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楊曜 @
| Start Time | End Time | Text |
|---|---|---|
| 00:00:00,000 | 00:00:03,440 | 搞不好,我先把調查身nk |
| 00:00:03,440 | 00:00:15,260 | 我連續看了各種媒體提供,相當иход認真的 password,b站內 describes 黑客關係的分派 |
| 00:00:19,980 | 00:00:27,120 | 同學,ской慢慢打開運送a鐵鐵,但百敗萬禍 |
| 00:00:27,120 | 00:00:28,120 | 主席 |
| 00:00:29,120 | 00:00:31,120 | 謝謝主席 主席請一下 |
| 00:00:31,820 | 00:00:34,880 | 一策會執行長是不是 董事長下午沒來 |
| 00:00:34,880 | 00:00:36,880 | 執行長 |
| 00:00:42,300 | 00:00:43,300 | 委員好 |
| 00:00:43,300 | 00:00:45,520 | 執行長好 因為今天也 |
| 00:00:45,520 | 00:00:47,320 | 我們也審查你們的 |
| 00:00:47,480 | 00:00:49,780 | 做預算審查的 |
| 00:00:49,780 | 00:00:51,280 | 大體詢答啦齁 |
| 00:00:51,280 | 00:00:53,760 | 所以 簡單問你幾個問題 |
| 00:00:54,320 | 00:00:57,760 | 我立委才幹世界而已 |
| 00:00:57,760 | 00:01:00,760 | 所以還沒有學會政治語言 |
| 00:01:00,760 | 00:01:03,760 | 我問的大概都是真正的問題 |
| 00:01:03,760 | 00:01:04,759 | 第二個問題就是 |
| 00:01:04,759 | 00:01:06,759 | 一策會因為最主要的 |
| 00:01:08,759 | 00:01:10,759 | 有一項最主要的工作是 |
| 00:01:10,759 | 00:01:12,759 | 醫院評鑑 |
| 00:01:12,759 | 00:01:13,759 | 對不對 |
| 00:01:13,759 | 00:01:16,759 | 我請問一下 先請問一個問題就是 |
| 00:01:16,759 | 00:01:18,759 | 你們在醫院評鑑上 |
| 00:01:18,759 | 00:01:20,759 | 能不能 |
| 00:01:20,759 | 00:01:22,759 | 做更 |
| 00:01:22,760 | 00:01:24,760 | 更簡化的 |
| 00:01:26,760 | 00:01:28,760 | 就是最少文書處理的方面 |
| 00:01:28,760 | 00:01:30,760 | 因為這個對於很多 |
| 00:01:30,760 | 00:01:33,760 | 很多小型醫院其實是一件 |
| 00:01:33,760 | 00:01:35,760 | 是一件很大的負擔 |
| 00:01:35,760 | 00:01:36,760 | 有沒有辦法 |
| 00:01:36,760 | 00:01:40,760 | 就是怎麼精進評鑑作業 |
| 00:01:40,760 | 00:01:42,760 | 你有沒有什麼想法 |
| 00:01:42,760 | 00:01:44,760 | 有 跟委員報告 那我們 |
| 00:01:44,760 | 00:01:46,760 | 部長上次說了 |
| 00:01:46,760 | 00:01:48,760 | 我們要變成6年評鑑一次 |
| 00:01:48,760 | 00:01:50,760 | 不是 我覺得 |
| 00:01:50,760 | 00:01:52,760 | 我覺得 延長連線 |
| 00:01:52,760 | 00:01:55,760 | 跟我現在問的問題是兩件事 |
| 00:01:55,760 | 00:01:57,760 | 我還沒講完 |
| 00:01:57,760 | 00:01:59,760 | 就是部長也交代我們要減少 |
| 00:01:59,760 | 00:02:01,760 | 不必要的這些文書作業 |
| 00:02:01,760 | 00:02:04,760 | 那減少大家的作業 |
