{"id":149608,"url":"https://ivod.ly.gov.tw/Play/Clip/1M/149608","video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/e7383c0ce4a703cce50c4e9dd3195c82d230da91660cc9cbf8ba9b0039caa7a67c45cb4d80bcee6c5ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"陳菁徽","委員發言時間":"16:14:22 - 16:45:03","影片長度":"00:30:41","會議時間":"2024-03-08T09:00:00+08:00","會議名稱":"第11屆第1會期第4次會議（事由：一、對行政院院長提出施政方針及施政報告繼續質詢。\n二、3月8日上午9時至10時為國是論壇時間。 \n三、3月12日下午1時50分至2時30分為處理臨時提案時間。）","meet":{"tmpMeeting":null,"title":"立法院第11屆第1會期第4次會議","id":"院會-11-1-4","type":"院會","term":11,"sessionPeriod":1,"sessionTimes":4},"date":"2024-03-08","duration":1841,"end_time":"2024-03-08T16:45:03+08:00","start_time":"2024-03-08T16:14:22+08:00","features":["ai-transcript","gazette"],"type":"Clip","gazette":{"lineno":559,"blocks":[["陳委員菁徽：（16時14分）主席好、各位官員好，請行政院長。"],["主席：麻煩請陳院長備詢。"],["陳院長建仁：陳委員午安，恭喜你當選立委，還有祝你婦女節快樂。"],["陳委員菁徽：謝謝院長。其實院長是我長期以來非常敬佩的醫界前輩、大老。"],["陳院長建仁：不敢當。"],["陳委員菁徽：我也是您美國研究所的學妹。"],["陳院長建仁：對，也是Hopkins的光榮啦！"],["陳委員菁徽：我們今天各自在這樣的位置，我們就希望把我們份內工作做好，理性問政、理性討論。"],["陳院長建仁：好，像在Hopkins時候的討論一樣。"],["陳委員菁徽：謝謝。第一個問題，早上已經聽到非常多委員同事有詢問，臺灣的詐騙已經是指數型成長，所以2023年一整年民眾被詐騙金額高達88億，而且報案件數幾乎直逼4萬件，非常誇張，所以全民要打詐、反詐，並且內政部偕同各部會一同宣傳，這是很重要的，對吧？"],["陳院長建仁：對。"],["陳委員菁徽：所以我自從來這邊上班後，我很仔細的研究了所有部會的網站，我看到這個宣傳反詐騙的網站，點閱率只有88，它到底都在談些什麼？還有什麼可以進步的空間？等一下我想播放一段影片，讓大家看一下這個網站的內容為何？","我們先從「防詐學堂」按進去，你會發現裡面的影片是空白的，什麼都沒有。再來我又按了第二個連結，是所有防詐影片，「30秒短版影片」，裡面用政府的預算花了很多錢，請非常多名人拍這樣的短影片，但它是一個雲端硬碟，而且我差點就刪除了一個，但我不太敢刪，所以我幫院長把所有檔案都先存起來，因為我怕現在在線上看的人有人誤刪了這個檔案，請問我們行政院的資安是出了什麼問題？"],["陳院長建仁：這個部分我想我們會請……這是衛福部的網站嘛？我們請他們再來好好check，不過……"],["陳委員菁徽：這是內政部提供給各個所有部門的材料……"],["陳院長建仁：對，然後互相連結起來，我想我們再請打詐辦公室好好檢討一下，委員都發現這樣的疏失，我們應該要來改進。但委員剛才提到打詐的成果，我也跟委員做一個簡單報告，你剛才說有4萬通的詐騙，但我們在去年一整年境外竄改電話詐騙的遏止、攔阻量就有1,851萬通電話，然後惡意簡訊就攔阻了801萬則，所以如果沒有這樣的努力，搞不好受騙的人會更多。","另外，我們攔阻詐騙件數有一萬一千多件，攔阻金額就已經到達76億，所以我們打詐是有成果，但當然還要再精進。另外我們也查緝了犯罪集團，這個犯罪集團的一千七百多個犯罪案件，其不法所得我們也扣查了40億，所以我們會繼續努力，謝謝你給我機會來講。"],["陳委員菁徽：謝謝院長，謝謝，所以感覺現在打詐的進度還有上升的幅度是「趨緩」，最近各部門都喜歡用這個字，所以我覺得趨緩也是一個好的趨勢。","再來，我在這網站繼續看有什麼素材是讓全民可以欣賞、可以學習的，更令人驚訝的是在反詐騙網站的素材裡面，竟然有民眾黨柯文哲主席競選總統時候的所有錄音檔案，怎麼會發生這種奇怪的事情？","（播放影片）"],["陳院長建仁：對，謝謝你告訴我，我想這實在太不應該啦！"],["陳委員菁徽：還有台語版，幾十個檔案我也幫……","（播放影片）"],["陳委員菁徽：我跟辦公室同仁一開始聽到這樣子音檔的時候……"],["陳院長建仁：我嚇一跳。"],["陳委員菁徽：你也嚇一跳？我們可以再聽一次。我也嚇一跳，我以為是說這個音檔，現在市面上流傳在電話裡面會詐騙嗎？當時我是這樣想，第一念頭啦！","（播放影片）"],["陳委員菁徽：我相信柯文哲的競選錄音檔在上面，應該不是暗指它是正面教材或者是負面教材吧？"],["陳院長建仁：我想這個一定要來好好查，為什麼內政部會有這樣……"],["陳委員菁徽：你們應該也不是指他是打詐高手，或者是他自己是……這些音檔是詐騙集團吧？應該也不是這個意思啦！"],["陳院長建仁：我想大概不會是詐騙的做法，但是對於內政部宣導詐騙的影片資料檔一定要好好地檢討。"],["陳委員菁徽：當然，我走進這個議場時都還親身操作過一次，現在相信很多線上的朋友也發現了。本院很多的委員其實都有經營自己的頻道，也有自己的粉專、社群等等，我們要如何去檢視我們宣傳的政見或是我們的短片等等是不是有跟著人民的方向？其實對一般的民意代表來說，你一直回頭去審視自己上線的這些素材是非常重要的，因為你可以調整你的腳步。但現在看起來，你們花了很多錢拍這些影片，但其實我從第一天上班到現在每天都有看喔！都沒有人去注意到這件事，表示你們宣傳詐騙、宣傳反詐，其實你就把它丟上去，你就再也不管這些影片到底符不符合人民的口味、有沒有人在看嘛！"],["陳院長建仁：我們請部長簡單回答一下。"],["林部長右昌：委員，這個是不是容我們查一下？因為這個看起來怪怪的，柯P的競選廣告在這個上面，不過這個並不是網站，這個看起來應該是一個……"],["陳委員菁徽：這是你給的連結，因為……"],["林部長右昌：這個應該是一個雲……對不起，但是這個……是不是我們看一下，好不好？因為這個連結……"],["陳委員菁徽：你給了反詐、防詐請大家幫忙宣導的公文，發到各級學校、各單位，包括退輔會、小學、大學等等，每個人都很用力地在幫你貼耶！"],["林部長右昌：我們來瞭解一下，好不好？"],["陳委員菁徽：結果點進去是這樣子，當然……"],["林部長右昌：因為這個是……我確認一下再跟委員回報。"],["陳院長建仁：對，我們瞭解以後再給委員。"],["陳委員菁徽：好。"],["陳院長建仁：我看這個是雲端的問題還是……"],["林部長右昌：對，因為這個看起來怪怪的。"],["陳委員菁徽：這個禮拜大家也在吵數位身分證嘛！我們的資安到底有沒有辦法被嚴格的把關？看起來連行政院的資安，好像數位部長都沒有幫大家做好一些教育訓練。這部分也希望大概一週內可不可以給個書面的解釋，看未來你們應該要如何改善，還有這件事情到底是怎麼發生的。"],["陳院長建仁：好，就如同委員所說的，我們大概一週內一定得要來完整的瞭解，也會請數位部幫忙各個部會檢查，等一下也請委員給我們你剛才的這些……"],["林部長右昌：提供給我們。"],["陳院長建仁：提供這些資料，讓我們……"],["陳委員菁徽：現在大家用手機上去看應該也有，不過我是怕有一些網民已經惡搞，把它刪除了。"],["陳院長建仁：好。"],["陳委員菁徽：那沒有關係，所以比較有可能的是你們的協力廠商出包，我們當然比較不去懷疑你們內部的人是不是違反了任何的行政中立，但是最終我們來檢討你做宣傳的內容是不是有閱覽、是不是有資安的問題，甚至有牽涉到柯主席的隱私部分，這些都要通盤的檢討。未來也期待你們宣傳這些反詐的素材都可以再後續去追，到底這些素材有沒有發揮它應該要有的效果，好嗎？"],["陳院長建仁：好，這是應該要做的，謝謝你的指教，我們請相關部會一定要在一個禮拜內完全瞭解，謝謝。"],["陳委員菁徽：謝謝兩位部長。"],["林部長右昌：謝謝。"],["陳委員菁徽：接下來，我也希望請院長看這份草案文件，您是否有覺得似曾相識呢？"],["陳院長建仁：確實，因為在我擔任衛生署署長的時候，當時代理孕母的事情，現在的陳昭姿委員就有提出很多的建議，我們也召開了公民共識會議，在公民審議會議之後是有條件的開放，確實當時是有，也有一些法案，但是您可能也瞭解，因為令堂也是我們資深的立委，這個案子實際上在立法院也討論過。"],["陳委員菁徽：有，這份文件的第一行，「為因應不孕夫妻生育需求，保障人權，保護代孕子女、代孕者及委託夫妻之權益，特制定本法。」這段話讓人非常非常地感動，在民國93年，時任陳署長就有這樣子高瞻遠矚的遠見而且先進的進步價值，是非常值得令人讚許的。","再來，我從立法院的圖書館發現，93年前2年，91年賴準總統當選人在當時是賴清德委員的時候，也曾經提出了代理孕母的修法草案，而且當時賴清德委員研究了世界各國的現況，他還分析了因為代孕所產生的法律糾紛遠低於收養的糾紛。","10年、20年、30年就這樣過去了，看一下我們的衛生署，後來變衛福部，開了多少的公聽會、專家學者會議、公民審議會議以及無數的民意調查，接下來第幾屆的立委紛紛推出自己的版本，第10屆不分朝野，藍綠白全部都有提案，包括代理孕母。到第11屆，就是本屆，很奇怪地，3位民進黨委員就把代理孕母的篇章拿掉了。我們開了這麼多的公民會議，還有這麼多的公聽會，但是議而不決，決而不行，說實在的，把這麼多的學者、專家、倡議團體召集在一起，還有各位官員，是消耗極大的社會成本。","我給大家看一下這個，這是我形容的，需要代理孕母個案他們的無間地獄啊！因為這是一個迴轉壽司的火車，永遠轉不出去，從公聽會、學者專家會議，性平會、法規會，部長核定、預告草案、行政院審議，繞不出這個圈子，就這樣30年繞不出這個圈子。對於有代理孕母需求，比如您剛剛提到的陳昭姿委員，在這二、三十年簡直就是一個精神的凌遲啊！","我自己有臨床案例，他流產了14次，他本來算不清楚，我回去看病例加一加有14次，他只好出國找代理孕母生了第一個小孩。他希望有第二個小孩，結果他存錢存了10年，才有辦法再生第二個小孩，所以他現在剛生完第二個小孩回來。我有患者因為先天無月經被我診斷出來，臺大的女學生無子宮，跟陳昭姿委員一樣，自從第一天被診斷出來，他媽媽就告訴他：你絕對不可以把這件事情告訴任何一個你交往的對象，以免對方的家庭反對。因此他現在染上了重度的……"],["陳院長建仁：憂鬱。"],["陳委員菁徽：憂鬱，並且有一些傷害自己身體的行為，我看了也非常地於心不忍。","20年前的陳署長在舉辦完國健署的公民會議報告記者會上表示，公民會議的共識，極具知識性、合理性、可行性，是一個歷史創舉，也為延宕近10年的代理孕母立法問題提供許多重要的參考。當時是延宕10年喔，當時陳署長覺得已經延宕10年，至今已經延宕30年了，當時的歷史創舉，現在也已經有三十幾國通過代理孕母，iPhone都不知道出了幾代，我們還能再等幾個30年？","最近我把所有關於代理孕母的文件全部看完，近期部長發表過，草案已經逐漸成型了，提出版本很可能包含代理孕母，這樣子人民才能有更多的選擇在生育上。兩次很公正的官方民調也發現，支持代理孕母的比例一次是過半，一次是86%，大家都認同說因病或者是身體真的沒有辦法的，應該要有這樣子有人權的法案支持他們。","但是陳院長，為什麼今天要問你？解鈴還需繫鈴人，陳院長你就是那個解鈴人，剛剛看到無間地獄的這個循環裡面，有非常多都在行政院的性平會裡面，但內部的人都知道性平會的共識始終都沒有辦法達成，而且一樣的論點已經爭吵了30年，其實從第一次的論點這樣子爭吵，你就錄影就好啦！因為第二次、第三次、第四次，陳院長你應該也參加很多次會議有在討論代理孕母，所以你知道從你們的會議紀錄看起來，其實這個爭吵是不會停，而且沒有改變立場，也沒有改變論點，所以我希望，您身為性平會的召集人，您是否可以回到您20年前的初衷？"],["陳院長建仁：我想我對代理孕母的態度大家都很清楚，但是一個法案要通過，在早期的時候不瞞您說，確實在大院這邊有些討論的時候，就有一些委員反對。後來在行政院的討論，因為我當時不在院裡面，我不太清楚，但是這一個法案，代理孕母的部分，實際上在人工生殖法的公聽會，最近辦的公聽會裡面，衛福部也表達了很明確的態度，我們是不是給部長簡單的講一下？"],["陳委員菁徽：其實衛福部表明的態度是部長算支持，但次長那天說沒有立場，所以我也還沒有機會問到部長。"],["薛部長瑞元：是沒有既定的立場，因為不管怎麼樣這一個案子會到立法院來討論，縱然如果說行政院的院版沒有把代理孕母放進來的話，到立法院也一定會有委員的版本是有代理孕母，所以避免不了要做討論啦！"],["陳委員菁徽：院長，但它現在卡關，它其實始終出不了行政院，依您在公衛界、醫界的聲望還有您的高度，其實您在性平會當一個召集人調和鼎鼐，至少我們要讓這些苦等代理孕母的人知道，我們國家的方向到底是做還是不做，對吧？