.whisperx[476].end |
13154.584 |
| transcript.whisperx[476].text |
再來預估 未使用數26億多 你再加明年明年再加 再領這個50億 還是不到百億啊還是不到百億 就馬上就是回復 部長剛剛答覆其他委員講的一百億現在不夠用啊 但是我們2025到2026 根本連一百億也沒有 |
| transcript.whisperx[477].start |
13160.737 |
| transcript.whisperx[477].end |
13185.614 |
| transcript.whisperx[477].text |
你知道這是要掛的嘛這是掛速度掛密切嘛所以期程縮短所以加快這個審查的速度然後你看對剛剛蘇清晴她也是來自醫界不過她有些講一些話都非常恐怖啦她那個角度有時候不是一個醫師的一個思維她也有她的專才不過我是覺得不是說今天我們縮短這些 |
| transcript.whisperx[478].start |
13187.476 |
| transcript.whisperx[478].end |
13211.139 |
| transcript.whisperx[478].text |
有些病患有些病患因為你在當健保署長像費林癌像這個小細胞癌等等的對象因為他有加上免疫療法他現在還可以恢復他的工作能力啊要給他賠錢要給他高薪啊不然你做化療養金服就賣你賣黨啊趕快給他賠對不對他還有生產力這個這個怎麼都不去算這個部長都可以答覆的啊 |
| transcript.whisperx[479].start |
13212.882 |
| transcript.whisperx[479].end |
13237.154 |
| transcript.whisperx[479].text |
很多面向啦 真的很多面向所以我是希望部長可以再思考一下能不能在你就任不到一年的時間我們把這個事情就讓癌症新藥多元支持基金法制化然後我們讓基金會我不敢說一低年就到位但是就很加快速度可以讓基金成立至於基金的這個費用絕對超過百億以上嘛 |
| transcript.whisperx[480].start |
13238.812 |
| transcript.whisperx[480].end |
13249.096 |
| transcript.whisperx[480].text |
我們一起來努力啦不對好不好好 我們繼續努力啦但是這個預算我們一定會努力一時爭取啦好 謝謝好 謝謝謝謝劉建國召委的發言謝謝部長答詢下一位請方國昌委員發言 |
| transcript.whisperx[481].start |
13267.454 |
| transcript.whisperx[481].end |
13293.56 |
| transcript.whisperx[481].text |
謝謝主席 麻煩有請衛福部時事部長以及健保署陳署長黃委員好部長好 署長好今天這場質詢最主要的重點是要幫我們所有的新北市民來請命為什麼我說有必要幫所有的新北市民來請命我們先看一下數據 |
| transcript.whisperx[482].start |
13295.704 |
| transcript.whisperx[482].end |
13318.71 |
| transcript.whisperx[482].text |
這個官方數據的統計是我先從2019年開始看2019年每萬人醫療攻擊新北市全國倒數第二全國倒數第二書難想像最後一名是金門金門的醫療問題你們在那邊有鼠立醫院 |
| transcript.whisperx[483].start |
13319.796 |
| transcript.whisperx[483].end |
13339.181 |
| transcript.whisperx[483].text |
有很多金門的鄉親跟我澄清這個是下一次質詢的重點我先謝題讓部長可以回去好好準備但今天我要處理的是新北市的問題新北市每萬人口急性一般病床數只有17到18床 |
| transcript.whisperx[484].start |
13341.903 |
| transcript.whisperx[484].end |
13366.642 |
| transcript.whisperx[484].text |
2019年17床這兩年多一點點到18床來依照衛福部你們頒布的標準每萬人急性一般病床數要有幾床跟委員報告我們10床以下是短缺就是缺乏不好意思請針對問題回答但是我們的平均現在是設定在30平均你們設定的目標值每萬人要有幾床 |
| transcript.whisperx[485].start |
13367.594 |
| transcript.whisperx[485].end |
13395.857 |
| transcript.whisperx[485].text |
你自己的業務自己不熟我們沒有這個叫做目標來看一下衛福部醫療網計畫全程目標規劃執委急性一般病床數每萬人口35床這個是衛福部的報告部長你新上任我給你一點時間自己的業務要熟我黃國昌絕對不會隨便編造數字的這是你們衛福部報告自己寫的但我現在看不懂不管你講的30床 |
| transcript.whisperx[486].start |
13397.785 |
| transcript.whisperx[486].end |
13411.858 |
| transcript.whisperx[486].text |
或者是我援引的衛福報告的三十五床每萬人三十床也好 三十五床也好結果現在新北市新北市每萬人只有十七到十八床太離譜了吧 |
| transcript.whisperx[487].start |
13413.359 |
| transcript.whisperx[487].end |
13439.693 |
| transcript.whisperx[487].text |
真的是太離譜了吧所有的數字我把它全部都統計出來新北市來來來部長看一下數字我如果update到2024年的時候一般急性病床數新北市18.96六都最低我們來看一下全國32全國32新北市只有18.96 |
| transcript.whisperx[488].start |
13441.636 |
| transcript.whisperx[488].end |
13470.329 |
| transcript.whisperx[488].text |
我看了這個數字以後我再懷疑說新北是不是很偏鄉住的人是不是很少結果新北市全國人口數最多的第一都但是每萬人分配到的一般急性病床數只有18.96衛福部針對這個現象打算怎麼辦有計畫嗎還是沒有計畫新北市的人生病鼓勵大家跑到台北來看就好了 |
| transcript.whisperx[489].start |
13472.585 |
| transcript.whisperx[489].end |
13484.478 |
| transcript.whisperx[489].text |
這個我認為是個問題所以我請教部長你有什麼計畫還是部長要跟所有的新北市人講這根本不是問題你們新北市的人生病就乖乖去台北市看就好了是這樣嗎 |
| transcript.whisperx[490].start |
13486.455 |
| transcript.whisperx[490].end |
13509.603 |
| transcript.whisperx[490].text |
來 請教部長跟委員報告那麼過去呢在大生活圈的概念下那確實新北跟台北很多的這個行政區是劃在同一個醫療網裡頭就是所謂的我等一下再跟你講醫療網啦我等一下再跟你講醫療網但是後來有辦法再做一些調整因為新的生活圈在形成沒有關係啦你認為這四個問題我覺得四個問題面對這個問題你要怎麼解決 |
| transcript.whisperx[491].start |
13513.484 |
| transcript.whisperx[491].end |
13528.817 |
| transcript.whisperx[491].text |
再重新的檢討 你檢討需要多久醫療區有重新再劃分沒有關係你檢討需要多久那我了解現在這個板橋的地方呢有要新設的板橋的地方那個是侯友宜市長的努力啊 |
| transcript.whisperx[492].start |
13529.938 |
| transcript.whisperx[492].end |
13553.473 |
| transcript.whisperx[492].text |
他的努力歸他的努力我現在是問衛福部啊你打算要怎麼辦你剛承認是問題了嘛那我現在的問題是你要怎麼解決問題啊我們面對問題才能解決問題嘛你願意面對問題承認是個問題我肯定啊現在我要的是你要怎麼解決問題啊我們在詳細的這個規劃之後呢再需要多久 |
| transcript.whisperx[493].start |
13554.744 |
| transcript.whisperx[493].end |
13579.557 |
| transcript.whisperx[493].text |
大概也要一個月的時間我給你一個月一個月以後請衛福部給我一份完整的報告你們要怎麼解決這件事情我願意等你一個月從今天開始算我願意等你一個月剛剛你說你們有分區域對台北二級醫療區域西區 |
| transcript.whisperx[494].start |
13582.816 |
| transcript.whisperx[494].end |
13612.028 |
| transcript.whisperx[494].text |
人口最多什麼是西區包括你剛所講的板橋新莊土城樹林三峽英哥新莊板橋土樹山陰這是你們分的二級醫療區域的西區人口最多160萬人每萬人急性一般病床數最少這就是你剛所講的分區 |
| transcript.whisperx[495].start |
13614.367 |
| transcript.whisperx[495].end |
13642.374 |
| transcript.whisperx[495].text |
我代部長看第一個是大的新北市的picture第二個按照你們的醫療分區我再往下分第二級的西區比新北市人口數最多的160萬人居住在你們所謂的西區結果更慘更慘平均的病床數更低每萬人只有14床 |
| transcript.whisperx[496].start |
13643.55 |
| transcript.whisperx[496].end |
13668.87 |
| transcript.whisperx[496].text |
越來越糟糕剛剛你說這是個問題要解決問題所以新北市他們提出了板橋醫療園區的申請案2020年9月這是內政部通過都市計畫變更他要先變更2021年依照內政部所通過的都市計畫變更他核定了板橋醫療園區的西部計畫 |
| transcript.whisperx[497].start |
13671.4 |
| transcript.whisperx[497].end |
13694.772 |
| transcript.whisperx[497].text |
核定了西部計畫以後2022年6月衛福部同意板橋醫療園區的計畫多499床我老實講499床除以160萬人每萬人多幾床3床不要說跟其他都比啦離全國的平均還很遙遠但總是個進步嘛 |
| transcript.whisperx[498].start |
13698.298 |
| transcript.whisperx[498].end |
13714.548 |
| transcript.whisperx[498].text |
總是個進步嘛提供給我們新北市民或者是具體的講新北市的西 新北市你們所劃定的西區班橋 新莊 土樹山陰那邊的新北市民有一個 |
| transcript.whisperx[499].start |
13717.185 |
| transcript.whisperx[499].end |
13744.756 |
| transcript.whisperx[499].text |
公平可以親近的醫療環境我覺得這是地方政府跟中央政府要攜手合作責無旁貸的責任現在我看不懂的事情是什麼這是個問題侯友宜市長他提出了這個問題他還提出了解決的方案他規劃了板橋醫療園區內政部也同意了你們衛福部也同意了 |
| transcript.whisperx[500].start |
13746.045 |
| transcript.whisperx[500].end |
13772.298 |
| transcript.whisperx[500].text |
結果搞到今天現在卡關了為什麼卡關我下去了解卡關的理由是你們的健保署從今年第二季起全面採醫院總額管制對新設醫院採病床及額度限制導致這個園區做不下去了部長這件事情有沒有掌握這個我了解 這個今年第二季開始 對 |
| transcript.whisperx[501].start |
13773.635 |
| transcript.whisperx[501].end |
13783.188 |
| transcript.whisperx[501].text |
那現在怎麼辦因為你們這樣的總額管制所以你認為是問題的新北市民的權益也好新北市西區的權益也好就要被犧牲掉嗎 |
| transcript.whisperx[502].start |
13784.349 |
| transcript.whisperx[502].end |
13804.74 |
| transcript.whisperx[502].text |
跟委員說明對新社醫院我們有一套的給予額度的方式是逐年的開放是並不是說沒有關係啊我現在只問你嘛剛你承認這是個問題嘛那我現在問的是你要怎麼解決問題嘛那我現在看到的是中央不僅不解決問題 |
| transcript.whisperx[503].start |
13806.508 |
| transcript.whisperx[503].end |
13832.356 |
| transcript.whisperx[503].text |
還在卡新北市要解決問題的侯友宜市長我看不懂啊今天如果新北市這個板橋醫療園區會造成醫療資源的浪費醫院太多了病床太多了浪費健保資源那我會說侯友宜你不對侯友宜你不對你怎麼會在有這麼多醫療資源的地方還要蓋新醫院亂搞 |
| transcript.whisperx[504].start |
13834.485 |
| transcript.whisperx[504].end |
13855.856 |
| transcript.whisperx[504].text |
你衛福部卡他我認同但人家現在在設的是什麼就是有缺的地方啊每萬人的平均急性一般病床數全國最低耶你們還在卡人家是有政治考慮嗎 |
| transcript.whisperx[505].start |
13857.593 |
| transcript.whisperx[505].end |
13881.024 |
| transcript.whisperx[505].text |
這個跟委員報告 當然這個醫院 設在什麼地方還可以討論啦 因為所以你們有另外主義的地點是不是以板橋而言 他不能說這個地區是所以你們有另外主義的地點是不是但是整個大區 我們先回去看2022年6月 不就是衛福部同意的嗎 |
| transcript.whisperx[506].start |
13882.358 |
| transcript.whisperx[506].end |
13910.691 |
| transcript.whisperx[506].text |
所以你覺得2022年6月 衛福部同意板橋醫療園區的這個計畫是個錯誤嗎要撤銷掉嗎既然已經同意了對啊那只是現在卡在後面所以我就看不懂啊之前同意了現在用別的問題 技術性在卡沒有卡他啦就是他要分期開設的概念而已我們剛剛已經說明了他會有分期開設的額度並不是完全不給他額度來齁上一次 |
| transcript.whisperx[507].start |
13911.786 |
| transcript.whisperx[507].end |
13940.967 |
| transcript.whisperx[507].text |
媒體報導了以後衛福部的次長說會進一步了解現在了解完了沒有我看到你們很會講光話在媒體上都很會講光話現在了解完了沒有十月說會了解嘛現在了解完了沒有我們會進一步再深究啦不過就是還是那一句話就是前面是初步了解現在是進一步深究未來他還是可以開設但是 |
| transcript.whisperx[508].start |
13941.775 |
| transcript.whisperx[508].end |
13970.153 |
| transcript.whisperx[508].text |
未來還是可以開設 要再拖多久要卡到侯友宜卸任嗎不會啊 我們是按照泰民進黨的人當市長馬上就OK嗎 是這樣嗎已經同意了 對嘛這就是問題啊 你已經同意啦用其他的方法去卡人家 我有說錯嗎沒有卡啦 我再說一次啊今天侯友宜如果把這個醫院放在病床過多的地方 浪費醫療資源 |
| transcript.whisperx[509].start |
13972.133 |
| transcript.whisperx[509].end |
13991.239 |
| transcript.whisperx[509].text |
我和歐商跳出來挺你衛福部 侯友宜你不對但人家就是把他放在有缺的地方是你自己喔你剛剛都承認有缺的地方喔 要解決問題我看到的是地方政府要解決問題結果中央政府在卡沒有卡他非常好 那這個問題你需要多久 |
| transcript.whisperx[510].start |
13997.065 |
| transcript.whisperx[510].end |
14002.503 |
| transcript.whisperx[510].text |
之前媒體報導嘛然後你說好從今天開始你會進一步申救你申救需要多久 |
| transcript.whisperx[511].start |
14003.1 |
| transcript.whisperx[511].end |
14031.851 |
| transcript.whisperx[511].text |
不是 他現在已經同意了是對啊 就同意就去招標啊對啊 但是問題你社會二種而限制了以後沒有沒有沒有人家就坐不下去啦我們不是給零啊我們還是會給他足期的沒有關係啦他把他的時間到了我只要求一件事我接下來針對這件事情我非常的重視我會召開正式的會議來討論這件事我會邀請新北市政府的代表 |
| transcript.whisperx[512].start |
14032.867 |
| transcript.whisperx[512].end |
14058.395 |
| transcript.whisperx[512].text |
到時候也請衛福部或者是麻煩署長一起來參與我們怎麼樣解決這個問題能夠滿足新北市民特別是板橋新莊土樹山醫那邊的人他們的醫療需求請衛福部到時候一起參與我們坐下來把數字對清楚這樣可以嗎可以 我們會協助可以喔 好 謝謝好 謝謝委員好 謝謝接下來請羅廷偉委員來做選擇 |
| transcript.whisperx[513].start |
14067.076 |
| transcript.whisperx[513].end |
14068.604 |
| transcript.whisperx[513].text |
好 謝謝主席 有請部長請部長 |
| transcript.whisperx[514].start |
14074.582 |
