{"id":149468,"url":"https://ivod.ly.gov.tw/Play/Clip/1M/149468","video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/1441ba9c2015bdbe654752e5ec513df7dc62c46c87ca327ff8ba9b0039caa7a64c09370e43f311c45ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"廖偉翔","委員發言時間":"09:56:48 - 10:12:34","影片長度":"00:15:46","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":946,"end_time":"2024-03-07T10:12:34+08:00","start_time":"2024-03-07T09:56:48+08:00","features":["ai-transcript","gazette"],"type":"Clip","gazette":{"lineno":406,"blocks":[["廖委員偉翔：（9時56分）有請部長。"],["主席：部長請。"],["薛部長瑞元：委員好。"],["廖委員偉翔：部長好。衛福部在前天突然無預警宣布掛號費取消上限，請教部長，在做這個行為之前，你們有做所謂的啟動社會溝通以及邀請學者專家研議或評估嗎？在做政策之前。"],["薛部長瑞元：倒是沒有這樣大規模地去做這種……"],["廖委員偉翔：如果沒有，政策沒有評估就上路，完全沒有考慮到取消上限後會造成的任何影響，包含醫療可近性、包含醫療階級化或者醫療體系長期上會發生什麼狀況、有沒有可能不利醫療分級等等的影響，針對這樣子的取消上限，我想請問部長，你覺得對百姓的醫療負擔會漲幾成呢？"],["薛部長瑞元：以目前來講的話，第一個我要講我們在公告之前，其實有一些……"],["廖委員偉翔：你知道會漲幾成嗎？你們有研究過會漲幾成嗎？"],["薛部長瑞元：這沒有辦法去做的……"],["廖委員偉翔：沒有辦法做？"],["薛部長瑞元：對啊！"],["廖委員偉翔：所以其實你們沒有審慎的評估研究，也沒有足夠的溝通，對不對？"],["薛部長瑞元：應該不是說這樣，因為如果回歸到市場……"],["廖委員偉翔：部長，政策是不能隨性的，我覺得很多政策你們必須要經過審慎的評估才可以，尤其是這個對於長期的影響，所以你們聽起來就是沒有評估，而且看起來的行為就是甩鍋給地方政府，面對這樣的問題，你們選擇便宜行事的方式……"],["薛部長瑞元：沒有甩鍋給地方政府啦！"],["廖委員偉翔：我知道學界或者是醫藥界對這件事情普遍是積極的看法，可是這幾年來，對於百姓來講，除了從去年提高部分負擔、增加醫學中心的名額，讓民眾看病變得更貴之外，這次直接拿掉所謂的掛號費上限，對百姓而言就是漲漲漲，所以對於人民而言是被剝了三層皮。部長，我想要請問，你這樣拿掉掛號費上限就解決問題了嗎？掛號費不是只是行政費用而已嗎？事實上，問題的核心不就是因為健保點值長期不公而且過低，所以才造成醫事人員被政府拗做功德？"],["薛部長瑞元：跟委員報告……"],["廖委員偉翔：醫護低薪與過勞，並且人力流失，所以才造成我們的醫療體系可能崩潰。我覺得你們倉促做這件事情，既沒有充分的溝通，也沒有充分地去評估，你們造成的事情也沒有評估這樣對百姓可能造成多少負擔，對於這些比較低薪或者是收入較低的百姓的配套方案也沒有做，看起來就是你不去思考健保總額制度要怎麼改革，不去解決問題，這樣是一個治標不治本的狀況，而且也沒有根治問題，這樣的作法還可能衍生更多對於社會的影響。我想這個部分，部長，你們是不是不夠嚴謹？所以看起來你們衛福部的作法就是把這個責任推得一乾二淨，也把你們對於健保應該改革的問題推得一乾二淨。"],["薛部長瑞元：健保的改革是健保的改革，這是……"],["廖委員偉翔：但是你們現在看起來就是急就章嘛！"],["薛部長瑞元：沒有、沒有，掛號費這個部分，因為掛號費本來就是行政費用，醫療院所……"],["廖委員偉翔：那我想請問部長，健保的總額制度改革什麼時候要提出？"],["薛部長瑞元：現在都逐漸在進行當中。"],["廖委員偉翔：下次期待你提出一個更完整的方案，而不是急就章的方式來做這件事情，好嗎？"],["薛部長瑞元：跟委員報告，因為整個最後健保的改革會在修法的這個部分。"],["廖委員偉翔：真正的問題是健保點值長期不公，你認不認同？"],["薛部長瑞元：但是跟那個是兩件事情。"],["廖委員偉翔：您認不認同？你認不認同這件事情？這個簡報現在是寫這樣。"],["薛部長瑞元：健保點值沒有到1點1塊是沒有錯。"],["廖委員偉翔：所以你認同還是不認同？我沒有要你解釋，我問你Yes or No？"],["薛部長瑞元：我是認為這個沒有去講到核心。"],["廖委員偉翔：沒有講到核心？"],["薛部長瑞元：對。"],["廖委員偉翔：那你會改革健保點值的問題嗎？"],["薛部長瑞元：這個茲事體大，健保所謂的點值是跟量有關的，如果說在總額預算下的話……"],["廖委員偉翔：好，部長，我們現在進行下一題。","部長，這是今天的重點，過年前傳出缺藥時，你說堅持品牌迷思、堅持原廠藥，只能等死，恕我不能同意你這樣的看法，因為官員存在的目的不就是應該解決百姓的問題嗎？為什麼可以說人民只能等死呢？你承不承認這句話是失言？"],["薛部長瑞元：沒有……"],["廖委員偉翔：您覺得不是失言？"],["薛部長瑞元：因為這個病人如果堅持這個藥，這個藥一定要用哪個品牌的話，但就是沒有，你要怎麼辦？"],["廖委員偉翔：部長，但是缺藥是重要的民生議題，攸關人民的健康，可以這樣子講話嗎？你可以只講堅持品牌迷思會造成問題，你不能說民眾只能等死啊！對吧？"],["薛部長瑞元：委員，我想遣詞用字是每一個人有每一個人的……"],["廖委員偉翔：部長，今天要討論的是健保藥價調整以及藥廠慢性病用藥的因應作為，我想要請問，這兩年的缺藥問題很嚴重，有些是真的缺藥、有些是假的缺藥，但是近半年缺藥問題是越來越嚴重，包含媒體人陳文茜女士也在臉書說，現在健保制度下卻買不到1粒1元的口服劑型類固醇，所以他還請人從美國代購，甚至現在也傳出藥局為了留住客戶而開始賠錢加價囤一些常用的慢性藥品，例如我們調整心跳速率的康肯，包含愛敏釋也已經長期1年多缺藥了，我想請問部長，你有沒有掌握到這樣的狀況？"],["薛部長瑞元：這個都有替代的或者是同成分的品牌。"],["廖委員偉翔：沒有，我剛剛講的事情是現在藥局為了留住客戶開始賠錢加價囤一些常用的慢性藥品，你有沒有掌握到這樣的狀況？"],["薛部長瑞元：委員，要不要聽我稍微對這一點做一點解釋？現在complain的是我們現在把藥價調下來，但是當初他進藥的成本是比較高的。"],["廖委員偉翔：部長，你沒有聽清楚我的問題，我剛剛是說你有沒有掌握到這樣的狀況？你不用解釋。"],["薛部長瑞元：有。"],["廖委員偉翔：好，有，對不對？"],["薛部長瑞元：總是要讓我解釋一下吧？"],["廖委員偉翔：沒有，我只問你有沒有掌握到？"],["薛部長瑞元：有。"],["廖委員偉翔：我只想問你有沒有掌握到。"],["薛部長瑞元：有。"],["廖委員偉翔：所以類似overbooking的作法是不是只會讓缺藥的問題雪上加霜？我想要請教部長，你們衛福部是不是要公開呼籲藥局不要囤貨？"],["薛部長瑞元：沒有，所謂的囤貨，我剛剛講……"],["廖委員偉翔：你會公開呼籲嗎？"],["薛部長瑞元：我剛剛要解釋，委員就沒有時間給我解釋嘛！這不是囤貨，而是他已經買進來了，他早就買進來了。"],["廖委員偉翔：但是現在藥局……"],["薛部長瑞元：但是當時的價格是比較高的，現在我們……"],["廖委員偉翔：好，所以你是說你不會公開呼籲他們不要囤貨？會還是不會？"],["薛部長瑞元：藥局要囤貨也是有一點困難啦！"],["廖委員偉翔：請問你會公開呼籲，會還是不會？"],["薛部長瑞元：我們會監測整個的……還有醫院嘛！"],["廖委員偉翔：好，部長，今天你的報告寫了很多，事實上很多東西都是過去或現在已經都在做了，但是你們還是沒有針對缺藥的問題和原因去詳細瞭解。","我整理出缺藥的原因在供應或是製造端方面有4點：製造品質或法規要求改變、原料藥供應不及跟物流運送延遲，還有藥廠商業考量或是製造排程延遲，或停止製造逾專利很久的藥品。另外在輸入端，也就是需求端的部分，庫存量管理不佳和我們突然增加的需求，以及季節需求因素都會造成缺藥。我想請問，這些所有可能缺藥的因素我們點出來，食藥署除了建置一個缺藥通報平台之外，有沒有針對這些因素預先去因應或是做危機的管控？"],["薛部長瑞元：如果是在所謂必要藥品的項目裡面，我們要求是6個月之前，如果……就要通報。"],["廖委員偉翔：部長，我知道，藥界都很清楚，食藥署只是控藥，就是發生缺藥的時候要求優先提供給大醫院，所以，為何食藥署不能夠從製造端和輸入端常態性地去瞭解未來1年的供應狀況？"],["薛部長瑞元：沒有、沒有……"],["廖委員偉翔：因為時間有限，下一題，請教部長和我們健保署的石署長，現在缺藥問題涉及層面很廣，所以外界普遍的看法，因為藥價不斷被砍所導致，所以藥品的支付改革也是我們缺藥的重要一環，對不對？"],["薛部長瑞元：對。"],["廖委員偉翔：所以請教署長，已經開了無數次健保藥品政策改革方案溝通會議何時會定案？"],["石署長崇良：跟委員報告，我們近期還會再開一次，包含一些保障的措施，還有鼓勵在臺製造的政策，來確定溝通之後，然後接著進行法規的預告。"],["廖委員偉翔：好，因為已經開了很多次，所以還是請健保署可以趕快進行。"],["石署長崇良：是。"],["廖委員偉翔：另外，因為藥價改革也涉及到修正全民健康保險藥物給付項目跟支付標準，我想要請教部長和署長何時會預告、何時會公告？"],["石署長崇良：快的話大概在4月份我們就會進行預告了。"],["廖委員偉翔：因為我在面對缺藥問題的時候，一個星期前有公開主張過，同時符合三個條件，各該品項的藥價就可以排除在每年藥價調整之外，或者不受藥價調整的影響，這三個條件分別是：臨床上有需求，也就是必須經過醫學會認證；第二個是鼓勵在地製造，希望可以穩定供應鏈；第三個是三張以下的稀缺藥證。