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09:56:42","影片長度":"00:09:16","會議時間":"2024-03-07T09:00:00+08:00","會議名稱":"立法院第11屆第1會期社會福利及衛生環境委員會第4次全體委員會議（事由：邀請衛生福利部部長、中央健康保險署、食品藥物管理署就「健保藥價調整，藥廠停產慢性病用藥之因應作為」進行專題報告，並備質詢。）","meet":{"tmpMeeting":null,"title":"第11屆第1會期社會福利及衛生環境委員會第4次全體委員會議","term":11,"type":"委員會","sessionPeriod":1,"sessionTimes":4,"committees":[26],"id":"委員會-11-1-26-4"},"date":"2024-03-07","duration":556,"end_time":"2024-03-07T09:56:42+08:00","start_time":"2024-03-07T09:47:26+08:00","features":["ai-transcript","gazette"],"type":"Clip","gazette":{"lineno":336,"blocks":[["邱委員鎮軍：（9時47分）我們一樣有請部長。"],["主席：好，請部長。"],["薛部長瑞元：委員好。"],["邱委員鎮軍：部長，蘇丹紅的事件這兩天又上頭版，最近又爆出有11家餐飲及食品業者都中標了。這是今天早上兩大報的頭版，大家可以看一下。部長有看到嗎？"],["薛部長瑞元：我知道。"],["邱委員鎮軍：這兩大報，我們先談聯合報報導的：食藥署不保證市場沒有問題。這是真的嗎？"],["薛部長瑞元：跟委員報告，目前都往下在查，因為這個辣椒粉做成很多成品，所以現在我們是往下在查。"],["邱委員鎮軍：你多久可以查？"],["薛部長瑞元：現在陸陸續續都一直在查。"],["邱委員鎮軍：可以給我一個時間嗎？我覺得這樣一直等，拖的時間太久，國人的安全誰負責？"],["薛部長瑞元：1個月內應該可以把這些通通查完。"],["邱委員鎮軍：從今天開始？"],["薛部長瑞元：對、對、對，效期之內的這些產品。"],["邱委員鎮軍：那你查的方式呢？你現在怎麼查？"],["薛部長瑞元：現在是從原料開始往下第二層加工的部分，然後再第三層，就是零售的部分，要一家一家去查。"],["邱委員鎮軍：我覺得民眾的食安問題不能拖、不能等，尤其是我們16縣市的營養午餐部分，部長可不可以承諾先處理？"],["薛部長瑞元：營養午餐部分，我們尊重地方的決定，因為小孩子吃辣的……"],["邱委員鎮軍：這個怎麼可以尊重地方決定呢？這不是部長這邊就可以要求的嗎？"],["薛部長瑞元：小孩子吃辣的習慣是比較少的，如果營養午餐要去禁辣椒粉……"],["邱委員鎮軍：我覺得營養午餐這部分是不是我們要先嚴格禁止，先預防性下架？"],["薛部長瑞元：因為營養午餐的業務並不是由衛福部這邊來控制的……"],["邱委員鎮軍：但是你可以通知各縣市吧？"],["薛部長瑞元：辣椒粉的部分，我們是可以跟教育部這邊再來討論一下，看用什麼方式……"],["邱委員鎮軍：針對這個問題，預防性的下架也不敢，暫時下架待檢驗的全部可以……"],["薛部長瑞元：如果有問題的是預防性下架，本來現在就在做。"],["邱委員鎮軍：你上次講大概只抽驗20%、50%，我們關心的是沒有驗的50%、80%。"],["薛部長瑞元：對，所以現在就循線在找那個嘛！"],["邱委員鎮軍：這個部分應該要儘快，好不好？"],["薛部長瑞元：對。"],["邱委員鎮軍：另外，第二個，今天談的議題是關於藥價的部分，今年總共有4,568項藥品的價格異動，其中調降4,551項、調升17項，當然這是2013年以後調整最少的一個紀錄，表示醫界跟藥界的聲音有被聽到。我想請問部長，這次藥價被砍最多的前三類藥品是什麼？"],["薛部長瑞元：這個問題我是不是可以請健保署署長來回答？"],["邱委員鎮軍：好。"],["石署長崇良：委員好。跟委員報告，大概還是以慢性病的用藥、高血壓、神經用藥、血糖的藥這幾類為主。"],["邱委員鎮軍：就是心血管藥、神經系統及全身性抗感染劑用藥。"],["石署長崇良：對。"],["邱委員鎮軍：這四千多項調整藥品裡面，慢性病用藥占了多少？"],["石署長崇良：慢性病大概是八成，涉及到慢性處方箋的大概是七成。"],["邱委員鎮軍：聯合報2023年8月有一篇關於慢性病共同防治的報導說，2022年慢性病就醫人數高達1,286萬人，超過700萬人罹患兩種以上的慢性病，以臺灣的人口結構來看，數字應該是會增加的。假如在未來半年到一年，部分藥廠退出臺灣市場或是不生產，我們怎麼確保慢性病患的用藥穩定性？"],["石署長崇良：跟委員報告，目前拿慢性處方箋的人數大概近800萬人。