| transcript.whisperx[514].end |
14103.542 |
| transcript.whisperx[514].text |
好部長好今天排審這個癌症防治法我想基本上朝野共識幾乎很多的版本大家都是要設置癌症新藥的多元基金那我想今天呢也看到了大家都很希望法律明確的確定有一個制度化長期運作的一個基金讓這個癌症病患能夠穩定的用藥不會再受限於每一次的年度預算或政策的變動但很可惜今天看到你們的報告指出因為財政機率法 |
| transcript.whisperx[515].start |
14104.322 |
| transcript.whisperx[515].end |
14127.818 |
| transcript.whisperx[515].text |
所以呢你們已經有癌症新藥的一個暫時性的支付業務已經納入了健保基金的辦理所以就是建議講白的就是維持現行條文但是我想部長癌症新藥給付長期且持續性的這樣子我們看到以暫時性支付也已經說明了他就是暫時意味著不確定 |
| transcript.whisperx[516].start |
14129.019 |
| transcript.whisperx[516].end |
14149.53 |
| transcript.whisperx[516].text |
所以整個哪一天因為公務預算或者特殊原因被終止這就是我們並有所擔心的斷崖式的風險所以今天我還是要再一次的跟您請託你也看到這麼多的委員在關心是不是能夠走向永續保障重要的一步若現行暫時性的一個支付 |
| transcript.whisperx[517].start |
14150.35 |
| transcript.whisperx[517].end |
14160.116 |
| transcript.whisperx[517].text |
有天因為財政預算特別情況然後呢衛福部有何具體的一個方案去做替代你能夠及時保障新藥給付不中斷嗎 |
| transcript.whisperx[518].start |
14161.764 |
| transcript.whisperx[518].end |
14186.981 |
| transcript.whisperx[518].text |
跟委員說明這個暫時性支付的意思不是不穩定的意思他是說在進入健保之前因為我們健保是這個前一年度就決定了下一年度在審核的過程當中呢認為說剛好今年的budget不夠所以先放在這個基金所以他大概是兩三年之後還是要回到健保所以即使不論你是現在的在健保基金裡面的專款 |
| transcript.whisperx[519].start |
14187.481 |
| transcript.whisperx[519].end |
14217.161 |
| transcript.whisperx[519].text |
或者是未來的這個癌症的這個新藥的多元基金也是一樣它都是暫時性的待會我們來談一下這個審查的時間這個審查時間我也可以跟你就教但是第二個問題先請教部長目前癌症新藥基金對不起癌藥的基金給付的藥品原則上還是屬於暫時性支付兩至三年要如何透過醫療科技的評估將效益明確的回歸藥品常規的健保給付 |
| transcript.whisperx[520].start |
14218.022 |
| transcript.whisperx[520].end |
14237.524 |
| transcript.whisperx[520].text |
這個有沒有衛福部有沒有部分的完整規劃在我們成立這個專款支付的時候都已經設計好了他要進來的時候呢就有一個HTAHTR的評估計劃如何收資料然後到時候時間快到的時候兩年快到的時候那麼如何 |
| transcript.whisperx[521].start |
14238.044 |
| transcript.whisperx[521].end |
14266.936 |
| transcript.whisperx[521].text |
依据临床的实际的使用的情形跟结果来做评估最后来决定他要纳入到正式健保给付的价格或者是适应证那最后再做决定大概是这个都已经设计的我想我们都很关切就是准备使用的这些病友他们治疗的一个权益那会不会被迫中断或者是自费治疗这部分我们都很关心当然我看到听到你的回应我们还是希望这个部分一定要特别注重 |
| transcript.whisperx[522].start |
14267.336 |
| transcript.whisperx[522].end |
14287.155 |
| transcript.whisperx[522].text |
除非我們後面的評估是沒有效當然就不再付啦如果是有效的那他可能會去調整剛剛其他委員有提到那我想部長那個賴總統說啊4月份才說基金這個新藥基金的規模是100億這個基金的水庫一定要保持在這個水位請問何時會達到100億 |
| transcript.whisperx[523].start |
14288.864 |
| transcript.whisperx[523].end |
14316.502 |
| transcript.whisperx[523].text |
跟文說明我們今年大概是用掉在差不多20億左右那明年又50億所以明年還有七八十億可以用啦那之後呢但是他有講嘛水庫要保持這個水位嘛這個水位會一直上去所以大概後年就會到100億我想癌症新藥基金後年癌症新藥基金暫時性的給付目前最快速度是3.5個月最慢要等10個月部長 |
| transcript.whisperx[524].start |
14317.608 |
| transcript.whisperx[524].end |
14322.745 |
| transcript.whisperx[524].text |
等10個月往往病友還沒有等到藥人就先躺平了這審查時間這麼久的原因 |
| transcript.whisperx[525].start |
14324.13 |
| transcript.whisperx[525].end |
14347.728 |
| transcript.whisperx[525].text |
目前最大的瓶頸是什麼如果是指納入幾戶的審查時間我們在縮短那個是您說的那個10個月是叫做平行審查我們有另外有一個新的平行審查一般我們現在大概都需要在一年半到兩年才會進入到幾戶從它來申請所以你能不能認為這10個月可不可以再縮短對對對 這已經在縮短 |
| transcript.whisperx[526].start |
14350.05 |
| transcript.whisperx[526].end |
14374.611 |
| transcript.whisperx[526].text |
這有必要性吧我今天提出這樣子的對就是我們會去選擇說這個是不可替代那臨床上確實有他的需要才會進入平行審查那一般如果現在已經有藥的已經有藥那你進來的話現在已經有藥的那就不會進入到平行審查好另外跟你針對健康政策與醫療科技的祭品評估中心什麼時候可以送到行政院 |
| transcript.whisperx[527].start |
14375.958 |
| transcript.whisperx[527].end |
14401.153 |
| transcript.whisperx[527].text |
这个法人叫做国家医疗科技评估中心的设置条例我们现在已经在行政院审查中了审查中了对对对预计什么时候会到立法院我们会尽量努力那么快的话可能年底前就可以送到立法院今年年底今年年底好最后我想问一下部长这个癌症病友所需要使用的这个医材能不能也纳入补助 |
| transcript.whisperx[528].start |
14403.115 |
| transcript.whisperx[528].end |
14418.272 |
| transcript.whisperx[528].text |
醫材醫材的那個樣態就很多了是啊他是非常多樣多元性的所以也是一樣我們都會經過如果是一般的醫材大概都付了啦那很高價很特殊的還是一樣會經過那個剛剛講的這個科技評估科技評估評估之後來看看 |
| transcript.whisperx[529].start |
14422.136 |
| transcript.whisperx[529].end |
14444.949 |
| transcript.whisperx[529].text |
那還是回到我們剛剛說的嘛因為有一些我們希望未來有機會能夠納入評估當然我們尊重評估啦評估的結果如果有的我們是全給付有的是用差額負擔的方式最後我想再請教一個問題因為剛剛黃委員在關心這個病床的問題那其實就我們自己的選區台中東南區我這邊有這個中興 |
| transcript.whisperx[530].start |
14447.132 |
| transcript.whisperx[530].end |
14464.987 |
| transcript.whisperx[530].text |
醫學院 對不起中興大學申請的輻射醫院目前他們也在申請說要輻射醫院的成立那他們當時是申請大概好像也是五六百床然後 499那499床目前審議的過程當中你們在審查嘛對 狀況怎麼樣 |
| transcript.whisperx[531].start |
14466.618 |
| transcript.whisperx[531].end |
14486.271 |
| transcript.whisperx[531].text |
因為還是看這個醫療資源的情形那台中跟剛剛新北比起來是剛剛數字比較豐沛一點這個數據我都知道就高很多目前他所在的那個新聞也出了然後大家也期盼了房價也漲了然後他就說要拼2030年要完工 |
| transcript.whisperx[532].start |
14487.472 |
| transcript.whisperx[532].end |
14508.539 |
| transcript.whisperx[532].text |
然後想請問一下你可不可以給我最現在最具體的目前審查狀況是會通過還是不會通過以那個設立的地點周邊的醫療資源真的太豐沛他就在市中心所以你不會通過所以這個恐怕這個對於資源的這個投入會過剩但什麼時候會有這個審查的決議出來 |
| transcript.whisperx[533].start |
14512.112 |
| transcript.whisperx[533].end |
14529.785 |
| transcript.whisperx[533].text |
因為這個是要由醫審會去審查我比較不好因為醫審會什麼時候都在排審中可以幫我們加快一下嗎因為民眾很期待嘛我剛說民眾期待新聞出了房價也漲了結果最後到底是有還是沒有不過以中興大學有設立醫學系他應該去 |
| transcript.whisperx[534].start |
14532.006 |
| transcript.whisperx[534].end |
14553.137 |
| transcript.whisperx[534].text |
支援現行的在台中還有很多醫院他去協助提升到他們的醫療這個我知道啦反正我的意思是說輻射醫院的這個審查能不能幫我們催一下加速一下就剛剛你所說的嘛很豐沛看起來就是不行了嘛那我們要知道具體的結果好不好程序上我們來加快好謝謝謝謝謝謝委員好謝謝接下來請圖全集委員來做選擇 |
| transcript.whisperx[535].start |
14566.502 |
| transcript.whisperx[535].end |
14588.067 |
| transcript.whisperx[535].text |
好 謝謝主席 請我們石部長還有國建署省署長部長 署長 國建署 圖遠好部長 那我們罕病也知道及早篩檢是很重要的早期發現 早期治療那我們目前台灣少子的話每年大概超過 |
| transcript.whisperx[536].start |
14589.84 |
| transcript.whisperx[536].end |
14616.939 |
| transcript.whisperx[536].text |
600位的婴儿死亡那也就是说每15个小时就超过一个婴儿失去生命那后来我们来探究他死亡的原因超过100位的婴儿大部分都是因为先天性畸形变形或者染色体异常等先天疾病那部长我请问一下像我们脊髓性的肌肉萎缩症SMA也是婴儿死亡 |
| transcript.whisperx[537].start |
14617.859 |
| transcript.whisperx[537].end |
14638.57 |
| transcript.whisperx[537].text |
死亡機率低高的遺傳疾病那龐貝氏症如果在兩歲以前沒有治療他的死亡率幾乎高達百分之百那目前我們國健署補助公費針對新生兒先天性代謝異常的疾病篩檢裡面有21項那我請問一下這21項有包含我剛剛說的那兩項嗎 |
| transcript.whisperx[538].start |
14642.652 |
| transcript.whisperx[538].end |
14662.324 |
| transcript.whisperx[538].text |
跟委員說明這兩個罕病目前都有健保給付的藥品治療那至於說篩檢新生兒篩檢的部分這個SMA經過了大概一年的討論那麼現在大概有了定案會納入公費的新生兒篩檢的項目以前是建議啦 |
| transcript.whisperx[539].start |
14663.064 |
| transcript.whisperx[539].end |
14683.562 |
| transcript.whisperx[539].text |
是自费的项目那明年会把它纳入那这个是已经经过HTA的评估是OK那另外庞氏症的部分现在还在评估当中所以因为我看国建署今年9月就说演绎要纳入所以现在已经确定会纳入了SMA确定会纳入 |
| transcript.whisperx[540].start |
14683.962 |
| transcript.whisperx[540].end |
14704.641 |
| transcript.whisperx[540].text |
那什麼時候可以開始實施應該是在明年的下半年因為要配合地方政府編列的有六都的預算他們要配合去編列其他縣市我們都補助好 所以SMA明年下半年度就可以實施對那龐貝市政也希望龐貝市政是現在還在進行HTA當中就是科技評估當中 |
| transcript.whisperx[541].start |
14705.382 |
| transcript.whisperx[541].end |
14727.363 |
| transcript.whisperx[541].text |
那一有结果的话就会送到专家会议来讨论来决定那这部分就请部长来帮我们进行所以SMS确定啦那庞贝斯症现在也在评估现在在评估对好那我再请问一下像我们今天主要是针对我们癌症新药基金嘛那赖总统健康台湾政策他有讲 |
| transcript.whisperx[542].start |
14728.084 |
| transcript.whisperx[542].end |
14751.583 |
| transcript.whisperx[542].text |
百亿癌症新药基金那我看一下我们2025年是编列50亿那50亿我刚才有听部长讲所以预计到明年应该是有七八十亿因为今年大概会留下二十几亿然后再加上明年50亿所以大概会有76亿多我们大概有算了一下可是这76亿多 |
| transcript.whisperx[543].start |
14752.904 |
| transcript.whisperx[543].end |
14776.69 |
| transcript.whisperx[543].text |
我們要包含2025年已經收載的藥品它分期可能會支付掉39億多所以76億多裡面支付掉39億多其實它也只剩下30幾億那30幾億如果說以我們今年2025年你看你下半年度就大概20億 20幾億那如果全年度30幾億勢必是會不夠用的 |
| transcript.whisperx[544].start |
14779.221 |
| transcript.whisperx[544].end |
14800.371 |
| transcript.whisperx[544].text |
如果以這樣子來推算4BH不夠用而且你到2027年還要支付2025年收窄的分期的費用還有到2026也要付他分期的費用算下來就要70幾億所以你到2027年如果沒有到百億絕對是破產了 |
| transcript.whisperx[545].start |
14802.045 |
| transcript.whisperx[545].end |
14817.878 |
| transcript.whisperx[545].text |
那部長針對這一部分你們有沒有了解過我們推估啦大概也是差不多2027是要百億啦因為我們是這樣這個要不是大家一起在同一個時間收窄進來他會有時間嘛一月幾個二月這樣陸陸續續進來 |
| transcript.whisperx[546].start |
14819.759 |
| transcript.whisperx[546].end |
14841.961 |
| transcript.whisperx[546].text |
然後進來我們審查通過發布要幾副的時候醫院還要去採購 溢價等等的程序所以都稍微會delay所以明年大概我們認為大概七八十一是夠用但後年會到百億沒有錯接下來我們前面的這些藥會因為經過三年他有的就評估完就會回到健保 |
| transcript.whisperx[547].start |
14843.042 |
| transcript.whisperx[547].end |
14857.635 |
| transcript.whisperx[547].text |
所以它就會有進進出出啦就是一個這個活水的概念這樣對 所以因為它本身沒有公務預算嘛那目前也沒有辦法編列正式編列這個基金進來嘛現在是用公務預算 |
| transcript.whisperx[548].start |
14858.835 |
| transcript.whisperx[548].end |
14870.021 |
| transcript.whisperx[548].text |
來撥補在這個 你是撥補的嘛對對對 是挪用嘛從公務預算去編列進來 去挪用嘛它不是正式編列嘛正式編列專款專用專款專用 對 專款專用那可是照現在50億看起來是勢必到2027是絕對不夠對 2027就會到100億就會再 我們會再去爭取100億進來 |
| transcript.whisperx[549].start |
14877.785 |
| transcript.whisperx[549].end |
14896.354 |
| transcript.whisperx[549].text |
好 我們希望一定要逐年增加因為如果說以現在這樣子的算法2025、51、2026、51勢必到2027年錢就絕對不夠用最少要到百億那不然到2028年很多這些癌症的患者 |
| transcript.whisperx[550].start |
14896.894 |
| transcript.whisperx[550].end |
14908.346 |
| transcript.whisperx[550].text |
它就會變成藥品的孤兒甚至自己要自費負擔這高額的費用好 我們會去做好預估跟預算的編列好 希望這個趕快在逐年最慢在2027年一定要達到百年會 |