這三個具體提議的背後就是希望尊重各醫學會，他們最清楚藥的需求；第二個是希望鼓勵在地製造，希望可以穩定我們的藥品供應，增加我們的就業機會；第三個是希望稀缺藥證，就是誠如部長說的替代性藥品，儘量不要調整。這三個方案是否可行請你們好好的評估，好不好？"],["薛部長瑞元：跟委員報告，這方向上面我們是贊同，但是要醫學會認證這件事情要保留。"],["廖委員偉翔：好，請你們回去好好地評估，因為醫學會他們在臨床上有他們的需求，這個部分請你們……"],["薛部長瑞元：過去的經驗他們都說好。"],["廖委員偉翔：我知道你會這樣講，沒關係。","下一題，因為時間快到了，最後一題我們要回到人民最關心的食安問題，最近蘇丹紅的事情越演越烈，已經是一個系統性的問題，而且辣椒原料從禮拜一的時候你們說查出二萬多公斤，到今天（3天後）已經查出6.4萬公斤，而且我去調了海關進口辣椒製品，在2023年，也就是112年的時候，總共進口了276萬公斤，部長，你知道嗎？"],["薛部長瑞元：但是它不是統統都不合格。"],["廖委員偉翔：好，不是統統不合格，但是我告訴你，這276萬公斤進來了，對不對？"],["薛部長瑞元：對。"],["廖委員偉翔：你已經查到了6.4萬公斤了。"],["薛部長瑞元：對。"],["廖委員偉翔：你已經查到6.4萬公斤，已經是2%多、將近3%了，依照民進黨陳建仁和你部長的統計學，我可不可以說這276萬公斤很多都有問題？你敢保證都沒問題嗎？我依照你們的統計學說的。"],["薛部長瑞元：這不能這樣講。"],["廖委員偉翔：我依照你們的統計學說的，因為你們上次說這個3%不能夠代表，但現在已經驗出這麼多了，你有多少量還有沒有掌握到？"],["薛部長瑞元：我們現在就是對於那些沒有掌握到的逐批再往下去查。"],["廖委員偉翔：你剛剛說一個多月，然後現在人民已經暴露在這樣系統性的食安風暴裡面。好，部長，我只是把這個數據提供給你，讓你好好地嚴加調查，276萬多公斤吔，會影響臺灣多少的食品？而且你們食藥署也說不保證市場沒有問題，所以你這276萬公斤很可怕，請你們好好地把皮繃緊一點。"],["薛部長瑞元：那個是有包括……"],["廖委員偉翔：而且現在縣市政府都跟進，我們很多團膳，包含六都，全部在野黨執政的縣市、地方政府縣市都宣布說不准營養午餐用辣椒粉，反而是我看到中央好像把關不力，變成地方很努力地在為你們擋，然後也要求縣市政府說營養午餐團膳不可以使用，可是看起來民進黨執政的縣市沒有跟進，我想請問部長有什麼看法？"],["薛部長瑞元：我們是不反對地方政府對於這個……因為小孩子吃辣的習慣是少的。"],["廖委員偉翔：你不能夠說吃辣的習慣是少的，任何可能吃到的風險呢？"],["薛部長瑞元：所以那個部分去禁止，我們並不反對。"],["廖委員偉翔：你並不反對……"],["薛部長瑞元：但是在全民的話……"],["廖委員偉翔：那為什麼你不可以說你建議這些縣市可以先不要用？因為你現在查不到嘛！276萬公斤你沒辦法馬上查完嘛！衛福部、中央是不是應該要有一點guts擔當起來？"],["薛部長瑞元：我們會跟教育部討論這件事情。"],["廖委員偉翔：現在看起來就是地方為你們把關得很嚴謹，中央發生的這個事情好像不關你們的事，全部推給地方。"],["薛部長瑞元：沒有，這個有權責分工。"],["廖委員偉翔：部長，食安的預警、溯源10年來都沒有進步，我們星期一的時候也請教你跟許輔主任有關食安會報的狀況，你們本來說今年1月份要召開，但是因為選舉因素，現在還沒有確定日期。大家都說食安不能有假期，但是看起來你們民進黨政府選舉最大，食安會報一拖再拖也沒有關係，我想問這是你們對食安的態度嗎？"],["薛部長瑞元：據我所知道的，應該這一個月會召開。"],["廖委員偉翔：好，最後我還是要問你，你到底重不重視食安？"],["薛部長瑞元：我當然重視。"],["廖委員偉翔：你很重視食安，對不對？"],["薛部長瑞元：對。"],["廖委員偉翔：你很重視。"],["薛部長瑞元：對。"],["廖委員偉翔：好，但是上次我問你，你缺席去年的食安會報，你告訴我，因為你要接受立法院質詢。"],["薛部長瑞元：對。"],["廖委員偉翔：但是我去查了，食安會報那一次是下午3點召開，可是我們的委員會1點22就散會了，中間還有一個半小時。你說你很重視食安的話，你有充分的時間可以去參加食安會報，但你卻選擇缺席，而且面對國會議員的公開質疑，你選擇說謊解釋不去參加的理由。"],["薛部長瑞元：當然我們……"],["廖委員偉翔：現在不夠重視食安的情況之下，讓人民暴露在系統性的食安風險中，可能有兩百七十六萬多公斤的問題食品存在在我們社會上。我想要請問部長，你願不願意就這件事情跟全國人民道歉？"],["薛部長瑞元：我跟委員解釋一下，第一個，當我知道隔天要開食安會報，而且……"],["廖委員偉翔：不用解釋，我沒有要你解釋那一件事情。"],["薛部長瑞元：沒有，這一定要解釋，這不能……"],["廖委員偉翔：我要跟你講的事情是……"],["薛部長瑞元：你不能拋了一個東西要我吞下去。"],["廖委員偉翔：因為這樣子導致現在臺灣……不是說你這個態度……"],["薛部長瑞元：這個因果關係是有問題的。"],["廖委員偉翔：你這個態度現在讓276萬公斤流竄在我們的社會裡面。"],["薛部長瑞元：沒有，這個沒有因果關係啦！"],["廖委員偉翔：你要不要因為這個系統性的食安問題……"],["薛部長瑞元：我去參加食安會議也不會讓276公斤就不見了……"],["廖委員偉翔：你要不要因為系統性的食安問題跟全國人民道歉？"],["薛部長瑞元：沒有，這個……"],["廖委員偉翔：所以你不道歉，對不對？你不會針對現在發生蘇丹紅的系統性食安問題對全國人民道歉？"],["薛部長瑞元：委員會開完會之後，我回到部裡面……"],["廖委員偉翔：好，主席，我沒有話好說了，我想部長繼續硬拗，對我們的食安沒有任何幫助。"],["薛部長瑞元：我們都要找幕僚再討論委員的指教我們要怎麼因應。"],["廖委員偉翔：現在我們遇到系統性的食安問題，你用這種硬拗的態度是沒有辦法幫助我們的。好，謝謝大家。"],["主席：好，謝謝廖偉翔委員的質詢。","主席宣告一下，等王育敏委員質詢完之後，我們休息5分鐘。","接下來請黃秀芳委員進行質詢。"]],"agenda":{"page_end":210,"meet_id":"委員會-11-1-26-4","speakers":["王育敏","陳昭姿",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00:01:48,772\n尤其是這個對於長期的影響所以你們聽起來就是沒有評估而且看起來的行為就是用甩鍋給地方政府面對這樣的問題你們選擇偏移一下形式的方式我知道學界或者是醫藥界對這件事情普遍是積極的看法可是\n\n5\n00:01:49,752 --> 00:02:06,506\n這幾年來對於百姓來講你從去年提高部分的負擔增加醫學中心的名額讓百姓、民眾看病變得更貴之外現在這一次直接拿掉我們所謂的掛號費上限對百姓而言就是漲漲漲所以對於人民而言是被剝了三層皮\n\n6\n00:02:07,347 --> 00:02:24,093\n部長我想要請問你這樣拿掉掛號費上線就解決問題了嗎?因為掛號費不是只是行政費用而已嗎?事實上對問題的核心不就是因為健保點值長期的不公而且過低所以才造成這個醫事人員被政府拗作功德\n\n7\n00:02:25,053 --> 00:02:48,319\n各位委員報告醫護低薪與過勞並且人力流失所以才造成我們醫療體系可能崩潰所以我覺得你們倉促做這件事情又沒有充分的溝通也沒有充分的去評估你們造成的事情也沒有評估說那這樣對百姓可能造成多少負擔有沒有對於這些比較低薪的百姓或者是比較收入較低的配套方案也沒有做\n\n8\n00:02:49,397 --> 00:03:06,392\n我們看起來就是你不去思考怎麼改革健保總額的制度要怎麼改革不去解決問題這樣是一個治標不治本的狀況而且也沒有根治的問題這樣的做法還可能衍生更多的這個對於社會的影響我想這個部分\n\n9\n00:03:07,153 --> 00:03:25,063\n部長你們是不是不夠的嚴謹所以看起來你們衛福部的做法就是把這個責任推到推得一竿而盡也把你們對於健保應該改革的問題推得一竿而盡健保的改革是健保的改革這是一樣但是你們現在看起來就是急救張馬\n\n10\n00:03:26,664 --> 00:03:28,345\n真正的問題是健保點值長期不公你認不認同?\n\n11\n00:03:52,176 --> 00:03:58,822\n你認不認同?你認不認同這件事?這個簡報現在是寫的那樣子所以你認同還不認同?我沒有要你解釋,我問你yesorno\n\n12\n00:04:08,430 --> 00:04:08,890\n好,部長\n\n13\n00:04:23,596 --> 00:04:45,137\n我們現在進行下一題部長過年前今天的重點過年前這個傳出缺藥時你說堅持品牌迷思堅持原廠藥只能等死喔恕我不能同意你這樣的看法因為官員存在的目的不就是應該解決百姓的問題嗎為什麼可以說只有人民只能等死呢你承不承認這句話是失言\n\n14\n00:04:46,478 --> 00:05:13,555\n沒有因為只有一個病人如果你堅持這個藥但是缺藥、失明的重要的民生一級有關人民的健康可以這樣子講話嗎?