在用藥上，我們這一次調降的時候有特別宣布，公告之後是4月1號才實施，但是在3月8號之前提出，如果有不敷成本，我們會重新調整價格。到目前為止，提出的只有5項藥。"],["邱委員鎮軍：那些藥萬一沒有了怎麼辦？"],["石署長崇良：到目前為止，提出不敷成本的有5項藥品而已，那麼這5項就暫時不會調降它的藥價，讓它確保能夠繼續供藥。"],["邱委員鎮軍：據本席瞭解，以慢性病用藥的習慣來講，如果換藥的話，大家都會有抱怨聲，而且對藥會沒有信心。署長，如果有這個問題的話，請你們一定要慎重來處理，好不好？"],["石署長崇良：好。"],["薛部長瑞元：這個藥的替代性我們還是必須要有，不然的話，這會被延長，把我們整個的健保掐死。"],["邱委員鎮軍：當然我也不是說你們一定要用一種藥，只是我希望能夠儘量降低民眾用藥的疑慮。","再來就是醫院的分級、我們的醫療落實、城鄉醫療差距，原本台灣社區醫院協會2月21日在國民黨團開記者會說要在3月8日上街遊行表達訴求，到3月4日行政院才進行溝通。我想知道為什麼每次都要到準備抗爭的時候，我們才要進行溝通呢？"],["薛部長瑞元：本來這個溝通就是有的，只是當時他們對於這一個結果並不滿意，所以才有這樣子的一些舉動。"],["邱委員鎮軍：我看到3月4日會議裡面達成的共識，其中一個就是檢討健保藥價的政策，來協助解決社區醫院用藥的採購困難。你們每年都說調整藥價是例行行業，每年都看不到地區醫院的困難，都要走上街頭才來處理，我希望部長能夠認真來看待這件事情。"],["薛部長瑞元：有，地區醫院經營的一些困難情形，我們跟他們已經有相關的……"],["邱委員鎮軍：我們推動醫療分級是從什麼時候開始？"],["薛部長瑞元：醫療分級算是很早，從醫療網計畫差不多在民國74年左右的時候就開始了，但是時空環境的一些演變，這中間也必須要去做一些調整。跟委員報告……"],["邱委員鎮軍：我不知道部長有沒有想過，就算是費用高一點，以我們苗栗縣民來講，有碰到什麼問題，他還是願意多花一點錢往大醫院跑，你知道這是為什麼嗎？"],["薛部長瑞元：當然有一些是品牌的迷思，大醫院的醫師是……"],["邱委員鎮軍：對，像苗栗的醫院都是區域醫院跟地區醫院，這幾年針對醫院的部分，縣府和中央相互合作做了策略聯盟，當然慢慢地會有提升。我們當然有別的想法，就是說如果將苗栗現有的醫院就地升級的可能性大不大？"],["薛部長瑞元：這就是我們鼓勵的方向，我們希望在地的醫院都能夠提升它的品質，建立品牌的形象，讓我們的民眾有信心。"],["邱委員鎮軍：像部苗醫院，現在急重症大樓跟癌症中心兩個大樓沒有辦法……"],["薛部長瑞元：我們已經增加它的……"],["邱委員鎮軍：主席，請再給我1分鐘。你知道除了費用的問題，還有沒有其他問題？"],["薛部長瑞元：主要還是費用的問題，所以現在工程費用已經有追加了。"],["邱委員鎮軍：我是有聽到一些聲音，針對設計這個部分，我希望部長也能夠去瞭解一下是不是有一些問題，讓廠商不敢去投標，我是有聽到別的聲音啦！"],["薛部長瑞元：這我們再進一步來理解。"],["邱委員鎮軍：不要造成連包商都不敢去標，這個問題就很嚴重了。"],["薛部長瑞元：是。"],["邱委員鎮軍：它不是沒有利潤，可能是有一些複雜性的東西在裡面，在這邊我就不講得太清楚了。"],["薛部長瑞元：OK，我們再進一步來瞭解。"],["邱委員鎮軍：謝謝。"],["薛部長瑞元：謝謝委員。"],["邱委員鎮軍：謝謝主席。"],["主席：謝謝邱鎮軍委員的質詢。","接下來請廖偉翔委員進行質詢。"]],"agenda":{"page_end":210,"meet_id":"委員會-11-1-26-4","speakers":["王育敏","陳昭姿","陳菁徽","林月琴","盧縣一","邱鎮軍","廖偉翔","黃秀芳","蘇清泉","涂權吉","王正旭","林德福","王鴻薇","羅廷瑋","李彥秀","林淑芬","黃健豪","謝衣鳯","鍾佳濱","林憶君","劉建國","陳瑩","楊曜","楊瓊瓔"],"page_start":133,"meetingDate":["2024-03-07"],"gazette_id":"1130901","agenda_lcidc_ids":["1130901_00003"],"meet_name":"立法院第11屆第1會期社會福利及衛生環境委員會第4次全體委員會議紀錄","content":"邀請衛生福利部部長、中央健康保險署、食品藥物管理署就「健保藥價調整，藥廠停產慢性病用\n藥之因應作為」進行專題報告，並備質詢","agenda_id":"1130901_00002"}},"transcript":{"id":"149463","pyannote":{"name":"ronny","tool":"pyannote","data":{"url":"https://ivod.ly.gov.tw/Play/Clip/1M/149463","tool":"pyannote","id":"149463-pyannote"},"job_id":"k10tNEsa5YKS1G49","queued_at":"2024-06-02 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00:01:14,840\n我想兩大報我們先拿聯合報講的食藥署不保證市場沒有問題這是真的嗎?