我們總不能再讓他們繼續期盼30年、20年，這樣子下去很多人的生殖細胞也已經老化了啊！就算30年後通過，他也沒有機會再使用代理孕母了啊！"],["陳院長建仁：我會來注意這個法案現在進行的進度。"],["陳委員菁徽：是，大家都知道少子化是國安危機，少子化就是一個國家的慢性自我毀滅。少子化就是一個國家的慢性自我毀滅，您認同嗎？"],["陳院長建仁：少子化的原因有很多，一個國家確實是需要維持人口適度的成長……"],["陳委員菁徽：是，人口永續。"],["陳院長建仁：但少子化我們會來繼續改進，這個很重要。"],["陳委員菁徽：所以我們來放寬人工生殖法，甚至代理孕母就是人工生殖法的一個延伸，去幫助這些想生而生不出來的人生育。"],["陳院長建仁：對，但是……"],["陳委員菁徽：因為人工生殖法一開始的初衷……"],["陳院長建仁：有點幫助啦！可是對於是少子化的解決，好像真的是……"],["陳委員菁徽：它是其中的一塊拼圖……"],["陳院長建仁：對啦！"],["陳委員菁徽：也是您讓我很感動的一句話，93年您說這是一個保障人權的法案嘛！所以第一次公聽會我有參加，當時次長也說3月中旬、下旬會有第二次公聽會……"],["薛部長瑞元：第二次，對。"],["陳委員菁徽：而且在14個工作天以前會通知大家，我算了一下14個工作天以前其實就是下個禮拜一，請問我們下個禮拜一會收到第二次公聽會的議程內容還有與會的名單嗎？"],["薛部長瑞元：我回去再確定一下，應該就差不多在這個時候。"],["陳委員菁徽：我們希望下週可以看到下一次公聽會的進度。"],["薛部長瑞元：我要跟委員報告，人工生殖法這次要修正也不是只有處理代理孕母。"],["陳委員菁徽：瞭解、理解。"],["薛部長瑞元：因為有好幾個issue要去處理的。"],["陳院長建仁：對。"],["陳委員菁徽：好，我們期待大家一起努力，為臺灣人口永續而努力。","再來，這一段話描述臺灣的醫療問題，比如分級轉診沒有落實，分工做得不好，醫療人員的勞動條件惡化。跟OECD國家相比，我們醫療支出中，公部門的比例真的相對比較低。基層醫療資源匱乏，偏鄉醫療不均。請問陳院長，你覺得這形容得中肯嗎？"],["陳院長建仁：我覺得確實臺灣的社區健康照護網絡，還有需要精進的地方。"],["陳委員菁徽：還有很多空間。"],["陳院長建仁：但是對於OECD的這一個醫療保健支出，公部門的比例是不是偏低，這一個要看我們現在的……需要做盤點啦，因為在上一個會期，我們就對National Health Expenditure有一些討論。"],["陳委員菁徽：瞭解，等一下我會給大家看一下您講的Health Expenditure的數據，剛剛這段話是您2015年競選總統、副總統時所提出的醫療政見。2015年啊！現在已經2023、2024年了，我怎麼還是濃濃的即時感，我看到這段話的時候，我以為在講今天耶！去年我相信大家記憶猶新，「黑十字」，醫護人員已經二十幾年沒有走上街頭了，居然又走上街頭。去年11月，護理師執業人數每一個月不斷地在下降，執業比率只剩58.4%，每一個護理師執業6年就quit不做了。如果大家有機會到急診室看一下急診目前的亂象，那個醫療品質，以及衛福部長自己都說臺灣重症兒童10年後可能要送出國救。我們剛還在討論少子化，我們還希望大家多生一點，結果你跟大家說10年後可能沒有重症的兒科醫師！"],["陳院長建仁：讓你講一下。"],["薛部長瑞元：跟委員報告，對於兒童的這部分，我們已經有對策，而且行政院也已經核定了。"],["陳院長建仁：對。"],["薛部長瑞元：所以這個部分，在最近我們就會把整個的對策announce，對於兒科醫師的保障。至於委員的這一個護理人員執業問題，這是每一年從1月到2月、3月、4月、5月都會下降……"],["陳院長建仁：都會下降。"],["薛部長瑞元：然後6月以後會上升啦！所以這樣會有一點點誤導。"],["陳委員菁徽：說實在的一個護理系的學生……"],["薛部長瑞元：但是今年沒有喔！今年都沒有！"],["陳院長建仁：對，今年沒有往下。"],["陳委員菁徽：一個護理系的學生他做6年，正值年輕力壯，但是他就quit了，大部分的人平均做6年就quit了。"],["薛部長瑞元：所以這個問題有一個很大的因素是在於他要值夜班，他要輪夜班，很多是對身體的影響、對家庭照顧的影響……"],["陳院長建仁：照顧。"],["薛部長瑞元：所以他就quit。"],["陳委員菁徽：對。"],["薛部長瑞元：所以我們也在處理這個問題。"],["陳委員菁徽：對，所以我們一定要給足他們的補貼。","接下來，我們就談您的2015醫療政見，有哪一些還做得不足的？有講到健保支出只占GDP的3.3%，我當然肯定你們有增加支出，可是很顯然還是不夠，因為我們的健保已經快要破產了，可是總額成長率卻是下降的。我很認同你們剛剛講的Health Expenditure，衛福部很會算CHE、NHE，一被發現醫療支出只占GDP的6.6%，趕快東加西加，加起來就7.5 %……"],["陳院長建仁：不，不，不，這是OECD的規定啦！"],["薛部長瑞元：對，對，對……care是……要算進來的。"],["陳委員菁徽：昨天部長跟我們衛環委員會的人說，我們的目標是要追上韓國，你還要找一個訪問團去OECD。"],["薛部長瑞元：對。"],["陳委員菁徽：可是韓國現在在暴動耶！"],["薛部長瑞元：韓國暴動是另外一回事啦！"],["陳院長建仁：對啦！那是醫師的問題。"],["薛部長瑞元：但是我們必須在國際比較的時候要能夠精確。也跟委員報告，即使用占GDP的多少去做評估，也不是很準確。因為我們的GDP成長很大、很快。"],["陳院長建仁：這幾年很好。"],["薛部長瑞元：對。"],["陳委員菁徽：沒關係。"],["薛部長瑞元：GDP我們如果是縮減，它成長的話，當然比例就高起來了。"],["陳委員菁徽：是，但是我們的目標，請不要只跟韓國靠近嘛，我們也要跟其他世界先進國家，至少10到12之間嘛！"],["薛部長瑞元：所以最好是自己跟……"],["陳院長建仁：自我來比，長期趨勢嘛！"],["薛部長瑞元：對啦！"],["陳委員菁徽：所以2015年蔡總統說，跟其他國家比較，我們醫療部分公部門比例真的相對比較低。我們看右邊，這是衛福部自己整理出來的表格，2020年公部門經常性醫療保健支出占經常性醫療支出比，這些數據是你提供的，這些國家也是你選的，其實你也可以再選比我們更差的國家，我只能說很誠實，我們在裡面是倒數第二名耶！所以從2015年到現在，我們公部門的支出到底是相對比較低還是又趨緩了？"],["陳院長建仁：委員我跟你講，這也是我們在上個會期時有很多的討論，因為這個比較是OECD公布的資料，在OECD的資料裡面，你說我們就給它加多一點，不是啦，因為OECD資料裡面，像長照就應該要加進來等等……"],["陳委員菁徽：你的意思是說，這表還沒有加長照？"],["薛部長瑞元：對。"],["陳院長建仁：對，所以我們還有另外一件事情也很重要，就是公家醫院的設施，或者譬如公家醫院蓋新醫院的支出，也應該算在healthcare的expenditure裡面，所以我們現在正在做最後的一些盤點，盤點完之後再提供給委員。"],["陳委員菁徽：好，更新的數據。"],["陳院長建仁：對、對、對，這樣比較才合理。"],["陳委員菁徽：好，希望不是從倒數第二變成第三還是第四之類的。","再來，蔡總統2015年安撫我們全國的醫護人員說：健保給各位點值一直在打折，感謝醫護人員守護國人健康所付出的犧牲，未來要檢討健保支付標準表。結果現在是112年，北部最慘，北部是0.7、0.8打八折，打八折是大家的常態耶！"],["薛部長瑞元：那個是浮動點值的部分，因為也有一些是固定點值，所以一般在算的話用平均點值，平均點值大概在零點九多。"],["陳委員菁徽：部長，您昨天也收了執政黨林俊憲委員的提案，他也同時提到，您真的應該要再調整浮動點值至少到0.95塊吧！"],["薛部長瑞元：沒有，跟委員報告，如果要能夠這樣調整的話，因為點值跟量有關。"],["陳院長建仁：對……"],["薛部長瑞元：我們就是用總額預算制度，所以變成要去修法啦。"],["陳委員菁徽：好，所以我真的很期待，因為你們提到疫情影響等等，未來還是有很多新興傳染病嘛，所以我們要把這些因素考慮進去。"],["薛部長瑞元：這些特殊的狀況我們都有特殊去處理，但是基本上要拉到點值1點1元的話，我們就要有很強的手段去控制它的量，這個對醫界也不一定是好的，因為整個總額就是那麼多錢，也不會從天上再掉下來。"],["陳委員菁徽：好，我們之後再來慢慢討論我們健保應該要怎麼改革，這是一個很大的議題。"],["薛部長瑞元：對，好。"],["陳院長建仁：對，這個需要很精準的討論。"],["陳委員菁徽：當時2015年的政見二，落實分級醫療及雙向轉診，我們來比較，這也是您提供的表格，106年到112年醫學中心跟基層診所紋風不動，10%、64%，甚至基層診所的、就醫比例還下降！"],["薛部長瑞元：委員選的這2年是在疫情期間。"],["陳委員菁徽：所以因為疫情打亂了你們六大政策的節奏。"],["薛部長瑞元：對。"],["陳委員菁徽：六大政策我讀完了，打亂你們六大政策的節奏。"],["陳院長建仁：現在很多數據，委員你也是Hopkins畢業，你是專家啦，剛好在疫情間的比較，我們在2020、2021、2022，在全世界的比較都會把它當作是一個pandemic period，然後在比較的時候通常會……例如2013的時候會比2019，我想我們……但是數據還是來好好整理。"],["陳委員菁徽：好，我期待你們疫情後調整的數據。","第三，當時說要建立一個專業調解機制，由受過訓練的法律及醫療專業者提供公正的意見、縮短醫病認知差距。結果108年出了一個醫療爭議的試辦計畫，第一句是叫我們「當醫療爭議發生時，若病方對醫療過程有疑義，可先與醫療院所溝通」。這不就是一般人每天……不然先跟誰溝通？跟里長嗎？"],["薛部長瑞元：當然這個是現實的狀況，不過跟委員報告，因為貴院也通過一個醫療糾紛……這個法律。"],["陳委員菁徽：有！終於！"],["薛部長瑞元：今年要開始實施。"],["陳委員菁徽：好，2015年的政見終於今年要開始實施了，真的很可惜，我沒有機會檢視這個政見有沒有辦法好好的落實……"],["薛部長瑞元：今年才開始實施，委員的任期剛好就可以檢視。"],["陳委員菁徽：我也期待它可以好好的落實。謝謝。"],["主席：謝謝陳委員菁徽的質詢，也謝謝陳院長的備詢。","接下來我們請登記第55號羅委員美玲質詢。"]],"agenda":{"page_end":98,"meet_id":"院會-11-1-4","speakers":["韓國瑜","黃健豪","沈發惠","柯志恩","陳瑩","楊瓊瓔","林淑芬","王育敏","張宏陸","陳菁徽","羅美玲","徐欣瑩"],"page_start":24,"meetingDate":["2024-03-08"],"gazette_id":"1130601","agenda_lcidc_ids":["1130601_00002","1130601_00003"],"meet_name":"立法院第11屆第1會期第4次會議紀錄","content":"施政質詢\n對行政院院長提出施政方針及施政報告繼續質詢─ 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\"法\", \"start\": 1821.767, \"end\": 1822.067, \"score\": 0.914}, {\"word\": \"律\", \"start\": 1822.067, \"end\": 1822.407, \"score\": 0.941}, {\"word\": \",\"}, {\"word\": \"今\", \"start\": 1822.407, \"end\": 1822.628, \"score\": 0.907}, {\"word\": \"年\", \"start\": 1822.628, \"end\": 1822.868, \"score\": 0.916}, {\"word\": \"要\", \"start\": 1822.868, \"end\": 1823.708, \"score\": 0.899}, {\"word\": \"開\"}, {\"word\": \"始\", \"start\": 1823.708, \"end\": 1823.928, \"score\": 0.909}, {\"word\": \"實\"}, {\"word\": \"施\", \"start\": 1823.928, \"end\": 1824.668, \"score\": 0.974}, {\"word\": \"了\", \"start\": 1824.668, \"end\": 1825.188, \"score\": 0.88}, {\"word\": \"。