| transcript.whisperx[551].start |
14910.607 |
| transcript.whisperx[551].end |
14927.206 |
| transcript.whisperx[551].text |
那还有针对部长你在六月受访的时候你有说失智症百万新药今年年底有机会完成评估研疫纳保那这个阿兹海默症的新药纳入健保给付 |
| transcript.whisperx[552].start |
14928.347 |
| transcript.whisperx[552].end |
14949.039 |
| transcript.whisperx[552].text |
請問現在的審議制度進行到哪裡這個已經經過那個專家會議已經討論過了那根據這個HTA的報告那麼還有其他國家的HTA的報告是目前認為這一個阿茲海默症的新藥它的這個療效 長期療效不明所以還需要再繼續的 |
| transcript.whisperx[553].start |
14950.82 |
| transcript.whisperx[553].end |
14973.049 |
| transcript.whisperx[553].text |
更多的數據所以目前還沒有確定所以暫時不納入健保的給付好 那今天主要要討論一下審議進度的問題因為我們看一下國健署他在針對藥品健康風險評估審查的情形他不管是申請的業者 流程還有他的進度 |
| transcript.whisperx[554].start |
14974.369 |
| transcript.whisperx[554].end |
15001.084 |
| transcript.whisperx[554].text |
都很明確一目了然然後國健署在這一方面我們感覺他做得還算非常的完善那部長你1月份我記得1月份那時候還擔任健保署署長那時候你在詢答的時候你也答應說針對這個審議制度盡量炒透明公開藥品的審查案件那你現在也做部長了不知道這一個部分 |
| transcript.whisperx[555].start |
15001.704 |
| transcript.whisperx[555].end |
15022.764 |
| transcript.whisperx[555].text |
什麼時候可以讓藥品審查的審議進度能夠公開透明跟委員說明我們那個有醫材跟藥品那醫材的部分現在進度就像這樣都可以查了那個醫材的這個審查的進度已經做好了那個資訊公開透明了那現在正在進行 |
| transcript.whisperx[556].start |
15023.765 |
| transcript.whisperx[556].end |
15042.671 |
| transcript.whisperx[556].text |
藥品的部分仿造這個醫材這樣一併把它公開應該是那大概什麼時候可以做到大概年底前會完成年底前可以完成所以一般來講如果照部長這樣講明年我們就有機會把這些對 這不論是醫材或者是藥品的審議的進度公開透明對 因為 |
| transcript.whisperx[557].start |
15044.492 |
| transcript.whisperx[557].end |
15072.472 |
| transcript.whisperx[557].text |
我們當然我們立法委員他可以透過詢答去了解你這個制度可是很多民眾他不知道他不知道他什麼時候他這個用藥到底什麼時候才可以用造成他很不明確不知道到底什麼時候才可以使用所以我覺得公開透明對民眾一定有很大的幫助就是審查的進度到哪裡然後最後的審查結果如何是怎麼樣的給付方式都會在未來都可以查詢得到所以部長說明年就應該就沒問題了 |
| transcript.whisperx[558].start |
15074.994 |
| transcript.whisperx[558].end |
15087.549 |
| transcript.whisperx[558].text |
還有我們最近食安聯環報一下黑心豬大腸現在又有毒雞蛋一下豬大腸用工業級的雙氧水毒雞蛋 |
| transcript.whisperx[559].start |
15089.051 |
| transcript.whisperx[559].end |
15109.889 |
| transcript.whisperx[559].text |
分埔泥又超標那針對這一部分我們這食安武漢看起來又破功了那這一部分看起來是不是源頭控管的問題跟委員報告其實這一次這個問題彈是我們的例行性查核查出來的就是從在2017年之後我們就開始做這個 |
| transcript.whisperx[560].start |
15112.091 |
| transcript.whisperx[560].end |
15135.572 |
| transcript.whisperx[560].text |
後市場的例行性的抽菸所以這個是例行性抽菸我們過去七年其實都是零檢出啦抽菸的都是正常這一次才有發現有一個不合格品所以這個食安五環其實是有發揮它的所以目前抽菸到只有彰化這個畜牧場是嗎這個畜牧場出來的所以抽菸其他都沒有問題對 目前的都是這樣 |
| transcript.whisperx[561].start |
15136.432 |
| transcript.whisperx[561].end |
15152.822 |
| transcript.whisperx[561].text |
那我們之前抽驗出來現在聽說好像我們復驗又針對蛋機它的羽毛還有它的代謝物都是超標而且超標很多對 就是為了要找源頭因為我們是在後市場所以後市場是查到蛋有 |
| transcript.whisperx[562].start |
15153.602 |
| transcript.whisperx[562].end |
15181.121 |
| transcript.whisperx[562].text |
但是為什麼蛋裡面會有分譜你就要找原因所以才有農政單位去介入從這個環境包含它的飲用水 它的飼料包含它的羽毛其他的雞的蛋都去更過大抽菸所以針對你們抽菸的結果看出來應該是不是注射在雞的身上不是 現在抽菸的結果因為它的飲用水 飼料都沒有檢出 |
| transcript.whisperx[563].start |
15181.921 |
| transcript.whisperx[563].end |
15205.163 |
| transcript.whisperx[563].text |
剪出的是它的羽毛而且羽毛跟蛋跟它的排泄物來比是比較高的所以它的飼料跟土囊沒有問題啊但是它蛋積本身的羽毛還有它的代謝物是驗出來超標啊而且超標很高嘛跟委員這邊進一步說明那目前因為剛好這次是剪掉跨部會其實進去協助的 |
| transcript.whisperx[564].start |
15205.743 |
| transcript.whisperx[564].end |
15233.233 |
| transcript.whisperx[564].text |
在這個抽煉的過程中羽毛上面有其實不是常態所以的確在推論上面是高度懷疑是直接有在噴灑在羽毛身上在農政單位的就我了解我剛才跟畜牧師去做溝通這個是嚴格禁止他們也是積極過去從107以後積極輔導從來都沒有查到有這樣的情形所以他們現在也是積極的那現在到底知道原因是 |
| transcript.whisperx[565].start |
15233.673 |
| transcript.whisperx[565].end |
15255.556 |
| transcript.whisperx[565].text |
對 原因就是應該是業主個人的行為對於這個施藥的行為其實本來不能施藥的他做了一個錯誤的施藥那過去的管理也相對我聽起來是很嚴格那個人行為這個他們去積極矯正在後市場端4382次的抽驗裡面我們目前 |
| transcript.whisperx[566].start |
15256.417 |
| transcript.whisperx[566].end |
15272.967 |
| transcript.whisperx[566].text |
都沒有 所以整個看起來台灣對於分譜尼這個管制其實是有效那這一次失靈我相信在農場端他們應該會改變所以署長的意思說這個目前看起來是個案對不對那我們其他的都有去抽菸嗎都有去抽菸嗎 |
| transcript.whisperx[567].start |
15273.487 |
| transcript.whisperx[567].end |
15288.737 |
| transcript.whisperx[567].text |
我們其實今年度到現在461件11 12月持續一個月都還有五六十件所以這個是不會停止的那過去的數據是在隨機抽驗下來在一些科學的基礎上面我們看起來的確 |
| transcript.whisperx[568].start |
15290.018 |
| transcript.whisperx[568].end |
15308.354 |
| transcript.whisperx[568].text |
農政單位往前的部分還持續的我們後市長端也會持續的監測那部長也跟我們提到只要有任何新的任何資訊一直查到哪裡我們就公佈到哪裡一定再會有大家委員其實很多的期許我們會努力的 謝謝希望部長跟署長我們這食安五環尤其這源頭控管的部分還是要幫我們加強 |
| transcript.whisperx[569].start |
15310.395 |
| transcript.whisperx[569].end |
15332.3 |
| transcript.whisperx[569].text |
好 謝謝 原則把關讓大家都時的安心好 謝謝委員時的安心 好 謝謝來 謝謝 時的安心那接下來請廖翔 趙偉來做巡打對啊 看得出來謝謝主席 謝謝趙偉那請石部長以及國建署長石部長 |
| transcript.whisperx[570].start |
15334.798 |
| transcript.whisperx[570].end |
15347.887 |
| transcript.whisperx[570].text |
是石部長石丹心料理人好謝謝石部長這個第一個我想問一下因為根據國健署的這個癌症登記報告跟健保大數據顯示其實攝護腺癌發生個案從2000 |
| transcript.whisperx[571].start |
15352.59 |
| transcript.whisperx[571].end |
15373.36 |
| transcript.whisperx[571].text |
2022年9062人那也增加到2024年達到了9858人那他成為男性的第三大癌症而且發生率增加比例最高的癌症那從這個部分來看流行病學的數據這個攝護腺癌的發生率每10萬人大概是41.7人 |
| transcript.whisperx[572].start |
15375.141 |
| transcript.whisperx[572].end |
15401.248 |
| transcript.whisperx[572].text |
那子宮頸癌是7.6人等於是攝護腺癌是子宮頸癌的5.5倍那攝護腺癌的死亡率每10萬人大概是7.8人那也是子宮頸癌2.56人的3倍所以2024年這個攝護腺癌的死亡還將近了2000人1897人所以值得注意的是其實早在2003年攝護腺癌的發生率就超過了子宮頸癌 |
| transcript.whisperx[573].start |
15402.188 |
| transcript.whisperx[573].end |
15418.224 |
| transcript.whisperx[573].text |
那2005年攝護腺癌的死亡率也大於子宮頸癌那我國從1995年開始就有開始提供30歲以上的女性免費的這個子宮頸抹片檢查嘛但是男性的攝護腺癌的篩檢 |
| transcript.whisperx[574].start |
15419.525 |
| transcript.whisperx[574].end |
15441.118 |
| transcript.whisperx[574].text |
到現在都沒有納入全民篩檢延遲近30年那相較於美國在1988年他們就就是開始進行攝護腺癌的篩檢而且他在幾年內也成功的下降了死亡率所以台灣在這部分的篩檢似乎是落後的蠻多想要請問一下為什麼至今沒有想要把它納入公費篩檢的規劃 |
| transcript.whisperx[575].start |
15442.099 |
| transcript.whisperx[575].end |
15464.647 |
| transcript.whisperx[575].text |
好跟委員說明這個確實這個攝護腺癌隨著我們高齡化年齡的延長這個發生率越來越高那死亡率我們也看到這個還是有一定診斷出來的時候是第四期的攝護腺癌所以死亡率也相對高所以這確實是我們現在在癌症防治上需要有一個國家的政策出來所以我們現在也正在研擬 |
| transcript.whisperx[576].start |
15465.347 |
| transcript.whisperx[576].end |
15491.384 |
| transcript.whisperx[576].text |
至於說傳統我們常認為是拿來做攝護腺癌指標的PSA因為它的干擾因素多現在很多的國家並還沒有把它列為常規因為它的干擾因素跟判讀會影響到後續會不會因為就不必要的侵入性我覺得部長是這樣其實身邊有很多真的是因為沒有去篩檢所以太晚發現對不對 |
| transcript.whisperx[577].start |
15492.845 |
| transcript.whisperx[577].end |
15509.077 |
| transcript.whisperx[577].text |
但是現在又有新的就是我們傳統只有PSA那現在還有用FreePSA甚至透過那個計算方式去更精準的去區分它是癌或者是良性所以這個我們現在正在請專家做評估 |
| transcript.whisperx[578].start |
15509.497 |
| transcript.whisperx[578].end |
15526.125 |
| transcript.whisperx[578].text |
未來我們會提出一個關於攝護腺癌所以現在有在評估嘛對不對現在有在評估嘛 納入公費篩檢所以基本上不是因為經費的問題主要就是說你們覺得夠不夠精準這樣子那你們有沒有預計什麼時間可不可以在這裡給本席一個時間和方向 |
| transcript.whisperx[579].start |
15536.836 |
| transcript.whisperx[579].end |
15560.035 |
| transcript.whisperx[579].text |
應該是半年半年之後會確定是不是都會有一個策略所以到時候不見得是透過所謂的PSA可能是你用其他的方式可能要有一個protocol就是要有一個流程什麼樣的人怎麼驗出來的紙在哪裡叫加驗什麼的對啊 因為通常可能是PSA然後發現有異常然後再進一步可能不管是這個肛門之症或是你說這個相關的其他的 |
| transcript.whisperx[580].start |
15561.677 |
| transcript.whisperx[580].end |
15577.439 |
| transcript.whisperx[580].text |
對 所以本席想要講的事情是要加速因為其實我有發現在民間可能很少人真的主動去檢查等他發現的時候就已經太晚了所以我是覺得如果可以當然你說現在近期已經有很快有可能有更精準的工具了 |
| transcript.whisperx[581].start |
15577.759 |
| transcript.whisperx[581].end |
15597.674 |
| transcript.whisperx[581].text |
那當然希望加速那如果不行的話其實就算他所謂的素質有異常可是也是促使他要進一步去檢查這樣還是可以提早知道自己到底在哪一期或甚至沒事沒事那是最好所以本席想要講的是說部長這部分要請你這個禁訴好不好所以半年內會有消息有沒有可能再加速 |
| transcript.whisperx[582].start |
15598.922 |
| transcript.whisperx[582].end |
15611.994 |
| transcript.whisperx[582].text |
因為這個是委託學者在做我們給他催催看好再麻煩部長我們盡量快那再來就是有關於罕病專用藥的部分這個115年的罕病專款預算編列方式是有改變的對不對 |
| transcript.whisperx[583].start |
15613.612 |
| transcript.whisperx[583].end |
15638.756 |
| transcript.whisperx[583].text |
罕要的這個專款預算在115年度這個是153.97億可是他跟罕病基金會的推估的實際需求相比有蠻大的落差那最後你們這個罕病的專款僅編列了136億所以這個大概差了18億嘛那我想這不只是數字上的短缺我覺得他可能更對於這個17627位的罕病家庭 |
| transcript.whisperx[584].start |
15642.877 |
| transcript.whisperx[584].end |
15665.567 |
| transcript.whisperx[584].text |
是一個無情的打擊所以基金會也指出健保署一反常態沒有依往年以這個近5年的平均成長率推估隔年的罕病罕藥的專款成長率卻改以113年這個已收載之94項的罕藥依令的申報費用乘以近5年的平均成長率 |
| transcript.whisperx[585].start |
15666.207 |
| transcript.whisperx[585].end |
15690.828 |
| transcript.whisperx[585].text |
所以用這種所謂依令的推估模式是這個至少遺漏了114年新增給付之罕要的費用以及這個專款結算邏輯中應該納入計算之非公告罕要品項所以導致這個預估有重大落差所以想要請問署長這部分或是部長這部分為什麼今年突然要改變這樣的公式導致有這樣18億的 |
| transcript.whisperx[586].start |
15692.864 |
| transcript.whisperx[586].end |
15709.844 |
| transcript.whisperx[586].text |
落差跟委員說明這個也是經過目前還在等待要納入的藥去推估出來的所以以現在這樣的預算推估據瞭解是可以把現行申請要進入這個健保給付的含藥應該是足以含納 |
| transcript.whisperx[587].start |
15710.945 |
| transcript.whisperx[587].end |
15728.236 |
| transcript.whisperx[587].text |
但是這個基金會他們因為海耀的特性就是不是隨時都要一直出來他可能久久才有一個突破所以我們經過HTA的評估所以你們是特別今年才改變這樣子的算法嗎算法好像也沒有太大的差異也是這樣推估的嘛 |
| transcript.whisperx[588].start |
15729.016 |
| transcript.whisperx[588].end |