根本報告目前都往下在查那因為他這個辣椒粉做成很多成品所以我們現在是往下去查你多久可以查?現在陸陸續續都一直在查你可以給我一個時間嗎?我覺得這樣一直等拖的時間太久我們國內的安全誰負責?\n\n4\n00:01:16,923 --> 00:01:19,918\n一個月內應該是可以把這些通通查完\n\n5\n00:01:21,207 --> 00:01:48,879\n從今天開始?對對對,校期之內的這一些產品那你查的方式勒?你現在怎麼查?因為現在從原料開始往下第二層加工的然後再第三層的話就是這個零售的這部分因為我覺得啦,我們民眾食安的問題不能拖不能等尤其是在我們16縣市的營養午餐這個部分部長可不可以承諾先可以處理?\n\n6\n00:01:50,386 --> 00:02:19,389\n營養午餐的部分我們尊重地方的決定因為小孩子吃辣的這個習慣是比較少的所以營養午餐要去禁這個我覺得營養午餐這部分應該是不是我們這邊要嚴格先禁止先預防性的這些下架因為營養午餐的業務並不是說由衛福部這邊來控制的但你可以通知各縣市\n\n7\n00:02:20,970 --> 00:02:40,100\n那個辣椒粉的部分,這個我們是可以來跟教育部這邊再來討論一下。我們這個問題,預防性的下架也不敢,那暫時下架待檢才檢驗的全部可以?因為有問題的是預防性下架本來就要做。你上次講的,我們只抽了大概20%、50%。我們關心的是沒有驗的50%。\n\n8\n00:02:46,847 --> 00:02:50,992\n對,所以我們現在就尋先再找那個所以應該要照著這個部分要盡快,好不好?\n\n9\n00:02:54,468 --> 00:03:19,773\n另外第二個我們今天談的議題就是藥價的我們今年總共有4568項藥品的價格異動那其中調降了4551項調升17項那當然這是我們2013年以後調整最少的一個紀錄那表示說我們醫界跟藥界的他們的聲音有被聽到那我想請問部長那這次藥價\n\n10\n00:03:23,481 --> 00:03:52,200\n備砍最多的前三類藥品是什麼我是不是這個問題我是不是可以請我們健保署長來回答委員好跟委員報告大概還是以這個慢性病的用藥高血壓還有這個神經用藥還有這個血糖的藥這幾類為主就是心血管藥嘛神經系統的還有全身性抗感染劑用藥那這4000多項裡的調整藥品裡面的慢性病佔了多少\n\n11\n00:03:52,956 --> 00:04:09,242\n慢性病大概是八成那涉及到這個慢性處方籤的大概是七成我們以聯合報2023年8月有一篇關於慢性病共同防治的報導說2022年我們慢性病就醫人數高達1286萬人超過700萬人罹患兩種以上的慢性病以臺灣的人口結構來看\n\n12\n00:04:19,005 --> 00:04:20,367\n跟委員報告目前拿慢性處方籤的人數大概近800萬人那我們在這個用藥上呢\n\n13\n00:04:40,349 --> 00:05:04,665\n這一次調降的時候有特別也宣布說如果我們公告之後是4月1號才實施但是在3月8號之前提出那麼如果有不敷成本我們都會重新的調整價格到目前為止提出的只有五項藥對那些藥萬一沒有了怎麼辦到目前為止提出不敷成本的有五項的藥而已啦那我們這五項就會暫時不會調降它的這個藥價讓它這個確保能夠繼續供藥\n\n14\n00:05:10,223 --> 00:05:26,870\n因為據本席了解,我們慢性病的用藥的習慣,你如果換藥的話,大家都會有抱怨聲,而且對藥會沒有信心。我希望剛剛我們市長,署長,你這邊有這個問題的話,請你們就一定要慎重來處理好不好?\n\n15\n00:05:34,889 --> 00:05:35,089\n那再來齁,就是\n\n16\n00:05:58,462 --> 00:06:21,902\n我們的醫院的分級我們的醫療落實成相這個醫療差距那麼原本台灣社區醫院協會在2月21號在國民黨團開記者會說要在3月8日上街遊行表達訴求到3月4號我們行政院才進行溝通那我想知道為什麼每次都要準備抗爭的時候我們才要進行溝通呢\n\n17\n00:06:22,842 --> 00:06:49,471\n本來這個溝通就是有的只是說當時他們對於這個結果並不滿意所以才有這樣子的一些舉動我看到3月4號會議裡面達成的一個共識其中一個就是檢討我們健保藥價的政策來協助解決社區醫院用藥的採購困難你們每年說調整藥價是這個例行行業每年都看不到地區醫院的困難\n\n18\n00:06:51,277 --> 00:07:05,577\n都要走上街頭才來處理我希望部長這邊能夠認真來看待這個事情第7月經營的一些困難的情形我們有跟他們已經有我們推動醫療分級的時候是從什麼時候開始\n\n19\n00:07:06,700 --> 00:07:33,343\n醫療分級算是很早,從醫療網計畫在民國差不多74年左右的時候就開始但是時空環境的一些演變,這東西也必須要去做一些調整。