\"}, {\"word\": \"2\"}, {\"word\": \"0\"}, {\"word\": \"1\"}, {\"word\": \"5\"}, {\"word\": \"年\", \"start\": 1825.188, \"end\": 1825.328, \"score\": 0.998}, {\"word\": \"的\", \"start\": 1825.328, \"end\": 1825.488, \"score\": 1.0}, {\"word\": \"政\", \"start\": 1825.488, \"end\": 1826.169, \"score\": 0.912}, {\"word\": 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0.943}, {\"word\": \"我\", \"start\": 1828.929, \"end\": 1829.09, \"score\": 0.878}, {\"word\": \"沒\", \"start\": 1829.09, \"end\": 1829.19, \"score\": 0.798}, {\"word\": \"有\", \"start\": 1829.19, \"end\": 1830.51, \"score\": 0.909}, {\"word\": \"機\"}, {\"word\": \"會\"}, {\"word\": \"檢\"}, {\"word\": \"視\"}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"政\", \"start\": 1830.51, \"end\": 1831.27, \"score\": 0.947}, {\"word\": \"見\"}, {\"word\": \",\"}, {\"word\": \"有\", \"start\": 1831.27, \"end\": 1831.41, \"score\": 0.998}, {\"word\": \"沒\", \"start\": 1831.41, \"end\": 1831.51, \"score\": 0.603}, {\"word\": \"有\", \"start\": 1831.51, \"end\": 1831.83, \"score\": 0.937}, {\"word\": \"辦\"}, {\"word\": \"法\", \"start\": 1831.83, \"end\": 1832.03, \"score\": 1.0}, {\"word\": \"好\", \"start\": 1832.03, \"end\": 1832.17, \"score\": 0.859}, {\"word\": \"好\", \"start\": 1832.17, \"end\": 1832.31, \"score\": 0.861}, {\"word\": \"的\", \"start\": 1832.31, \"end\": 1832.451, \"score\": 0.997}, {\"word\": \"落\", \"start\": 1832.451, \"end\": 1832.471, \"score\": 0.075}, {\"word\": \"實\"}, {\"word\": \"。\"}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"陳\"}, {\"word\": \"委\", \"start\": 1840.038, \"end\": 1840.34, \"score\": 0.847}, {\"word\": \"員\"}, {\"word\": \"、\"}, {\"word\": \"菁\", \"start\": 1840.34, \"end\": 1840.482, \"score\": 0.857}, {\"word\": \"威\", \"start\": 1840.482, \"end\": 1840.623, \"score\": 0.867}, {\"word\": \"的\", \"start\": 1840.623, \"end\": 1840.643, \"score\": 0.843}, {\"word\": \"質\"}, {\"word\": \"詢\"}, {\"word\": \"。\"}], \"language\": \"zh\"}","srt":"1\n00:00:10,138 --> 00:00:11,479\n陳委員午安,恭喜你當選議委,還有祝你婦女節快樂。\n\n2\n00:00:29,049 --> 00:00:41,335\n謝謝院長。其實院長是我長期以來非常敬佩的一屆前輩、大佬。不敢當。我也是您美國研究所的學妹。對。但是我們今天各自在……你說Hopkins的光榮嗎?\n\n3\n00:00:41,335 --> 00:00:51,200\n對。所以我們今天各自在這樣子的位置,我們就希望把我們分內的工作做好,理性的問政、理性的討論。好,像Hopkins的時候的討論一樣。謝謝。\n\n4\n00:00:54,775 --> 00:01:16,804\n第一個問題呢早上已經聽到非常多的委員同事有詢問臺灣的詐騙啊已經是指數型的成長所以2023年一整年民眾被詐騙的金額高達88億而且報案的件數呢幾乎直逼4萬件非常的誇張所以全民要\n\n5\n00:01:26,152 --> 00:01:48,251\n我是所以呢我自從來這邊上班以後我很仔細的研究我們所有部會的網站我來看到了這個宣傳反詐騙的網站點閱率只有88他到底都在談些什麼還有什麼可以進步的空間呢等一下我想播放一段影片讓大家看一下這個網站的內容為何\n\n6\n00:01:53,151 --> 00:02:04,690\n好,我們先從這個反詐學堂按進去,你會發現裡面的影片是空白的,什麼都沒有。\n\n7\n00:02:11,311 --> 00:02:23,117\n再來我又按了第二個連結是所有防炸影片30秒短版影片裡面用我們政府預算花了很多錢請非常多的名人拍這樣子的短影片\n\n8\n00:02:28,951 --> 00:02:29,731\n請問我們行政院的資安是出了什麼問題?\n\n9\n00:02:49,772 --> 00:03:12,871\n這一個部分的話我想我們會請這是衛福部的網站我們請他們再來好好的check這個是內政部提供給各個所有部門的互相連結起來的材料我想我們這個再請我們打造辦公室來好好檢討一下看委員都發現這樣的疏失的話我們應該要來改進\n\n10\n00:03:13,872 --> 00:03:33,610\n但是委員剛才提到的這個打詐的成果,我也跟委員做一個簡單的報告。就像說我們這個近,你剛才講到有4萬通的詐騙嘛,4萬多的詐騙。但是我們在去年一整年,就是境外篡改的這個電話詐騙的阻止攔阻量就有1851萬通的電話。然後惡意簡訊就攔阻了這個801萬則的簡訊。\n\n11\n00:03:40,316 --> 00:03:40,356\n﹚陳菁徽﹚\n\n12\n00:04:08,796 --> 00:04:36,852\n謝謝院長謝謝感覺現在我們打架的進度還有這個上升的幅度是趨緩趨緩最近各部門都很喜歡用這個字所以我覺得趨緩好也是一個好的趨勢再來我在這個網站呢繼續看有什麼素材是讓我們全民可以欣賞的可以學習的更令人驚訝的是在反詐騙的網站這個素材裡面竟然有\n\n13\n00:04:42,964 --> 00:05:04,555\n民眾黨柯文哲主席競選總統時候的所有錄音檔案怎麼會發生這種奇怪的事情?雞蛋的供給是數學問題出問題是腦袋不好雞蛋的品質是食安問題出問題是政客的良性不足我承諾當選總統將積極輔導升級養雞產業\n\n14\n00:05:10,162 --> 00:05:13,885\n我跟辦公室同仁一開始聽到這樣子的影檔的時候我嚇一跳你也嚇一跳我們可以再聽一次\n\n15\n00:05:40,629 --> 00:05:44,410\n雞蛋的供給是數學問題,出問題是腦袋不好。雞蛋的品質是食安問題,出問題是政客的良心不足。我承諾當選總統將積極輔導升級養雞產業。\n\n16\n00:06:13,396 --> 00:06:25,776\n我作為本年的台北市長,藉由今天570天,民進黨這場議會面對問題,只能開心而已。防疫預算貴重失敗,就夠大行就欠,欠水安,欠疫苗,欠...\n\n17\n00:06:28,547 --> 00:06:49,481\n我相信這個錄音檔柯文哲的競選錄音檔在上面應該不是暗指他是正面教材或者是負面教材吧?我想這個一定要來好好查,為什麼政部為了這樣?那應該也不是指他是打詐高手或者是他自己是這些音檔是詐騙集團吧?應該也不是這個意思啦!\n\n18\n00:06:50,581 --> 00:07:05,686\n我想大概不會是詐騙的做法,但是這一定裡面在內政部的宣導這個詐騙的影片的資料檔一定要好好的檢討。當然我在走進這個議場都還親身操作過一次,現在相信很多線上的朋友也發現了。\n\n19\n00:07:08,390 --> 00:07:33,762\n本院很多的委員其實都有經營自己的頻道也有自己的粉專、社群等等我們要如何去檢視我們宣傳的證件或是我們的短片等等的是不是有跟著人民的方向其實對一般的民意代表來說你一直回頭去審視自己上線的這些素材是非常重要的因為你可以調整你的腳步\n\n20\n00:07:34,462 --> 00:07:35,603\n這個委員是不是請容我們查一下,因為這個看起來怪怪的。\n\n21\n00:08:05,576 --> 00:08:11,781\n這個科批的那個競選廣告在這個上面不過這個並不是網站喔這個看起來應該是一個這是你給的連結因為這個應該是一個雲但是這個對不起\n\n22\n00:08:23,487 --> 00:08:38,761\n你給了反詐防詐請大家幫忙宣導的公文發到這些各級的學校各單位包括退福會小學大學等等每個人都很用力幫你在貼耶我們來瞭解一下好不好結果點進去是這樣子\n\n23\n00:08:40,854 --> 00:08:49,135\n這個禮拜大家也在炒數位身分證嗎?我們的資安到底有沒有辦法被嚴格的把關?看起來連行政院的資安好像數位部長都沒有幫大家做好一些教育訓練。部長沒有,我只是稍微提到而已。\n\n24\n00:09:09,239 --> 00:09:32,953\n所以這部分的話也希望大概一週內看可不可以給個書面的解釋未來你們應該要如何改善還有這件事情到底是怎麼發生的我想就如同委員所說的我們大概一週內一定得要來完整的了解那我們也會請數位部來幫忙我們各個部會來檢查那等一下也請委員給我們\n\n25\n00:09:35,315 --> 00:09:59,316\n現在大家用手機上去看應該也有不過我是怕有一些網民已經惡搞把它刪除了但沒有關係所以呢比較有可能的是你們的協力廠商出包我們當然比較不去懷疑你們內部的人是不是違反了任何行政中立但是最終呢\n\n26\n00:10:00,117 --> 00:10:21,156\n我們來檢討你做宣傳的內容是不是有越覽那是不是有資安的問題甚至有牽涉到這個柯主席的隱私部分這些都要通盤的檢討所以未來也期待你們宣傳這些反詐的素材都可以在後續的去追到底這些素材有沒有發揮他應該要有的效果好嗎\n\n27\n00:10:21,997 --> 00:10:28,830\n這應該要做的,謝謝你的指教,我們一定來請相關的部會一定要在一個禮拜內完全了解。\n\n28\n00:10:32,093 --> 00:10:56,008\n接下來我也希望請院長看這份草案文件您是否有覺得似曾相識呢?確實因為在我擔任衛生署署長的時候呢當時代理孕母的事情我們現在的陳肇志委員就有提出很多的這個建議我們也召開了公民共識會議公民審議會議之後呢是有條件開放確實當時是\n\n29\n00:11:00,191 --> 00:11:00,692\n臨時提案時間\n\n30\n00:11:15,388 --> 00:11:31,501\n這份文件的第一行為因應不孕夫妻生育需求保障人權保護代孕子女代孕者及委託夫妻的權益特制定本法這段話讓人非常非常的感動而且在民國93年\n\n31\n00:11:33,741 --> 00:11:40,676\n實任陳署長就這樣子高瞻遠見而且先進的進步價值是非常值得令人\n\n32\n00:11:44,471 --> 00:12:08,404\n再來我從立法院的圖書館發現9393年前兩年91年賴準總統當選人在當時是賴清德委員的時候也曾經提出了代理育母的修法草案而且當時賴清德委員他研究了世界各國的現況他還分析了\n\n33\n00:12:22,828 --> 00:12:47,127\n衛生署後來編衛福部拍了多少的公聽會專家學者會議公民審議會議以及無數的民意調查接下來呢第幾屆的立委紛紛推出自己的版本第10屆不分朝野藍、綠、白全部都有提案包括代理任務到第11屆就是本屆呢\n\n34\n00:12:49,175 --> 00:13:17,656\n很奇怪的三位民進黨委員就把代理運母的篇章拿掉了我們開了這麼多的公民會議還有這麼多的公聽會但是一而不絕絕而不行說實在的把這麼多的學者專家倡議團體召集在一起還有各位的官員是消耗極大的社會成本我給大家看一下這個\n\n35\n00:13:19,133 --> 00:13:38,607\n這是我形容的需要代理孕母個案他們的無間地獄啊,因為這是一個迴轉壽司的火車,永遠轉不出去,從公聽會、學者專家會、性品會、法規會、部長合定、預告草案、行政院審議,繞不出這個圈子,就這樣30年繞不出這個圈子。