因為你可以只講堅持品牌迷失是會造成問題你不能說民眾只能等死啊,對吧?委員我想齁,這個遣食用字是沒有好,部長今天要討論的這個健保藥價調整以及藥廠慢性病用藥的因應作為我想要請問\n\n15\n00:05:14,755 --> 00:05:35,345\n這兩年的缺藥問題很嚴重有些是真的缺藥有些是假的缺藥但是近半年缺藥問題是越來越嚴重包含這個媒體人我們陳文茜女士也在臉書說現在健保制度下卻買不到一粒一元的口服劑型的類固醇所以他還請人從美國代購甚至\n\n16\n00:05:36,225 --> 00:05:53,240\n現在也傳出這個藥局為了留住客戶而開始賠錢加價囤一些常用的慢性藥品例如我們調整心跳速率的這個康肯我想要請教部長包含著這個我們的\n\n17\n00:05:54,751 --> 00:06:10,078\n愛敏氏也已經長期一年多缺藥了我想請問部長你有沒有掌握到這樣的狀況這個都有替代的或者是說同成分的一個品牌沒有我剛剛講的事情是現在的藥局為了留住客戶開始賠錢加價囤\n\n18\n00:06:13,579 --> 00:06:40,038\n一些常用的慢性藥品你有沒有掌握到這樣的狀況?委員要不要聽我稍微這一點做一點解釋他現在在抱怨的是我們現在把藥價調下來但是當初他禁的藥部長你沒有聽清楚我的問題我剛說你有沒有掌握到這樣的狀況?有你不用解釋對好有對不對那這種類似沒有我只問你有沒有掌握到我沒有說這個事情發生就是我只想問你有沒有掌握到所以這類似overbooking的做法\n\n19\n00:06:40,538 --> 00:07:06,286\n是不是只會讓缺藥的問題雪上加霜?那我想要請教部長,你們衛福部是不是要公開呼籲藥局不要囤貨?沒有啊,這所謂的囤貨,我剛剛...你會公開呼籲嗎?我剛剛解釋,委員就沒有時間給我解釋嘛。這個不是囤貨,是他已經買進來了啦。但是現在藥局...但是當時的價格是比較高的。那所以你是說你不會公開呼籲他們不要囤貨?\n\n20\n00:07:08,668 --> 00:07:32,414\n會還是不會?那請問你會公開呼籲會還是不會?好部長你今天你報告寫了很多喔事實上很多東西都是過去或現在已經都在做了但是你們還是沒有針對缺藥的問題和原因去詳細的了解我整理出缺藥的原因在供應或是製造端方面有4點喔\n\n21\n00:07:33,474 --> 00:07:50,332\n製造品質或法規要求改變原料藥的供應不及跟物流運送的延遲還有這個藥廠商業考量或是製造排成延遲或停止製造這個預專利很久的藥品而另外在輸入端也就是需求端的部分\n\n22\n00:07:51,260 --> 00:07:55,023\n食藥署除了建置一個缺藥通報平台之外有沒有針對這些因素預先去因應或是做危機的管控?\n\n23\n00:08:10,673 --> 00:08:30,474\n如果是在這所謂的必要藥品的項目裡面的話那我們要求是6個月之前若可以是部長我知道藥界都很清楚食藥署只是控藥就是發生缺藥的時候要求這個優先提供給大醫院所以為何食藥署不能夠從製造端或是物端常態性的去了解未來一年的供應狀況\n\n24\n00:08:33,632 --> 00:08:55,659\n好因為時間有限下一題請教部長和我們的健保署的時署長現在缺藥問題涉及的層面很廣所以外界普遍的看法因為藥價不斷被砍鎖導致所以這個藥品的支付改革也是我們缺藥的重要的一環對不對所以請教署長已經開了無數次的這個健保藥品政策改革方案溝通會議何時會定案\n\n25\n00:08:57,723 --> 00:09:25,613\n跟委員報告我們近期還會再開一次那包含一些保障的措施還有鼓勵在台製造的政策來確定溝通之後然後接著進行法規的預告好因為已經開了很多次了所以還是請這個我們食藥署的部分還不是請我們健保署的部分可以趕快的進行還有另外因為藥價改革也涉及到修正全民健康保險藥物給付項目跟支付標準我想要請教部長和署長何時會預告何時會公告\n\n26\n00:09:27,073 --> 00:09:45,613\n都會在快的話大概在4月份我們就會進行預告了好因為我在面對缺藥問題的時候我一個星期前有公開主張過同時符合三個這個條件我們該各該品項的藥價就可以排除在每年藥價調整之外或者不受藥價調整的影響\n\n27\n00:09:46,354 --> 00:10:04,954\n那這三個條件分別是臨床上有需求臨床上有需求也是也就是要必須經過我們的醫學會的認證第二個是鼓勵在地製造希望可以穩定供應鏈第三個是三張以下的稀缺藥證這三個具體的項目這個提議的背後就是希望\n\n28\n00:10:05,535 --> 00:10:31,247\n尊重各醫學會他們最清楚藥的需求然後第二個是希望鼓勵在地製造希望可以穩定我們的藥品供應增加我們的就業機會第三個是希望稀缺藥證就是誠如部長說的替代性的藥品盡量不要調整這三個方案是否可行所以請你們好好的評估好不好這方向上面我們是贊同但是要醫學會認證這件事情要保留\n\n29\n00:10:31,707 --> 00:10:58,895\n好請你們回去好好的評估因為醫學會他們在臨床上有他們的需求這部分請你們相加所以我知道你會這樣講沒關係下一題因為時間快到了最後一題我們要回到我們人民最關心的食安問題最近蘇丹紅的事情越演越烈已經是一個系統性的問題而且辣椒原料從禮拜一的時候你們說查出2萬多公斤到今天3天後已經查出6.4萬公斤\n\n30\n00:11:01,058 --> 00:11:16,353\n而且我去調了海關進口這個所謂的辣椒製品在2023年也就是112年的時候總共進口了276萬公斤啊部長你知道嗎但是他不是通通都不合格\n\n31\n00:11:17,094 --> 00:11:33,908\n不是通通不合格但是我告訴你這276萬公斤進來了對不對你已經查到了6.4萬公斤了你查到了6.4萬公斤了已經2點多趴將近3趴了依照你民進黨陳建仁和你部長的統計學我可不可以說這276萬公斤很多都有問題\n\n32\n00:11:34,969 --> 00:11:47,302\n你敢保證都沒問題嗎?我依照你們統計學說的我依照你們統計學說因為你們上次說這個3%不能夠代表你現在已經驗出了這麼多了你有多少量你還有沒有掌握到?\n\n33\n00:11:48,157 --> 00:12:07,694\n我們現在就是對於那些沒有掌握到的我們逐批的再往下你剛才說一個多月然後現在人民已經暴露在這樣系統性的食安風暴裡面好部長我只是把這數據提供給你讓你好好的嚴加嚴加的去查276萬多公斤會影響台灣多少的食品\n\n34\n00:12:08,955 --> 00:12:25,885\n而且你們食藥署也說不保證市場沒有問題所以你這276萬公斤很可怕請你們好好的把皮繃緊一點而且現在縣市政府都跟進我們的很多這個團戰包含我們六都裡面全部\n\n35\n00:12:27,126 --> 00:12:50,288\n這個在野黨執政的縣市地方政府縣市都宣布說不准營養午餐用這個辣椒粉那反而是我看到中央好像把關不利變成地方很努力的在為你們擋然後也要求這個縣市政府說這個營養午餐團散不可以使用可是看起來這個民進黨執政的縣市沒有跟進我想請問部長有什麼看法\n\n36\n00:12:51,248 --> 00:13:16,989\n我們是不反對說地方政府對於這個因為小孩子吃辣的習慣是少的你不能夠說吃辣習慣少那他任何可能吃辣的風險呢所以那個部分的話你去說禁止我們並不反對你並不反對那為什麼你不可以說你建議你建議這些縣市可以先不要用因為你現在查不到嘛276萬公斤你沒辦法馬上查完嘛那你是不是應該衛福部中央應該要有點尬詞\n\n37\n00:13:18,490 --> 00:13:18,510\n部長﹖\n\n38\n00:13:32,836 --> 00:13:57,217\n食安的預警溯源十年來都沒有進步所以我們星期一的時候也請教你跟徐副主任有關食安匯報的狀況你們本來說今年一月份要召開但是因為選舉因素現在還沒有確定日期大家都說食安不能有假期但是看起來你們民進黨政府選舉最大食安匯報一拖再拖也沒有關係我想問這是你們對食安的態度嗎\n\n39\n00:13:59,540 --> 00:14:09,193\n應該我所知道的應該是這一個議會召開那我問部長最後我還是要問你你到底重不重視食安我當然重視你很重視食安對不對你很重視\n\n40\n00:14:10,782 --> 00:14:33,417\n但是上次我問你的時候你缺席去年食安會報你告訴我說因為你要接受立法院的質詢但是我去查了你的食安會報那一次是下午3點召開可是我們的委員會1點22就散會了中間還有一個半小時你說你很重視食安的話你有充分的時間可以去參加食安會報但你卻選擇出席喔而且面對國會議員的公開質疑你卻選擇說謊不去參加的理由\n\n41\n00:14:37,099 --> 00:14:37,579\n我跟委員解釋一下第一個\n\n42\n00:14:55,664 --> 00:15:06,246\n當我知道隔天要食安會報告和解釋不用解釋我沒有要你解釋那件事情我要跟你講的事情是你因為這樣子導致現在臺灣喔不是說你的這個態度喔你這個態度讓現在這個276萬公斤流竄在我們的社會裡面你要不要因為這個系統性的食安問題你要不要因為這個系統性的食安問題跟全國人民道歉\n\n43\n00:15:22,959 --> 00:15:44,685\n李翠你不道歉嗎?