15754.088 |
| transcript.whisperx[588].text |
但是這跟這個罕病基金會過去他們推估因為他們有來澄清說這個是跟他們的過去以往的推估方式是不同的而且有很大的落差的應該是說是按照過去的這個罕病的病人需要用的藥去推估再加上未來要納入的所以它是兩塊併起來所以應該是但是現在114年你們有遺漏114年的新增給複製罕藥費用嗎 |
| transcript.whisperx[589].start |
15756.289 |
| transcript.whisperx[589].end |
15785.113 |
| transcript.whisperx[589].text |
都有全部納入了所以你們覺得這個部分是跟這個基金會的這個認知是有落差嗎跟委員報告這個10月3號的立法院公聽會之後我們跟罕病病友學會事實上也開了蠻多次會已經充分的解釋清楚目前所有在Horizon scan在等待中的所有藥物等待審議還沒過的所有藥物全部納入以上補充全部都會納入好所以所以已經跟他們解釋過沒有落差那你們的這個計算方式也沒有改變沒有沒有 |
| transcript.whisperx[590].start |
15786.774 |
| transcript.whisperx[590].end |
15800.192 |
| transcript.whisperx[590].text |
跟這個委員報告我們也是用過去5年只是說這次是更精準的把94項每一項的成長率分開算這個也是公衛學者給我們的建議那關於公視我們已經給海濱裡面但你們在食物上會不會因此而短少 |
| transcript.whisperx[591].start |
15801.914 |
| transcript.whisperx[591].end |
15822.668 |
| transcript.whisperx[591].text |
目前海耀基金會認為的房缺是18億那我們目前到明年健保內的額度是192還有另外的公務預算20應該是足以營業以上補充所以20會補進去我們有編在我們的公務預算裡頭好 謝謝部長到時候再請委員對 到時候再提供一個本席說明再來就是 |
| transcript.whisperx[592].start |
15823.729 |
| transcript.whisperx[592].end |
15844.388 |
| transcript.whisperx[592].text |
百億的新藥基金的部分那我想這個百億癌症基金是賴清德總統也很重要的競選政見那他的目的是要加速引進與給付這個癌症新藥和新療法應對癌症連續43年為國人為國人的十大死因十大死因 |
| transcript.whisperx[593].start |
15845.149 |
| transcript.whisperx[593].end |
15867.224 |
| transcript.whisperx[593].text |
但是呢這個他的相關的規劃是從2025年起公務預算一柱50億然後2026年再爭取50億所以這個準百億癌症基金卻怎麼樣好像都還沒湊到百億喔那那個時候就說要先用站邊站邊的這個部分然後雖然號稱說未來會逐年增加到底什麼時候才會足額 |
| transcript.whisperx[594].start |
15868.741 |
| transcript.whisperx[594].end |
15879.618 |
| transcript.whisperx[594].text |
按照我們的推估因為今年大概用掉20幾億然後明年50億的這個公寓算進來會有70億左右那預計大概後年的時候會到達百億 |
| transcript.whisperx[595].start |
15880.785 |
| transcript.whisperx[595].end |
15909.113 |
| transcript.whisperx[595].text |
你們今天的報告有提到說後續會看相關的需求嘛爭取預算預注嘛那要保持所謂專款經費在一定的水位那請問部長一定的水位到底是指多少因為外界的理解就是不是又是百億嗎那這樣算不算我們未來都會維持因為他是逐步上來因為他要申請審查然後醫院採購使用嘛所以會逐步上來所以未來大概會維持在至少百億的水準 |
| transcript.whisperx[596].start |
15909.993 |
| transcript.whisperx[596].end |
15938.566 |
| transcript.whisperx[596].text |
所以您的水準就是百億的水準會維持在百億水準不是說就是剛好一百億啦可能也會超過也不一定我們看看未來的情形這樣對因為這個東西跟一開始大家的理解不同一開始不是應該就是一次到位嗎就是應該一次到位百億結果現在變成一直拖延後延後沒有拖啦就是說大家的理解的百億其實就是最終一定在兩三年內因為它的用藥是逐步上來的 |
| transcript.whisperx[597].start |
15938.726 |
| transcript.whisperx[597].end |
15956.202 |
| transcript.whisperx[597].text |
所以是先畫一個大餅說我們會到百億但是時間就是後面再來推這樣子我們預估這真的跟外界的期待和落差很大部長沒有我們一開始規劃就是差不多兩三年達到這樣的水準這樣好這個部分我想這裡是所有癌症病友的期待和需求這個請部長要盡速達標會好謝謝好謝謝謝謝委員 |
| transcript.whisperx[598].start |
15962.947 |
| transcript.whisperx[598].end |
15988.558 |
| transcript.whisperx[598].text |
好 謝謝廖長偉 謝謝部長接下來請葉元之葉委員那個麻煩請部長 謝謝主持人請部長 |
| transcript.whisperx[599].start |
15992.798 |
| transcript.whisperx[599].end |
16016.409 |
| transcript.whisperx[599].text |
業員好部長好我現在反映一下一些學生家長心聲因為現在最近是流感季節學校在打流感疫苗但是因為校方大概一個月前就在調查學生接種的意願可是卻在接種前一天才公佈疫苗的品牌我早上看到部長回應是很嗆 |
| transcript.whisperx[600].start |
16017.645 |
| transcript.whisperx[600].end |
16039.632 |
| transcript.whisperx[600].text |
跟家長講說你不必要知道你就打就對了後來這個新聞在網路上就發酵很多家長都在罵你都說台灣是極權國家現在連知的權利都沒有資訊不能透明嗎我覺得家長講得蠻有道理的但是部長也不要讓你被斷章取義所以想問一下部長 |
| transcript.whisperx[601].start |
16041.445 |
| transcript.whisperx[601].end |
16063.155 |
| transcript.whisperx[601].text |
為什麼不能先公佈不是不先公佈早上的說法是說其實我們公費的疫苗都是經過CDC我們那個疾病管制署他們挑過的就是由這個專家決定今年施打哪一種疫苗然後採購的方式來提供所以這每一種疫苗我們提供的公費疫苗 |
| transcript.whisperx[602].start |
16063.795 |
| transcript.whisperx[602].end |
16091.024 |
| transcript.whisperx[602].text |
效率效果都是一樣的大家不用挑所以我們只是說如果你在施打的時候對於過去施打的經驗裡面有對某一個廠牌會有不良反應那你可以反應那就不要當天就不要打然後再去醫療院所選擇其他的這個好像你新聞有講過但現在問題在哪裡你知道嗎那沒有辦法說每一個學校呢大家都來登記我要什麼牌我要什麼什麼牌這樣就沒有辦法打了 |
| transcript.whisperx[603].start |
16091.524 |
| transcript.whisperx[603].end |
16110.51 |
| transcript.whisperx[603].text |
沒有說叫大家來登記什麼牌什麼牌而是說希望先讓他知道可能會打什麼品牌再讓他決定要不要同意那這個我們再跟教育部大家討論一下那這個為什麼大家會我家長為什麼會這麼憂心呢我念一下拿五個疫苗品牌我相信部長就很清楚了 |
| transcript.whisperx[604].start |
16111.679 |
| transcript.whisperx[604].end |
16128.533 |
| transcript.whisperx[604].text |
這五個品牌有高端國光 GSK東洋跟賽諾飛那裡面有特定的品牌在當時COVID-19的時候其實大家就很有疑慮那當時衛福部也是用專家會議決定要給國人打 |
| transcript.whisperx[605].start |
16129.454 |
| transcript.whisperx[605].end |
16158.513 |
| transcript.whisperx[605].text |
可是大家對於那個品牌的效力就高端了也是大打折扣很多專家學者包括陳培祥中研院士都出來質疑那請問一下那個疫苗有沒有經過專家會議有但大家有沒有質疑也有而且質疑的人很多都是醫界的因為那時候用免疫橋接沒有做完二期實驗我相信大家都記憶猶新所以本來要打不打包括那時候COVID-19你選擇什麼品牌國人也可以選擇 |
| transcript.whisperx[606].start |
16159.674 |
| transcript.whisperx[606].end |
16183.2 |
| transcript.whisperx[606].text |
而且事先都告訴你比如說我這一波我要打哪一個品牌疫苗你要不要要就來不要就不要來所以當時可以為什麼只有針對學生不可以我覺得這件事情是說不過去的那我不知道這個是您說這是教育部的決定是不是不是不是這個所有的這些品牌像我就是打高端跟國光沒有那政府當然都打高端 |
| transcript.whisperx[607].start |
16185.18 |
| transcript.whisperx[607].end |
16213.613 |
| transcript.whisperx[607].text |
這個涉及到我們自己的醫療韌性我們要自己能夠產製這個疫苗才能夠有這個醫療韌性所以所有的廠牌都一樣都一樣不需要挑啦你不挑可是每一個人都是獨立的個體啦你自己不挑你不能夠剝奪別人挑的權利所以我們可以去強化讓他資訊讓大家知道那我覺得並不是像你講的就是說那個大家來報你想打的品牌我們在配合你到學校施打不是嘛 |
| transcript.whisperx[608].start |
16213.993 |
| transcript.whisperx[608].end |
16234.489 |
| transcript.whisperx[608].text |
不是嘛現在你老早就決定可能今天要開打是打什麼品牌嘛那你一個月前叫人家簽同意書的時候你就可以說我要打什麼那你自己決定嘛那大家都沒有意見嘛大家都沒有意見而且如果說比如說他一天前才發現說這個疫苗不是他想打的品牌他選擇不打他還要再等 |
| transcript.whisperx[609].start |
16235.089 |
| transcript.whisperx[609].end |
16254.456 |
| transcript.whisperx[609].text |
一兩個禮拜才能拿到那種拿到那個補接總單是不是自己再去打再去醫療院搜查那又拖了一兩個禮拜那家長也會擔心那個流感的流行季節就是這段時間那我現在又要拖一兩個禮拜我才有辦法去打那我這一段時間我就沒有抵抗力啊 |
| transcript.whisperx[610].start |
16255.43 |
| transcript.whisperx[610].end |
16280.356 |
| transcript.whisperx[610].text |
所以我覺得你要做這個彈性嘛你訂什麼疫苗品牌 正譜因為這是免費的正譜可以決定但是你讓人家有知的權利公開透明我認為這個是完全沒有衝突的狀況好不好如果是像這個情形我們來檢討一下就是更早讓這個家長們知道哪一天要來打的疫苗是什麼疫苗 |
| transcript.whisperx[611].start |
16283.157 |
| transcript.whisperx[611].end |
16308.347 |
| transcript.whisperx[611].text |
那后面那个自行施打的部分如何加快作业我们再跟教育部来讨论一下因为不同的品牌虽然专家会议说效力一样但大家也会担心副作用啊风险啊还有它是不是真的效力有这么好我觉得这个在家长的角度一定会担心的所以这件事情才会大家讨论那么热烈所以卫福部不能等闲视之那希望说你可以跟教育部 |
| transcript.whisperx[612].start |
16309.307 |
| transcript.whisperx[612].end |
16334.696 |
| transcript.whisperx[612].text |
溝通一下 溝通一下吧那這什麼時候可以給一個答案咧一個月 一個月會不會流感不會啊 我們繼續說差不多 打了差不多啦打差不多了 就是針對下一次的改進方案對對對 OK 好 謝謝 謝謝部長謝謝委員好 謝謝列委員還有部長接下來請徐滬魁委員來做選擇 |
| transcript.whisperx[613].start |
16344.461 |
| transcript.whisperx[613].end |
16345.127 |
| transcript.whisperx[613].text |
謝謝主席 有請我們時部長 |
| transcript.whisperx[614].start |
16349.896 |
| transcript.whisperx[614].end |
16374.272 |
| transcript.whisperx[614].text |
市委員好 部長好 部長我想過去您在這個1441號或是監報所署長的任內對於屏東的醫療環境給予很大力的支持那您在還沒有上任之前我也有幾次跟你談到屏東的醫療問題啊當時我想不當時您那時候還沒有當部長之前 都給我打電話說這一定會拖延幾次那當部長之後這個態度有沒有改變沒有改變 這個我們 |
| transcript.whisperx[615].start |
16376.013 |
| transcript.whisperx[615].end |
16401.035 |
| transcript.whisperx[615].text |
一項就是追求這個健康平權所以資源越不足的地方我們就要投入更多好 我想很高興聽到部長這樣子一個重視我們這個醫療平權的一個說法那我們也期待你帶領的團隊要有這個做法啦那所以今天特別針對小琉球的醫療問題還有我們恆春半島的醫療問題特別再請部長這邊幫忙那我想這個小琉球 |
| transcript.whisperx[616].start |
16403.357 |
| transcript.whisperx[616].end |
16411.436 |
| transcript.whisperx[616].text |
從過去這個90年左右一年大概有15萬人到小琉球來觀光旅遊保齡到目前為止你覺得今年有多少人來祈禱 |
| transcript.whisperx[617].start |
16413.488 |
| transcript.whisperx[617].end |
16442.407 |
| transcript.whisperx[617].text |
我有去過 都是人現在一年大概平均有120萬的遊客我想比這個遠遠大過於我們現在常住的人口那尤其這個連續假期有時候當天超過萬五個人去小琉球所以我們相對性我們也憂心這個小琉球醫療量量的問題不足尤其我們這邊有潛水 有浮潛甚至有一些可能會有發生一些交通事故甚至有一些緊急的醫療狀況 |
| transcript.whisperx[618].start |
16443.808 |
| transcript.whisperx[618].end |
16465.966 |
| transcript.whisperx[618].text |
部長那過去因為我知道您在這個當健保署長的時候也有大力支持我們的IDS一個計畫但是部長我還是有一個現實面的問題要給您歡迎目前小琉球只有一家衛生所和有六間的診所那假日的時候這個IDS只能派遣一名醫生來值班而且沒有藥師來協助變成醫生還要看診還要保養啊 |
| transcript.whisperx[619].start |
16469.609 |
| transcript.whisperx[619].end |
16492.592 |
| transcript.whisperx[619].text |
這個是一個很離譜的一個現象那一旦發生狀況他又必須要把這個整個門診的部分要停掉部長針對這部分有沒有什麼樣的改進的方法我剛剛跟署長討論一下我們立刻來檢討提升因為才一個醫師確實是不夠啦而且又沒有藥師這個我們立刻回去檢討 |
| transcript.whisperx[620].start |
16493.453 |
| transcript.whisperx[620].end |
16509.046 |
| transcript.whisperx[620].text |
那麼來修正這個IDS的方案內容因為現在這個預算夠我們全力會支持這一個這個偏鄉的需要尤其我想現在的這個整個小琉球的觀光環境跟以前大不相同 |
| transcript.whisperx[621].start |
16509.626 |
| transcript.whisperx[621].end |
16535.9 |
| transcript.whisperx[621].text |
接著降臨100多萬人次的遊客量我想我們不能用過去的這種處理方式所以我們也查到了像我們在嘉義阿里山甚至苗栗泰安我們衛福部都有一個彈性調整的醫療服務比如說24小時定點的一個醫療站或是假日急診的醫療站由醫學中心來支援我想這是一個很好的方式部長可不可以用這個方式copy到我們小琉球 |
| transcript.whisperx[622].start |
16536.26 |
| transcript.whisperx[622].end |
16564.476 |
| transcript.whisperx[622].text |
我们IDS有好几种有的是寻常的有的是有那个假日的或者是全日的就全年的有好几种不同的模式那我们会跟当地卫生局讨论看看这个小琉球需要是什么样的模式那我们再来协调其他的这个不论是医学中心或大型的这个区域医院来支援这样部长我想我们现在都跟时间赛跑那尤其现在已经11月中旬明年 |
| transcript.whisperx[623].start |
16565.336 |
| transcript.whisperx[623].end |
16581.104 |
| transcript.whisperx[623].text |
我們有9個連續假期我相信小琉球又湧入非常多的遊客能不能我們今年底趕快把這個案子我們跟縣政府跟我們琉球衛生所趕快來做討論我們年底前把它調整完讓它明年1月1號就可以上路謝謝部長這個正面的支持 |