\n\n36\n00:13:39,520 --> 00:14:00,161\n對於有代理孕婦需求,比如您剛提到的陳昭芝委員,這二、三十年簡直就是一個精神的臨時啊。我自己有臨床案例,她流產了14次,她本來算不清楚,我回去看病歷加一加14次,她只好出國找代理孕婦,生了第一個小孩。\n\n37\n00:14:00,942 --> 00:14:10,722\n好,他希望有第二個小孩結果他存錢存了10年才有辦法再生第二個小孩所以他現在剛生完第二個小孩回來\n\n38\n00:14:11,721 --> 00:14:38,137\n我有患者因為先天五月經被我診斷出臺大的女學生吳子工跟陳昭芝委員一樣。自從第一天被診斷出來他媽媽就告訴他你絕對不可以把這件事情告訴任何一個你交往的對象以免對方的家庭反對因此他現在染上了重度的憂鬱並且有一些傷害自己身體的行為我看了也非常的於心不忍\n\n39\n00:14:39,485 --> 00:15:04,778\n二十年前的陳署長在舉辦完國建署的公民會議報告記者會上表示說公民會議的共識極具知識性、合理性、可行性是一個歷史創舉也為延宕近十年的代理業母立法問題提供許多重要的參考。好\n\n40\n00:15:06,339 --> 00:15:24,533\n當時是延宕10年喔,當時陳署長覺得已經延宕10年,至今已經延宕30年了,當時的歷史創舉現在也已經30幾國通過代理運母,iPhone都不知道出了幾代,我想我們還能再等幾個,30年了。\n\n41\n00:15:27,861 --> 00:15:46,398\n最近呢我把所有關於代理育母的文件全部看完。近期部長發表過草案已經逐漸成型了提出版本很可能包含代理育母這樣子人民才能有更多的選擇更多的選擇在生育上兩次很公正\n\n42\n00:15:47,850 --> 00:16:11,685\n官方民調也發現說支持代理孕母的比例一次是過半一次是86%大家都認同說因病或者是身體真的沒有辦法的應該要這樣子有人權的法案支持他們但是啊為什麼陳院長今天要問你解零還需繫零人啊\n\n43\n00:16:12,822 --> 00:16:35,282\n陳院長你就是那個解鈴人剛看到無間地獄的這個循環裡面有非常多都在行政院的性評會裡面但內部的人都知道性評會的共識始終沒有辦法達成而且一樣的論點已經爭吵了30年其實啊從第一次的論點這樣子爭吵\n\n44\n00:16:36,983 --> 00:16:38,985\n您是否可以回到您20年前的初衷?\n\n45\n00:17:02,608 --> 00:17:15,756\n我想我對代理運母的態度大家都很清楚但是一個法案要通過在早期的時候不瞞您說確實在大院這邊在有些討論的時候就有一些委員反對後來\n\n46\n00:17:18,557 --> 00:17:20,819\n其實衛福部表明的態度是\n\n47\n00:17:43,004 --> 00:18:09,913\n雖然支持,但次長那天說沒有立場,所以我也還沒有機會問到比長。是沒有既定的立場,因為不管怎麼樣這一個案子會到立法院來討論。縱然如果說行政院的院本沒有去討論,就是說沒有把代理任務放進來的話,到立法院也一定會有委員的版本是有這一個代理任務,所以避免不了要做討論。\n\n48\n00:18:11,374 --> 00:18:35,354\n但院長他現在卡關他其實始終出不了行政院以您的在公衛界醫界的聲望還有您的高度其實您在姓平會當一個召集人調和頂讓至少我們要讓這些苦等代理孕母的人知道說好我們國家的方向到底是做還是不做對吧\n\n49\n00:18:35,774 --> 00:18:36,855\n我會來注意這個法案現在進行的進度。是。\n\n50\n00:18:56,590 --> 00:19:06,738\n少子化大家都知道國安危機少子化就是一個國家的慢性自我毀滅少子化就是一個國家的慢性自我毀滅您認同嗎\n\n51\n00:19:09,653 --> 00:19:35,607\n少子化的原因有很多一個國家確實是需要維持人口的這個適度的這個成長是人口永續但少子化我們會來繼續改進所以我們來放寬人工生殖法甚至代理孕母就是人工生殖法的一個延伸去幫助這些想生生不出來的人生育對因為人工生殖法一開始的初衷有點幫助了\n\n52\n00:19:36,627 --> 00:20:06,087\n可是對於掃紙化的解決好像這個是﹖他是其中的一塊拼圖也是您讓我很感動的一句話9393年您說這是一個保障人權的法案﹖對所以第一次公聽會我有參加當時次長也說3月中旬下旬會有第二次公聽會而且在14個工作天以前會通知大家我算了一下14個工作天以前其實就是下個禮拜一\n\n53\n00:20:06,667 --> 00:20:35,394\n下個禮拜一請問我們會收到第二次公聽會的議程內容還有與會的名單嗎?我回去再確定一下,應該就在差不多這個時候。我們希望下週我們可以看到下一次公聽會的進度。我跟委員報告人工生殖法這一次要修正也不是只有處理代理運沫。瞭解、理解。因為有好幾個議題要去處理的。好,我們期待大家一起努力,為臺灣人口永續而努力。\n\n54\n00:20:36,674 --> 00:21:02,159\n再來呢這一段話描述臺灣的醫療問題比如分級轉整沒有落實分工做得不好醫療人員的勞動條件惡化OECD國家相比我們醫療支出中公部門的比例真的相對比較低基層醫療資源匱乏偏向醫療不均請問陳院長你覺得這形容的中肯嗎\n\n55\n00:21:04,997 --> 00:21:05,338\n還有很多空間。\n\n56\n00:21:13,160 --> 00:21:35,311\n但是對於OECD的這個醫療保健支出公部門的比例是不是偏低這一個要看我們現在的需要做盤點因為在上一個會期我們就對那個healthexpenditure的部分nationalhealthexpenditure有一些討論等一下我會給大家看一下您講的healthexpenditure的數據\n\n57\n00:21:37,714 --> 00:21:56,128\n剛剛這段話是您2015年競選總統副總統時所提出的醫療證件2015年啊現在已經2023、2024年了我怎麼還是濃濃的即視感我以為我看到這段話的時候我以為在講今天欸\n\n58\n00:21:57,645 --> 00:22:11,358\n今天去年我相信大家記憶猶新啊黑十字醫護人員喔已經20幾年沒有走上街頭了居然又走上街頭去年11月護理師職業人數\n\n59\n00:22:12,839 --> 00:22:42,041\n每一個月不斷地在下降職業比率只剩58.4%每一個護理師職業6年就quit不做了如果大家有機會到急診室看一下急診目前的亂象那個醫療品質以及衛福部長自己都說臺灣重症兒童10年後可能要送出國舊我們剛還在討論少子化我們還希望大家多聲一點結果你跟大家說10年後可能沒有重症的兒科醫師\n\n60\n00:22:43,842 --> 00:23:07,349\n對於兒童這部分我們已經有對策,而且這一個行政院也已經核定了。所以這一個部分在最近我們就會把整個的對策是announce出來,對於兒科醫師的保障。至於委員這一個護理人員之約,這是每一年從1月到2月、3月、4月、5月都會下降,然後6月以後會上升。\n\n61\n00:23:09,437 --> 00:23:10,998\n所以這個問題有一個很大的因素是在於他要職業班\n\n62\n00:23:29,344 --> 00:23:31,585\n接下來我們就談剛您的醫療2015醫療政見有哪一些還做得不足的有講到說\n\n63\n00:23:52,233 --> 00:24:08,302\n建保支出只佔GDP的3.3%我當然肯定你們有增加支出可是很顯然還是不夠因為我們的建保已經快要破產了可是總額成長率卻是下降的\n\n64\n00:24:09,042 --> 00:24:35,550\n我很認同你們剛講的HealthExpenditure衛福部很會算CHE、MHE一被發現說醫療支出只佔6.6%,GDP6.6%趕快東加西加加起來就7.5%這是按照OECD的規定昨天部長跟我們衛環委員會的人說我們的目標是要追上韓國嘛你還要找一個訪問團去OECD\n\n65\n00:24:37,631 --> 00:24:39,194\n可是韓國現在在暴動欸\n\n66\n00:24:41,205 --> 00:25:06,945\n韓國暴動另外一回事,但是我們必須要在這個國際比較的時候要能夠精確。那也跟委員報告,即使用佔GDP的多少去做評估的話,也不是很準確。因為我們的GDP成長很大、很快。這幾年很好。沒關係。GDP我們如果是縮減它成長的話,當然比例就高起來了。\n\n67\n00:25:08,626 --> 00:25:13,689\n請不要只跟韓國靠近嘛,我們也要跟其他世界先進公關至少10嘛,10到12之間嘛。\n\n68\n00:25:20,711 --> 00:25:38,654\n所以2015年蔡總統說跟其他國家比較我們醫療公部門比例真的相對比較低好我們看右邊這是衛福部自己整理出來的表格2020年公部門經常性醫療支出佔經常性醫療支出比\n\n69\n00:25:39,633 --> 00:25:39,853\n所以我們從2015年到現在\n\n70\n00:25:53,610 --> 00:26:08,727\n我們公部門的支出到底是還是相對比較低還是又趨緩了?好,委員我跟你講,這也是我們在上個會期的時候有很多的討論,因為這個比較是OECD公部的這個資料。\n\n71\n00:26:11,590 --> 00:26:31,975\n那在OECD的資料裡面你說我們就給他加多一點,不是啦,因為OECD的資料裡面像長照就應該要加進來等等。你意思是說這個表還沒加長照。對,所以我們還有另外一件事情也很重要,就是說公家醫院的那個設施或者是\n\n72\n00:26:33,115 --> 00:26:36,157\n希望不是從倒數第二變成倒數第三還是第四之類的。\n\n73\n00:26:56,147 --> 00:27:22,477\n再來呢蔡總統2015年安撫我們全國的醫護人員說健保給各位點值一直在打折我們感謝醫護人員守護國人的健康所付出的犧牲未來我們要檢討健保支付標準表結果現在是2012年北部最慘北部是0.7、0.8打8折打8折是大家的常態\n\n74\n00:27:23,797 --> 00:27:45,347\n那個是浮動點值的部分,因為也有一些是固定點值,所以一般來算的話用平均點值,平均點值大概在0.9多。部長您昨天也收了執政黨林俊憲委員的提案,他也同時提到您真的應該要再調整浮動點值至少到1.0.95塊吧?\n\n75\n00:27:47,768 --> 00:28:02,637\n沒有,跟委員報告,你如果要能夠這樣調整的話,因為點子是跟量是有關的。我們就是用總額預算制度,所以變成要去修法。我真的很期待,因為你們提到疫情的影響啊等等啊。\n\n76\n00:28:03,237 --> 00:28:26,284\n未來還是有很多新型傳染病嗎?所以我們要把這些因素考慮進去。這些特殊的狀況我們都有特殊去做處理,但是基本上要拉到點子1.1元的話,我們就要有很強的手段去控制它的量。這個對醫界也不一定是好的,因為整個總額就是那麼多錢,也不會從天上再掉下來。\n\n77\n00:28:26,544 --> 00:28:47,082\n我們之後再來慢慢討論我們健保會健保應該要怎麼改革這是一個很大的議題好當時2015年的政見二落實分級醫療雙向轉診我們來比較這也是您提供的表格106年到112年醫學中心跟基層診所聞風不動10%、64%甚至基層診所的\n\n78\n00:28:54,099 --> 00:29:17,113\n還下降欸,就醫比例還下降欸。委員選了這兩年是在疫情的期間欸。所以因為疫情打亂了你們六大政策的節奏。六大政策我也讀完了。打亂你們六大政策的節奏。現在很多數據,委員你是HopkinsBL,你是很專家啦。\n\n79\n00:29:18,643 --> 00:29:18,723\n第三﹖\n\n80\n00:29:42,932 --> 00:30:10,152\n當時說要建立一個專業調解的機制,由受過訓練的法律及醫療專業者提供公正的意見,縮短醫病認知差距。好,結果呢,108年出了一個醫療爭議事辦計劃。第一句是叫我們醫療爭議發生時若病方對醫療過程有疑議,可先與醫療院所溝通。