| 00:02:04,760 | 00:02:06,760 | 那其實我也是醫師出身 |
| 00:02:06,760 | 00:02:09,759 | 所以我也知道我以前也被評鑑過 |
| 00:02:09,759 | 00:02:11,760 | 所以我們都了解評鑑有一些 |
| 00:02:11,760 | 00:02:14,760 | 大家有一些覺得太多的 |
| 00:02:14,760 | 00:02:16,760 | 一些不必要的這個流程 |
| 00:02:16,760 | 00:02:18,760 | 我們現在在未來的這個 |
| 00:02:18,760 | 00:02:20,760 | 新的一輪的評鑑中 |
| 00:02:20,760 | 00:02:22,760 | 我們有新的評鑑制度 |
| 00:02:22,760 | 00:02:24,760 | 還有新的評鑑的條文 |
| 00:02:24,760 | 00:02:26,760 | 通通都會朝這些方向 |
| 00:02:26,760 | 00:02:28,760 | 目前有沒有進度 |
| 00:02:28,760 | 00:02:30,760 | 有 有現在 |
| 00:02:30,760 | 00:02:33,760 | 因為你也當 |
| 00:02:33,760 | 00:02:34,760 | 也是醫生 |
| 00:02:34,760 | 00:02:35,760 | 然後也接受過評鑑 |
| 00:02:35,760 | 00:02:36,760 | 你應該知道 |
| 00:02:36,760 | 00:02:38,760 | 這個對於很多 |
| 00:02:38,760 | 00:02:40,760 | 特別是中小型的醫院 |
| 00:02:40,760 | 00:02:42,760 | 人力上本來就不足 |
| 00:02:42,760 | 00:02:44,760 | 那好 這個你們要持續 |
| 00:02:44,760 | 00:02:47,760 | 那個我還是就 |
| 00:02:47,760 | 00:02:49,760 | 醫學中心的評鑑 |
| 00:02:49,760 | 00:02:51,760 | 這個我剛才為什麼說 |
| 00:02:51,760 | 00:02:52,760 | 我說真話 |
| 00:02:52,760 | 00:02:55,760 | 因為這個問題我問過好幾次 |
| 00:02:55,760 | 00:02:58,760 | 只是沒有直接問過醫車會 |
| 00:02:58,760 | 00:03:00,760 | 醫車會負責醫院評鑑 |
| 00:03:00,760 | 00:03:03,760 | 所以醫學中心也是有你們評鑑 |
| 00:03:03,760 | 00:03:04,760 | 是對不對 |
| 00:03:04,760 | 00:03:06,760 | 好 那評鑑是這樣子 |
| 00:03:06,760 | 00:03:08,760 | 有兩種方式 |
| 00:03:08,760 | 00:03:10,760 | 一般的考試也是 |
| 00:03:10,760 | 00:03:11,760 | 一個就是及格分數 |
| 00:03:11,760 | 00:03:12,760 | 就是只要通過了 |
| 00:03:12,760 | 00:03:14,760 | 就全部都過 |
| 00:03:14,760 | 00:03:16,760 | 一個是錄取分數 |
| 00:03:16,760 | 00:03:18,760 | 就有限額的 |
| 00:03:18,760 | 00:03:20,760 | 譬如說一般的公務員 |
| 00:03:20,760 | 00:03:22,760 | 就缺幾個錄取幾個 |
| 00:03:22,760 | 00:03:24,760 | 那我們的醫學中心 |
| 00:03:24,760 | 00:03:30,760 | 這兩者執行長覺得是哪一種 |
| 00:03:30,760 | 00:03:34,760 | 是通過分數就可以 |
| 00:03:34,760 | 00:03:36,760 | 還是按照錄取 |
| 00:03:36,760 | 00:03:38,760 | 我們醫學中心的評鑑 |
| 00:03:38,760 | 00:03:40,760 | 有兩個流程 |
| 00:03:40,760 | 00:03:41,760 | 第一個流程 |
| 00:03:41,760 | 00:03:43,760 | 他必須在我們的醫學中心 |
| 00:03:43,760 | 00:03:46,760 | 評鑑的基準下 |