我不知道部長有沒有想過就是說,就算是費用高一點,我們像我們苗栗縣,苗栗縣民來講有碰到什麼問題,他還是願意多花一點錢到大醫院跑,你知道這為什麼嗎?\n\n20\n00:07:35,000 --> 00:08:01,748\n當然有一些是品牌的迷思,大醫院這醫師是...對,像我們苗栗醫院都是區域醫院跟地區醫院這幾年在醫院縣府我們中央相互的合作做了策略聯盟那當然慢慢的會有提升那我們當然有別的想法就是希望說如果苗栗現有的醫院裡我們就地升級的可能性大不大\n\n21\n00:08:02,508 --> 00:08:22,287\n這就是我們鼓勵的方向我們希望說在地的醫院都能夠提升它的品質讓建立這個品牌的形象讓我們的民眾有這個信心像布苗醫院像集中跟大樓跟我們的癌症中心兩個大樓沒有辦法主席再給我一分鐘\n\n22\n00:08:26,511 --> 00:08:51,366\n因為你知道除了是費用的關係是費用的問題還有沒有其他問題主要還是費用的問題所以我們現在已經工程費用已經有追加了對我這樣講我是有聽到就是說我們的設計跟這個部分我希望部長也能夠去了解一下是不是有一些問題讓廠商不敢去投標\n\n23\n00:08:52,467 --> 00:08:52,547\n邱鎮軍委員\n\n","tsv":"start\tend\ttext\n322\t923\t邱鎮軍委員進行質詢。\n18804\t35490\t部長請問那個蘇丹鴻的事件我想這兩天又上頭版最近又爆出11家的餐飲以及食品業者都中標了這是今天早上的一個兩大報的一個頭版大家可以看一下部長有看到嗎?我知道\n47455\t74840\t我想兩大報我們先拿聯合報講的食藥署不保證市場沒有問題這是真的嗎?根本報告目前都往下在查那因為他這個辣椒粉做成很多成品所以我們現在是往下去查你多久可以查?現在陸陸續續都一直在查你可以給我一個時間嗎?我覺得這樣一直等拖的時間太久我們國內的安全誰負責?\n76923\t79918\t一個月內應該是可以把這些通通查完\n81207\t108879\t從今天開始?對對對,校期之內的這一些產品那你查的方式勒?你現在怎麼查?因為現在從原料開始往下第二層加工的然後再第三層的話就是這個零售的這部分因為我覺得啦,我們民眾食安的問題不能拖不能等尤其是在我們16縣市的營養午餐這個部分部長可不可以承諾先可以處理?\n110386\t139389\t營養午餐的部分我們尊重地方的決定因為小孩子吃辣的這個習慣是比較少的所以營養午餐要去禁這個我覺得營養午餐這部分應該是不是我們這邊要嚴格先禁止先預防性的這些下架因為營養午餐的業務並不是說由衛福部這邊來控制的但你可以通知各縣市\n140970\t160100\t那個辣椒粉的部分,這個我們是可以來跟教育部這邊再來討論一下。我們這個問題,預防性的下架也不敢,那暫時下架待檢才檢驗的全部可以?因為有問題的是預防性下架本來就要做。你上次講的,我們只抽了大概20%、50%。我們關心的是沒有驗的50%。\n166847\t170992\t對,所以我們現在就尋先再找那個所以應該要照著這個部分要盡快,好不好?\n174468\t199773\t另外第二個我們今天談的議題就是藥價的我們今年總共有4568項藥品的價格異動那其中調降了4551項調升17項那當然這是我們2013年以後調整最少的一個紀錄那表示說我們醫界跟藥界的他們的聲音有被聽到那我想請問部長那這次藥價\n203481\t232200\t備砍最多的前三類藥品是什麼我是不是這個問題我是不是可以請我們健保署長來回答委員好 跟委員報告大概還是以這個慢性病的用藥高血壓還有這個神經用藥還有這個血糖的藥這幾類為主就是心血管藥嘛神經系統的還有全身性抗感染劑用藥那這4000多項裡的調整藥品裡面的慢性病佔了多少\n232956\t249242\t慢性病大概是八成那涉及到這個慢性處方籤的大概是七成我們以聯合報2023年8月有一篇關於慢性病共同防治的報導說2022年我們慢性病就醫人數高達1286萬人超過700萬人罹患兩種以上的慢性病以臺灣的人口結構來看\n259005\t260367\t跟委員報告目前拿慢性處方籤的人數大概近800萬人那我們在這個用藥上呢\n280349\t304665\t這一次調降的時候有特別也宣布說如果我們公告之後是4月1號才實施但是在3月8號之前提出那麼如果有不敷成本我們都會重新的調整價格到目前為止提出的只有五項藥對 那些藥萬一沒有了怎麼辦到目前為止提出不敷成本的有五項的藥而已啦那我們這五項就會暫時不會調降它的這個藥價讓它這個確保能夠繼續供藥\n310223\t326870\t因為據本席了解,我們慢性病的用藥的習慣,你如果換藥的話,大家都會有抱怨聲,而且對藥會沒有信心。我希望剛剛我們市長,署長,你這邊有這個問題的話,請你們就一定要慎重來處理好不好?