| transcript.whisperx[624].start |
16582.225 |
| transcript.whisperx[624].end |
16611.244 |
| transcript.whisperx[624].text |
那另外我想這個我過去跟部長也提過恆春旅遊醫院的一個狀況那當然部長也很支持所以我們這個包含跟南門醫院跟恆春基督教醫院我們有分工負責的一個制度大家各施其職然後把這個醫療環境照顧好那部長一樣恆春半島每年有超過兩百多萬的遊客在那邊尤其這個過去潛水的這個交通事故或者一些急重症的一些患者過去往往要北送到高雄或是屏東都不會去啦 |
| transcript.whisperx[625].start |
16612.626 |
| transcript.whisperx[625].end |
16621.424 |
| transcript.whisperx[625].text |
那所以過去你們有支援這個一中計畫但是一中計畫的時間也到今天底就結束了有沒有繼續支持的可能性 |
| transcript.whisperx[626].start |
16622.723 |
| transcript.whisperx[626].end |
16644.994 |
| transcript.whisperx[626].text |
跟委員說明這個恆春旅遊醫院是我們自己的醫院所以不會讓他斷吹我們一定會持續的維持他的量能來為恆春這幾年從之前的潘縣長周縣長跟委員的關心之下這個恆春的醫療資源一直在提升那我們責無旁貸這個沒有問題 |
| transcript.whisperx[627].start |
16646.394 |
| transcript.whisperx[627].end |
16669.308 |
| transcript.whisperx[627].text |
不知道我們不能只是用基本設備基本門檻的觀念來看我已經強調了一年有超過好幾百萬的遊客萬一有緊急的重大的事故或是緊急的一些急重症必須要馬上可以做心導管也好甚至高壓氧這些馬上可以處理的機制但是你沒有醫生沒有食品沒辦法處理能不能趕快在全面盤點這部分的需求能夠來做處理 |
| transcript.whisperx[628].start |
16671.049 |
| transcript.whisperx[628].end |
16694.702 |
| transcript.whisperx[628].text |
這個我們不會讓他斷槌啦所以這個一定會延續 請你放心我有邀請你過槌的時間 你也要來屏東看看我相信讓我們第一線的醫護人員有更大的一個力道你去年也支持這樣好不好好 謝謝 謝謝委員好 謝謝接下來請洪秀芳 洪委員來做詢問 |
| transcript.whisperx[629].start |
16700.972 |
| transcript.whisperx[629].end |
16720.738 |
| transcript.whisperx[629].text |
謝謝我們請部長跟食藥署署長食藥署 江署長方委員好部長好部長這個針對我們這幾天這個含有分譜尼的這個雞蛋流入市面那15萬顆的雞蛋那其中有追回就是3萬3萬顆那其他12萬顆 |
| transcript.whisperx[630].start |
16724.939 |
| transcript.whisperx[630].end |
16741.54 |
| transcript.whisperx[630].text |
就不知去向了 是不是是是是這樣子嗎那報告一下因為這次的我們抽的時候是27號抽是6號抽抽的時候呢27號那一批呢實際上是10月3號跟8號跟10號進去水洗場洗的 |
| transcript.whisperx[631].start |
16742.84 |
| transcript.whisperx[631].end |
16761.106 |
| transcript.whisperx[631].text |
所以我們知道台灣一天要有兩千萬顆的蛋那這樣的抽的量抽中之後我們去把它封住那時間點的話我們的確在11月4號知道之後呢針對那一批其實是就已經下了那有一部分的確是有點困難 |
| transcript.whisperx[632].start |
16762.026 |
| transcript.whisperx[632].end |
16777.557 |
| transcript.whisperx[632].text |
所以我們部長以及各位委員其實先前有給我們一些建議跟支持跟檢討我們會針對如何在非常精準的跟最快速的時間讓國人能夠知道哪一個是標的而做更快速的因應 |
| transcript.whisperx[633].start |
16778.377 |
| transcript.whisperx[633].end |
16789.424 |
| transcript.whisperx[633].text |
這是我們可以努力的地方 謝謝那個署長我今天要針對就是說這個含有分譜尼的這個雞蛋那你知道說彰化這邊全台灣兩顆雞蛋有一顆是來自彰化所以彰化蛋基農對於署長這個 |
| transcript.whisperx[634].start |
16799.151 |
| transcript.whisperx[634].end |
16815.477 |
| transcript.whisperx[634].text |
這個昨天講的還是昨天講的就是說你如果覺得有疑慮的話就不要吃雞蛋這個讓所有的蛋農覺得很不可思議你怎麼會講這種話是不是我跟委員澄清一下我說應該是更精準我們那個I47那個廠 |
| transcript.whisperx[635].start |
16817.558 |
| transcript.whisperx[635].end |
16832.548 |
| transcript.whisperx[635].text |
不是說所有的雞蛋都不吃是I47那個廠都不要吃你有這樣說嗎我那時候其實在公佈的時候把I47我可能講得比較不夠精準了這部分我會虛心的修正所以我給你時間你再澄清一下因為原本今天有一些 |
| transcript.whisperx[636].start |
16833.328 |
| transcript.whisperx[636].end |
16847.252 |
| transcript.whisperx[636].text |
但那個蛋積農他們想要能夠當面跟署長講個話那也希望說署長能夠透過媒體然後你再澄清一下因為確實這兩天的這個蛋價因為這個含有分譜尼的這個雞蛋的問題那這個蛋價其實都有一些波動那都影響到這些蛋積農他們的那個生產出來的蛋這個雞蛋其實要賣他也很怕說賣不多少不然就是幫忙 |
| transcript.whisperx[637].start |
16863.197 |
| transcript.whisperx[637].end |
16877.206 |
| transcript.whisperx[637].text |
所以我是不是再給你給署長一個時間你澄清一下我相信這應該是一個個案因為所有的淡金農他們會覺得說這個應該是只有個案原本還有分譜你不應該出現所以是這樣的話應該就是個案他們 |
| transcript.whisperx[638].start |
16886.113 |
| transcript.whisperx[638].end |
16907.033 |
| transcript.whisperx[638].text |
蛋積協會他們也很自治也希望說所有的會員就是要按照這樣子不可以有不該出現的這個藥變成說雞蛋裡面含有這樣的藥所以他們認為說這應該是一個個案那當然就是說未來我們食藥署這邊應該也要再加強力道不論是洗血 |
| transcript.whisperx[639].start |
16908.154 |
| transcript.whisperx[639].end |
16932.4 |
| transcript.whisperx[639].text |
這個洗選的這個蛋有裝盒然後在超市賣的因為上面都有編號這個都可以溯源那另外可能在傳統市場的傳統市場它一箱一箱的一箱一箱在賣那這個一箱一箱它上面也會有一個也會有編號也可以溯源所以我是不是可以請署長你在這邊再次的聲明 |
| transcript.whisperx[640].start |
16935.421 |
| transcript.whisperx[640].end |
16949.899 |
| transcript.whisperx[640].text |
他們很害怕 你又說你有疑慮不要吃這個對所有的淡基農影響很大謝謝委員這樣讓我有機會能夠更針對這件事情讓所有國人以及基農能夠清楚的了解 |
| transcript.whisperx[641].start |
16950.9 |
| transcript.whisperx[641].end |
16977.11 |
| transcript.whisperx[641].text |
其實我們在107年到現在的茶茶其實歷來都是標準的 沒有違規的其實有4382次的茶茶直到這一次有所以我們台灣的雞蛋是絕對相當相當的安全雞農是在非常潔身之愛的追尋農政單位的一些輔導做很好的管制所以蛋是絕對的安全 |
| transcript.whisperx[642].start |
16977.89 |
| transcript.whisperx[642].end |
17001.121 |
| transcript.whisperx[642].text |
那這一個個案目前查查的情形的確是個人的一個機場的業者的行為跟整體的來講是沒有關係的我相信我們查起來過去都是100分的 100%的這次因為它變成99.8分但是這0.2%的我們也是要持續的去修正跟持續的支持 |
| transcript.whisperx[643].start |
17001.681 |
| transcript.whisperx[643].end |
17023.82 |
| transcript.whisperx[643].text |
那我這邊跟全國的養雞的蛋農我每一天都有吃兩顆水煮蛋超過全國的這一定是超過全國的那我也不會對於這個吃這個雞蛋裡面會有什麼疑慮的地方因為大家的努力其實是看得到的後市場的雞茶食藥署這邊在努力我們持續的查查 |
| transcript.whisperx[644].start |
17024.48 |
| transcript.whisperx[644].end |
17042.331 |
| transcript.whisperx[644].text |
我們的力度我們會持續的監測如部長所提的我們查到哪裡有什麼發現異常的一定能夠去在最早的時間內我們能夠讓國人知道但是目前沒有其他的任何的異常請大家安心放心的持續的吃我們的雞蛋謝謝 |
| transcript.whisperx[645].start |
17044.253 |
| transcript.whisperx[645].end |
17060.909 |
| transcript.whisperx[645].text |
跟委員我補充一下就是說目前這個養雞場所有在市面上的蛋都已經下架然後它的蛋也都不准再進入到市場所以換句話說現在在市面上的蛋都是安全的請大家安心食用 |
| transcript.whisperx[646].start |
17062.39 |
| transcript.whisperx[646].end |
17088.205 |
| transcript.whisperx[646].text |
那原本這些蛋基農他們希望能夠今天來這邊然後能夠希望署長這邊可以再度的澄清因為這幾天的這個蛋價其實也會因為署長講的一句話然後就是會這個蛋的價格會有一些波動那這確實都影響很大就是說我們所有的行政官員講的每一句話其實都會影響到 |
| transcript.whisperx[647].start |
17090.527 |
| transcript.whisperx[647].end |
17113.315 |
| transcript.whisperx[647].text |
也許是無心也許我們覺得說這樣子回應應該是還蠻正常可是聽者有意所以我今天給時間給署長也希望就是說後續如果你要講話真的要非常小心因為這個也許會傷了某一群人接下來我想請教就是說署長不論前一陣子的黑心的豬場 |
| transcript.whisperx[648].start |
17115.676 |
| transcript.whisperx[648].end |
17142.988 |
| transcript.whisperx[648].text |
到現在的我們的這個雞蛋的問題那我希望就是說未來因為這個食安是大家最重視的因為大家要吃的東西那這個尤其是雞蛋幾乎每一天都會吃得到就是幾乎三餐都會有所以我希望就是說署長針對這一部分一方面就是說你說在過去你們都有一些茶廠 |
| transcript.whisperx[649].start |
17144.75 |
| transcript.whisperx[649].end |
17159.811 |
| transcript.whisperx[649].text |
不是茶茶厂我们是后市场厂的部分是农业部的是市场的茶叶我们希望就是说未来针对这一部分还有需要加强的地方另外就是说像猪大厂猪大厂的那个部分 |
| transcript.whisperx[650].start |
17161.132 |
| transcript.whisperx[650].end |
17185.062 |
| transcript.whisperx[650].text |
這個也是幾乎每個人都會吃得到的那如果說大家會覺得說這個東西讓大家吃得不安心或者是會有疑慮我覺得說我們在食藥署在最前端你應該就要很嚴格的去把關那另外就是說那為什麼這樣的藥這種東西為什麼會進入到可以進入到去洗大腸 |
| transcript.whisperx[651].start |
17188.423 |
| transcript.whisperx[651].end |
17214.365 |
| transcript.whisperx[651].text |
為什麼可以進到這樣的一個場所進去這個不是可以吃的東西那為什麼可以進到這個可以去洗我覺得這個就很奇怪了這跟委員做進一步說明也針對這事情我們前天才在跨部會環境部 農業部跟我們的衛福部我們剛好會議底下有做討論因為食安的部分其實是環安 農安才會有食安在食藥署 衛福部整個的 |
| transcript.whisperx[652].start |
17215.366 |
| transcript.whisperx[652].end |
17236.672 |
| transcript.whisperx[652].text |
監管的向下我們一定後市場端用最快時間最快速度如果任何異常我們一定會最快速度讓國人知道然後用最快速度去追查它的原因來源像這一次在黑心所謂的黑心的主場其實它是用工業用的雙氧水雙氧水代謝之後其實是水分其實就 |
| transcript.whisperx[653].start |
17237.512 |
| transcript.whisperx[653].end |
17262.403 |
| transcript.whisperx[653].text |
它會洗過之後 只是它不應該是用工業用的它本身雙氧水是一個殺菌機那它怎麼可以流入到食品就是因為這個部分我們也跨部會之後經濟部也同意能夠進入化學院關注的一些化學物質我們勾結它的查查因為過去沒有把這個因為雙氧水其實並不是那麼高毒性的化學物質 |
| transcript.whisperx[654].start |
17263.443 |
| transcript.whisperx[654].end |
17290.843 |
| transcript.whisperx[654].text |
可是不行就是不行啊不是毒性的化学物质所以没有被勾击到所以我们这一次呢既然有这样的行为我们加速把它勾击进去那也已经达成共识了这边跟委员做报告我想这部分我们会更积极的去随时也观测关注有什么样子的化学物质是我们值得去进一步的去了解去把它勾击的那我们在后市场端以及我们的相关的非追的系统里面呢也才能够在不同的 |
| transcript.whisperx[655].start |
17291.583 |
| transcript.whisperx[655].end |
17319.314 |
| transcript.whisperx[655].text |
資料庫裡面能夠查到這樣的異常特別是針對我們看到的這個所謂的食品加工場面有異常的這種所謂的工業用的雙氧水的進出的能夠快速能夠攔截住能夠有一個警訊這是我們持續會努力的地方謝謝委員我希望就是說有這樣的發生事情那後續怎麼再去把它補漏洞這不行的 不可以的 |
| transcript.whisperx[656].start |
17319.794 |
| transcript.whisperx[656].end |
17339.344 |
| transcript.whisperx[656].text |
就是不能進到食品廠所以我覺得說也感謝衛福部我們食藥署然後我覺得這個都有一些連帶的關係不論是衛福部然後農業部其實我們都要一起合作甚至環境部都是要一起合作要不然你看這個分譜你會進到 |
| transcript.whisperx[657].start |
17340.484 |
| transcript.whisperx[657].end |
17364.255 |
| transcript.whisperx[657].text |
就是會進到這個蛋機廠其實我覺得這個應該不論是農業部 然後環境部然後我們的這個衛福部其實我們應該都要在一個跨部會的怎麼樣不可以的重要就是不能進到食品廠不能進到這樣的一個畜牧場裡面去 是 |
| transcript.whisperx[658].start |
17366.415 |
| transcript.whisperx[658].end |
17391.963 |
| transcript.whisperx[658].text |
我們會強化那個跨部會之間的合作其實我們都經常這三個部會我們有一個聯繫會議我再次的講因為今天原本這個蛋雞協會他們希望我帶他們來跟署長見個面我想說應該不用那就透過剛剛署長也有做一個澄清那真的確實要講話真的也要很細節因為有時候會傷了另外一群人好 謝謝最近我們一定會多吃蛋 |
| transcript.whisperx[659].start |
17399.197 |
| transcript.whisperx[659].end |
17416.244 |
| transcript.whisperx[659].text |
那個已經1點20幾分了 各位可以先用餐好不好可以一般用餐邊出來 接下來請楊瓊英委員謝謝主席 楊瓊英發言 邀請部長來 請部長楊委員好 |
| transcript.whisperx[660].start |
17424.639 |
| transcript.whisperx[660].end |
17449.227 |
| transcript.whisperx[660].text |
部長好 我們在討論這個癌症長年是國人的十大死因之首我們也做了一個統計每一年超過五萬條寶貴的生命所以政府也推出了癌症心藥基金協助需要心藥的人經過了尤其是經濟較困難的人縮小他治療的一個落差 |
| transcript.whisperx[661].start |