| 00:03:46,760 | 00:03:48,760 | 達到一定的及格分數以後 |
| 00:03:48,760 | 00:03:51,760 | 再進入第二階段的評鑑 |
| 00:03:51,760 | 00:03:52,760 | 第二階段是評鑑什麼 |
| 00:03:52,760 | 00:03:55,760 | 第二階段再加上這個 |
| 00:03:55,760 | 00:03:57,760 | 醫學中心五大任務指標的分數 |
| 00:03:57,760 | 00:03:58,760 | 再加進去 |
| 00:03:58,760 | 00:04:02,760 | 沒有 那個都屬於資格 |
| 00:04:02,760 | 00:04:04,760 | 我現在是問名額的部分 |
| 00:04:04,760 | 00:04:06,760 | 我直接講好了 |
| 00:04:06,760 | 00:04:08,760 | 我們其實現在是實施 |
| 00:04:08,760 | 00:04:11,760 | 第二期的醫療網計畫 |
| 00:04:11,760 | 00:04:14,760 | 裡面規定是每200萬人口 |
| 00:04:14,760 | 00:04:16,760 | 配置一家醫學中心 |
| 00:04:16,760 | 00:04:19,760 | 台灣現在2300萬 |
| 00:04:19,760 | 00:04:22,760 | 現在台灣有幾家醫學中心 |
| 00:04:22,760 | 00:04:25,760 | 現在23家 |
| 00:04:25,760 | 00:04:31,760 | 那就是已經超額錄取一倍 |
| 00:04:31,760 | 00:04:33,760 | 這個都你們評鑑的嗎 |
| 00:04:33,760 | 00:04:35,760 | 我們提供分數 |
| 00:04:35,760 | 00:04:39,760 | 由衛福部決定醫學中心的錄取 |
| 00:04:39,760 | 00:04:41,760 | 你們提供分數 |
| 00:04:41,760 | 00:04:45,760 | 因為醫學中心最後的評鑑的分數 |
| 00:04:45,760 | 00:04:47,760 | 我剛才講的就是說 |
| 00:04:47,760 | 00:04:50,760 | 他必須達到一定的分數以上才可以 |
| 00:04:50,760 | 00:04:51,760 | 這就是您剛才說的 |
| 00:04:51,760 | 00:04:53,760 | 有一個及格標準 |
| 00:04:53,760 | 00:04:55,760 | 到及格標準以後 |
| 00:04:55,760 | 00:04:58,760 | 我們會把這些分數提報給衛福部 |
| 00:04:58,760 | 00:04:59,760 | 由衛福部來決定 |
| 00:04:59,760 | 00:05:01,760 | 醫學中心是哪幾家 |
| 00:05:01,760 | 00:05:04,760 | 那在以往的話就是 |
| 00:05:04,760 | 00:05:06,760 | 有所謂的醫學中心和準醫學中心 |
| 00:05:06,760 | 00:05:10,760 | 所以超過的部分就是歷任部長 |
| 00:05:10,760 | 00:05:14,760 | 沒有按照我們的指標來走 |
| 00:05:14,760 | 00:05:19,760 | 石部長比較沒有責任 |
| 00:05:19,760 | 00:05:23,760 | 因為石部長的任內還沒有遇到醫學 |
| 00:05:23,760 | 00:05:24,760 | 對對對 |
| 00:05:24,760 | 00:05:27,760 | 執行長我再問一個問題 |
| 00:05:27,760 | 00:05:31,760 | 你們醫生會能不能 |
| 00:05:31,760 | 00:05:36,760 | 你們不能研擬醫學中心退場機制 |
| 00:05:36,760 | 00:05:41,760 | 就讓他更符合我們的醫療計畫 |
| 00:05:41,760 | 00:05:45,760 | 因為我們一個大的概念在那邊 |
| 00:05:45,760 | 00:05:47,760 | 就兩百萬人口一家 |
| 00:05:47,760 | 00:05:54,760 | 那現在因為很多考量 |
| 00:05:54,760 | 00:05:57,760 | 所以就變成已經一倍了 |
| 00:05:57,760 | 00:06:00,760 | 你們能不能擬定退場機制 |