\n334889\t335089\t那再來齁,就是\n358462\t381902\t我們的醫院的分級我們的醫療落實成相這個醫療差距那麼原本台灣社區醫院協會在2月21號在國民黨團開記者會說要在3月8日上街遊行表達訴求到3月4號我們行政院才進行溝通那我想知道為什麼每次都要準備抗爭的時候我們才要進行溝通呢\n382842\t409471\t本來這個溝通就是有的只是說當時他們對於這個結果並不滿意所以才有這樣子的一些舉動我看到3月4號會議裡面達成的一個共識其中一個就是檢討我們健保藥價的政策來協助解決社區醫院用藥的採購困難你們每年說調整藥價是這個例行行業每年都看不到地區醫院的困難\n411277\t425577\t都要走上街頭才來處理我希望部長這邊能夠認真來看待這個事情第7月經營的一些困難的情形我們有跟他們已經有我們推動醫療分級的時候是從什麼時候開始\n426700\t453343\t醫療分級算是很早,從醫療網計畫在民國差不多74年左右的時候就開始但是時空環境的一些演變,這東西也必須要去做一些調整。我不知道部長有沒有想過就是說,就算是費用高一點,我們像我們苗栗縣,苗栗縣民來講有碰到什麼問題,他還是願意多花一點錢到大醫院跑,你知道這為什麼嗎?\n455000\t481748\t當然有一些是品牌的迷思,大醫院這醫師是...對,像我們苗栗醫院都是區域醫院跟地區醫院這幾年在醫院縣府我們中央相互的合作做了策略聯盟那當然慢慢的會有提升那我們當然有別的想法就是希望說如果苗栗現有的醫院裡我們就地升級的可能性大不大\n482508\t502287\t這就是我們鼓勵的方向我們希望說在地的醫院都能夠提升它的品質讓建立這個品牌的形象讓我們的民眾有這個信心像布苗醫院像集中跟大樓跟我們的癌症中心兩個大樓沒有辦法主席再給我一分鐘\n506511\t531366\t因為你知道除了是費用的關係是費用的問題還有沒有其他問題主要還是費用的問題所以我們現在已經工程費用已經有追加了對我這樣講我是有聽到就是說我們的設計跟這個部分我希望部長也能夠去了解一下是不是有一些問題讓廠商不敢去投標\n532467\t532547\t邱鎮軍委員\n","txt":"邱鎮軍委員進行質詢。\n部長請問那個蘇丹鴻的事件我想這兩天又上頭版最近又爆出11家的餐飲以及食品業者都中標了這是今天早上的一個兩大報的一個頭版大家可以看一下部長有看到嗎?我知道\n我想兩大報我們先拿聯合報講的食藥署不保證市場沒有問題這是真的嗎?根本報告目前都往下在查那因為他這個辣椒粉做成很多成品所以我們現在是往下去查你多久可以查?現在陸陸續續都一直在查你可以給我一個時間嗎?我覺得這樣一直等拖的時間太久我們國內的安全誰負責?\n一個月內應該是可以把這些通通查完\n從今天開始?對對對,校期之內的這一些產品那你查的方式勒?你現在怎麼查?因為現在從原料開始往下第二層加工的然後再第三層的話就是這個零售的這部分因為我覺得啦,我們民眾食安的問題不能拖不能等尤其是在我們16縣市的營養午餐這個部分部長可不可以承諾先可以處理?\n營養午餐的部分我們尊重地方的決定因為小孩子吃辣的這個習慣是比較少的所以營養午餐要去禁這個我覺得營養午餐這部分應該是不是我們這邊要嚴格先禁止先預防性的這些下架因為營養午餐的業務並不是說由衛福部這邊來控制的但你可以通知各縣市\n那個辣椒粉的部分,這個我們是可以來跟教育部這邊再來討論一下。我們這個問題,預防性的下架也不敢,那暫時下架待檢才檢驗的全部可以?因為有問題的是預防性下架本來就要做。你上次講的,我們只抽了大概20%、50%。我們關心的是沒有驗的50%。\n對,所以我們現在就尋先再找那個所以應該要照著這個部分要盡快,好不好?\n另外第二個我們今天談的議題就是藥價的我們今年總共有4568項藥品的價格異動那其中調降了4551項調升17項那當然這是我們2013年以後調整最少的一個紀錄那表示說我們醫界跟藥界的他們的聲音有被聽到那我想請問部長那這次藥價\n備砍最多的前三類藥品是什麼我是不是這個問題我是不是可以請我們健保署長來回答委員好 跟委員報告大概還是以這個慢性病的用藥高血壓還有這個神經用藥還有這個血糖的藥這幾類為主就是心血管藥嘛神經系統的還有全身性抗感染劑用藥那這4000多項裡的調整藥品裡面的慢性病佔了多少\n慢性病大概是八成那涉及到這個慢性處方籤的大概是七成我們以聯合報2023年8月有一篇關於慢性病共同防治的報導說2022年我們慢性病就醫人數高達1286萬人超過700萬人罹患兩種以上的慢性病以臺灣的人口結構來看\n跟委員報告目前拿慢性處方籤的人數大概近800萬人那我們在這個用藥上呢\n這一次調降的時候有特別也宣布說如果我們公告之後是4月1號才實施但是在3月8號之前提出那麼如果有不敷成本我們都會重新的調整價格到目前為止提出的只有五項藥對 那些藥萬一沒有了怎麼辦到目前為止提出不敷成本的有五項的藥而已啦那我們這五項就會暫時不會調降它的這個藥價讓它這個確保能夠繼續供藥\n因為據本席了解,我們慢性病的用藥的習慣,你如果換藥的話,大家都會有抱怨聲,而且對藥會沒有信心。