你不會針對現在發生蘇丹紅的系統食安問題對全國人民道歉?主席我沒有話好說了我想這樣部長繼續硬拗喔對我們的食安沒有任何的幫助因為現在我們遇到的系統性食安問題你用這種硬拗的態度是沒有辦法幫助到我們的好謝謝大家\n\n","tsv":"start\tend\ttext\n10578\t37254\t有請部長好 部長請委員好部長好部長衛福部在前天突然無預警的宣布掛號費的取消上限請教部長你在做這個行為之前你沒有做所謂的啟動社會溝通以及邀請學者專家研議或評估嗎在做這個政策之前\n38734\t64303\t倒是沒有說有這樣大規模的去作證如果沒有政策沒有評估就上路完全沒有考慮到取消上限後會造成的任何的影響包含醫療可進性包含醫療階級化或者醫療體系長期上會有發生什麼狀況有沒有可能不利這個醫療分級等等的影響喔我在想這樣子的取消上限我想請問部長你覺得對百姓的醫療負擔會長幾成呢\n66624\t89154\t以目前來講的話,第一個我要講,我們在做這個公告之前,其實有一些...你知道會長幾層嗎?你們有研究過會長幾層嗎?這個沒有辦法去做這個...所以其實你們沒有審慎的評估研究,也沒有足夠的溝通,對不對?應該不是說這樣,因為...部長,政策是不能隨性的,我覺得很多政策你們必須要經過審慎的評估才可以喔\n90094\t108772\t尤其是這個對於長期的影響所以你們聽起來就是沒有評估而且看起來的行為就是用甩鍋給地方政府面對這樣的問題你們選擇偏移一下形式的方式我知道學界或者是醫藥界對這件事情普遍是積極的看法可是\n109752\t126506\t這幾年來對於百姓來講你從去年提高部分的負擔增加醫學中心的名額讓百姓、民眾看病變得更貴之外現在這一次直接拿掉我們所謂的掛號費上限對百姓而言就是漲漲漲所以對於人民而言是被剝了三層皮\n127347\t144093\t部長我想要請問你這樣拿掉掛號費上線就解決問題了嗎?因為掛號費不是只是行政費用而已嗎?事實上對問題的核心不就是因為健保點值長期的不公而且過低所以才造成這個醫事人員被政府拗作功德\n145053\t168319\t各位委員報告醫護低薪與過勞並且人力流失所以才造成我們醫療體系可能崩潰所以我覺得你們倉促做這件事情又沒有充分的溝通也沒有充分的去評估你們造成的事情也沒有評估說那這樣對百姓可能造成多少負擔有沒有對於這些比較低薪的百姓或者是比較收入較低的配套方案也沒有做\n169397\t186392\t我們看起來就是你不去思考怎麼改革健保總額的制度要怎麼改革不去解決問題這樣是一個治標不治本的狀況而且也沒有根治的問題這樣的做法還可能衍生更多的這個對於社會的影響我想這個部分\n187153\t205063\t部長你們是不是不夠的嚴謹所以看起來你們衛福部的做法就是把這個責任推到推得一竿而盡也把你們對於健保應該改革的問題推得一竿而盡健保的改革是健保的改革這是一樣但是你們現在看起來就是急救張馬\n206664\t208345\t真正的問題是健保點值長期不公你認不認同?\n232176\t238822\t你認不認同?你認不認同這件事?這個簡報現在是寫的那樣子所以你認同還不認同?我沒有要你解釋,我問你yes or no\n248430\t248890\t好,部長\n263596\t285137\t我們現在進行下一題部長過年前今天的重點過年前這個傳出缺藥時你說堅持品牌迷思堅持原廠藥只能等死喔恕我不能同意你這樣的看法因為官員存在的目的不就是應該解決百姓的問題嗎為什麼可以說只有人民只能等死呢你承不承認這句話是失言\n286478\t313555\t沒有因為只有一個病人如果你堅持這個藥但是缺藥、失明的重要的民生一級有關人民的健康可以這樣子講話嗎?因為你可以只講堅持品牌迷失是會造成問題你不能說民眾只能等死啊,對吧?委員我想齁,這個遣食用字是沒有好,部長今天要討論的這個健保藥價調整以及藥廠慢性病用藥的因應作為我想要請問\n314755\t335345\t這兩年的缺藥問題很嚴重有些是真的缺藥有些是假的缺藥但是近半年缺藥問題是越來越嚴重包含這個媒體人我們陳文茜女士也在臉書說現在健保制度下卻買不到一粒一元的口服劑型的類固醇所以他還請人從美國代購甚至\n336225\t353240\t現在也傳出這個藥局為了留住客戶而開始賠錢加價囤一些常用的慢性藥品例如我們調整心跳速率的這個康肯我想要請教部長包含著這個我們的\n354751\t370078\t愛敏氏也已經長期一年多缺藥了我想請問部長你有沒有掌握到這樣的狀況這個都有替代的或者是說同成分的一個品牌沒有我剛剛講的事情是現在的藥局為了留住客戶開始賠錢加價囤\n373579\t400038\t一些常用的慢性藥品你有沒有掌握到這樣的狀況?委員要不要聽我稍微這一點做一點解釋他現在在抱怨的是我們現在把藥價調下來但是當初他禁的藥部長你沒有聽清楚我的問題我剛說你有沒有掌握到這樣的狀況?有你不用解釋對好有對不對那這種類似沒有我只問你有沒有掌握到我沒有說這個事情發生就是我只想問你有沒有掌握到所以這類似overbooking的做法\n400538\t426286\t是不是只會讓缺藥的問題雪上加霜?那我想要請教部長,你們衛福部是不是要公開呼籲藥局不要囤貨?沒有啊,這所謂的囤貨,我剛剛...你會公開呼籲嗎?我剛剛解釋,委員就沒有時間給我解釋嘛。這個不是囤貨,是他已經買進來了啦。但是現在藥局...但是當時的價格是比較高的。那所以你是說你不會公開呼籲他們不要囤貨?\n428668\t452414\t會還是不會?那請問你會公開呼籲會還是不會?好部長你今天你報告寫了很多喔事實上很多東西都是過去或現在已經都在做了但是你們還是沒有針對缺藥的問題和原因去詳細的了解我整理出缺藥的原因在供應或是製造端方面有4點喔\n453474\t470332\t製造品質或法規要求改變原料藥的供應不及跟物流運送的延遲還有這個藥廠商業考量或是製造排成延遲或停止製造這個預專利很久的藥品而另外在輸入端也就是需求端的部分\n471260\t475023\t食藥署除了建置一個缺藥通報平台之外有沒有針對這些因素預先去因應或是做危機的管控?\n490673\t510474\t如果是在這所謂的必要藥品的項目裡面的話那我們要求是6個月之前若可以是部長我知道藥界都很清楚食藥署只是控藥就是發生缺藥的時候要求這個優先提供給大醫院所以為何食藥署不能夠從製造端或是物端常態性的去了解未來一年的供應狀況\n513632\t535659\t好因為時間有限下一題請教部長和我們的健保署的時署長現在缺藥問題涉及的層面很廣所以外界普遍的看法因為藥價不斷被砍鎖導致所以這個藥品的支付改革也是我們缺藥的重要的一環對不對所以請教署長已經開了無數次的這個健保藥品政策改革方案溝通會議何時會定案\n537723\t565613\t跟委員報告我們近期還會再開一次那包含一些保障的措施還有鼓勵在台製造的政策來確定溝通之後然後接著進行法規的預告好因為已經開了很多次了所以還是請這個我們食藥署的部分還不是請我們健保署的部分可以趕快的進行還有另外因為藥價改革也涉及到修正全民健康保險藥物給付項目跟支付標準我想要請教部長和署長何時會預告何時會公告\n567073\t585613\t都會在快的話大概在4月份我們就會進行預告了好因為我在面對缺藥問題的時候我一個星期前有公開主張過同時符合三個這個條件我們該各該品項的藥價就可以排除在每年藥價調整之外或者不受藥價調整的影響\n586354\t604954\t那這三個條件分別是臨床上有需求臨床上有需求也是也就是要必須經過我們的醫學會的認證第二個是鼓勵在地製造希望可以穩定供應鏈第三個是三張以下的稀缺藥證這三個具體的項目這個提議的背後就是希望\n605535\t631247\t尊重各醫學會他們最清楚藥的需求然後第二個是希望鼓勵在地製造希望可以穩定我們的藥品供應增加我們的就業機會第三個是希望稀缺藥證就是誠如部長說的替代性的藥品盡量不要調整這三個方案是否可行所以請你們好好的評估好不好這方向上面我們是贊同但是要醫學會認證這件事情要保留\n631707\t658895\t好請你們回去好好的評估因為醫學會他們在臨床上有他們的需求這部分請你們相加所以我知道你會這樣講沒關係下一題因為時間快到了最後一題我們要回到我們人民最關心的食安問題最近蘇丹紅的事情越演越烈已經是一個系統性的問題而且辣椒原料從禮拜一的時候你們說查出2萬多公斤到今天3天後已經查出6.4萬公斤\n661058\t676353\t而且我去調了海關進口這個所謂的辣椒製品在2023年也就是112年的時候總共進口了276萬公斤啊部長你知道嗎但是他不是通通都不合格\n677094\t693908\t不是通通不合格但是我告訴你這276萬公斤進來了對不對你已經查到了6.4萬公斤了你查到了6.4萬公斤了已經2點多趴將近3趴了依照你民進黨陳建仁和你部長的統計學我可不可以說這276萬公斤很多都有問題\n694969\t707302\t你敢保證都沒問題嗎?我依照你們統計學說的我依照你們統計學說因為你們上次說這個3%不能夠代表你現在已經驗出了這麼多了你有多少量你還有沒有掌握到?