| 00:06:00,760 | 00:06:03,760 | 其實我是一直覺得評鑑本身 |
| 00:06:03,760 | 00:06:06,760 | 本來就是應該要有上有下 |
| 00:06:06,760 | 00:06:10,760 | 要不然我不知道醫學中心評鑑 |
| 00:06:10,760 | 00:06:14,760 | 的用意到底在哪裡 |
| 00:06:14,760 | 00:06:20,760 | 是那我們醫策會可以提供評鑑的分數 |
| 00:06:20,760 | 00:06:22,760 | 那至於說這個分數的話 |
| 00:06:22,760 | 00:06:26,760 | 就是表示他符合醫學中心的資格 |
| 00:06:26,760 | 00:06:29,760 | 所以現在已經有所謂準醫學中心 |
| 00:06:29,760 | 00:06:32,760 | 準醫學中心是沒有這個限制 |
| 00:06:32,760 | 00:06:35,760 | 因為基本上他的最大的問題 |
| 00:06:35,760 | 00:06:37,760 | 還是在於健保給付的 |
| 00:06:37,760 | 00:06:41,760 | 我知道準醫學中心就是安慰獎 |
| 00:06:41,760 | 00:06:45,760 | 我大概知道就是給你一個虛的名字 |
| 00:06:45,760 | 00:06:51,760 | 然後健保給付上跟區議院大概是一樣的 |
| 00:06:51,760 | 00:06:53,760 | 不過我的意思就是說 |
| 00:06:53,760 | 00:06:55,760 | 他都是有分數的 |
| 00:06:55,760 | 00:06:56,760 | 我的意思就是說 |
| 00:06:56,760 | 00:06:58,760 | 我們假如說 |
| 00:07:01,760 | 00:07:02,760 | 堅守住 |
| 00:07:02,760 | 00:07:07,760 | 因為接下來少子化也會很嚴重 |
| 00:07:07,760 | 00:07:12,760 | 就是說我們假如堅守住200萬人口 |
| 00:07:12,760 | 00:07:14,760 | 一家醫學中心 |
| 00:07:14,760 | 00:07:22,760 | 那你們能不能去研究出一套退場機制 |
| 00:07:22,760 | 00:07:24,760 | 部長請 |
| 00:07:24,760 | 00:07:26,760 | 我想說你比較累 |
| 00:07:26,760 | 00:07:30,760 | 因為楊偉仁問到的這個都非常專業跟深入 |
| 00:07:30,760 | 00:07:34,760 | 確實我們這一個醫學中心的加速 |
| 00:07:34,760 | 00:07:38,760 | 是在醫療網開始的時候我們就設定 |
| 00:07:38,760 | 00:07:40,760 | 大概在民國70幾年的時候 |
| 00:07:40,760 | 00:07:44,760 | 我們開始推醫療網是民國75年 |
| 00:07:44,760 | 00:07:47,760 | 然後在那個後面就把他這個定下來 |
| 00:07:47,760 | 00:07:49,760 | 第二期醫療網我們就把它定住了 |
| 00:07:49,760 | 00:07:51,760 | 所以時至今日 |
| 00:07:51,760 | 00:07:55,760 | 我們確實需要考慮到那個地域的分佈 |
| 00:07:55,760 | 00:07:56,760 | 讓他均衡 |
| 00:07:56,760 | 00:08:00,760 | 那麼讓民眾在一定的範圍裡面 |
| 00:08:00,760 | 00:08:03,760 | 都能夠得到這些三級醫院的服務 |
| 00:08:03,760 | 00:08:06,760 | 包含多少的範圍有地區醫院 |
| 00:08:06,760 | 00:08:08,760 | 多大的範圍要有醫學中心 |
| 00:08:08,760 | 00:08:13,760 | 所以這個是需要有整個這個分佈的概念 |
| 00:08:13,760 | 00:08:14,760 | 再加上說未來 |
| 00:08:14,760 | 00:08:18,760 | 當然我們以目前的少子化的情形 |
| 00:08:18,760 | 00:08:19,760 | 我們的人口數會下降 |
| 00:08:19,760 | 00:08:21,760 | 所以這個200萬 |