17450.327 |
| transcript.whisperx[661].end |
17468.373 |
| transcript.whisperx[661].text |
總統先生也提出在2030年的時候希望達成癌症標準化死亡率降低三分之一的願景所以我們行政院今年也編列了新藥的癌症基金的部分癌藥基金的部分是50億 |
| transcript.whisperx[662].start |
17469.853 |
| transcript.whisperx[662].end |
17498.027 |
| transcript.whisperx[662].text |
但我們看到根據了台灣癌症基金會他所做的公佈今年度我們新藥基金專款的部分呢支用了23.58億元那總共大概有將近3351個家庭受惠所以換句話說平均大概一個人大概將近120萬左右的治療負擔不過在執行率我們目前看到不及五成 |
| transcript.whisperx[663].start |
17499.708 |
| transcript.whisperx[663].end |
17515.745 |
| transcript.whisperx[663].text |
有不少的病友我覺得既然有這樣子能夠讓大家身體可以往健康的方向去執行為什麼會如此原來有很多的病友以及他的家人說了他說你這個基金第一個 是不是會長遠 |
| transcript.whisperx[664].start |
17518.708 |
| transcript.whisperx[664].end |
17544.147 |
| transcript.whisperx[664].text |
這個藥會不會也是長遠他很深怕我用了之後我只有一年因為這個要長期來保養長期來保養那身體健康是我們國家這個很重要的一個責任所以本席要請教有了錢但是我們的執行率不到五成那中間到底是為什麼擔憂治療可能中斷 |
| transcript.whisperx[665].start |
17545.528 |
| transcript.whisperx[665].end |
17564.711 |
| transcript.whisperx[665].text |
本席在看待這個數字的時候我發覺很多的家屬以及病人本身他提出了這一段所以這個因子讓他們身具恐懼所以本席要請教心藥基金會不會長期的運作那癌症基金法治化 |
| transcript.whisperx[666].start |
17565.752 |
| transcript.whisperx[666].end |
17590.937 |
| transcript.whisperx[666].text |
应该要如何的来做请做说明谢谢委员关心到癌友的权益治疗这个很重要所以我借这个机会说明今年我们刚开始有专款专用这个50亿是不会留到别的地方专门专款用在癌症新药但是因为第一年开始执行它前面要有评估才纳入几副纳入这个基金来几副但是呢 |
| transcript.whisperx[667].start |
17592.857 |
| transcript.whisperx[667].end |
17614.624 |
| transcript.whisperx[667].text |
我們通過之後發布之後醫院還要採購 進藥所以它時間就會往後延而且這個藥不是像我們今年一共有10個藥它也不是一次10個藥宣布它也是一個月一個月一個月來所以它的第一年的執行的時候會發生這個情況但是今年已經通過的這10個藥明年它一定是繼續給付 |
| transcript.whisperx[668].start |
17615.504 |
| transcript.whisperx[668].end |
17631.384 |
| transcript.whisperx[668].text |
所以換句話說剛剛本席第一個提問新藥基金會長期運作是不是如此本席要問的是也是癌症病人家人他怕會中斷最重要的根基應該是說我們這個基金一定會長期運作只不過這個藥呢 |
| transcript.whisperx[669].start |
17633.647 |
| transcript.whisperx[669].end |
17651.949 |
| transcript.whisperx[669].text |
這個放在這個基金裡面大概我們的設計是兩三年的時間會收集這個臨床使用的結果跟他的效果怎麼樣然後就會評估完之後有效的我們就納入到健保的幾戶常態區然後再採納新的進來所以他是變成是一個活水 |
| transcript.whisperx[670].start |
17653.21 |
| transcript.whisperx[670].end |
17678.508 |
| transcript.whisperx[670].text |
你这个活水就是本席所解读您的回答也就是新药基金本席具体要求必须要长期的来运作让我们癌症的病人跟家属不用怕会中断的这个议题除非是评估没有效当然当然没有效人家也不会去用对对对所以癌症基金法之化这是必要的 |
| transcript.whisperx[671].start |
17679.662 |
| transcript.whisperx[671].end |
17696.894 |
| transcript.whisperx[671].text |
事实上我们现在已经让他有法源了我们去修订了全民健康保险基金的收支保管及运用办法所以他已经有一个法源让他专款专用不会挪出其他的地方但是您说的你是以暂时性的支付基金 |
| transcript.whisperx[672].start |
17698.415 |
| transcript.whisperx[672].end |
17720.34 |
| transcript.whisperx[672].text |
所以民眾還是會有質疑沒有 跟委員報告所以要給民眾說明清楚暫時的意思是說在這個基金裡面暫時未來它會回到健保裡面去在這個基金不可能永久所以藉這個機會也給社會大眾說明清楚我們關心的是讓民眾能夠好好的能夠健康 治療過程可以有效用了有效就會一定讓他用 |
| transcript.whisperx[673].start |
17720.6 |
| transcript.whisperx[673].end |
17747.358 |
| transcript.whisperx[673].text |
用了有效所以在心藥基金會長期的運作那兩三年滾動式檢討有效的會回到健保去做給付所以只要是有效一定會讓病人繼續用接下來本席要請教癌篩的問題因為我在總諮詢的時候也跟院長也討論過因為我們知道經費我們從去年的28億癌篩的部分提高今年是68億到10月底 |
| transcript.whisperx[674].start |
17747.958 |
| transcript.whisperx[674].end |
17769.311 |
| transcript.whisperx[674].text |
本席給你做了一個統計癌篩的部分是400萬人次所以本席特別關心的也就是攝護腺癌的問題因為我們看到攝護腺癌已經進入到第六癌而且它2024年的攝護腺癌它新增加快要1萬人同時是男性第三大癌症 |
| transcript.whisperx[675].start |
17770.441 |
| transcript.whisperx[675].end |
17786.537 |
| transcript.whisperx[675].text |
那這樣的情況更是發生率比例是最高的所以早期來篩他是早期治療是都可以得到幾乎可以痊癒的那這個是保護人民最重要的一個根源 |
| transcript.whisperx[676].start |
17787.418 |
| transcript.whisperx[676].end |
17804.327 |
| transcript.whisperx[676].text |
那所以將發生率跟死亡率都是最高的來納入篩檢它絕對是有必要性的所以本席要請教你是不是同意納入因為在總質詢的時候院長也認為這個必要這個必要發生率死亡率都是比例最高沒有理由不納入請教 |
| transcript.whisperx[677].start |
17805.067 |
| transcript.whisperx[677].end |
17818.323 |
| transcript.whisperx[677].text |
跟委員報告這個攝護腺癌隨著我們國人的年齡的延長這個發生率會越來越高所以一定要有一個國家的防治政策所以早期治療早期發現早期治療要治療你要先篩啊早期發現早期治療絕對是這樣沒有錯只是說怎麼樣的篩法 |
| transcript.whisperx[678].start |
17825.451 |
| transcript.whisperx[678].end |
17846.017 |
| transcript.whisperx[678].text |
這個我們需要有學者大家你多多時間要告訴本席因為本席在我們地方我很感謝善心人士他們願意出點錢然後到我們的社區來篩那個數字讓我會嚇到以80個人來篩20幾個中標這個我們真的很緊張所以你不管你什麼方式你可以篩納入將攝護腺癌這個篩檢納入公費 |
| transcript.whisperx[679].start |
17850.339 |
| transcript.whisperx[679].end |
17872.875 |
| transcript.whisperx[679].text |
請問什麼時候會公佈跟委員報告 如果用傳統就是用PSA它的那個偽陽性蠻高的所以我們現在正在研究大概半年就會有一個結果報告出來說接下來我們這個對於攝護線來的防治應該怎麼做如果要篩 要怎麼篩法好 所以等於是在明年的3月份左右你可以告訴我們現在原則同意納入公費來篩 |
| transcript.whisperx[680].start |
17876.336 |
| transcript.whisperx[680].end |
17885.408 |
| transcript.whisperx[680].text |
怎麼篩方法你們去原則上同一本席的建議發生率最高死亡率最高我們應該是要將攝護腺癌篩檢納入供費 |
| transcript.whisperx[681].start |
17891.796 |
| transcript.whisperx[681].end |
17911.499 |
| transcript.whisperx[681].text |
那至於方式由你們明年大概三四月份來給社會大眾說明清楚同意納入公費的篩檢是不是我們有個委託研究計畫在進行是 那你現在部長你的方向就是同意將男性的這個攝護腺癌的篩檢列入重要的篩檢列入公費來篩檢 |
| transcript.whisperx[682].start |
17912.76 |
| transcript.whisperx[682].end |
17938.895 |
| transcript.whisperx[682].text |
我們認同要有篩檢這個政策出來但是怎麼篩我們要有科學證據認同要篩就是納入公會來篩委員過去也很關心肺癌篩檢Low dose CT的肺癌篩檢也是先經過研究計畫非常好本期再強調一次男性的攝護腺癌篩檢我們方向一致納入公會的篩檢至於方法 |
| transcript.whisperx[683].start |
17939.375 |
| transcript.whisperx[683].end |
17955.503 |
| transcript.whisperx[683].text |
要怎麼篩 明年三四月你跟社會大眾說明清楚這樣方法我要謝謝你我們一定要這麼去執行那接下來本期要請教你健保開源這現在你要傷腦筋去做的但是你突然來一個預告從這個 |
| transcript.whisperx[684].start |
17959.931 |
| transcript.whisperx[684].end |
17968.329 |
| transcript.whisperx[684].text |
這個單比你把它列為所有不管房租啦不管你買賣股票什麼的累進兩萬你就要把人家增2.1% |
| transcript.whisperx[685].start |
17970.482 |
| transcript.whisperx[685].end |
17992.807 |
| transcript.whisperx[685].text |
這個炸鍋 這是誰這麼天才有沒有跨部會去討論因為卓院長說他不知道預告金管會我就問他 他也說他不知道那到底是怎麼冒出來的那將近500萬人的中小的小資族的一個權益誰這麼天才冒出這個 |
| transcript.whisperx[686].start |
17995.286 |
| transcript.whisperx[686].end |
18009.674 |
| transcript.whisperx[686].text |
跟委員說明為了讓這個健保的財務可以永續然後大家的付費更公平我們健保一直都在討論各種不同的商案請你針對本席的提問是誰去想到這個預告而且沒有跨部會沒有預告沒有預告有沒有跨部會去討論 |
| transcript.whisperx[687].start |
18013.436 |
| transcript.whisperx[687].end |
18031.209 |
| transcript.whisperx[687].text |
我们都是还在进行程序在讨论当中学者专家给我们意见都在讨论这个只是所有的方案之一你这样讨论人家社会大众都已经知道了引起社会的哗然不可以如此这个过程当中你现在暂缓你什么时候要动 |
| transcript.whisperx[688].start |
18032.349 |
| transcript.whisperx[688].end |
18052.817 |
| transcript.whisperx[688].text |
你現在所謂的暫緩是什麼意思不是不是我們健保的財務改革一直持續在討論當然要持續改革你的新的規劃方案你也要去提出嘛那就針對這個累進的兩萬元不管你房租不管你什麼一年你只要利息什麼都只要兩萬那還會不會動沒有沒有這個沒有定案你現在只是暫緩喔他會不會動不是是取消還是暫緩沒有沒有定案根本連定案都還沒有我很感謝我聽到這個訊息讓社會大眾知道 |
| transcript.whisperx[689].start |
18061.86 |
| transcript.whisperx[689].end |
18085.897 |
| transcript.whisperx[689].text |
是根本沒有定案所以沒有暫緩的問題嘛是不是因為本席之所以願意讓你講也就是讓社會大眾不要恐慌小資族現在通盤這麼嚴重你來一個將近500萬人的小資族這個嚴肅的議題這是本席絕對不同意的好不好所以一個結論根本沒有這個議案沒有沒有 沒有這個議案所以也沒有暫緩的問題嘛好 謝謝 |
| transcript.whisperx[690].start |
18090.308 |
| transcript.whisperx[690].end |
18115.814 |
| transcript.whisperx[690].text |
謝謝楊瓊英委員接下來請楊耀委員發言謝謝主席主席我先請一下江署長請江署長署長好署長在台灣呢就是 |
| transcript.whisperx[691].start |
18116.994 |
| transcript.whisperx[691].end |
18143.981 |
| transcript.whisperx[691].text |
有的時候不能太專業發言太專業的發言有的時候會引起很大的風波我其實是還蠻支持專業的就是讓很多事情讓社會大眾知道而台灣就是一個很奇怪的社會就是你把真實的事情說出去以後 |
| transcript.whisperx[692].start |
18145.861 |
| transcript.whisperx[692].end |
18170.261 |
| transcript.whisperx[692].text |
你就會變成劍靶所以有關分埔泥的殘留的部分我還是還是有幾個問題想要請教一下署長就按照過往的標準作業流程假如抽抽檢發現市售的食品不符食安規定的時候第一時間你們應變措施是什麼委員說明因為 |
| transcript.whisperx[693].start |
18175.185 |
| transcript.whisperx[693].end |
18201.686 |
| transcript.whisperx[693].text |
我們抽檢是常態抽檢常態抽檢其實樣態非常非常多從我們的食品從我們的飲食的餐廳 場所 市場等等GHP或者是我們所謂的工廠的節點符合的以及說保健食品保健相關食品 健康食品的這些廠的茶廠所以它的茶茶其實非常多元而且是連續性的 |
| transcript.whisperx[694].start |
18203.103 |
| transcript.whisperx[694].end |
18230.777 |
| transcript.whisperx[694].text |
那對於多元連續性下呢我們其實會有常態的監測監測裡面呢如果沒有什麼特別的大的明顯的變動我們其實是每個禮拜固定在禮拜二的時候比如說邊境進來的我們其實會公告讓國人能夠知道因為這個訊息是透明的那這樣子的透明其實是要讓它的風險讓國人知道那持續的對於邊境的來去做查查 |
| transcript.whisperx[695].start |
18231.817 |
| transcript.whisperx[695].end |
18256.779 |
| transcript.whisperx[695].text |
那國內的話 針對這一次的我們提到的這個雞蛋的計畫其實它計畫的全名稱其實叫做114年度禽畜水產品藥物殘留監測計畫那這個計畫也不是今年才開始這個計畫在107年就開始那就是執行好幾年了對 已經持續有每年大概平均是500例到800例 |
| transcript.whisperx[696].start |
18259.521 |
| transcript.whisperx[696].end |
18265.465 |
| transcript.whisperx[696].text |
執行到目前為止是有4282例那這4282例裡面呢所以包含了農藥的監測裡面其實一個檢體其實委託出去要4000多塊來檢驗所以檢驗的持續為了去監測裡面的含量 |
| transcript.whisperx[697].start |
18277.213 |
| transcript.whisperx[697].end |
18297.963 |
| transcript.whisperx[697].text |
那中間過程中其實就包含分譜尼的監測因為分譜尼的雞蛋其實過去在106年的時候2017年的時候有特別有這樣的事件之後去家鄉查查也把它列管之後所以對於蛋的部分其實是在環安 農安之後的食安食安的部分是在最後的 |
| transcript.whisperx[698].start |
18299.443 |
| transcript.whisperx[698].end |
18323.914 |
| transcript.whisperx[698].text |
其實蛋的話是進入席選場之後就歸食藥署做監測之前其實是農業部在協助做一些監測最這樣子的一個前提之下我們在4282次之後我們看到的這一次其實在這一次的檢查過程中非常感謝彰化縣衛生局尤其葉彥博業局長非常機敏的針對這個高度敏感的一個議題 |