\n708157\t727694\t我們現在就是對於那些沒有掌握到的我們逐批的再往下你剛才說一個多月然後現在人民已經暴露在這樣系統性的食安風暴裡面好部長我只是把這數據提供給你讓你好好的嚴加嚴加的去查276萬多公斤會影響台灣多少的食品\n728955\t745885\t而且你們食藥署也說不保證市場沒有問題所以你這276萬公斤很可怕請你們好好的把皮繃緊一點而且現在縣市政府都跟進我們的很多這個團戰包含我們六都裡面全部\n747126\t770288\t這個在野黨執政的縣市地方政府縣市都宣布說不准營養午餐用這個辣椒粉那反而是我看到中央好像把關不利變成地方很努力的在為你們擋然後也要求這個縣市政府說這個營養午餐團散不可以使用可是看起來這個民進黨執政的縣市沒有跟進我想請問部長有什麼看法\n771248\t796989\t我們是不反對說地方政府對於這個因為小孩子吃辣的習慣是少的你不能夠說吃辣習慣少那他任何可能吃辣的風險呢所以那個部分的話你去說禁止我們並不反對你並不反對那為什麼你不可以說你建議你建議這些縣市可以先不要用因為你現在查不到嘛276萬公斤你沒辦法馬上查完嘛那你是不是應該衛福部中央應該要有點尬詞\n798490\t798510\t部長﹖\n812836\t837217\t食安的預警溯源十年來都沒有進步所以我們星期一的時候也請教你跟徐副主任有關食安匯報的狀況你們本來說今年一月份要召開但是因為選舉因素現在還沒有確定日期大家都說食安不能有假期但是看起來你們民進黨政府選舉最大食安匯報一拖再拖也沒有關係我想問這是你們對食安的態度嗎\n839540\t849193\t應該我所知道的應該是這一個議會召開那我問部長最後我還是要問你你到底重不重視食安我當然重視你很重視食安對不對你很重視\n850782\t873417\t但是上次我問你的時候你缺席去年食安會報你告訴我說因為你要接受立法院的質詢但是我去查了你的食安會報那一次是下午3點召開可是我們的委員會1點22就散會了中間還有一個半小時你說你很重視食安的話你有充分的時間可以去參加食安會報但你卻選擇出席喔而且面對國會議員的公開質疑你卻選擇說謊不去參加的理由\n877099\t877579\t我跟委員解釋一下第一個\n895664\t906246\t當我知道隔天要食安會報告和解釋不用解釋我沒有要你解釋那件事情我要跟你講的事情是你因為這樣子導致現在臺灣喔不是說你的這個態度喔你這個態度讓現在這個276萬公斤流竄在我們的社會裡面你要不要因為這個系統性的食安問題你要不要因為這個系統性的食安問題跟全國人民道歉\n922959\t944685\t李翠你不道歉嗎?你不會針對現在發生蘇丹紅的系統食安問題對全國人民道歉?主席我沒有話好說了我想這樣部長繼續硬拗喔對我們的食安沒有任何的幫助因為現在我們遇到的系統性食安問題你用這種硬拗的態度是沒有辦法幫助到我們的好謝謝大家\n","txt":"有請部長好 部長請委員好部長好部長衛福部在前天突然無預警的宣布掛號費的取消上限請教部長你在做這個行為之前你沒有做所謂的啟動社會溝通以及邀請學者專家研議或評估嗎在做這個政策之前\n倒是沒有說有這樣大規模的去作證如果沒有政策沒有評估就上路完全沒有考慮到取消上限後會造成的任何的影響包含醫療可進性包含醫療階級化或者醫療體系長期上會有發生什麼狀況有沒有可能不利這個醫療分級等等的影響喔我在想這樣子的取消上限我想請問部長你覺得對百姓的醫療負擔會長幾成呢\n以目前來講的話,第一個我要講,我們在做這個公告之前,其實有一些...你知道會長幾層嗎?你們有研究過會長幾層嗎?這個沒有辦法去做這個...所以其實你們沒有審慎的評估研究,也沒有足夠的溝通,對不對?應該不是說這樣,因為...部長,政策是不能隨性的,我覺得很多政策你們必須要經過審慎的評估才可以喔\n尤其是這個對於長期的影響所以你們聽起來就是沒有評估而且看起來的行為就是用甩鍋給地方政府面對這樣的問題你們選擇偏移一下形式的方式我知道學界或者是醫藥界對這件事情普遍是積極的看法可是\n這幾年來對於百姓來講你從去年提高部分的負擔增加醫學中心的名額讓百姓、民眾看病變得更貴之外現在這一次直接拿掉我們所謂的掛號費上限對百姓而言就是漲漲漲所以對於人民而言是被剝了三層皮\n部長我想要請問你這樣拿掉掛號費上線就解決問題了嗎?因為掛號費不是只是行政費用而已嗎?事實上對問題的核心不就是因為健保點值長期的不公而且過低所以才造成這個醫事人員被政府拗作功德\n各位委員報告醫護低薪與過勞並且人力流失所以才造成我們醫療體系可能崩潰所以我覺得你們倉促做這件事情又沒有充分的溝通也沒有充分的去評估你們造成的事情也沒有評估說那這樣對百姓可能造成多少負擔有沒有對於這些比較低薪的百姓或者是比較收入較低的配套方案也沒有做\n我們看起來就是你不去思考怎麼改革健保總額的制度要怎麼改革不去解決問題這樣是一個治標不治本的狀況而且也沒有根治的問題這樣的做法還可能衍生更多的這個對於社會的影響我想這個部分\n部長你們是不是不夠的嚴謹所以看起來你們衛福部的做法就是把這個責任推到推得一竿而盡也把你們對於健保應該改革的問題推得一竿而盡健保的改革是健保的改革這是一樣但是你們現在看起來就是急救張馬\n真正的問題是健保點值長期不公你認不認同?\n你認不認同?你認不認同這件事?這個簡報現在是寫的那樣子所以你認同還不認同?我沒有要你解釋,我問你yes or no\n好,部長\n我們現在進行下一題部長過年前今天的重點過年前這個傳出缺藥時你說堅持品牌迷思堅持原廠藥只能等死喔恕我不能同意你這樣的看法因為官員存在的目的不就是應該解決百姓的問題嗎為什麼可以說只有人民只能等死呢你承不承認這句話是失言\n沒有因為只有一個病人如果你堅持這個藥但是缺藥、失明的重要的民生一級有關人民的健康可以這樣子講話嗎?因為你可以只講堅持品牌迷失是會造成問題你不能說民眾只能等死啊,對吧?委員我想齁,這個遣食用字是沒有好,部長今天要討論的這個健保藥價調整以及藥廠慢性病用藥的因應作為我想要請問\n這兩年的缺藥問題很嚴重有些是真的缺藥有些是假的缺藥但是近半年缺藥問題是越來越嚴重包含這個媒體人我們陳文茜女士也在臉書說現在健保制度下卻買不到一粒一元的口服劑型的類固醇所以他還請人從美國代購甚至\n現在也傳出這個藥局為了留住客戶而開始賠錢加價囤一些常用的慢性藥品例如我們調整心跳速率的這個康肯我想要請教部長包含著這個我們的\n愛敏氏也已經長期一年多缺藥了我想請問部長你有沒有掌握到這樣的狀況這個都有替代的或者是說同成分的一個品牌沒有我剛剛講的事情是現在的藥局為了留住客戶開始賠錢加價囤\n一些常用的慢性藥品你有沒有掌握到這樣的狀況?委員要不要聽我稍微這一點做一點解釋他現在在抱怨的是我們現在把藥價調下來但是當初他禁的藥部長你沒有聽清楚我的問題我剛說你有沒有掌握到這樣的狀況?有你不用解釋對好有對不對那這種類似沒有我只問你有沒有掌握到我沒有說這個事情發生就是我只想問你有沒有掌握到所以這類似overbooking的做法\n是不是只會讓缺藥的問題雪上加霜?那我想要請教部長,你們衛福部是不是要公開呼籲藥局不要囤貨?沒有啊,這所謂的囤貨,我剛剛...你會公開呼籲嗎?我剛剛解釋,委員就沒有時間給我解釋嘛。這個不是囤貨,是他已經買進來了啦。但是現在藥局...但是當時的價格是比較高的。那所以你是說你不會公開呼籲他們不要囤貨?\n會還是不會?那請問你會公開呼籲會還是不會?好部長你今天你報告寫了很多喔事實上很多東西都是過去或現在已經都在做了但是你們還是沒有針對缺藥的問題和原因去詳細的了解我整理出缺藥的原因在供應或是製造端方面有4點喔\n製造品質或法規要求改變原料藥的供應不及跟物流運送的延遲還有這個藥廠商業考量或是製造排成延遲或停止製造這個預專利很久的藥品而另外在輸入端也就是需求端的部分\n食藥署除了建置一個缺藥通報平台之外有沒有針對這些因素預先去因應或是做危機的管控?\n如果是在這所謂的必要藥品的項目裡面的話那我們要求是6個月之前若可以是部長我知道藥界都很清楚食藥署只是控藥就是發生缺藥的時候要求這個優先提供給大醫院所以為何食藥署不能夠從製造端或是物端常態性的去了解未來一年的供應狀況\n好因為時間有限下一題請教部長和我們的健保署的時署長現在缺藥問題涉及的層面很廣所以外界普遍的看法因為藥價不斷被砍鎖導致所以這個藥品的支付改革也是我們缺藥的重要的一環對不對所以請教署長已經開了無數次的這個健保藥品政策改革方案溝通會議何時會定案\n跟委員報告我們近期還會再開一次那包含一些保障的措施還有鼓勵在台製造的政策來確定溝通之後然後接著進行法規的預告好因為已經開了很多次了所以還是請這個我們食藥署的部分還不是請我們健保署的部分可以趕快的進行還有另外因為藥價改革也涉及到修正全民健康保險藥物給付項目跟支付標準我想要請教部長和署長何時會預告何時會公告\n都會在快的話大概在4月份我們就會進行預告了好因為我在面對缺藥問題的時候我一個星期前有公開主張過同時符合三個這個條件我們該各該品項的藥價就可以排除在每年藥價調整之外或者不受藥價調整的影響\n那這三個條件分別是臨床上有需求臨床上有需求也是也就是要必須經過我們的醫學會的認證第二個是鼓勵在地製造希望可以穩定供應鏈第三個是三張以下的稀缺藥證這三個具體的項目這個提議的背後就是希望\n尊重各醫學會他們最清楚藥的需求然後第二個是希望鼓勵在地製造希望可以穩定我們的藥品供應增加我們的就業機會第三個是希望稀缺藥證就是誠如部長說的替代性的藥品盡量不要調整這三個方案是否可行所以請你們好好的評估好不好這方向上面我們是贊同但是要醫學會認證這件事情要保留\n好請你們回去好好的評估因為醫學會他們在臨床上有他們的需求這部分請你們相加所以我知道你會這樣講沒關係下一題因為時間快到了最後一題我們要回到我們人民最關心的食安問題最近蘇丹紅的事情越演越烈已經是一個系統性的問題而且辣椒原料從禮拜一的時候你們說查出2萬多公斤到今天3天後已經查出6.4萬公斤\n而且我去調了海關進口這個所謂的辣椒製品在2023年也就是112年的時候總共進口了276萬公斤啊部長你知道嗎但是他不是通通都不合格\n不是通通不合格但是我告訴你這276萬公斤進來了對不對你已經查到了6.4萬公斤了你查到了6.4萬公斤了已經2點多趴將近3趴了依照你民進黨陳建仁和你部長的統計學我可不可以說這276萬公斤很多都有問題\n你敢保證都沒問題嗎?我依照你們統計學說的我依照你們統計學說因為你們上次說這個3%不能夠代表你現在已經驗出了這麼多了你有多少量你還有沒有掌握到?