| 00:08:21,760 | 00:08:24,760 | 或者是他的這個分佈的配置 |
| 00:08:24,760 | 00:08:28,760 | 各區域的配置確實是可以有檢討的空間 |
| 00:08:28,760 | 00:08:32,760 | 部長是這樣子就是說區域的均衡 |
| 00:08:32,760 | 00:08:36,760 | 有的時候會進入一個盲區 |
| 00:08:36,760 | 00:08:39,760 | 就是說以北中南來看好了 |
| 00:08:39,760 | 00:08:44,760 | 北部在上一次評鑑多了兩家 |
| 00:08:44,760 | 00:08:47,760 | 隨便南部也必須要多一家 |
| 00:08:47,760 | 00:08:54,760 | 這個就是我們只要說用區域的分佈來看 |
| 00:08:54,760 | 00:08:55,760 | 會變成這樣子 |
| 00:08:55,760 | 00:08:59,760 | 當然區域均衡還是很重要 |
| 00:08:59,760 | 00:09:03,760 | 怎麼退場也好 |
| 00:09:03,760 | 00:09:06,760 | 或者是降等也好 |
| 00:09:06,760 | 00:09:10,760 | 或者是減少醫學中心的健保給付 |
| 00:09:10,760 | 00:09:12,760 | 因為我今天時間的關係 |
| 00:09:12,760 | 00:09:16,760 | 要不然接下來典職保障0.9 |
| 00:09:16,760 | 00:09:20,760 | 那醫學中心的健保給付是最高的 |
| 00:09:20,760 | 00:09:25,760 | 怎麼會造成健保的財務黑洞 |
| 00:09:25,760 | 00:09:28,760 | 這個都必須要很謹慎面對 |
| 00:09:28,760 | 00:09:31,760 | 所以這個分級醫療制度的落實就會很重要 |
| 00:09:31,760 | 00:09:32,760 | 對好 |
| 00:09:32,760 | 00:09:34,760 | 部長講到分級醫療 |
| 00:09:34,760 | 00:09:38,760 | 醫學中心加速越多 |
| 00:09:38,760 | 00:09:40,760 | 分級醫療越困難 |
| 00:09:40,760 | 00:09:42,760 | 部長信不信 |
| 00:09:42,760 | 00:09:43,760 | 為什麼呢 |
| 00:09:43,760 | 00:09:44,760 | 為什麼呢 |
| 00:09:44,760 | 00:09:49,760 | 因為就醫太方便了 |
| 00:09:49,760 | 00:09:54,760 | 某些程度上委員說的是很正確 |
| 00:09:54,760 | 00:09:59,760 | 因為我們對於民眾的就醫的門檻並不高 |
| 00:09:59,760 | 00:10:01,760 | 所以他直接到醫學中心就醫 |
| 00:10:01,760 | 00:10:03,760 | 雖然有多的部分負擔 |
| 00:10:03,760 | 00:10:06,760 | 但是金額並不高 |
| 00:10:06,760 | 00:10:08,760 | 所以這個確實是有可能 |
| 00:10:08,760 | 00:10:09,760 | 好 執行長請回 |
| 00:10:09,760 | 00:10:11,760 | 部長我最後要講一段話 |
| 00:10:11,760 | 00:10:13,760 | 就是說以這次有品來看 |
| 00:10:13,760 | 00:10:20,760 | 我還是要從食品安全管理法來做綜合的判斷 |
| 00:10:20,760 | 00:10:25,760 | 我們在食品安全管理法裡面大概就規定 |
| 00:10:25,760 | 00:10:27,760 | 有關查核的部分 |
| 00:10:27,760 | 00:10:32,760 | 大概就規定三千萬以上資本額的廠 |
| 00:10:32,760 | 00:10:37,760 | 必須要每年做兩次的自主檢驗 |
| 00:10:37,760 | 00:10:39,760 | 那有問題就通報 |
| 00:10:39,760 | 00:10:41,760 | 地方政府 |
| 00:10:41,760 | 00:10:46,760 | 其實我看食安法的規定 |
| 00:10:46,760 | 00:10:50,760 | 地方政府負擔的責任 |