| transcript.whisperx[699].start |
18325.094 |
| transcript.whisperx[699].end |
18338.84 |
| transcript.whisperx[699].text |
在10月27號常態的檢驗送出去它其實要寄去寄到屏東的中央續產所去驗那驗的時候呢剛好遇到假日所以驗的時間排成就到驗出來所以當 |
| transcript.whisperx[700].start |
18340.396 |
| transcript.whisperx[700].end |
18367.954 |
| transcript.whisperx[700].text |
接受檢驗接到檢體的時候其實也簽合約所以之前委員有特別提到檢驗時間需要多少時間的確是我們有檢驗時間在兩天內要把它驗出來那他們也的確是在這樣兩天只是剛好寄出去假日等等的剛好是10月27號採11月4號其實驗到了那驗到之後呢4號驗到中央續產所因為我們長期是中央的計畫請他們驗驗來其實是到食藥署來 |
| transcript.whisperx[701].start |
18370.416 |
| transcript.whisperx[701].end |
18377.084 |
| transcript.whisperx[701].text |
所以食藥署10月4號看到這個報告之後也就是我旁邊的我們續陽的主任 中區的主任 |
| transcript.whisperx[702].start |
18378.57 |
| transcript.whisperx[702].end |
18403.465 |
| transcript.whisperx[702].text |
馬上同仁把這樣的訊息告訴了我們的彰化縣衛生局彰化縣衛生局其實用最快速的速度當天就要求我們10號要求他們做所謂的下架能夠回收那5號的上午的時候我們就通報了三部會的剛剛有跟委員號這邊提到三部會裡面包含我們的環境部農業部跟 |
| transcript.whisperx[703].start |
18405.486 |
| transcript.whisperx[703].end |
18422.133 |
| transcript.whisperx[703].text |
衛福部所謂的環境保護與食品安全通報及應變的流程通報的農業部 跨部會農業部 環境部跟食安辦這一次會那麼快的去後續的其實是在食安辦整個中央部會 跨部會 明察 暗訪 |
| transcript.whisperx[704].start |
18423.874 |
| transcript.whisperx[704].end |
18440.054 |
| transcript.whisperx[704].text |
請所謂的檢調系統介入之後才進去把機場看了一遍 把蛋也取了把裡面的羽毛也取了 所以環境也取了所以才能夠確立在我們的11月的11號 |
| transcript.whisperx[705].start |
18443.601 |
| transcript.whisperx[705].end |
18462.571 |
| transcript.whisperx[705].text |
的傍晚就確立了診斷診斷是來自於雞的羽毛上游雞的羽毛上游其實跟環境跟飼料就沒有關係的其實就是來自於那是噴灑在身上的所以這是個人的行為那我們剛才提到的因為這麼大量的長期的監測之下只有這個案例我們比較高度 |
| transcript.whisperx[706].start |
18463.231 |
| transcript.whisperx[706].end |
18487.628 |
| transcript.whisperx[706].text |
的確之前委員有特別提醒我們要注意也很難去把它說是百分之百說一定是沒有問題但是從監測的一個角度來講的確是這樣那我們消暑這邊針對的監測的計畫等等我們也會增加我們的監測的量能持續來去做高度的監測 以上辛苦了 那剛剛署長大概做了很詳細的 |
| transcript.whisperx[707].start |
18488.929 |
| transcript.whisperx[707].end |
18503.414 |
| transcript.whisperx[707].text |
的一個說明食品安全的把關確實是跟國人是最相近的因為食品每天都在用所以我剛剛開頭也講了就是怎麼 |
| transcript.whisperx[708].start |
18504.753 |
| transcript.whisperx[708].end |
18523.451 |
| transcript.whisperx[708].text |
署長的專業是絕對沒有問題那我也覺得像我個人的立場我也覺得把真實的情況告知國人這個你沒有責任只是說台灣現在就是有的時候資訊太發達了所以很多東西會 |
| transcript.whisperx[709].start |
18525.232 |
| transcript.whisperx[709].end |
18536.902 |
| transcript.whisperx[709].text |
會比較容易被做大 這個部分可能以後可能我也不知道要建議你小心一點還是怎麼樣我也不知道好 謝謝署長 請教部長 |
| transcript.whisperx[710].start |
18542.918 |
| transcript.whisperx[710].end |
18556.255 |
| transcript.whisperx[710].text |
梁委員好部長我看來今天是沒有辦法討論到新藥了因為新藥的部分就是新藥的部分就是 |
| transcript.whisperx[711].start |
18558.125 |
| transcript.whisperx[711].end |
18587.088 |
| transcript.whisperx[711].text |
癌症新藥的基金你們為什麼那麼抗拒不想設置我們不是抗拒跟委員報告我們很想所以才會很快的去爭取到那個專款放在這個健保基金裡面的專款專用只不過是因為財政基金法我們要新成立一個基金法治上有一些問題要新成立一個基金一定要有因為我手頭上其實是有去年你們回覆郭建國委員 |
| transcript.whisperx[712].start |
18588.368 |
| transcript.whisperx[712].end |
18609.338 |
| transcript.whisperx[712].text |
的書面資料可能後來總統就宣誓了所以希望你們還是要去克服法治上的困難因為現在的癌症的死亡率確實是太高了還有一點就是 |
| transcript.whisperx[713].start |
18610.743 |
| transcript.whisperx[713].end |
18636.573 |
| transcript.whisperx[713].text |
還有一點就是我們現在每年都是用公務預算對不對公務預算撥補那癌症的新藥用公務預算撥補然後醫生的點子保障公務預算撥補對不對然後保費的增加連討論都不准討論是不是這樣子 |
| transcript.whisperx[714].start |
18641.515 |
| transcript.whisperx[714].end |
18669.262 |
| transcript.whisperx[714].text |
這個跟我們健保的原始設計的精神並非如此完全跟已經完全脫離了保險的概念就是說我不知道為什麼就是很為什麼大家會願意再讓健保的坑越來越大然後產生另外一個像勞保這樣子沒有辦法解決的問題 |
| transcript.whisperx[715].start |
18670.822 |
| transcript.whisperx[715].end |
18694.735 |
| transcript.whisperx[715].text |
像我個人我向來是主張就是在保險的理論架構裡面來處理健保的問題就是所以我也在這邊講過嘛就是典值保障我也是反對的公務撥補我也是反對的我覺得應該是要先窮盡所有的收支 |
| transcript.whisperx[716].start |
18697.944 |
| transcript.whisperx[716].end |
18721.861 |
| transcript.whisperx[716].text |
所有的收支可以解決的方法以後才來動用其他脫離保險以外的問題那現在我們不是我們就明明保險費率一般保險費率也還沒有到法定上限然後也不討論然後補充保費不准討論然後新藥預算要增加 |
| transcript.whisperx[717].start |
18723.018 |
| transcript.whisperx[717].end |
18750.634 |
| transcript.whisperx[717].text |
公務預算撥補那醫生的點子要保障公務預算撥補我覺得過不了幾年啦過不了幾年我覺得健保的洞就會跟勞保一樣那麼大我們找其他的時間再做討論謝謝我完全認同委員的看法應該要重啟我們的現有機制去檢討盡量的讓財務健全 |
| transcript.whisperx[718].start |
18752.575 |
| transcript.whisperx[718].end |
18774.222 |
| transcript.whisperx[718].text |
那這個政府的撥補不是長遠但是呢政府的責任也應該隨著我們人口的結構的改變兼顧到世代之間的公平來做這個挹注的調整政府責任的調整應該也是要有啦我們會多努力從各方面各種的財源來思考還是有順序的問題啦還是有順序的問題好 謝謝部長 謝謝主席謝謝 謝謝委員 |
| transcript.whisperx[719].start |
18781.274 |
| transcript.whisperx[719].end |
18796.526 |
| transcript.whisperx[719].text |
好 接下來請林憲熙委員來做懸答對不起 徐靜穎委員徐靜穎委員不在請林委員來做懸答謝謝我們的主席劉昭偉我們請部長 謝謝 |
| transcript.whisperx[720].start |
18803.16 |
| transcript.whisperx[720].end |
18824.305 |
| transcript.whisperx[720].text |
林委員好部長您好本席今天還是要來跟您討論一下有關於健保補充保費你們在研擬的過程當中一些想法我相信這個議題有很多人關心因為上個禮拜這樣消息一出就讓大家好像爐洗三溫暖一樣 |
| transcript.whisperx[721].start |
18825.325 |
| transcript.whisperx[721].end |
18845.737 |
| transcript.whisperx[721].text |
那導致很多人反彈那可是剛才本席也聽了一下您回應幾位關心的這個委員的一個答詢那當然您跟楊烏委員這邊的一個答詢就是目前沒有定案所以也沒有所謂暫緩的問題那至少也把這個疑慮給釐清 |
| transcript.whisperx[722].start |
18849.18 |
| transcript.whisperx[722].end |
18865.697 |
| transcript.whisperx[722].text |
楊委員這邊也跟您做個提醒可是我覺得那個提醒是很重要的也就是現在的問題到底誰能夠有擔當來處理我們可能都知道可能解決的一個大的方向應該是如何可是還有很多的細節那就看誰願意真正去 |
| transcript.whisperx[723].start |
18866.678 |
| transcript.whisperx[723].end |
18884.045 |
| transcript.whisperx[723].text |
就問題本身去處理但是也有很多的考量所以本席這邊要做一個提醒也確定了說目前也在討論的過程當中但是卻是在消息一出那整個社會就會反彈那我想這個部分你們真的確實也必須要在 |
| transcript.whisperx[724].start |
18884.525 |
| transcript.whisperx[724].end |
18893.01 |
| transcript.whisperx[724].text |
未來的這個方案裡面做一個真正的很細緻的一個對應跟處理那所以本席這邊也是要談一下啦那重點當然就是原本你們從單筆的兩萬塊改成年度累計兩萬塊就要課2.1%那麼這個七個小時之內的這種政策三溫暖其實在我們施政來講是也不太健康啦但是呢 |
| transcript.whisperx[725].start |
18910.68 |
| transcript.whisperx[725].end |
18928.091 |
| transcript.whisperx[725].text |
可是後來又有很多政委還有相關的這個醫界的反應就說目前也不是真正的終止了它只是暫時的退場那日後也可能捲土重來所以剛剛楊委員這邊問了你們說對 還沒有定案所以目前沒有暫緩的問題但是本席要就這一次的事件來提醒一下部長 |
| transcript.whisperx[726].start |
18929.272 |
| transcript.whisperx[726].end |
18953.446 |
| transcript.whisperx[726].text |
我們都同意健保的財務需要穩定的來源所以剛才楊委員這邊其實也講得很好就是說他其實很支持健保的財源的穩定但是健保的意義是什麼或許在剛開始政策的一個處理上我們就有很多的現在必須要彌補的狀況但是這邊我要提醒的是說但是改革不能都找同一群人在開刀 |
| transcript.whisperx[727].start |
18955.387 |
| transcript.whisperx[727].end |
18981.849 |
| transcript.whisperx[727].text |
依照你們的估算應該如果改為雷勁制那目前會有將近500萬人受到影響那麼這群人很多都是定存族那就算有買股票那定存族他也是小資產階級中產階級他也不是股票的大戶也不是大富豪他們只是透過股票好好的儲蓄穩健理財然後來領取一些股息或依照利息來維持生活結果 |
| transcript.whisperx[728].start |
18983.55 |
| transcript.whisperx[728].end |
19009.857 |
| transcript.whisperx[728].text |
卻被視為被一再剋稅的裁員我想這是這群人或者是整個社會化來的很重要的原因那這樣一個政策訊號呢對社會的信任也產生了一些疑慮那麼也製造了一些新的不公平那本席舉例啦如果一個長輩辛苦的存了三百萬那一年利息只有五萬元結果你們採累計制又要跟他多那他補充健保費又要多繳一千元 |
| transcript.whisperx[729].start |
19011.457 |
| transcript.whisperx[729].end |
19037.262 |
| transcript.whisperx[729].text |
對 真的就靠穩定財務來源的小資族其實是很大的一個衝擊那麼這裡面很重要就是說那麼在股市或者是在這些我們的一般民眾在頻繁重大的一個交易賺取的巨額財富卻不在課徵的範圍內那導致讓你們撈了一堆小蝦米結果大鯨魚卻放過了 |
| transcript.whisperx[730].start |
19038.422 |
| transcript.whisperx[730].end |
19060.355 |
| transcript.whisperx[730].text |
我想這是大家對於感覺這整個過程當中你們瞌睡的這個族群是很不公平的所以形成了不公平中的不公平那股票大筆進出獲利者不但沒有被課徵補充保費結果呢 股票好好放在股市裡面收股息的人卻被你們這樣課徵我想這是很重要的一個問題 |
| transcript.whisperx[731].start |
19061.897 |
| transcript.whisperx[731].end |
19076.537 |
| transcript.whisperx[731].text |
雖然目前還沒有要進行但是我也不希望這樣子的一個考量未來再被繼續持續的這樣子課徵所以本席這邊想請教部長那你們在研擬補充保費改為年度累積課徵時那麼 |
| transcript.whisperx[732].start |
19079.58 |
| transcript.whisperx[732].end |
19104.51 |
| transcript.whisperx[732].text |
門檻傾向定在多少作為未來的改革方向這是第一個第二個是健保的財務應該考慮更公平的方式是不是以實際醫療使用量或者是所得的階層為基準或回歸制度面重新檢討基本費率與稅收的撥補機制而不是針對中產階級或固定收入的族群來開刀 |
| transcript.whisperx[733].start |
19105.951 |
| transcript.whisperx[733].end |
19133.745 |
| transcript.whisperx[733].text |
所以民眾都可以體諒我們醫療的困境也願意支持健保的永續但重點是公平跟信任所以每一次透過補充保費的撥補對政策鎖定的族群都是一種考驗剛才我們楊委員也講了他認為撥補也有一些缺失但是這群人也不是逃稅的富豪也不是高所得的菁英可是政策經常在鎖定最穩定的這一群人你想這樣子我們一般聽起來 |
| transcript.whisperx[734].start |
19134.645 |
| transcript.whisperx[734].end |
19155.557 |
| transcript.whisperx[734].text |
就感覺你們的改革很像都在削弱全民健保最珍貴的一個社會共識所以本席這邊建議啦除了剛才的這個問題你們如果有相關的答案給本席一個比較詳盡的一個回應但是本席的建議就是說健保的財務永續要以健保費來著手回歸制度面而不是挖東牆補西牆不過這就要看 |
| transcript.whisperx[735].start |
19158.999 |
| transcript.whisperx[735].end |
19181.716 |
| transcript.whisperx[735].text |
你們的魄力了那第二個部分是在任何修法或調整前是不是可以也先去評估一下民意的取向也做一些比較深度或廣度的諮詢不會像這樣子7小時的政策災難對很多人如果心臟沒有很強的話他可能真的是做直升機這樣子這實在不是一個很好的施政作為 |
| transcript.whisperx[736].start |
19182.637 |
| transcript.whisperx[736].end |
19205.454 |
| transcript.whisperx[736].text |
那最後一個就是我們可不可以嚴厲更進步的風險導向的費率結構比如說考量某一些人吸菸的或者是檳榔使用的一些高風險的族群那讓醫療的這個使用率可以依照這樣子風險族群來合理的分擔那這是本席幾個問題跟建議那部長您的看法 |
| transcript.whisperx[737].start |
19206.355 |