這不就是我們一般人每天大家亂先跟誰溝通,跟里長嗎?\n\n81\n00:30:11,684 --> 00:30:32,471\n當然這個是現實的狀況,不過跟委員報告,因為我們貴院也通過了一個醫療糾紛這個法律,今年要開始實施了。2015年的政見終於今年要開始實施了,真的很可惜我沒有機會檢視這個政見,有沒有辦法好好的落實。\n\n82\n00:30:40,038 --> 00:30:40,643\n謝謝陳委員、菁威的質詢。\n\n","tsv":"start\tend\ttext\n10138\t11479\t陳委員午安,恭喜你當選議委,還有祝你婦女節快樂。\n29049\t41335\t謝謝院長。 其實院長是我長期以來非常敬佩的一屆前輩、大佬。 不敢當。 我也是您美國研究所的學妹。 對。 但是我們今天各自在…… 你說Hopkins的光榮嗎?\n41335\t51200\t對。 所以我們今天各自在這樣子的位置,我們就希望把我們分內的工作做好,理性的問政、理性的討論。 好,像Hopkins的時候的討論一樣。 謝謝。\n54775\t76804\t第一個問題呢早上已經聽到非常多的委員同事有詢問臺灣的詐騙啊已經是指數型的成長所以2023年一整年民眾被詐騙的金額高達88億而且報案的件數呢幾乎直逼4萬件非常的誇張所以全民要\n77244\t85776\t對﹖\n86152\t108251\t我是所以呢我自從來這邊上班以後我很仔細的研究我們所有部會的網站我來看到了這個宣傳反詐騙的網站點閱率只有88他到底都在談些什麼還有什麼可以進步的空間呢等一下我想播放一段影片讓大家看一下這個網站的內容為何\n113151\t124690\t好,我們先從這個反詐學堂按進去,你會發現裡面的影片是空白的,什麼都沒有。\n131311\t143117\t再來我又按了第二個連結是所有防炸影片30秒短版影片裡面用我們政府預算花了很多錢請非常多的名人拍這樣子的短影片\n148951\t149731\t請問我們行政院的資安是出了什麼問題?\n169772\t192871\t這一個部分的話我想我們會請這是衛福部的網站我們請他們再來好好的check這個是內政部提供給各個所有部門的互相連結起來的材料我想我們這個再請我們打造辦公室來好好檢討一下看委員都發現這樣的疏失的話我們應該要來改進\n193872\t213610\t但是委員剛才提到的這個打詐的成果,我也跟委員做一個簡單的報告。就像說我們這個近,你剛才講到有4萬通的詐騙嘛,4萬多的詐騙。但是我們在去年一整年,就是境外篡改的這個電話詐騙的阻止攔阻量就有1851萬通的電話。然後惡意簡訊就攔阻了這個801萬則的簡訊。\n220316\t220356\t﹚陳菁徽﹚\n248796\t276852\t謝謝院長謝謝感覺現在我們打架的進度還有這個上升的幅度是趨緩趨緩最近各部門都很喜歡用這個字所以我覺得趨緩好也是一個好的趨勢再來我在這個網站呢繼續看有什麼素材是讓我們全民可以欣賞的可以學習的更令人驚訝的是在反詐騙的網站這個素材裡面竟然有\n282964\t304555\t民眾黨柯文哲主席競選總統時候的所有錄音檔案怎麼會發生這種奇怪的事情?雞蛋的供給是數學問題出問題是腦袋不好雞蛋的品質是食安問題出問題是政客的良性不足我承諾當選總統將積極輔導升級養雞產業\n310162\t313885\t我跟辦公室同仁一開始聽到這樣子的影檔的時候我嚇一跳你也嚇一跳我們可以再聽一次\n340629\t344410\t雞蛋的供給是數學問題,出問題是腦袋不好。雞蛋的品質是食安問題,出問題是政客的良心不足。我承諾當選總統將積極輔導升級養雞產業。\n373396\t385776\t我作為本年的台北市長,藉由今天570天,民進黨這場議會面對問題,只能開心而已。防疫預算貴重失敗,就夠大行就欠,欠水安,欠疫苗,欠...\n388547\t409481\t我相信這個錄音檔柯文哲的競選錄音檔在上面應該不是暗指他是正面教材或者是負面教材吧?我想這個一定要來好好查,為什麼政部為了這樣?那應該也不是指他是打詐高手或者是他自己是這些音檔是詐騙集團吧?應該也不是這個意思啦!\n410581\t425686\t我想大概不會是詐騙的做法,但是這一定裡面在內政部的宣導這個詐騙的影片的資料檔一定要好好的檢討。當然我在走進這個議場都還親身操作過一次,現在相信很多線上的朋友也發現了。\n428390\t453762\t本院很多的委員其實都有經營自己的頻道也有自己的粉專、社群等等我們要如何去檢視我們宣傳的證件或是我們的短片等等的是不是有跟著人民的方向其實對一般的民意代表來說你一直回頭去審視自己上線的這些素材是非常重要的因為你可以調整你的腳步\n454462\t455603\t這個委員是不是請容我們查一下,因為這個看起來怪怪的。\n485576\t491781\t這個科批的那個競選廣告在這個上面不過這個並不是網站喔這個看起來應該是一個這是你給的連結因為這個應該是一個雲但是這個對不起\n503487\t518761\t你給了反詐防詐請大家幫忙宣導的公文發到這些各級的學校各單位包括退福會小學大學等等每個人都很用力幫你在貼耶我們來瞭解一下好不好結果點進去是這樣子\n520854\t529135\t這個禮拜大家也在炒數位身分證嗎?我們的資安到底有沒有辦法被嚴格的把關?看起來連行政院的資安好像數位部長都沒有幫大家做好一些教育訓練。部長沒有,我只是稍微提到而已。\n549239\t572953\t所以這部分的話也希望大概一週內看可不可以給個書面的解釋未來你們應該要如何改善還有這件事情到底是怎麼發生的我想就如同委員所說的我們大概一週內一定得要來完整的了解那我們也會請數位部來幫忙我們各個部會來檢查那等一下也請委員給我們\n575315\t599316\t現在大家用手機上去看應該也有不過我是怕有一些網民已經惡搞把它刪除了但沒有關係所以呢比較有可能的是你們的協力廠商出包我們當然比較不去懷疑你們內部的人是不是違反了任何行政中立但是最終呢\n600117\t621156\t我們來檢討你做宣傳的內容是不是有越覽那是不是有資安的問題甚至有牽涉到這個柯主席的隱私部分這些都要通盤的檢討所以未來也期待你們宣傳這些反詐的素材都可以在後續的去追到底這些素材有沒有發揮他應該要有的效果好嗎\n621997\t628830\t這應該要做的,謝謝你的指教,我們一定來請相關的部會一定要在一個禮拜內完全了解。\n632093\t656008\t接下來我也希望請院長看這份草案文件您是否有覺得似曾相識呢?確實因為在我擔任衛生署署長的時候呢當時代理孕母的事情我們現在的陳肇志委員就有提出很多的這個建議我們也召開了公民共識會議公民審議會議之後呢是有條件開放確實當時是\n660191\t660692\t臨時提案時間\n675388\t691501\t這份文件的第一行為因應不孕夫妻生育需求保障人權保護代孕子女代孕者及委託夫妻的權益特制定本法這段話讓人非常非常的感動而且在民國93年\n693741\t700676\t實任陳署長就這樣子高瞻遠見而且先進的進步價值是非常值得令人\n704471\t728404\t再來我從立法院的圖書館發現9393年前兩年91年賴準總統當選人在當時是賴清德委員的時候也曾經提出了代理育母的修法草案而且當時賴清德委員他研究了世界各國的現況他還分析了\n729104\t742585\t﹗\n742828\t767127\t衛生署後來編衛福部拍了多少的公聽會專家學者會議公民審議會議以及無數的民意調查接下來呢第幾屆的立委紛紛推出自己的版本第10屆不分朝野藍、綠、白全部都有提案包括代理任務到第11屆就是本屆呢\n769175\t797656\t很奇怪的三位民進黨委員就把代理運母的篇章拿掉了我們開了這麼多的公民會議還有這麼多的公聽會但是一而不絕絕而不行說實在的把這麼多的學者專家倡議團體召集在一起還有各位的官員是消耗極大的社會成本我給大家看一下這個\n799133\t818607\t這是我形容的需要代理孕母個案他們的無間地獄啊,因為這是一個迴轉壽司的火車,永遠轉不出去,從公聽會、學者專家會、性品會、法規會、部長合定、預告草案、行政院審議,繞不出這個圈子,就這樣30年繞不出這個圈子。\n819520\t840161\t對於有代理孕婦需求,比如您剛提到的陳昭芝委員,這二、三十年簡直就是一個精神的臨時啊。 我自己有臨床案例,她流產了14次,她本來算不清楚,我回去看病歷加一加14次,她只好出國找代理孕婦,生了第一個小孩。\n840942\t850722\t好,他希望有第二個小孩結果他存錢存了10年才有辦法再生第二個小孩所以他現在剛生完第二個小孩回來\n851721\t878137\t我有患者因為先天五月經被我診斷出臺大的女學生吳子工跟陳昭芝委員一樣。自從第一天被診斷出來他媽媽就告訴他你絕對不可以把這件事情告訴任何一個你交往的對象以免對方的家庭反對因此他現在染上了重度的憂鬱並且有一些傷害自己身體的行為我看了也非常的於心不忍\n879485\t904778\t二十年前的陳署長在舉辦完國建署的公民會議報告記者會上表示說公民會議的共識極具知識性、合理性、可行性是一個歷史創舉也為延宕近十年的代理業母立法問題提供許多重要的參考。好\n906339\t924533\t當時是延宕10年喔,當時陳署長覺得已經延宕10年,至今已經延宕30年了,當時的歷史創舉現在也已經30幾國通過代理運母,iPhone都不知道出了幾代,我想我們還能再等幾個,30年了。\n927861\t946398\t最近呢我把所有關於代理育母的文件全部看完。近期部長發表過草案已經逐漸成型了提出版本很可能包含代理育母這樣子人民才能有更多的選擇更多的選擇在生育上兩次很公正\n947850\t971685\t官方民調也發現說支持代理孕母的比例一次是過半一次是86%大家都認同說因病或者是身體真的沒有辦法的應該要這樣子有人權的法案支持他們但是啊為什麼陳院長今天要問你解零還需繫零人啊\n972822\t995282\t陳院長你就是那個解鈴人剛看到無間地獄的這個循環裡面有非常多都在行政院的性評會裡面但內部的人都知道性評會的共識始終沒有辦法達成而且一樣的論點已經爭吵了30年其實啊從第一次的論點這樣子爭吵\n996983\t998985\t您是否可以回到您20年前的初衷?\n1022608\t1035756\t我想我對代理運母的態度大家都很清楚但是一個法案要通過在早期的時候不瞞您說確實在大院這邊在有些討論的時候就有一些委員反對後來\n1038557\t1040819\t其實衛福部表明的態度是\n1063004\t1089913\t雖然支持,但次長那天說沒有立場,所以我也還沒有機會問到比長。是沒有既定的立場,因為不管怎麼樣這一個案子會到立法院來討論。縱然如果說行政院的院本沒有去討論,就是說沒有把代理任務放進來的話,到立法院也一定會有委員的版本是有這一個代理任務,所以避免不了要做討論。\n1091374\t1115354\t但院長他現在卡關他其實始終出不了行政院以您的在公衛界醫界的聲望還有您的高度其實您在姓平會當一個召集人調和頂讓至少我們要讓這些苦等代理孕母的人知道說好我們國家的方向到底是做還是不做對吧\n1115774\t1116855\t我會來注意這個法案現在進行的進度。 是。\n1136590\t1146738\t少子化大家都知道國安危機少子化就是一個國家的慢性自我毀滅少子化就是一個國家的慢性自我毀滅您認同嗎\n1149653\t1175607\t少子化的原因有很多一個國家確實是需要維持人口的這個適度的這個成長是人口永續但少子化我們會來繼續改進所以我們來放寬人工生殖法甚至代理孕母就是人工生殖法的一個延伸去幫助這些想生生不出來的人生育對因為人工生殖法一開始的初衷有點幫助了\n1176627\t1206087\t可是對於掃紙化的解決好像這個是﹖他是其中的一塊拼圖也是您讓我很感動的一句話9393年您說這是一個保障人權的法案﹖對所以第一次公聽會我有參加當時次長也說3月中旬下旬會有第二次公聽會而且在14個工作天以前會通知大家我算了一下14個工作天以前其實就是下個禮拜一\n1206667\t1235394\t下個禮拜一請問我們會收到第二次公聽會的議程內容還有與會的名單嗎?我回去再確定一下,應該就在差不多這個時候。我們希望下週我們可以看到下一次公聽會的進度。我跟委員報告人工生殖法這一次要修正也不是只有處理代理運沫。瞭解、理解。因為有好幾個議題要去處理的。好,我們期待大家一起努力,為臺灣人口永續而努力。\n1236674\t1262159\t再來呢這一段話描述臺灣的醫療問題比如分級轉整沒有落實分工做得不好醫療人員的勞動條件惡化OECD國家相比我們醫療支出中公部門的比例真的相對比較低基層醫療資源匱乏偏向醫療不均請問陳院長你覺得這形容的中肯嗎\n1264997\t1265338\t還有很多空間。