\n我們現在就是對於那些沒有掌握到的我們逐批的再往下你剛才說一個多月然後現在人民已經暴露在這樣系統性的食安風暴裡面好部長我只是把這數據提供給你讓你好好的嚴加嚴加的去查276萬多公斤會影響台灣多少的食品\n而且你們食藥署也說不保證市場沒有問題所以你這276萬公斤很可怕請你們好好的把皮繃緊一點而且現在縣市政府都跟進我們的很多這個團戰包含我們六都裡面全部\n這個在野黨執政的縣市地方政府縣市都宣布說不准營養午餐用這個辣椒粉那反而是我看到中央好像把關不利變成地方很努力的在為你們擋然後也要求這個縣市政府說這個營養午餐團散不可以使用可是看起來這個民進黨執政的縣市沒有跟進我想請問部長有什麼看法\n我們是不反對說地方政府對於這個因為小孩子吃辣的習慣是少的你不能夠說吃辣習慣少那他任何可能吃辣的風險呢所以那個部分的話你去說禁止我們並不反對你並不反對那為什麼你不可以說你建議你建議這些縣市可以先不要用因為你現在查不到嘛276萬公斤你沒辦法馬上查完嘛那你是不是應該衛福部中央應該要有點尬詞\n部長﹖\n食安的預警溯源十年來都沒有進步所以我們星期一的時候也請教你跟徐副主任有關食安匯報的狀況你們本來說今年一月份要召開但是因為選舉因素現在還沒有確定日期大家都說食安不能有假期但是看起來你們民進黨政府選舉最大食安匯報一拖再拖也沒有關係我想問這是你們對食安的態度嗎\n應該我所知道的應該是這一個議會召開那我問部長最後我還是要問你你到底重不重視食安我當然重視你很重視食安對不對你很重視\n但是上次我問你的時候你缺席去年食安會報你告訴我說因為你要接受立法院的質詢但是我去查了你的食安會報那一次是下午3點召開可是我們的委員會1點22就散會了中間還有一個半小時你說你很重視食安的話你有充分的時間可以去參加食安會報但你卻選擇出席喔而且面對國會議員的公開質疑你卻選擇說謊不去參加的理由\n我跟委員解釋一下第一個\n當我知道隔天要食安會報告和解釋不用解釋我沒有要你解釋那件事情我要跟你講的事情是你因為這樣子導致現在臺灣喔不是說你的這個態度喔你這個態度讓現在這個276萬公斤流竄在我們的社會裡面你要不要因為這個系統性的食安問題你要不要因為這個系統性的食安問題跟全國人民道歉\n李翠你不道歉嗎?你不會針對現在發生蘇丹紅的系統食安問題對全國人民道歉?主席我沒有話好說了我想這樣部長繼續硬拗喔對我們的食安沒有任何的幫助因為現在我們遇到的系統性食安問題你用這種硬拗的態度是沒有辦法幫助到我們的好謝謝大家\n","vtt":"WEBVTT\n\n00:10.578 --> 00:37.254\n有請部長好部長請委員好部長好部長衛福部在前天突然無預警的宣布掛號費的取消上限請教部長你在做這個行為之前你沒有做所謂的啟動社會溝通以及邀請學者專家研議或評估嗎在做這個政策之前\n\n00:38.734 --> 01:04.303\n倒是沒有說有這樣大規模的去作證如果沒有政策沒有評估就上路完全沒有考慮到取消上限後會造成的任何的影響包含醫療可進性包含醫療階級化或者醫療體系長期上會有發生什麼狀況有沒有可能不利這個醫療分級等等的影響喔我在想這樣子的取消上限我想請問部長你覺得對百姓的醫療負擔會長幾成呢\n\n01:06.624 --> 01:29.154\n以目前來講的話,第一個我要講,我們在做這個公告之前,其實有一些...你知道會長幾層嗎?你們有研究過會長幾層嗎?這個沒有辦法去做這個...所以其實你們沒有審慎的評估研究,也沒有足夠的溝通,對不對?應該不是說這樣,因為...部長,政策是不能隨性的,我覺得很多政策你們必須要經過審慎的評估才可以喔\n\n01:30.094 --> 01:48.772\n尤其是這個對於長期的影響所以你們聽起來就是沒有評估而且看起來的行為就是用甩鍋給地方政府面對這樣的問題你們選擇偏移一下形式的方式我知道學界或者是醫藥界對這件事情普遍是積極的看法可是\n\n01:49.752 --> 02:06.506\n這幾年來對於百姓來講你從去年提高部分的負擔增加醫學中心的名額讓百姓、民眾看病變得更貴之外現在這一次直接拿掉我們所謂的掛號費上限對百姓而言就是漲漲漲所以對於人民而言是被剝了三層皮\n\n02:07.347 --> 02:24.093\n部長我想要請問你這樣拿掉掛號費上線就解決問題了嗎?因為掛號費不是只是行政費用而已嗎?事實上對問題的核心不就是因為健保點值長期的不公而且過低所以才造成這個醫事人員被政府拗作功德\n\n02:25.053 --> 02:48.319\n各位委員報告醫護低薪與過勞並且人力流失所以才造成我們醫療體系可能崩潰所以我覺得你們倉促做這件事情又沒有充分的溝通也沒有充分的去評估你們造成的事情也沒有評估說那這樣對百姓可能造成多少負擔有沒有對於這些比較低薪的百姓或者是比較收入較低的配套方案也沒有做\n\n02:49.397 --> 03:06.392\n我們看起來就是你不去思考怎麼改革健保總額的制度要怎麼改革不去解決問題這樣是一個治標不治本的狀況而且也沒有根治的問題這樣的做法還可能衍生更多的這個對於社會的影響我想這個部分\n\n03:07.153 --> 03:25.063\n部長你們是不是不夠的嚴謹所以看起來你們衛福部的做法就是把這個責任推到推得一竿而盡也把你們對於健保應該改革的問題推得一竿而盡健保的改革是健保的改革這是一樣但是你們現在看起來就是急救張馬\n\n03:26.664 --> 03:28.345\n真正的問題是健保點值長期不公你認不認同?\n\n03:52.176 --> 03:58.822\n你認不認同?你認不認同這件事?這個簡報現在是寫的那樣子所以你認同還不認同?我沒有要你解釋,我問你yesorno\n\n04:08.430 --> 04:08.890\n好,部長\n\n04:23.596 --> 04:45.137\n我們現在進行下一題部長過年前今天的重點過年前這個傳出缺藥時你說堅持品牌迷思堅持原廠藥只能等死喔恕我不能同意你這樣的看法因為官員存在的目的不就是應該解決百姓的問題嗎為什麼可以說只有人民只能等死呢你承不承認這句話是失言\n\n04:46.478 --> 05:13.555\n沒有因為只有一個病人如果你堅持這個藥但是缺藥、失明的重要的民生一級有關人民的健康可以這樣子講話嗎?因為你可以只講堅持品牌迷失是會造成問題你不能說民眾只能等死啊,對吧?委員我想齁,這個遣食用字是沒有好,部長今天要討論的這個健保藥價調整以及藥廠慢性病用藥的因應作為我想要請問\n\n05:14.755 --> 05:35.345\n這兩年的缺藥問題很嚴重有些是真的缺藥有些是假的缺藥但是近半年缺藥問題是越來越嚴重包含這個媒體人我們陳文茜女士也在臉書說現在健保制度下卻買不到一粒一元的口服劑型的類固醇所以他還請人從美國代購甚至\n\n05:36.225 --> 05:53.240\n現在也傳出這個藥局為了留住客戶而開始賠錢加價囤一些常用的慢性藥品例如我們調整心跳速率的這個康肯我想要請教部長包含著這個我們的\n\n05:54.751 --> 06:10.078\n愛敏氏也已經長期一年多缺藥了我想請問部長你有沒有掌握到這樣的狀況這個都有替代的或者是說同成分的一個品牌沒有我剛剛講的事情是現在的藥局為了留住客戶開始賠錢加價囤\n\n06:13.579 --> 06:40.038\n一些常用的慢性藥品你有沒有掌握到這樣的狀況?委員要不要聽我稍微這一點做一點解釋他現在在抱怨的是我們現在把藥價調下來但是當初他禁的藥部長你沒有聽清楚我的問題我剛說你有沒有掌握到這樣的狀況?有你不用解釋對好有對不對那這種類似沒有我只問你有沒有掌握到我沒有說這個事情發生就是我只想問你有沒有掌握到所以這類似overbooking的做法\n\n06:40.538 --> 07:06.286\n是不是只會讓缺藥的問題雪上加霜?那我想要請教部長,你們衛福部是不是要公開呼籲藥局不要囤貨?沒有啊,這所謂的囤貨,我剛剛...你會公開呼籲嗎?我剛剛解釋,委員就沒有時間給我解釋嘛。這個不是囤貨,是他已經買進來了啦。但是現在藥局...但是當時的價格是比較高的。那所以你是說你不會公開呼籲他們不要囤貨?\n\n07:08.668 --> 07:32.414\n會還是不會?那請問你會公開呼籲會還是不會?好部長你今天你報告寫了很多喔事實上很多東西都是過去或現在已經都在做了但是你們還是沒有針對缺藥的問題和原因去詳細的了解我整理出缺藥的原因在供應或是製造端方面有4點喔\n\n07:33.474 --> 07:50.332\n製造品質或法規要求改變原料藥的供應不及跟物流運送的延遲還有這個藥廠商業考量或是製造排成延遲或停止製造這個預專利很久的藥品而另外在輸入端也就是需求端的部分\n\n07:51.260 --> 07:55.023\n食藥署除了建置一個缺藥通報平台之外有沒有針對這些因素預先去因應或是做危機的管控?