我希望剛剛我們市長,署長,你這邊有這個問題的話,請你們就一定要慎重來處理好不好?\n那再來齁,就是\n我們的醫院的分級我們的醫療落實成相這個醫療差距那麼原本台灣社區醫院協會在2月21號在國民黨團開記者會說要在3月8日上街遊行表達訴求到3月4號我們行政院才進行溝通那我想知道為什麼每次都要準備抗爭的時候我們才要進行溝通呢\n本來這個溝通就是有的只是說當時他們對於這個結果並不滿意所以才有這樣子的一些舉動我看到3月4號會議裡面達成的一個共識其中一個就是檢討我們健保藥價的政策來協助解決社區醫院用藥的採購困難你們每年說調整藥價是這個例行行業每年都看不到地區醫院的困難\n都要走上街頭才來處理我希望部長這邊能夠認真來看待這個事情第7月經營的一些困難的情形我們有跟他們已經有我們推動醫療分級的時候是從什麼時候開始\n醫療分級算是很早,從醫療網計畫在民國差不多74年左右的時候就開始但是時空環境的一些演變,這東西也必須要去做一些調整。我不知道部長有沒有想過就是說,就算是費用高一點,我們像我們苗栗縣,苗栗縣民來講有碰到什麼問題,他還是願意多花一點錢到大醫院跑,你知道這為什麼嗎?\n當然有一些是品牌的迷思,大醫院這醫師是...對,像我們苗栗醫院都是區域醫院跟地區醫院這幾年在醫院縣府我們中央相互的合作做了策略聯盟那當然慢慢的會有提升那我們當然有別的想法就是希望說如果苗栗現有的醫院裡我們就地升級的可能性大不大\n這就是我們鼓勵的方向我們希望說在地的醫院都能夠提升它的品質讓建立這個品牌的形象讓我們的民眾有這個信心像布苗醫院像集中跟大樓跟我們的癌症中心兩個大樓沒有辦法主席再給我一分鐘\n因為你知道除了是費用的關係是費用的問題還有沒有其他問題主要還是費用的問題所以我們現在已經工程費用已經有追加了對我這樣講我是有聽到就是說我們的設計跟這個部分我希望部長也能夠去了解一下是不是有一些問題讓廠商不敢去投標\n邱鎮軍委員\n","vtt":"WEBVTT\n\n00:00.322 --> 00:00.923\n邱鎮軍委員進行質詢。\n\n00:18.804 --> 00:35.490\n部長請問那個蘇丹鴻的事件我想這兩天又上頭版最近又爆出11家的餐飲以及食品業者都中標了這是今天早上的一個兩大報的一個頭版大家可以看一下部長有看到嗎?我知道\n\n00:47.455 --> 01:14.840\n我想兩大報我們先拿聯合報講的食藥署不保證市場沒有問題這是真的嗎?根本報告目前都往下在查那因為他這個辣椒粉做成很多成品所以我們現在是往下去查你多久可以查?現在陸陸續續都一直在查你可以給我一個時間嗎?我覺得這樣一直等拖的時間太久我們國內的安全誰負責?\n\n01:16.923 --> 01:19.918\n一個月內應該是可以把這些通通查完\n\n01:21.207 --> 01:48.879\n從今天開始?對對對,校期之內的這一些產品那你查的方式勒?你現在怎麼查?因為現在從原料開始往下第二層加工的然後再第三層的話就是這個零售的這部分因為我覺得啦,我們民眾食安的問題不能拖不能等尤其是在我們16縣市的營養午餐這個部分部長可不可以承諾先可以處理?\n\n01:50.386 --> 02:19.389\n營養午餐的部分我們尊重地方的決定因為小孩子吃辣的這個習慣是比較少的所以營養午餐要去禁這個我覺得營養午餐這部分應該是不是我們這邊要嚴格先禁止先預防性的這些下架因為營養午餐的業務並不是說由衛福部這邊來控制的但你可以通知各縣市\n\n02:20.970 --> 02:40.100\n那個辣椒粉的部分,這個我們是可以來跟教育部這邊再來討論一下。我們這個問題,預防性的下架也不敢,那暫時下架待檢才檢驗的全部可以?因為有問題的是預防性下架本來就要做。你上次講的,我們只抽了大概20%、50%。我們關心的是沒有驗的50%。\n\n02:46.847 --> 02:50.992\n對,所以我們現在就尋先再找那個所以應該要照著這個部分要盡快,好不好?\n\n02:54.468 --> 03:19.773\n另外第二個我們今天談的議題就是藥價的我們今年總共有4568項藥品的價格異動那其中調降了4551項調升17項那當然這是我們2013年以後調整最少的一個紀錄那表示說我們醫界跟藥界的他們的聲音有被聽到那我想請問部長那這次藥價\n\n03:23.481 --> 03:52.200\n備砍最多的前三類藥品是什麼我是不是這個問題我是不是可以請我們健保署長來回答委員好跟委員報告大概還是以這個慢性病的用藥高血壓還有這個神經用藥還有這個血糖的藥這幾類為主就是心血管藥嘛神經系統的還有全身性抗感染劑用藥那這4000多項裡的調整藥品裡面的慢性病佔了多少\n\n03:52.956 --> 04:09.242\n慢性病大概是八成那涉及到這個慢性處方籤的大概是七成我們以聯合報2023年8月有一篇關於慢性病共同防治的報導說2022年我們慢性病就醫人數高達1286萬人超過700萬人罹患兩種以上的慢性病以臺灣的人口結構來看\n\n04:19.005 --> 04:20.367\n跟委員報告目前拿慢性處方籤的人數大概近800萬人那我們在這個用藥上呢\n\n04:40.349 --> 05:04.665\n這一次調降的時候有特別也宣布說如果我們公告之後是4月1號才實施但是在3月8號之前提出那麼如果有不敷成本我們都會重新的調整價格到目前為止提出的只有五項藥對那些藥萬一沒有了怎麼辦到目前為止提出不敷成本的有五項的藥而已啦那我們這五項就會暫時不會調降它的這個藥價讓它這個確保能夠繼續供藥\n\n05:10.223 --> 05:26.870\n因為據本席了解,我們慢性病的用藥的習慣,你如果換藥的話,大家都會有抱怨聲,而且對藥會沒有信心。