\n1273160\t1295311\t但是對於OECD的這個醫療保健支出公部門的比例是不是偏低這一個要看我們現在的需要做盤點因為在上一個會期我們就對那個health expenditure的部分national health expenditure有一些討論等一下我會給大家看一下您講的health expenditure的數據\n1297714\t1316128\t剛剛這段話是您2015年競選總統副總統時所提出的醫療證件2015年啊現在已經2023、2024年了我怎麼還是濃濃的即視感我以為我看到這段話的時候我以為在講今天欸\n1317645\t1331358\t今天去年我相信大家記憶猶新啊黑十字醫護人員喔已經20幾年沒有走上街頭了居然又走上街頭去年11月護理師職業人數\n1332839\t1362041\t每一個月不斷地在下降職業比率只剩58.4%每一個護理師職業6年就quit不做了如果大家有機會到急診室看一下急診目前的亂象那個醫療品質以及衛福部長自己都說臺灣重症兒童10年後可能要送出國舊我們剛還在討論少子化我們還希望大家多聲一點結果你跟大家說10年後可能沒有重症的兒科醫師\n1363842\t1387349\t對於兒童這部分我們已經有對策,而且這一個行政院也已經核定了。所以這一個部分在最近我們就會把整個的對策是announce出來,對於兒科醫師的保障。至於委員這一個護理人員之約,這是每一年從1月到2月、3月、4月、5月都會下降,然後6月以後會上升。\n1389437\t1390998\t所以這個問題有一個很大的因素是在於他要職業班\n1409344\t1411585\t接下來我們就談剛您的醫療2015醫療政見有哪一些還做得不足的有講到說\n1432233\t1448302\t建保支出只佔GDP的3.3%我當然肯定你們有增加支出可是很顯然還是不夠因為我們的建保已經快要破產了可是總額成長率卻是下降的\n1449042\t1475550\t我很認同你們剛講的Health Expenditure衛福部很會算CHE、MHE一被發現說醫療支出只佔6.6%,GDP 6.6%趕快東加西加加起來就7.5%這是按照OECD的規定昨天部長跟我們衛環委員會的人說我們的目標是要追上韓國嘛你還要找一個訪問團去OECD\n1477631\t1479194\t可是韓國現在在暴動欸\n1481205\t1506945\t韓國暴動另外一回事,但是我們必須要在這個國際比較的時候要能夠精確。那也跟委員報告,即使用佔GDP的多少去做評估的話,也不是很準確。因為我們的GDP成長很大、很快。這幾年很好。沒關係。GDP我們如果是縮減它成長的話,當然比例就高起來了。\n1508626\t1513689\t請不要只跟韓國靠近嘛,我們也要跟其他世界先進公關至少10嘛,10到12之間嘛。\n1520711\t1538654\t所以2015年蔡總統說跟其他國家比較我們醫療公部門比例真的相對比較低好我們看右邊這是衛福部自己整理出來的表格2020年公部門經常性醫療支出佔經常性醫療支出比\n1539633\t1539853\t所以我們從2015年到現在\n1553610\t1568727\t我們公部門的支出到底是還是相對比較低還是又趨緩了?好,委員我跟你講,這也是我們在上個會期的時候有很多的討論,因為這個比較是OECD公部的這個資料。\n1571590\t1591975\t那在OECD的資料裡面你說我們就給他加多一點,不是啦,因為OECD的資料裡面像長照就應該要加進來等等。 你意思是說這個表還沒加長照。 對,所以我們還有另外一件事情也很重要,就是說公家醫院的那個設施或者是\n1593115\t1596157\t希望不是從倒數第二變成倒數第三還是第四之類的。\n1616147\t1642477\t再來呢蔡總統2015年安撫我們全國的醫護人員說健保給各位點值一直在打折我們感謝醫護人員守護國人的健康所付出的犧牲未來我們要檢討健保支付標準表結果現在是2012年北部最慘北部是0.7、0.8打8折打8折是大家的常態\n1643797\t1665347\t那個是浮動點值的部分,因為也有一些是固定點值,所以一般來算的話用平均點值,平均點值大概在0.9多。部長您昨天也收了執政黨林俊憲委員的提案,他也同時提到您真的應該要再調整浮動點值至少到1.0.95塊吧?\n1667768\t1682637\t沒有,跟委員報告,你如果要能夠這樣調整的話,因為點子是跟量是有關的。我們就是用總額預算制度,所以變成要去修法。我真的很期待,因為你們提到疫情的影響啊等等啊。\n1683237\t1706284\t未來還是有很多新型傳染病嗎?所以我們要把這些因素考慮進去。這些特殊的狀況我們都有特殊去做處理,但是基本上要拉到點子1.1元的話,我們就要有很強的手段去控制它的量。這個對醫界也不一定是好的,因為整個總額就是那麼多錢,也不會從天上再掉下來。\n1706544\t1727082\t我們之後再來慢慢討論我們健保會健保應該要怎麼改革這是一個很大的議題好當時2015年的政見二落實分級醫療雙向轉診我們來比較這也是您提供的表格106年到112年醫學中心跟基層診所聞風不動10%、64%甚至基層診所的\n1734099\t1757113\t還下降欸,就醫比例還下降欸。委員選了這兩年是在疫情的期間欸。所以因為疫情打亂了你們六大政策的節奏。六大政策我也讀完了。打亂你們六大政策的節奏。現在很多數據,委員你是Hopkins BL,你是很專家啦。\n1758643\t1758723\t第三﹖\n1782932\t1810152\t當時說要建立一個專業調解的機制,由受過訓練的法律及醫療專業者提供公正的意見,縮短醫病認知差距。好,結果呢,108年出了一個醫療爭議事辦計劃。第一句是叫我們醫療爭議發生時若病方對醫療過程有疑議,可先與醫療院所溝通。這不就是我們一般人每天大家亂先跟誰溝通,跟里長嗎?\n1811684\t1832471\t當然這個是現實的狀況,不過跟委員報告,因為我們貴院也通過了一個醫療糾紛這個法律,今年要開始實施了。2015年的政見終於今年要開始實施了,真的很可惜我沒有機會檢視這個政見,有沒有辦法好好的落實。\n1840038\t1840643\t謝謝陳委員、菁威的質詢。\n","txt":"陳委員午安,恭喜你當選議委,還有祝你婦女節快樂。\n謝謝院長。 其實院長是我長期以來非常敬佩的一屆前輩、大佬。 不敢當。 我也是您美國研究所的學妹。 對。 但是我們今天各自在…… 你說Hopkins的光榮嗎?\n對。 所以我們今天各自在這樣子的位置,我們就希望把我們分內的工作做好,理性的問政、理性的討論。 好,像Hopkins的時候的討論一樣。 謝謝。\n第一個問題呢早上已經聽到非常多的委員同事有詢問臺灣的詐騙啊已經是指數型的成長所以2023年一整年民眾被詐騙的金額高達88億而且報案的件數呢幾乎直逼4萬件非常的誇張所以全民要\n對﹖\n我是所以呢我自從來這邊上班以後我很仔細的研究我們所有部會的網站我來看到了這個宣傳反詐騙的網站點閱率只有88他到底都在談些什麼還有什麼可以進步的空間呢等一下我想播放一段影片讓大家看一下這個網站的內容為何\n好,我們先從這個反詐學堂按進去,你會發現裡面的影片是空白的,什麼都沒有。\n再來我又按了第二個連結是所有防炸影片30秒短版影片裡面用我們政府預算花了很多錢請非常多的名人拍這樣子的短影片\n請問我們行政院的資安是出了什麼問題?\n這一個部分的話我想我們會請這是衛福部的網站我們請他們再來好好的check這個是內政部提供給各個所有部門的互相連結起來的材料我想我們這個再請我們打造辦公室來好好檢討一下看委員都發現這樣的疏失的話我們應該要來改進\n但是委員剛才提到的這個打詐的成果,我也跟委員做一個簡單的報告。就像說我們這個近,你剛才講到有4萬通的詐騙嘛,4萬多的詐騙。但是我們在去年一整年,就是境外篡改的這個電話詐騙的阻止攔阻量就有1851萬通的電話。然後惡意簡訊就攔阻了這個801萬則的簡訊。\n﹚陳菁徽﹚\n謝謝院長謝謝感覺現在我們打架的進度還有這個上升的幅度是趨緩趨緩最近各部門都很喜歡用這個字所以我覺得趨緩好也是一個好的趨勢再來我在這個網站呢繼續看有什麼素材是讓我們全民可以欣賞的可以學習的更令人驚訝的是在反詐騙的網站這個素材裡面竟然有\n民眾黨柯文哲主席競選總統時候的所有錄音檔案怎麼會發生這種奇怪的事情?雞蛋的供給是數學問題出問題是腦袋不好雞蛋的品質是食安問題出問題是政客的良性不足我承諾當選總統將積極輔導升級養雞產業\n我跟辦公室同仁一開始聽到這樣子的影檔的時候我嚇一跳你也嚇一跳我們可以再聽一次\n雞蛋的供給是數學問題,出問題是腦袋不好。雞蛋的品質是食安問題,出問題是政客的良心不足。我承諾當選總統將積極輔導升級養雞產業。\n我作為本年的台北市長,藉由今天570天,民進黨這場議會面對問題,只能開心而已。防疫預算貴重失敗,就夠大行就欠,欠水安,欠疫苗,欠...\n我相信這個錄音檔柯文哲的競選錄音檔在上面應該不是暗指他是正面教材或者是負面教材吧?我想這個一定要來好好查,為什麼政部為了這樣?那應該也不是指他是打詐高手或者是他自己是這些音檔是詐騙集團吧?應該也不是這個意思啦!\n我想大概不會是詐騙的做法,但是這一定裡面在內政部的宣導這個詐騙的影片的資料檔一定要好好的檢討。當然我在走進這個議場都還親身操作過一次,現在相信很多線上的朋友也發現了。\n本院很多的委員其實都有經營自己的頻道也有自己的粉專、社群等等我們要如何去檢視我們宣傳的證件或是我們的短片等等的是不是有跟著人民的方向其實對一般的民意代表來說你一直回頭去審視自己上線的這些素材是非常重要的因為你可以調整你的腳步\n這個委員是不是請容我們查一下,因為這個看起來怪怪的。\n這個科批的那個競選廣告在這個上面不過這個並不是網站喔這個看起來應該是一個這是你給的連結因為這個應該是一個雲但是這個對不起\n你給了反詐防詐請大家幫忙宣導的公文發到這些各級的學校各單位包括退福會小學大學等等每個人都很用力幫你在貼耶我們來瞭解一下好不好結果點進去是這樣子\n這個禮拜大家也在炒數位身分證嗎?我們的資安到底有沒有辦法被嚴格的把關?看起來連行政院的資安好像數位部長都沒有幫大家做好一些教育訓練。部長沒有,我只是稍微提到而已。\n所以這部分的話也希望大概一週內看可不可以給個書面的解釋未來你們應該要如何改善還有這件事情到底是怎麼發生的我想就如同委員所說的我們大概一週內一定得要來完整的了解那我們也會請數位部來幫忙我們各個部會來檢查那等一下也請委員給我們\n現在大家用手機上去看應該也有不過我是怕有一些網民已經惡搞把它刪除了但沒有關係所以呢比較有可能的是你們的協力廠商出包我們當然比較不去懷疑你們內部的人是不是違反了任何行政中立但是最終呢\n我們來檢討你做宣傳的內容是不是有越覽那是不是有資安的問題甚至有牽涉到這個柯主席的隱私部分這些都要通盤的檢討所以未來也期待你們宣傳這些反詐的素材都可以在後續的去追到底這些素材有沒有發揮他應該要有的效果好嗎\n這應該要做的,謝謝你的指教,我們一定來請相關的部會一定要在一個禮拜內完全了解。\n接下來我也希望請院長看這份草案文件您是否有覺得似曾相識呢?確實因為在我擔任衛生署署長的時候呢當時代理孕母的事情我們現在的陳肇志委員就有提出很多的這個建議我們也召開了公民共識會議公民審議會議之後呢是有條件開放確實當時是\n臨時提案時間\n這份文件的第一行為因應不孕夫妻生育需求保障人權保護代孕子女代孕者及委託夫妻的權益特制定本法這段話讓人非常非常的感動而且在民國93年\n實任陳署長就這樣子高瞻遠見而且先進的進步價值是非常值得令人\n再來我從立法院的圖書館發現9393年前兩年91年賴準總統當選人在當時是賴清德委員的時候也曾經提出了代理育母的修法草案而且當時賴清德委員他研究了世界各國的現況他還分析了\n﹗\n衛生署後來編衛福部拍了多少的公聽會專家學者會議公民審議會議以及無數的民意調查接下來呢第幾屆的立委紛紛推出自己的版本第10屆不分朝野藍、綠、白全部都有提案包括代理任務到第11屆就是本屆呢\n很奇怪的三位民進黨委員就把代理運母的篇章拿掉了我們開了這麼多的公民會議還有這麼多的公聽會但是一而不絕絕而不行說實在的把這麼多的學者專家倡議團體召集在一起還有各位的官員是消耗極大的社會成本我給大家看一下這個\n這是我形容的需要代理孕母個案他們的無間地獄啊,因為這是一個迴轉壽司的火車,永遠轉不出去,從公聽會、學者專家會、性品會、法規會、部長合定、預告草案、行政院審議,繞不出這個圈子,就這樣30年繞不出這個圈子。\n對於有代理孕婦需求,比如您剛提到的陳昭芝委員,這二、三十年簡直就是一個精神的臨時啊。 我自己有臨床案例,她流產了14次,她本來算不清楚,我回去看病歷加一加14次,她只好出國找代理孕婦,生了第一個小孩。\n好,他希望有第二個小孩結果他存錢存了10年才有辦法再生第二個小孩所以他現在剛生完第二個小孩回來\n我有患者因為先天五月經被我診斷出臺大的女學生吳子工跟陳昭芝委員一樣。自從第一天被診斷出來他媽媽就告訴他你絕對不可以把這件事情告訴任何一個你交往的對象以免對方的家庭反對因此他現在染上了重度的憂鬱並且有一些傷害自己身體的行為我看了也非常的於心不忍\n二十年前的陳署長在舉辦完國建署的公民會議報告記者會上表示說公民會議的共識極具知識性、合理性、可行性是一個歷史創舉也為延宕近十年的代理業母立法問題提供許多重要的參考。好\n當時是延宕10年喔,當時陳署長覺得已經延宕10年,至今已經延宕30年了,當時的歷史創舉現在也已經30幾國通過代理運母,iPhone都不知道出了幾代,我想我們還能再等幾個,30年了。\n最近呢我把所有關於代理育母的文件全部看完。