\n\n08:10.673 --> 08:30.474\n如果是在這所謂的必要藥品的項目裡面的話那我們要求是6個月之前若可以是部長我知道藥界都很清楚食藥署只是控藥就是發生缺藥的時候要求這個優先提供給大醫院所以為何食藥署不能夠從製造端或是物端常態性的去了解未來一年的供應狀況\n\n08:33.632 --> 08:55.659\n好因為時間有限下一題請教部長和我們的健保署的時署長現在缺藥問題涉及的層面很廣所以外界普遍的看法因為藥價不斷被砍鎖導致所以這個藥品的支付改革也是我們缺藥的重要的一環對不對所以請教署長已經開了無數次的這個健保藥品政策改革方案溝通會議何時會定案\n\n08:57.723 --> 09:25.613\n跟委員報告我們近期還會再開一次那包含一些保障的措施還有鼓勵在台製造的政策來確定溝通之後然後接著進行法規的預告好因為已經開了很多次了所以還是請這個我們食藥署的部分還不是請我們健保署的部分可以趕快的進行還有另外因為藥價改革也涉及到修正全民健康保險藥物給付項目跟支付標準我想要請教部長和署長何時會預告何時會公告\n\n09:27.073 --> 09:45.613\n都會在快的話大概在4月份我們就會進行預告了好因為我在面對缺藥問題的時候我一個星期前有公開主張過同時符合三個這個條件我們該各該品項的藥價就可以排除在每年藥價調整之外或者不受藥價調整的影響\n\n09:46.354 --> 10:04.954\n那這三個條件分別是臨床上有需求臨床上有需求也是也就是要必須經過我們的醫學會的認證第二個是鼓勵在地製造希望可以穩定供應鏈第三個是三張以下的稀缺藥證這三個具體的項目這個提議的背後就是希望\n\n10:05.535 --> 10:31.247\n尊重各醫學會他們最清楚藥的需求然後第二個是希望鼓勵在地製造希望可以穩定我們的藥品供應增加我們的就業機會第三個是希望稀缺藥證就是誠如部長說的替代性的藥品盡量不要調整這三個方案是否可行所以請你們好好的評估好不好這方向上面我們是贊同但是要醫學會認證這件事情要保留\n\n10:31.707 --> 10:58.895\n好請你們回去好好的評估因為醫學會他們在臨床上有他們的需求這部分請你們相加所以我知道你會這樣講沒關係下一題因為時間快到了最後一題我們要回到我們人民最關心的食安問題最近蘇丹紅的事情越演越烈已經是一個系統性的問題而且辣椒原料從禮拜一的時候你們說查出2萬多公斤到今天3天後已經查出6.4萬公斤\n\n11:01.058 --> 11:16.353\n而且我去調了海關進口這個所謂的辣椒製品在2023年也就是112年的時候總共進口了276萬公斤啊部長你知道嗎但是他不是通通都不合格\n\n11:17.094 --> 11:33.908\n不是通通不合格但是我告訴你這276萬公斤進來了對不對你已經查到了6.4萬公斤了你查到了6.4萬公斤了已經2點多趴將近3趴了依照你民進黨陳建仁和你部長的統計學我可不可以說這276萬公斤很多都有問題\n\n11:34.969 --> 11:47.302\n你敢保證都沒問題嗎?我依照你們統計學說的我依照你們統計學說因為你們上次說這個3%不能夠代表你現在已經驗出了這麼多了你有多少量你還有沒有掌握到?\n\n11:48.157 --> 12:07.694\n我們現在就是對於那些沒有掌握到的我們逐批的再往下你剛才說一個多月然後現在人民已經暴露在這樣系統性的食安風暴裡面好部長我只是把這數據提供給你讓你好好的嚴加嚴加的去查276萬多公斤會影響台灣多少的食品\n\n12:08.955 --> 12:25.885\n而且你們食藥署也說不保證市場沒有問題所以你這276萬公斤很可怕請你們好好的把皮繃緊一點而且現在縣市政府都跟進我們的很多這個團戰包含我們六都裡面全部\n\n12:27.126 --> 12:50.288\n這個在野黨執政的縣市地方政府縣市都宣布說不准營養午餐用這個辣椒粉那反而是我看到中央好像把關不利變成地方很努力的在為你們擋然後也要求這個縣市政府說這個營養午餐團散不可以使用可是看起來這個民進黨執政的縣市沒有跟進我想請問部長有什麼看法\n\n12:51.248 --> 13:16.989\n我們是不反對說地方政府對於這個因為小孩子吃辣的習慣是少的你不能夠說吃辣習慣少那他任何可能吃辣的風險呢所以那個部分的話你去說禁止我們並不反對你並不反對那為什麼你不可以說你建議你建議這些縣市可以先不要用因為你現在查不到嘛276萬公斤你沒辦法馬上查完嘛那你是不是應該衛福部中央應該要有點尬詞\n\n13:18.490 --> 13:18.510\n部長﹖\n\n13:32.836 --> 13:57.217\n食安的預警溯源十年來都沒有進步所以我們星期一的時候也請教你跟徐副主任有關食安匯報的狀況你們本來說今年一月份要召開但是因為選舉因素現在還沒有確定日期大家都說食安不能有假期但是看起來你們民進黨政府選舉最大食安匯報一拖再拖也沒有關係我想問這是你們對食安的態度嗎\n\n13:59.540 --> 14:09.193\n應該我所知道的應該是這一個議會召開那我問部長最後我還是要問你你到底重不重視食安我當然重視你很重視食安對不對你很重視\n\n14:10.782 --> 14:33.417\n但是上次我問你的時候你缺席去年食安會報你告訴我說因為你要接受立法院的質詢但是我去查了你的食安會報那一次是下午3點召開可是我們的委員會1點22就散會了中間還有一個半小時你說你很重視食安的話你有充分的時間可以去參加食安會報但你卻選擇出席喔而且面對國會議員的公開質疑你卻選擇說謊不去參加的理由\n\n14:37.099 --> 14:37.579\n我跟委員解釋一下第一個\n\n14:55.664 --> 15:06.246\n當我知道隔天要食安會報告和解釋不用解釋我沒有要你解釋那件事情我要跟你講的事情是你因為這樣子導致現在臺灣喔不是說你的這個態度喔你這個態度讓現在這個276萬公斤流竄在我們的社會裡面你要不要因為這個系統性的食安問題你要不要因為這個系統性的食安問題跟全國人民道歉\n\n15:22.959 --> 15:44.685\n李翠你不道歉嗎?你不會針對現在發生蘇丹紅的系統食安問題對全國人民道歉?主席我沒有話好說了我想這樣部長繼續硬拗喔對我們的食安沒有任何的幫助因為現在我們遇到的系統性食安問題你用這種硬拗的態度是沒有辦法幫助到我們的好謝謝大家\n\n","segments":[{"start":10.578,"end":37.254,"text":"有請部長好 部長請委員好部長好部長衛福部在前天突然無預警的宣布掛號費的取消上限請教部長你在做這個行為之前你沒有做所謂的啟動社會溝通以及邀請學者專家研議或評估嗎在做這個政策之前"},{"start":38.734,"end":64.303,"text":"倒是沒有說有這樣大規模的去作證如果沒有政策沒有評估就上路完全沒有考慮到取消上限後會造成的任何的影響包含醫療可進性包含醫療階級化或者醫療體系長期上會有發生什麼狀況有沒有可能不利這個醫療分級等等的影響喔我在想這樣子的取消上限我想請問部長你覺得對百姓的醫療負擔會長幾成呢"},{"start":66.624,"end":89.154,"text":"以目前來講的話,第一個我要講,我們在做這個公告之前,其實有一些...你知道會長幾層嗎?你們有研究過會長幾層嗎?這個沒有辦法去做這個...所以其實你們沒有審慎的評估研究,也沒有足夠的溝通,對不對?應該不是說這樣,因為...部長,政策是不能隨性的,我覺得很多政策你們必須要經過審慎的評估才可以喔"},{"start":90.094,"end":108.772,"text":"尤其是這個對於長期的影響所以你們聽起來就是沒有評估而且看起來的行為就是用甩鍋給地方政府面對這樣的問題你們選擇偏移一下形式的方式我知道學界或者是醫藥界對這件事情普遍是積極的看法可是"},{"start":109.752,"end":126.506,"text":"這幾年來對於百姓來講你從去年提高部分的負擔增加醫學中心的名額讓百姓、民眾看病變得更貴之外現在這一次直接拿掉我們所謂的掛號費上限對百姓而言就是漲漲漲所以對於人民而言是被剝了三層皮"},{"start":127.347,"end":144.093,"text":"部長我想要請問你這樣拿掉掛號費上線就解決問題了嗎?因為掛號費不是只是行政費用而已嗎?事實上對問題的核心不就是因為健保點值長期的不公而且過低所以才造成這個醫事人員被政府拗作功德"},{"start":145.053,"end":168.319,"text":"各位委員報告醫護低薪與過勞並且人力流失所以才造成我們醫療體系可能崩潰所以我覺得你們倉促做這件事情又沒有充分的溝通也沒有充分的去評估你們造成的事情也沒有評估說那這樣對百姓可能造成多少負擔有沒有對於這些比較低薪的百姓或者是比較收入較低的配套方案也沒有做"},{"start":169.397,"end":186.392,"text":"我們看起來就是你不去思考怎麼改革健保總額的制度要怎麼改革不去解決問題這樣是一個治標不治本的狀況而且也沒有根治的問題這樣的做法還可能衍生更多的這個對於社會的影響我想這個部分"},{"start":187.153,"end":205.063,"text":"部長你們是不是不夠的嚴謹所以看起來你們衛福部的做法就是把這個責任推到推得一竿而盡也把你們對於健保應該改革的問題推得一竿而盡健保的改革是健保的改革這是一樣但是你們現在看起來就是急救張馬"},{"start":206.664,"end":208.345,"text":"真正的問題是健保點值長期不公你認不認同?"},{"start":232.176,"end":238.822,"text":"你認不認同?你認不認同這件事?這個簡報現在是寫的那樣子所以你認同還不認同?我沒有要你解釋,我問你yes or no"},{"start":248.43,"end":248.89,"text":"好,部長"},{"start":263.596,"end":285.137,"text":"我們現在進行下一題部長過年前今天的重點過年前這個傳出缺藥時你說堅持品牌迷思堅持原廠藥只能等死喔恕我不能同意你這樣的看法因為官員存在的目的不就是應該解決百姓的問題嗎為什麼可以說只有人民只能等死呢你承不承認這句話是失言"},{"start":286.478,"end":313.555,"text":"沒有因為只有一個病人如果你堅持這個藥但是缺藥、失明的重要的民生一級有關人民的健康可以這樣子講話嗎?因為你可以只講堅持品牌迷失是會造成問題你不能說民眾只能等死啊,對吧?