我希望剛剛我們市長,署長,你這邊有這個問題的話,請你們就一定要慎重來處理好不好?\n\n05:34.889 --> 05:35.089\n那再來齁,就是\n\n05:58.462 --> 06:21.902\n我們的醫院的分級我們的醫療落實成相這個醫療差距那麼原本台灣社區醫院協會在2月21號在國民黨團開記者會說要在3月8日上街遊行表達訴求到3月4號我們行政院才進行溝通那我想知道為什麼每次都要準備抗爭的時候我們才要進行溝通呢\n\n06:22.842 --> 06:49.471\n本來這個溝通就是有的只是說當時他們對於這個結果並不滿意所以才有這樣子的一些舉動我看到3月4號會議裡面達成的一個共識其中一個就是檢討我們健保藥價的政策來協助解決社區醫院用藥的採購困難你們每年說調整藥價是這個例行行業每年都看不到地區醫院的困難\n\n06:51.277 --> 07:05.577\n都要走上街頭才來處理我希望部長這邊能夠認真來看待這個事情第7月經營的一些困難的情形我們有跟他們已經有我們推動醫療分級的時候是從什麼時候開始\n\n07:06.700 --> 07:33.343\n醫療分級算是很早,從醫療網計畫在民國差不多74年左右的時候就開始但是時空環境的一些演變,這東西也必須要去做一些調整。我不知道部長有沒有想過就是說,就算是費用高一點,我們像我們苗栗縣,苗栗縣民來講有碰到什麼問題,他還是願意多花一點錢到大醫院跑,你知道這為什麼嗎?\n\n07:35.000 --> 08:01.748\n當然有一些是品牌的迷思,大醫院這醫師是...對,像我們苗栗醫院都是區域醫院跟地區醫院這幾年在醫院縣府我們中央相互的合作做了策略聯盟那當然慢慢的會有提升那我們當然有別的想法就是希望說如果苗栗現有的醫院裡我們就地升級的可能性大不大\n\n08:02.508 --> 08:22.287\n這就是我們鼓勵的方向我們希望說在地的醫院都能夠提升它的品質讓建立這個品牌的形象讓我們的民眾有這個信心像布苗醫院像集中跟大樓跟我們的癌症中心兩個大樓沒有辦法主席再給我一分鐘\n\n08:26.511 --> 08:51.366\n因為你知道除了是費用的關係是費用的問題還有沒有其他問題主要還是費用的問題所以我們現在已經工程費用已經有追加了對我這樣講我是有聽到就是說我們的設計跟這個部分我希望部長也能夠去了解一下是不是有一些問題讓廠商不敢去投標\n\n08:52.467 --> 08:52.547\n邱鎮軍委員\n\n","segments":[{"start":0.322,"end":0.923,"text":"邱鎮軍委員進行質詢。"},{"start":18.804,"end":35.49,"text":"部長請問那個蘇丹鴻的事件我想這兩天又上頭版最近又爆出11家的餐飲以及食品業者都中標了這是今天早上的一個兩大報的一個頭版大家可以看一下部長有看到嗎?我知道"},{"start":47.455,"end":74.84,"text":"我想兩大報我們先拿聯合報講的食藥署不保證市場沒有問題這是真的嗎?根本報告目前都往下在查那因為他這個辣椒粉做成很多成品所以我們現在是往下去查你多久可以查?現在陸陸續續都一直在查你可以給我一個時間嗎?我覺得這樣一直等拖的時間太久我們國內的安全誰負責?"},{"start":76.923,"end":79.918,"text":"一個月內應該是可以把這些通通查完"},{"start":81.207,"end":108.879,"text":"從今天開始?對對對,校期之內的這一些產品那你查的方式勒?你現在怎麼查?因為現在從原料開始往下第二層加工的然後再第三層的話就是這個零售的這部分因為我覺得啦,我們民眾食安的問題不能拖不能等尤其是在我們16縣市的營養午餐這個部分部長可不可以承諾先可以處理?"},{"start":110.386,"end":139.389,"text":"營養午餐的部分我們尊重地方的決定因為小孩子吃辣的這個習慣是比較少的所以營養午餐要去禁這個我覺得營養午餐這部分應該是不是我們這邊要嚴格先禁止先預防性的這些下架因為營養午餐的業務並不是說由衛福部這邊來控制的但你可以通知各縣市"},{"start":140.97,"end":160.1,"text":"那個辣椒粉的部分,這個我們是可以來跟教育部這邊再來討論一下。我們這個問題,預防性的下架也不敢,那暫時下架待檢才檢驗的全部可以?