近期部長發表過草案已經逐漸成型了提出版本很可能包含代理育母這樣子人民才能有更多的選擇更多的選擇在生育上兩次很公正\n官方民調也發現說支持代理孕母的比例一次是過半一次是86%大家都認同說因病或者是身體真的沒有辦法的應該要這樣子有人權的法案支持他們但是啊為什麼陳院長今天要問你解零還需繫零人啊\n陳院長你就是那個解鈴人剛看到無間地獄的這個循環裡面有非常多都在行政院的性評會裡面但內部的人都知道性評會的共識始終沒有辦法達成而且一樣的論點已經爭吵了30年其實啊從第一次的論點這樣子爭吵\n您是否可以回到您20年前的初衷?\n我想我對代理運母的態度大家都很清楚但是一個法案要通過在早期的時候不瞞您說確實在大院這邊在有些討論的時候就有一些委員反對後來\n其實衛福部表明的態度是\n雖然支持,但次長那天說沒有立場,所以我也還沒有機會問到比長。是沒有既定的立場,因為不管怎麼樣這一個案子會到立法院來討論。縱然如果說行政院的院本沒有去討論,就是說沒有把代理任務放進來的話,到立法院也一定會有委員的版本是有這一個代理任務,所以避免不了要做討論。\n但院長他現在卡關他其實始終出不了行政院以您的在公衛界醫界的聲望還有您的高度其實您在姓平會當一個召集人調和頂讓至少我們要讓這些苦等代理孕母的人知道說好我們國家的方向到底是做還是不做對吧\n我會來注意這個法案現在進行的進度。 是。\n少子化大家都知道國安危機少子化就是一個國家的慢性自我毀滅少子化就是一個國家的慢性自我毀滅您認同嗎\n少子化的原因有很多一個國家確實是需要維持人口的這個適度的這個成長是人口永續但少子化我們會來繼續改進所以我們來放寬人工生殖法甚至代理孕母就是人工生殖法的一個延伸去幫助這些想生生不出來的人生育對因為人工生殖法一開始的初衷有點幫助了\n可是對於掃紙化的解決好像這個是﹖他是其中的一塊拼圖也是您讓我很感動的一句話9393年您說這是一個保障人權的法案﹖對所以第一次公聽會我有參加當時次長也說3月中旬下旬會有第二次公聽會而且在14個工作天以前會通知大家我算了一下14個工作天以前其實就是下個禮拜一\n下個禮拜一請問我們會收到第二次公聽會的議程內容還有與會的名單嗎?我回去再確定一下,應該就在差不多這個時候。我們希望下週我們可以看到下一次公聽會的進度。我跟委員報告人工生殖法這一次要修正也不是只有處理代理運沫。瞭解、理解。因為有好幾個議題要去處理的。好,我們期待大家一起努力,為臺灣人口永續而努力。\n再來呢這一段話描述臺灣的醫療問題比如分級轉整沒有落實分工做得不好醫療人員的勞動條件惡化OECD國家相比我們醫療支出中公部門的比例真的相對比較低基層醫療資源匱乏偏向醫療不均請問陳院長你覺得這形容的中肯嗎\n還有很多空間。\n但是對於OECD的這個醫療保健支出公部門的比例是不是偏低這一個要看我們現在的需要做盤點因為在上一個會期我們就對那個health expenditure的部分national health expenditure有一些討論等一下我會給大家看一下您講的health expenditure的數據\n剛剛這段話是您2015年競選總統副總統時所提出的醫療證件2015年啊現在已經2023、2024年了我怎麼還是濃濃的即視感我以為我看到這段話的時候我以為在講今天欸\n今天去年我相信大家記憶猶新啊黑十字醫護人員喔已經20幾年沒有走上街頭了居然又走上街頭去年11月護理師職業人數\n每一個月不斷地在下降職業比率只剩58.4%每一個護理師職業6年就quit不做了如果大家有機會到急診室看一下急診目前的亂象那個醫療品質以及衛福部長自己都說臺灣重症兒童10年後可能要送出國舊我們剛還在討論少子化我們還希望大家多聲一點結果你跟大家說10年後可能沒有重症的兒科醫師\n對於兒童這部分我們已經有對策,而且這一個行政院也已經核定了。所以這一個部分在最近我們就會把整個的對策是announce出來,對於兒科醫師的保障。至於委員這一個護理人員之約,這是每一年從1月到2月、3月、4月、5月都會下降,然後6月以後會上升。\n所以這個問題有一個很大的因素是在於他要職業班\n接下來我們就談剛您的醫療2015醫療政見有哪一些還做得不足的有講到說\n建保支出只佔GDP的3.3%我當然肯定你們有增加支出可是很顯然還是不夠因為我們的建保已經快要破產了可是總額成長率卻是下降的\n我很認同你們剛講的Health Expenditure衛福部很會算CHE、MHE一被發現說醫療支出只佔6.6%,GDP 6.6%趕快東加西加加起來就7.5%這是按照OECD的規定昨天部長跟我們衛環委員會的人說我們的目標是要追上韓國嘛你還要找一個訪問團去OECD\n可是韓國現在在暴動欸\n韓國暴動另外一回事,但是我們必須要在這個國際比較的時候要能夠精確。那也跟委員報告,即使用佔GDP的多少去做評估的話,也不是很準確。因為我們的GDP成長很大、很快。這幾年很好。沒關係。GDP我們如果是縮減它成長的話,當然比例就高起來了。\n請不要只跟韓國靠近嘛,我們也要跟其他世界先進公關至少10嘛,10到12之間嘛。\n所以2015年蔡總統說跟其他國家比較我們醫療公部門比例真的相對比較低好我們看右邊這是衛福部自己整理出來的表格2020年公部門經常性醫療支出佔經常性醫療支出比\n所以我們從2015年到現在\n我們公部門的支出到底是還是相對比較低還是又趨緩了?好,委員我跟你講,這也是我們在上個會期的時候有很多的討論,因為這個比較是OECD公部的這個資料。\n那在OECD的資料裡面你說我們就給他加多一點,不是啦,因為OECD的資料裡面像長照就應該要加進來等等。 你意思是說這個表還沒加長照。 對,所以我們還有另外一件事情也很重要,就是說公家醫院的那個設施或者是\n希望不是從倒數第二變成倒數第三還是第四之類的。\n再來呢蔡總統2015年安撫我們全國的醫護人員說健保給各位點值一直在打折我們感謝醫護人員守護國人的健康所付出的犧牲未來我們要檢討健保支付標準表結果現在是2012年北部最慘北部是0.7、0.8打8折打8折是大家的常態\n那個是浮動點值的部分,因為也有一些是固定點值,所以一般來算的話用平均點值,平均點值大概在0.9多。部長您昨天也收了執政黨林俊憲委員的提案,他也同時提到您真的應該要再調整浮動點值至少到1.0.95塊吧?\n沒有,跟委員報告,你如果要能夠這樣調整的話,因為點子是跟量是有關的。我們就是用總額預算制度,所以變成要去修法。我真的很期待,因為你們提到疫情的影響啊等等啊。\n未來還是有很多新型傳染病嗎?所以我們要把這些因素考慮進去。這些特殊的狀況我們都有特殊去做處理,但是基本上要拉到點子1.1元的話,我們就要有很強的手段去控制它的量。這個對醫界也不一定是好的,因為整個總額就是那麼多錢,也不會從天上再掉下來。\n我們之後再來慢慢討論我們健保會健保應該要怎麼改革這是一個很大的議題好當時2015年的政見二落實分級醫療雙向轉診我們來比較這也是您提供的表格106年到112年醫學中心跟基層診所聞風不動10%、64%甚至基層診所的\n還下降欸,就醫比例還下降欸。委員選了這兩年是在疫情的期間欸。所以因為疫情打亂了你們六大政策的節奏。六大政策我也讀完了。打亂你們六大政策的節奏。現在很多數據,委員你是Hopkins BL,你是很專家啦。\n第三﹖\n當時說要建立一個專業調解的機制,由受過訓練的法律及醫療專業者提供公正的意見,縮短醫病認知差距。好,結果呢,108年出了一個醫療爭議事辦計劃。第一句是叫我們醫療爭議發生時若病方對醫療過程有疑議,可先與醫療院所溝通。這不就是我們一般人每天大家亂先跟誰溝通,跟里長嗎?\n當然這個是現實的狀況,不過跟委員報告,因為我們貴院也通過了一個醫療糾紛這個法律,今年要開始實施了。2015年的政見終於今年要開始實施了,真的很可惜我沒有機會檢視這個政見,有沒有辦法好好的落實。\n謝謝陳委員、菁威的質詢。\n","vtt":"WEBVTT\n\n00:10.138 --> 00:11.479\n陳委員午安,恭喜你當選議委,還有祝你婦女節快樂。\n\n00:29.049 --> 00:41.335\n謝謝院長。其實院長是我長期以來非常敬佩的一屆前輩、大佬。不敢當。我也是您美國研究所的學妹。對。但是我們今天各自在……你說Hopkins的光榮嗎?\n\n00:41.335 --> 00:51.200\n對。所以我們今天各自在這樣子的位置,我們就希望把我們分內的工作做好,理性的問政、理性的討論。好,像Hopkins的時候的討論一樣。謝謝。\n\n00:54.775 --> 01:16.804\n第一個問題呢早上已經聽到非常多的委員同事有詢問臺灣的詐騙啊已經是指數型的成長所以2023年一整年民眾被詐騙的金額高達88億而且報案的件數呢幾乎直逼4萬件非常的誇張所以全民要\n\n01:26.152 --> 01:48.251\n我是所以呢我自從來這邊上班以後我很仔細的研究我們所有部會的網站我來看到了這個宣傳反詐騙的網站點閱率只有88他到底都在談些什麼還有什麼可以進步的空間呢等一下我想播放一段影片讓大家看一下這個網站的內容為何\n\n01:53.151 --> 02:04.690\n好,我們先從這個反詐學堂按進去,你會發現裡面的影片是空白的,什麼都沒有。\n\n02:11.311 --> 02:23.117\n再來我又按了第二個連結是所有防炸影片30秒短版影片裡面用我們政府預算花了很多錢請非常多的名人拍這樣子的短影片\n\n02:28.951 --> 02:29.731\n請問我們行政院的資安是出了什麼問題?\n\n02:49.772 --> 03:12.871\n這一個部分的話我想我們會請這是衛福部的網站我們請他們再來好好的check這個是內政部提供給各個所有部門的互相連結起來的材料我想我們這個再請我們打造辦公室來好好檢討一下看委員都發現這樣的疏失的話我們應該要來改進\n\n03:13.872 --> 03:33.610\n但是委員剛才提到的這個打詐的成果,我也跟委員做一個簡單的報告。就像說我們這個近,你剛才講到有4萬通的詐騙嘛,4萬多的詐騙。但是我們在去年一整年,就是境外篡改的這個電話詐騙的阻止攔阻量就有1851萬通的電話。然後惡意簡訊就攔阻了這個801萬則的簡訊。\n\n03:40.316 --> 03:40.356\n﹚陳菁徽﹚\n\n04:08.796 --> 04:36.852\n謝謝院長謝謝感覺現在我們打架的進度還有這個上升的幅度是趨緩趨緩最近各部門都很喜歡用這個字所以我覺得趨緩好也是一個好的趨勢再來我在這個網站呢繼續看有什麼素材是讓我們全民可以欣賞的可以學習的更令人驚訝的是在反詐騙的網站這個素材裡面竟然有\n\n04:42.964 --> 05:04.555\n民眾黨柯文哲主席競選總統時候的所有錄音檔案怎麼會發生這種奇怪的事情?雞蛋的供給是數學問題出問題是腦袋不好雞蛋的品質是食安問題出問題是政客的良性不足我承諾當選總統將積極輔導升級養雞產業\n\n05:10.162 --> 05:13.885\n我跟辦公室同仁一開始聽到這樣子的影檔的時候我嚇一跳你也嚇一跳我們可以再聽一次\n\n05:40.629 --> 05:44.410\n雞蛋的供給是數學問題,出問題是腦袋不好。雞蛋的品質是食安問題,出問題是政客的良心不足。我承諾當選總統將積極輔導升級養雞產業。\n\n06:13.396 --> 06:25.776\n我作為本年的台北市長,藉由今天570天,民進黨這場議會面對問題,只能開心而已。防疫預算貴重失敗,就夠大行就欠,欠水安,欠疫苗,欠...\n\n06:28.547 --> 06:49.481\n我相信這個錄音檔柯文哲的競選錄音檔在上面應該不是暗指他是正面教材或者是負面教材吧?我想這個一定要來好好查,為什麼政部為了這樣?那應該也不是指他是打詐高手或者是他自己是這些音檔是詐騙集團吧?應該也不是這個意思啦!\n\n06:50.581 --> 07:05.686\n我想大概不會是詐騙的做法,但是這一定裡面在內政部的宣導這個詐騙的影片的資料檔一定要好好的檢討。當然我在走進這個議場都還親身操作過一次,現在相信很多線上的朋友也發現了。\n\n07:08.390 --> 07:33.762\n本院很多的委員其實都有經營自己的頻道也有自己的粉專、社群等等我們要如何去檢視我們宣傳的證件或是我們的短片等等的是不是有跟著人民的方向其實對一般的民意代表來說你一直回頭去審視自己上線的這些素材是非常重要的因為你可以調整你的腳步\n\n07:34.462 --> 07:35.603\n這個委員是不是請容我們查一下,因為這個看起來怪怪的。\n\n08:05.576 --> 08:11.781\n這個科批的那個競選廣告在這個上面不過這個並不是網站喔這個看起來應該是一個這是你給的連結因為這個應該是一個雲但是這個對不起\n\n08:23.487 --> 08:38.761\n你給了反詐防詐請大家幫忙宣導的公文發到這些各級的學校各單位包括退福會小學大學等等每個人都很用力幫你在貼耶我們來瞭解一下好不好結果點進去是這樣子\n\n08:40.854 --> 08:49.135\n這個禮拜大家也在炒數位身分證嗎?我們的資安到底有沒有辦法被嚴格的把關?看起來連行政院的資安好像數位部長都沒有幫大家做好一些教育訓練。部長沒有,我只是稍微提到而已。