| transcript.whisperx[737].end |
19225.151 |
| transcript.whisperx[737].text |
謝謝委員的提醒剛剛所有的建議都會納入我們在未來討論整個健保的財務改革裡面也都會去進行討論跟評估這一次這個不是一個既定的政策只是在很多的討論當中的一小塊因為在 |
| transcript.whisperx[738].start |
19226.212 |
| transcript.whisperx[738].end |
19243.239 |
| transcript.whisperx[738].text |
前一版的健保法這個修法的過程當中那麼對於這個保費的來源這個都是都是保費啦只是分為叫做一般保費跟補充保費這個是前一版的這個修法的時候那麼跟 |
| transcript.whisperx[739].start |
19244.019 |
| transcript.whisperx[739].end |
19260.88 |
| transcript.whisperx[739].text |
第一版的這個差別就是一般保費跟這個補充保費當時候在補充保費設計的時候就曾經也有很多的討論就是在於要不要結算還有它的起徵門檻所以這個我想在未來我們如果要在 |
| transcript.whisperx[740].start |
19261.801 |
| transcript.whisperx[740].end |
19291.09 |
| transcript.whisperx[740].text |
做下一版的这个健保法的修正的时候呢那么包含这个刚刚您提到的要不要有这个差别的这个费率啊那么我们现在都是采统一费率那有没有要差别的费率啊那使用者是不是要负担更多啦使用者付费的精神要不要纳入啦我想都是秉持一个这个量能付费那公平的原则来讨论这个我们一定会强化沟通 |
| transcript.whisperx[741].start |
19292.49 |
| transcript.whisperx[741].end |
19312.201 |
| transcript.whisperx[741].text |
好的 謝謝部長所以你們上次的事件我想是在施政的一些技術上應該要再做一些調整那最重要的是健保是一個全民制度不能讓平民百姓只因為穩定理財就變成政府的提款機所以改建要穩健公平透明才是長治久安之計 |
| transcript.whisperx[742].start |
19313.061 |
| transcript.whisperx[742].end |
19341.049 |
| transcript.whisperx[742].text |
那針對過程當中你們可能技術性沒有很周全的部分我想是這次應該要檢討的最主要一個原因好不好好謝謝好謝謝林委員接下來請林楚瑩委員林楚瑩委員林楚瑩委員不在請李彥秀委員李彥秀委員李彥秀委員不在請王宏威委員王宏威委員王宏威委員不在請邱志維委員邱志維委員邱志維委員不在請陳委員來做選擇 |
| transcript.whisperx[743].start |
19353.035 |
| transcript.whisperx[743].end |
19378.412 |
| transcript.whisperx[743].text |
謝謝主席 麻煩請石部長部長好這個罕見疾病的發生是不是大部分都跟遺傳或者基因缺損有關係可以這麼說那如果是的話這些病可以被預防嗎 |
| transcript.whisperx[744].start |
19381.513 |
| transcript.whisperx[744].end |
19404.7 |
| transcript.whisperx[744].text |
我們現在在這個罕病的認定上分為原發性跟次發性所以次發性的那個多數還有其他因素但是原發性的大概都是沒有辦法先預測的好 那你們每年補助預防及研究的這個經費大概是多少那你覺得目前成效如何有沒有一個KPI的指標 |
| transcript.whisperx[745].start |
19406.857 |
| transcript.whisperx[745].end |
19424.206 |
| transcript.whisperx[745].text |
罕病的研究罕病的研究我們好像沒有特別啦我們對癌症的研究有有一個專門這個在國衛院裡面有一個這個癌症所專門會做這方面罕病好像我是不是請那個署長補充好請說 |
| transcript.whisperx[746].start |
19426.804 |
| transcript.whisperx[746].end |
19454.161 |
| transcript.whisperx[746].text |
我們在那個菸品福利捐裡面其實有部分是分配給罕見疾病相關的醫療費用那剩下來的話就是會投注在預防篩檢研究宣導還有其他健保沒有辦法支應的一些相對性支持療法或者是維持生命所需的特殊營養品所以確實研究的部分會在這個部分的一些小的部分好就是那你覺得成效 |
| transcript.whisperx[747].start |
19455.717 |
| transcript.whisperx[747].end |
19479.59 |
| transcript.whisperx[747].text |
怎麼樣因為罕見疾病的發生率就是很低所以相對應的研究來說的話它確實沒有辦法立刻的作為一個成效但是它可以作為我們相對應後續的政策的一個基礎跟科學的根據所以也沒有去特別去訂這個KPI的指標是 這比較困難好 沒關係我想這個部分確實是很困難因為一般 |
| transcript.whisperx[748].start |
19480.75 |
| transcript.whisperx[748].end |
19503.311 |
| transcript.whisperx[748].text |
這個要發現這個罹患罕見疾病除非透過是這個學友專精的專家然後透過非常繁複的檢測才能夠確認那後續的這個診治才真的是這個挑戰的開始那目前對於這個患者的家庭衛福部有就是說有提供什麼樣的協助呢跟委員說明確實 |
| transcript.whisperx[749].start |
19505.529 |
| transcript.whisperx[749].end |
19521.201 |
| transcript.whisperx[749].text |
這個罕病不好診斷除了幾個醫學中心也不是全部的醫學中心幾個醫學中心有專門的醫師多數是兒科的醫師有辦法做這些診斷其他的確實是困難 |
| transcript.whisperx[750].start |
19521.821 |
| transcript.whisperx[750].end |
19536.47 |
| transcript.whisperx[750].text |
所以呢我們在這個優化兒童醫療照護計畫裡面去建立一個叫兒童困難診斷平台就是希望說透過這個現在是委託台大在做那麼因為這些疾病的診斷要經驗的累積 |
| transcript.whisperx[751].start |
19538.451 |
| transcript.whisperx[751].end |
19555.451 |
| transcript.whisperx[751].text |
因为它本来就很少所以我们需要跨院之间的合作所以我们现在就有进行这个困难诊断平台的计划那补助台大在做这个事情初步的成效我们再把它整理一下提供给委员参考听起来还不错 |
| transcript.whisperx[752].start |
19556.011 |
| transcript.whisperx[752].end |
19571.38 |
| transcript.whisperx[752].text |
那除了你們剛剛所提的這些未證的資源之外有沒有其他社福的資源一起來無縫銜接還是說主要只是靠這個罕見疾病基金會去統籌處理民間的資源 |
| transcript.whisperx[753].start |
19576.752 |
| transcript.whisperx[753].end |
19589.821 |
| transcript.whisperx[753].text |
就是沒有我現在只衛福部裡面啦就除了你們的衛政資源之外有沒有其他社福的資源但你若要提民間的也OK啦但你們衛福部裡面 |
| transcript.whisperx[754].start |
19592.305 |
| transcript.whisperx[754].end |
19606.264 |
| transcript.whisperx[754].text |
我们现在主要就是有那个那个罕病基金另外一个就是健保主要大众还是在健保里面我会这样讲是因为赵伟今天排定这个题目我相信对于 |
| transcript.whisperx[755].start |
19607.485 |
| transcript.whisperx[755].end |
19632.682 |
| transcript.whisperx[755].text |
歷任的這個衛福部部長都是非常困難來回答的那因為這個資源一定是有限的而且幾乎都是其實它也不容易治療那除非說我們能夠控制它的發生那我們就要面臨就是說要延長壽命還有要兼顧這個生活品質的這個困難這些挑戰 |
| transcript.whisperx[756].start |
19633.723 |
| transcript.whisperx[756].end |
19657.827 |
| transcript.whisperx[756].text |
那同時還有面對就是說家庭沉重的這個經濟的負擔有時候是除了經濟的負擔還有這個心理上的負擔所以我希望在這個社會關懷方面社家屬也能夠扮演重要的角色畢竟就是說在這個周遭的這個患者周遭的照顧者常常要剛剛講面臨的這個經濟壓力之外 |
| transcript.whisperx[757].start |
19660.748 |
| transcript.whisperx[757].end |
19675.262 |
| transcript.whisperx[757].text |
他其實是身心俱疲的那有些可能照顧到後來自己也要去吃油啊看醫生那甚至有些會有親身的念頭這些都是我們要去注意的所以我今天才特別提出來 |
| transcript.whisperx[758].start |
19676.602 |
| transcript.whisperx[758].end |
19701.967 |
| transcript.whisperx[758].text |
說這些社會關懷的部分那例如說像我們這個偏遠的這個台東地區啦那比較弱勢的一些家庭啦那在這個法令上可以補助或協助的地方能夠有你們的這個關懷還有跟這個感受到你們支持的力量我想這個是很重要的所以這個部分我在這裡特別提醒部長好 |
| transcript.whisperx[759].start |
19703.587 |
| transcript.whisperx[759].end |
19721.317 |
| transcript.whisperx[759].text |
謝謝委員長期以來一直為偏鄉跟弱勢發聲確實我們明年的這個長照3.0會去擴大這個長照的對象過去像這樣的這個罕病如果是拿到身心障礙證明就會納入到我們的長照的服務裡頭 |
| transcript.whisperx[760].start |
19722.418 |
| transcript.whisperx[760].end |
19745.565 |
| transcript.whisperx[760].text |
因為這個照顧確實辛苦那我們會去逐步的去擴大不再是以年齡來限制是不是利用長照第二個是增加對家庭照顧者的支持所以我們會持續去擴大家照據點的設立偏鄉的部分我們一定會優先去關注讓在偏鄉優先有這樣的資源 |
| transcript.whisperx[761].start |
19747.725 |
| transcript.whisperx[761].end |
19764.033 |
| transcript.whisperx[761].text |
謝謝部長那我在這裡也特別對這個負責罕見疾病的醫護人員以及社福團體致上最深的敬意那另外就是說根據這個罕見疾病防治及這個藥物法的第33條的規定 |
| transcript.whisperx[762].start |
19765.994 |
| transcript.whisperx[762].end |
19780.226 |
| transcript.whisperx[762].text |
衛福部必須編列公務預算補助罕見疾病的預防篩檢跟研究相關經費以及健保未給付的診斷治療藥物特殊營養食品等的費用同時也可以利用菸捐的收入來支應 |
| transcript.whisperx[763].start |
19781.127 |
| transcript.whisperx[763].end |
19799.338 |
| transcript.whisperx[763].text |
那最近呢衛福部終於開放了這個加熱菸合法販售預期會增加罕見疾病的補助那將來想請教就是說在公務預算的補助專款會不會因此而大幅減少然後增加到這個健保跟這個菸捐之應的比例呢不會不會 |
| transcript.whisperx[764].start |
19799.998 |
| transcript.whisperx[764].end |
19828.845 |
| transcript.whisperx[764].text |
像我们明年还是持续有公务预算在抑制那个罕药的使用所以跟就不会往下调吗不会我们还是会该由公务预算来支持的因为我个人呢当然是比较倾向就原有的预算规模是不宜去删减那也应该让罕见疾病的这个家庭享有这个加热烟烟圈的滋应也就是说卫福部应该思考就是说让这个新增的资源有更好的运用 |
| transcript.whisperx[765].start |
19830.365 |
| transcript.whisperx[765].end |
19858.291 |
| transcript.whisperx[765].text |
所以在未來接下來本席也會持續在關注的這個重點就是如何使用罕見疾病的這個專款上面那另外就是依照這個罕見疾病防治藥物法第三條的規定罕見疾病是指這個疾病盛行率在中央主管機關公告的基準之下或者因為情況特殊經審議會認定及衛福部指定公告者 |
| transcript.whisperx[766].start |
19858.951 |
| transcript.whisperx[766].end |
19870.185 |
| transcript.whisperx[766].text |
所以目前盛行率的公告基準是多少現在是萬分之一那台灣罕見疾病的種類大概有多少種200多少 227 |
| transcript.whisperx[767].start |
19876.941 |
| transcript.whisperx[767].end |
19900.101 |
| transcript.whisperx[767].text |
247247247种对好那本席有一个问题我想就提出来讨论因为你们才是专家就是说用肾型率的基准来定义可能累积足够的病人那原本罕见就会变成不罕见了那除非说 |
| transcript.whisperx[768].start |
19901.022 |
| transcript.whisperx[768].end |
19923.033 |
| transcript.whisperx[768].text |
這部法呢完全沒有發揮作用那通通不篩檢不防治所以沒有發現新的個案或者我們不治療那每年死亡的個案數就會大於這個發現數那這樣子的累積個案就不會超過0.01%否則呢一旦就是說大家控制的 |
| transcript.whisperx[769].start |
19923.793 |
| transcript.whisperx[769].end |
19942.071 |
| transcript.whisperx[769].text |
控制的很好那累積的這個病人數終究他會超過這個基準盛行率更何況目前台灣的這個死亡率是大於出生率的所以我想我不知道部長有沒有同意本席這樣的一個推論 |
| transcript.whisperx[770].start |
19943.828 |
| transcript.whisperx[770].end |
19970.76 |
| transcript.whisperx[770].text |
那个钦佩委员您的推论完全正确因为我们要看的应该是发生率就是这个疾病的发生率很低这个才是正解不过过去是这样子写的可能在当时候药物的治疗的没有这么发达不像现在这个药物陆陆续续出来这么多所以我们来思考看看怎么来做一些调整 |
| transcript.whisperx[771].start |
19971.32 |
| transcript.whisperx[771].end |
19985.877 |
| transcript.whisperx[771].text |
我们来讨论看看因为有的发生率很难精准因为发生率是严谨的一种统计那盛行率比较容易所以这两个会有落差没错 |
| transcript.whisperx[772].start |
19986.678 |
| transcript.whisperx[772].end |
20001.575 |
| transcript.whisperx[772].text |
但是像委員說的確實如果治療的好他可能那個活下來了累積累積累積對 但這也是我們期待的發生率應該是不會改變只是發生率的統計跟調查難度比較高 |
| transcript.whisperx[773].start |
20002.298 |
| transcript.whisperx[773].end |
20023.793 |
| transcript.whisperx[773].text |
好因為本來我要問這個也不是很有把握那但是我想就是這樣今天這個討論我想也提醒大家有個新發現那未來可以去思考看看這個名詞的定義要是不是要換或者是去調整盛行率好這個就是大家未來要討論的課題好謝謝好謝謝委員好謝謝 |
| transcript.whisperx[774].start |
20036.704 |
| transcript.whisperx[774].end |
20044.431 |
| transcript.whisperx[774].text |
那本次會議詢答全部結束委員陳冠廷徐欣穎所提書面資料列入紀錄刊登公報現在作為下決議即決定 |
| transcript.whisperx[775].start |
20046.943 |
| transcript.whisperx[775].end |
20066.97 |
| transcript.whisperx[775].text |
一報告說明及詢討完畢第二委員詢諮詢為其答覆或請補充資料者請相關機關於兩週內以書面答覆委員另要求期限者從其鎖定第三癌症防治法修正草案等17案另則起繼續審查那本次會議到此結束現在散會 |
| transcript.whisperx[776].start |
20072.734 |
| transcript.whisperx[776].end |
20077.078 |
| transcript.whisperx[776].text |
對 我們等一下協商 休息五分鐘好不好 休息五分鐘 好 OK |