| 00:10:50,760 | 00:10:53,760 | 是比中央政府大很多 |
| 00:10:53,760 | 00:10:58,760 | 因為他們是有被41條 |
| 00:10:58,760 | 00:11:01,760 | 有被41條是有規定 |
| 00:11:01,760 | 00:11:06,760 | 縣市主管機關是可以去到場 |
| 00:11:06,760 | 00:11:10,760 | 去到場查驗的 |
| 00:11:10,760 | 00:11:11,760 | 對不對 |
| 00:11:11,760 | 00:11:15,760 | 那你衛福部食藥署 |
| 00:11:15,760 | 00:11:20,760 | 頂多也就在重大事故的時候才啟動專案查核 |
| 00:11:20,760 | 00:11:21,760 | 是不是這樣子 |
| 00:11:21,760 | 00:11:26,760 | 以目前跟文對完全正確 |
| 00:11:26,760 | 00:11:29,760 | 41條賦予的地方主管機關 |
| 00:11:29,760 | 00:11:31,760 | 可以實地查場 |
| 00:11:31,760 | 00:11:33,760 | 集合抽驗 |
| 00:11:33,760 | 00:11:38,760 | 那同時也賦予他下架停止銷售的權利 |
| 00:11:38,760 | 00:11:40,760 | 你們想做還不能做 |
| 00:11:40,760 | 00:11:42,760 | 我們是寫在 |
| 00:11:42,760 | 00:11:44,760 | 你們必要時 |
| 00:11:44,760 | 00:11:45,760 | 對不對 |
| 00:11:45,760 | 00:11:50,760 | 所以我覺得 |
| 00:11:50,760 | 00:11:54,760 | 並不一定要把每一件事情都變成政治事件 |
| 00:11:54,760 | 00:11:56,760 | 食安大家都重視 |
| 00:11:56,760 | 00:11:58,760 | 那假如說不分藍綠 |
| 00:11:58,760 | 00:12:00,760 | 大家這麼重視食安 |
| 00:12:00,760 | 00:12:02,760 | 是不是就請部裡面這邊 |
| 00:12:02,760 | 00:12:08,760 | 這一次就是我們詳盡的規範 |
| 00:12:08,760 | 00:12:10,760 | 那給足人理 |
| 00:12:10,760 | 00:12:14,760 | 要不然我看到我也不點名哪一個縣市 |
| 00:12:14,760 | 00:12:20,760 | 就是有的縣市5年查驗一次 |
| 00:12:20,760 | 00:12:22,760 | 搞不好還沒有送審 |
| 00:12:22,760 | 00:12:26,760 | 我就就是各縣市政府 |
| 00:12:26,760 | 00:12:29,760 | 我覺得事情發生了以後 |
| 00:12:29,760 | 00:12:32,760 | 作為執政黨我們處理善後 |
| 00:12:32,760 | 00:12:37,760 | 這個是執政的必要負擔 |
| 00:12:37,760 | 00:12:43,760 | 可是從法律賦予刻意的責任對象 |
| 00:12:43,760 | 00:12:46,760 | 並不是衛福部啊 |
| 00:12:46,760 | 00:12:49,760 | 那是不是 |
| 00:12:49,760 | 00:12:51,760 | 這個食安本來就是中央跟地方 |
| 00:12:51,760 | 00:12:53,760 | 大家都要密切的合作 |
| 00:12:53,760 | 00:12:57,760 | 我現在是說我們從法規範來看 |
| 00:12:57,760 | 00:12:59,760 | 從法規範來看 |
| 00:12:59,760 | 00:13:07,760 | 地方政府的查驗其實是41條是很明確的 |
| 00:13:07,760 | 00:13:13,760 | 怎麼會全部排罵衛福部和食藥署 |
| 00:13:13,760 | 00:13:15,760 | 我就搞不懂 |
| 00:13:15,760 | 00:13:17,760 | 沒有結束了 |
| 00:13:17,760 | 00:13:19,760 | 謝謝主席 |
| 00:13:19,760 | 00:13:21,760 | 謝謝委員 |