因為有問題的是預防性下架本來就要做。你上次講的,我們只抽了大概20%、50%。我們關心的是沒有驗的50%。"},{"start":166.847,"end":170.992,"text":"對,所以我們現在就尋先再找那個所以應該要照著這個部分要盡快,好不好?"},{"start":174.468,"end":199.773,"text":"另外第二個我們今天談的議題就是藥價的我們今年總共有4568項藥品的價格異動那其中調降了4551項調升17項那當然這是我們2013年以後調整最少的一個紀錄那表示說我們醫界跟藥界的他們的聲音有被聽到那我想請問部長那這次藥價"},{"start":203.481,"end":232.2,"text":"備砍最多的前三類藥品是什麼我是不是這個問題我是不是可以請我們健保署長來回答委員好 跟委員報告大概還是以這個慢性病的用藥高血壓還有這個神經用藥還有這個血糖的藥這幾類為主就是心血管藥嘛神經系統的還有全身性抗感染劑用藥那這4000多項裡的調整藥品裡面的慢性病佔了多少"},{"start":232.956,"end":249.242,"text":"慢性病大概是八成那涉及到這個慢性處方籤的大概是七成我們以聯合報2023年8月有一篇關於慢性病共同防治的報導說2022年我們慢性病就醫人數高達1286萬人超過700萬人罹患兩種以上的慢性病以臺灣的人口結構來看"},{"start":259.005,"end":260.367,"text":"跟委員報告目前拿慢性處方籤的人數大概近800萬人那我們在這個用藥上呢"},{"start":280.349,"end":304.665,"text":"這一次調降的時候有特別也宣布說如果我們公告之後是4月1號才實施但是在3月8號之前提出那麼如果有不敷成本我們都會重新的調整價格到目前為止提出的只有五項藥對 那些藥萬一沒有了怎麼辦到目前為止提出不敷成本的有五項的藥而已啦那我們這五項就會暫時不會調降它的這個藥價讓它這個確保能夠繼續供藥"},{"start":310.223,"end":326.87,"text":"因為據本席了解,我們慢性病的用藥的習慣,你如果換藥的話,大家都會有抱怨聲,而且對藥會沒有信心。我希望剛剛我們市長,署長,你這邊有這個問題的話,請你們就一定要慎重來處理好不好?"},{"start":334.889,"end":335.089,"text":"那再來齁,就是"},{"start":358.462,"end":381.902,"text":"我們的醫院的分級我們的醫療落實成相這個醫療差距那麼原本台灣社區醫院協會在2月21號在國民黨團開記者會說要在3月8日上街遊行表達訴求到3月4號我們行政院才進行溝通那我想知道為什麼每次都要準備抗爭的時候我們才要進行溝通呢"},{"start":382.842,"end":409.471,"text":"本來這個溝通就是有的只是說當時他們對於這個結果並不滿意所以才有這樣子的一些舉動我看到3月4號會議裡面達成的一個共識其中一個就是檢討我們健保藥價的政策來協助解決社區醫院用藥的採購困難你們每年說調整藥價是這個例行行業每年都看不到地區醫院的困難"},{"start":411.277,"end":425.577,"text":"都要走上街頭才來處理我希望部長這邊能夠認真來看待這個事情第7月經營的一些困難的情形我們有跟他們已經有我們推動醫療分級的時候是從什麼時候開始"},{"start":426.7,"end":453.343,"text":"醫療分級算是很早,從醫療網計畫在民國差不多74年左右的時候就開始但是時空環境的一些演變,這東西也必須要去做一些調整。我不知道部長有沒有想過就是說,就算是費用高一點,我們像我們苗栗縣,苗栗縣民來講有碰到什麼問題,他還是願意多花一點錢到大醫院跑,你知道這為什麼嗎?"},{"start":455,"end":481.748,"text":"當然有一些是品牌的迷思,大醫院這醫師是...對,像我們苗栗醫院都是區域醫院跟地區醫院這幾年在醫院縣府我們中央相互的合作做了策略聯盟那當然慢慢的會有提升那我們當然有別的想法就是希望說如果苗栗現有的醫院裡我們就地升級的可能性大不大"},{"start":482.508,"end":502.287,"text":"這就是我們鼓勵的方向我們希望說在地的醫院都能夠提升它的品質讓建立這個品牌的形象讓我們的民眾有這個信心像布苗醫院像集中跟大樓跟我們的癌症中心兩個大樓沒有辦法主席再給我一分鐘"},{"start":506.511,"end":531.366,"text":"因為你知道除了是費用的關係是費用的問題還有沒有其他問題主要還是費用的問題所以我們現在已經工程費用已經有追加了對我這樣講我是有聽到就是說我們的設計跟這個部分我希望部長也能夠去了解一下是不是有一些問題讓廠商不敢去投標"},{"start":532.467,"end":532.547,"text":"邱鎮軍委員"}]}}}}