委員我想齁,這個遣食用字是沒有好,部長今天要討論的這個健保藥價調整以及藥廠慢性病用藥的因應作為我想要請問"},{"start":314.755,"end":335.345,"text":"這兩年的缺藥問題很嚴重有些是真的缺藥有些是假的缺藥但是近半年缺藥問題是越來越嚴重包含這個媒體人我們陳文茜女士也在臉書說現在健保制度下卻買不到一粒一元的口服劑型的類固醇所以他還請人從美國代購甚至"},{"start":336.225,"end":353.24,"text":"現在也傳出這個藥局為了留住客戶而開始賠錢加價囤一些常用的慢性藥品例如我們調整心跳速率的這個康肯我想要請教部長包含著這個我們的"},{"start":354.751,"end":370.078,"text":"愛敏氏也已經長期一年多缺藥了我想請問部長你有沒有掌握到這樣的狀況這個都有替代的或者是說同成分的一個品牌沒有我剛剛講的事情是現在的藥局為了留住客戶開始賠錢加價囤"},{"start":373.579,"end":400.038,"text":"一些常用的慢性藥品你有沒有掌握到這樣的狀況?委員要不要聽我稍微這一點做一點解釋他現在在抱怨的是我們現在把藥價調下來但是當初他禁的藥部長你沒有聽清楚我的問題我剛說你有沒有掌握到這樣的狀況?有你不用解釋對好有對不對那這種類似沒有我只問你有沒有掌握到我沒有說這個事情發生就是我只想問你有沒有掌握到所以這類似overbooking的做法"},{"start":400.538,"end":426.286,"text":"是不是只會讓缺藥的問題雪上加霜?那我想要請教部長,你們衛福部是不是要公開呼籲藥局不要囤貨?沒有啊,這所謂的囤貨,我剛剛...你會公開呼籲嗎?我剛剛解釋,委員就沒有時間給我解釋嘛。這個不是囤貨,是他已經買進來了啦。但是現在藥局...但是當時的價格是比較高的。那所以你是說你不會公開呼籲他們不要囤貨?"},{"start":428.668,"end":452.414,"text":"會還是不會?那請問你會公開呼籲會還是不會?好部長你今天你報告寫了很多喔事實上很多東西都是過去或現在已經都在做了但是你們還是沒有針對缺藥的問題和原因去詳細的了解我整理出缺藥的原因在供應或是製造端方面有4點喔"},{"start":453.474,"end":470.332,"text":"製造品質或法規要求改變原料藥的供應不及跟物流運送的延遲還有這個藥廠商業考量或是製造排成延遲或停止製造這個預專利很久的藥品而另外在輸入端也就是需求端的部分"},{"start":471.26,"end":475.023,"text":"食藥署除了建置一個缺藥通報平台之外有沒有針對這些因素預先去因應或是做危機的管控?"},{"start":490.673,"end":510.474,"text":"如果是在這所謂的必要藥品的項目裡面的話那我們要求是6個月之前若可以是部長我知道藥界都很清楚食藥署只是控藥就是發生缺藥的時候要求這個優先提供給大醫院所以為何食藥署不能夠從製造端或是物端常態性的去了解未來一年的供應狀況"},{"start":513.632,"end":535.659,"text":"好因為時間有限下一題請教部長和我們的健保署的時署長現在缺藥問題涉及的層面很廣所以外界普遍的看法因為藥價不斷被砍鎖導致所以這個藥品的支付改革也是我們缺藥的重要的一環對不對所以請教署長已經開了無數次的這個健保藥品政策改革方案溝通會議何時會定案"},{"start":537.723,"end":565.613,"text":"跟委員報告我們近期還會再開一次那包含一些保障的措施還有鼓勵在台製造的政策來確定溝通之後然後接著進行法規的預告好因為已經開了很多次了所以還是請這個我們食藥署的部分還不是請我們健保署的部分可以趕快的進行還有另外因為藥價改革也涉及到修正全民健康保險藥物給付項目跟支付標準我想要請教部長和署長何時會預告何時會公告"},{"start":567.073,"end":585.613,"text":"都會在快的話大概在4月份我們就會進行預告了好因為我在面對缺藥問題的時候我一個星期前有公開主張過同時符合三個這個條件我們該各該品項的藥價就可以排除在每年藥價調整之外或者不受藥價調整的影響"},{"start":586.354,"end":604.954,"text":"那這三個條件分別是臨床上有需求臨床上有需求也是也就是要必須經過我們的醫學會的認證第二個是鼓勵在地製造希望可以穩定供應鏈第三個是三張以下的稀缺藥證這三個具體的項目這個提議的背後就是希望"},{"start":605.535,"end":631.247,"text":"尊重各醫學會他們最清楚藥的需求然後第二個是希望鼓勵在地製造希望可以穩定我們的藥品供應增加我們的就業機會第三個是希望稀缺藥證就是誠如部長說的替代性的藥品盡量不要調整這三個方案是否可行所以請你們好好的評估好不好這方向上面我們是贊同但是要醫學會認證這件事情要保留"},{"start":631.707,"end":658.895,"text":"好請你們回去好好的評估因為醫學會他們在臨床上有他們的需求這部分請你們相加所以我知道你會這樣講沒關係下一題因為時間快到了最後一題我們要回到我們人民最關心的食安問題最近蘇丹紅的事情越演越烈已經是一個系統性的問題而且辣椒原料從禮拜一的時候你們說查出2萬多公斤到今天3天後已經查出6.4萬公斤"},{"start":661.058,"end":676.353,"text":"而且我去調了海關進口這個所謂的辣椒製品在2023年也就是112年的時候總共進口了276萬公斤啊部長你知道嗎但是他不是通通都不合格"},{"start":677.094,"end":693.908,"text":"不是通通不合格但是我告訴你這276萬公斤進來了對不對你已經查到了6.4萬公斤了你查到了6.4萬公斤了已經2點多趴將近3趴了依照你民進黨陳建仁和你部長的統計學我可不可以說這276萬公斤很多都有問題"},{"start":694.969,"end":707.302,"text":"你敢保證都沒問題嗎?我依照你們統計學說的我依照你們統計學說因為你們上次說這個3%不能夠代表你現在已經驗出了這麼多了你有多少量你還有沒有掌握到?"},{"start":708.157,"end":727.694,"text":"我們現在就是對於那些沒有掌握到的我們逐批的再往下你剛才說一個多月然後現在人民已經暴露在這樣系統性的食安風暴裡面好部長我只是把這數據提供給你讓你好好的嚴加嚴加的去查276萬多公斤會影響台灣多少的食品"},{"start":728.955,"end":745.885,"text":"而且你們食藥署也說不保證市場沒有問題所以你這276萬公斤很可怕請你們好好的把皮繃緊一點而且現在縣市政府都跟進我們的很多這個團戰包含我們六都裡面全部"},{"start":747.126,"end":770.288,"text":"這個在野黨執政的縣市地方政府縣市都宣布說不准營養午餐用這個辣椒粉那反而是我看到中央好像把關不利變成地方很努力的在為你們擋然後也要求這個縣市政府說這個營養午餐團散不可以使用可是看起來這個民進黨執政的縣市沒有跟進我想請問部長有什麼看法"},{"start":771.248,"end":796.989,"text":"我們是不反對說地方政府對於這個因為小孩子吃辣的習慣是少的你不能夠說吃辣習慣少那他任何可能吃辣的風險呢所以那個部分的話你去說禁止我們並不反對你並不反對那為什麼你不可以說你建議你建議這些縣市可以先不要用因為你現在查不到嘛276萬公斤你沒辦法馬上查完嘛那你是不是應該衛福部中央應該要有點尬詞"},{"start":798.49,"end":798.51,"text":"部長﹖"},{"start":812.836,"end":837.217,"text":"食安的預警溯源十年來都沒有進步所以我們星期一的時候也請教你跟徐副主任有關食安匯報的狀況你們本來說今年一月份要召開但是因為選舉因素現在還沒有確定日期大家都說食安不能有假期但是看起來你們民進黨政府選舉最大食安匯報一拖再拖也沒有關係我想問這是你們對食安的態度嗎"},{"start":839.54,"end":849.193,"text":"應該我所知道的應該是這一個議會召開那我問部長最後我還是要問你你到底重不重視食安我當然重視你很重視食安對不對你很重視"},{"start":850.782,"end":873.417,"text":"但是上次我問你的時候你缺席去年食安會報你告訴我說因為你要接受立法院的質詢但是我去查了你的食安會報那一次是下午3點召開可是我們的委員會1點22就散會了中間還有一個半小時你說你很重視食安的話你有充分的時間可以去參加食安會報但你卻選擇出席喔而且面對國會議員的公開質疑你卻選擇說謊不去參加的理由"},{"start":877.099,"end":877.579,"text":"我跟委員解釋一下第一個"},{"start":895.664,"end":906.246,"text":"當我知道隔天要食安會報告和解釋不用解釋我沒有要你解釋那件事情我要跟你講的事情是你因為這樣子導致現在臺灣喔不是說你的這個態度喔你這個態度讓現在這個276萬公斤流竄在我們的社會裡面你要不要因為這個系統性的食安問題你要不要因為這個系統性的食安問題跟全國人民道歉"},{"start":922.959,"end":944.685,"text":"李翠你不道歉嗎?你不會針對現在發生蘇丹紅的系統食安問題對全國人民道歉?主席我沒有話好說了我想這樣部長繼續硬拗喔對我們的食安沒有任何的幫助因為現在我們遇到的系統性食安問題你用這種硬拗的態度是沒有辦法幫助到我們的好謝謝大家"}]}}}}