\n\n09:09.239 --> 09:32.953\n所以這部分的話也希望大概一週內看可不可以給個書面的解釋未來你們應該要如何改善還有這件事情到底是怎麼發生的我想就如同委員所說的我們大概一週內一定得要來完整的了解那我們也會請數位部來幫忙我們各個部會來檢查那等一下也請委員給我們\n\n09:35.315 --> 09:59.316\n現在大家用手機上去看應該也有不過我是怕有一些網民已經惡搞把它刪除了但沒有關係所以呢比較有可能的是你們的協力廠商出包我們當然比較不去懷疑你們內部的人是不是違反了任何行政中立但是最終呢\n\n10:00.117 --> 10:21.156\n我們來檢討你做宣傳的內容是不是有越覽那是不是有資安的問題甚至有牽涉到這個柯主席的隱私部分這些都要通盤的檢討所以未來也期待你們宣傳這些反詐的素材都可以在後續的去追到底這些素材有沒有發揮他應該要有的效果好嗎\n\n10:21.997 --> 10:28.830\n這應該要做的,謝謝你的指教,我們一定來請相關的部會一定要在一個禮拜內完全了解。\n\n10:32.093 --> 10:56.008\n接下來我也希望請院長看這份草案文件您是否有覺得似曾相識呢?確實因為在我擔任衛生署署長的時候呢當時代理孕母的事情我們現在的陳肇志委員就有提出很多的這個建議我們也召開了公民共識會議公民審議會議之後呢是有條件開放確實當時是\n\n11:00.191 --> 11:00.692\n臨時提案時間\n\n11:15.388 --> 11:31.501\n這份文件的第一行為因應不孕夫妻生育需求保障人權保護代孕子女代孕者及委託夫妻的權益特制定本法這段話讓人非常非常的感動而且在民國93年\n\n11:33.741 --> 11:40.676\n實任陳署長就這樣子高瞻遠見而且先進的進步價值是非常值得令人\n\n11:44.471 --> 12:08.404\n再來我從立法院的圖書館發現9393年前兩年91年賴準總統當選人在當時是賴清德委員的時候也曾經提出了代理育母的修法草案而且當時賴清德委員他研究了世界各國的現況他還分析了\n\n12:22.828 --> 12:47.127\n衛生署後來編衛福部拍了多少的公聽會專家學者會議公民審議會議以及無數的民意調查接下來呢第幾屆的立委紛紛推出自己的版本第10屆不分朝野藍、綠、白全部都有提案包括代理任務到第11屆就是本屆呢\n\n12:49.175 --> 13:17.656\n很奇怪的三位民進黨委員就把代理運母的篇章拿掉了我們開了這麼多的公民會議還有這麼多的公聽會但是一而不絕絕而不行說實在的把這麼多的學者專家倡議團體召集在一起還有各位的官員是消耗極大的社會成本我給大家看一下這個\n\n13:19.133 --> 13:38.607\n這是我形容的需要代理孕母個案他們的無間地獄啊,因為這是一個迴轉壽司的火車,永遠轉不出去,從公聽會、學者專家會、性品會、法規會、部長合定、預告草案、行政院審議,繞不出這個圈子,就這樣30年繞不出這個圈子。\n\n13:39.520 --> 14:00.161\n對於有代理孕婦需求,比如您剛提到的陳昭芝委員,這二、三十年簡直就是一個精神的臨時啊。我自己有臨床案例,她流產了14次,她本來算不清楚,我回去看病歷加一加14次,她只好出國找代理孕婦,生了第一個小孩。\n\n14:00.942 --> 14:10.722\n好,他希望有第二個小孩結果他存錢存了10年才有辦法再生第二個小孩所以他現在剛生完第二個小孩回來\n\n14:11.721 --> 14:38.137\n我有患者因為先天五月經被我診斷出臺大的女學生吳子工跟陳昭芝委員一樣。自從第一天被診斷出來他媽媽就告訴他你絕對不可以把這件事情告訴任何一個你交往的對象以免對方的家庭反對因此他現在染上了重度的憂鬱並且有一些傷害自己身體的行為我看了也非常的於心不忍\n\n14:39.485 --> 15:04.778\n二十年前的陳署長在舉辦完國建署的公民會議報告記者會上表示說公民會議的共識極具知識性、合理性、可行性是一個歷史創舉也為延宕近十年的代理業母立法問題提供許多重要的參考。好\n\n15:06.339 --> 15:24.533\n當時是延宕10年喔,當時陳署長覺得已經延宕10年,至今已經延宕30年了,當時的歷史創舉現在也已經30幾國通過代理運母,iPhone都不知道出了幾代,我想我們還能再等幾個,30年了。\n\n15:27.861 --> 15:46.398\n最近呢我把所有關於代理育母的文件全部看完。近期部長發表過草案已經逐漸成型了提出版本很可能包含代理育母這樣子人民才能有更多的選擇更多的選擇在生育上兩次很公正\n\n15:47.850 --> 16:11.685\n官方民調也發現說支持代理孕母的比例一次是過半一次是86%大家都認同說因病或者是身體真的沒有辦法的應該要這樣子有人權的法案支持他們但是啊為什麼陳院長今天要問你解零還需繫零人啊\n\n16:12.822 --> 16:35.282\n陳院長你就是那個解鈴人剛看到無間地獄的這個循環裡面有非常多都在行政院的性評會裡面但內部的人都知道性評會的共識始終沒有辦法達成而且一樣的論點已經爭吵了30年其實啊從第一次的論點這樣子爭吵\n\n16:36.983 --> 16:38.985\n您是否可以回到您20年前的初衷?\n\n17:02.608 --> 17:15.756\n我想我對代理運母的態度大家都很清楚但是一個法案要通過在早期的時候不瞞您說確實在大院這邊在有些討論的時候就有一些委員反對後來\n\n17:18.557 --> 17:20.819\n其實衛福部表明的態度是\n\n17:43.004 --> 18:09.913\n雖然支持,但次長那天說沒有立場,所以我也還沒有機會問到比長。是沒有既定的立場,因為不管怎麼樣這一個案子會到立法院來討論。縱然如果說行政院的院本沒有去討論,就是說沒有把代理任務放進來的話,到立法院也一定會有委員的版本是有這一個代理任務,所以避免不了要做討論。\n\n18:11.374 --> 18:35.354\n但院長他現在卡關他其實始終出不了行政院以您的在公衛界醫界的聲望還有您的高度其實您在姓平會當一個召集人調和頂讓至少我們要讓這些苦等代理孕母的人知道說好我們國家的方向到底是做還是不做對吧\n\n18:35.774 --> 18:36.855\n我會來注意這個法案現在進行的進度。是。\n\n18:56.590 --> 19:06.738\n少子化大家都知道國安危機少子化就是一個國家的慢性自我毀滅少子化就是一個國家的慢性自我毀滅您認同嗎\n\n19:09.653 --> 19:35.607\n少子化的原因有很多一個國家確實是需要維持人口的這個適度的這個成長是人口永續但少子化我們會來繼續改進所以我們來放寬人工生殖法甚至代理孕母就是人工生殖法的一個延伸去幫助這些想生生不出來的人生育對因為人工生殖法一開始的初衷有點幫助了\n\n19:36.627 --> 20:06.087\n可是對於掃紙化的解決好像這個是﹖他是其中的一塊拼圖也是您讓我很感動的一句話9393年您說這是一個保障人權的法案﹖對所以第一次公聽會我有參加當時次長也說3月中旬下旬會有第二次公聽會而且在14個工作天以前會通知大家我算了一下14個工作天以前其實就是下個禮拜一\n\n20:06.667 --> 20:35.394\n下個禮拜一請問我們會收到第二次公聽會的議程內容還有與會的名單嗎?我回去再確定一下,應該就在差不多這個時候。我們希望下週我們可以看到下一次公聽會的進度。我跟委員報告人工生殖法這一次要修正也不是只有處理代理運沫。瞭解、理解。因為有好幾個議題要去處理的。好,我們期待大家一起努力,為臺灣人口永續而努力。\n\n20:36.674 --> 21:02.159\n再來呢這一段話描述臺灣的醫療問題比如分級轉整沒有落實分工做得不好醫療人員的勞動條件惡化OECD國家相比我們醫療支出中公部門的比例真的相對比較低基層醫療資源匱乏偏向醫療不均請問陳院長你覺得這形容的中肯嗎\n\n21:04.997 --> 21:05.338\n還有很多空間。\n\n21:13.160 --> 21:35.311\n但是對於OECD的這個醫療保健支出公部門的比例是不是偏低這一個要看我們現在的需要做盤點因為在上一個會期我們就對那個healthexpenditure的部分nationalhealthexpenditure有一些討論等一下我會給大家看一下您講的healthexpenditure的數據\n\n21:37.714 --> 21:56.128\n剛剛這段話是您2015年競選總統副總統時所提出的醫療證件2015年啊現在已經2023、2024年了我怎麼還是濃濃的即視感我以為我看到這段話的時候我以為在講今天欸\n\n21:57.645 --> 22:11.358\n今天去年我相信大家記憶猶新啊黑十字醫護人員喔已經20幾年沒有走上街頭了居然又走上街頭去年11月護理師職業人數\n\n22:12.839 --> 22:42.041\n每一個月不斷地在下降職業比率只剩58.4%每一個護理師職業6年就quit不做了如果大家有機會到急診室看一下急診目前的亂象那個醫療品質以及衛福部長自己都說臺灣重症兒童10年後可能要送出國舊我們剛還在討論少子化我們還希望大家多聲一點結果你跟大家說10年後可能沒有重症的兒科醫師\n\n22:43.842 --> 23:07.349\n對於兒童這部分我們已經有對策,而且這一個行政院也已經核定了。所以這一個部分在最近我們就會把整個的對策是announce出來,對於兒科醫師的保障。至於委員這一個護理人員之約,這是每一年從1月到2月、3月、4月、5月都會下降,然後6月以後會上升。\n\n23:09.437 --> 23:10.998\n所以這個問題有一個很大的因素是在於他要職業班\n\n23:29.344 --> 23:31.585\n接下來我們就談剛您的醫療2015醫療政見有哪一些還做得不足的有講到說\n\n23:52.233 --> 24:08.302\n建保支出只佔GDP的3.3%我當然肯定你們有增加支出可是很顯然還是不夠因為我們的建保已經快要破產了可是總額成長率卻是下降的\n\n24:09.042 --> 24:35.550\n我很認同你們剛講的HealthExpenditure衛福部很會算CHE、MHE一被發現說醫療支出只佔6.6%,GDP6.6%趕快東加西加加起來就7.5%這是按照OECD的規定昨天部長跟我們衛環委員會的人說我們的目標是要追上韓國嘛你還要找一個訪問團去OECD\n\n24:37.631 --> 24:39.194\n可是韓國現在在暴動欸\n\n24:41.205 --> 25:06.945\n韓國暴動另外一回事,但是我們必須要在這個國際比較的時候要能夠精確。那也跟委員報告,即使用佔GDP的多少去做評估的話,也不是很準確。因為我們的GDP成長很大、很快。這幾年很好。沒關係。GDP我們如果是縮減它成長的話,當然比例就高起來了。\n\n25:08.626 --> 25:13.689\n請不要只跟韓國靠近嘛,我們也要跟其他世界先進公關至少10嘛,10到12之間嘛。\n\n25:20.711 --> 25:38.654\n所以2015年蔡總統說跟其他國家比較我們醫療公部門比例真的相對比較低好我們看右邊這是衛福部自己整理出來的表格2020年公部門經常性醫療支出佔經常性醫療支出比\n\n25:39.633 --> 25:39.853\n所以我們從2015年到現在\n\n25:53.610 --> 26:08.727\n我們公部門的支出到底是還是相對比較低還是又趨緩了?好,委員我跟你講,這也是我們在上個會期的時候有很多的討論,因為這個比較是OECD公部的這個資料。\n\n26:11.590 --> 26:31.975\n那在OECD的資料裡面你說我們就給他加多一點,不是啦,因為OECD的資料裡面像長照就應該要加進來等等。你意思是說這個表還沒加長照。對,所以我們還有另外一件事情也很重要,就是說公家醫院的那個設施或者是\n\n26:33.115 --> 26:36.157\n希望不是從倒數第二變成倒數第三還是第四之類的。\n\n26:56.147 --> 27:22.477\n再來呢蔡總統2015年安撫我們全國的醫護人員說健保給各位點值一直在打折我們感謝醫護人員守護國人的健康所付出的犧牲未來我們要檢討健保支付標準表結果現在是2012年北部最慘北部是0.7、0.8打8折打8折是大家的常態\n\n27:23.797 --> 27:45.347\n那個是浮動點值的部分,因為也有一些是固定點值,所以一般來算的話用平均點值,平均點值大概在0.9多。部長您昨天也收了執政黨林俊憲委員的提案,他也同時提到您真的應該要再調整浮動點值至少到1.0.95塊吧?\n\n27:47.768 --> 28:02.637\n沒有,跟委員報告,你如果要能夠這樣調整的話,因為點子是跟量是有關的。我們就是用總額預算制度,所以變成要去修法。我真的很期待,因為你們提到疫情的影響啊等等啊。\n\n28:03.237 --> 28:26.284\n未來還是有很多新型傳染病嗎?所以我們要把這些因素考慮進去。這些特殊的狀況我們都有特殊去做處理,但是基本上要拉到點子1.1元的話,我們就要有很強的手段去控制它的量。這個對醫界也不一定是好的,因為整個總額就是那麼多錢,也不會從天上再掉下來。\n\n28:26.544 --> 28:47.082\n我們之後再來慢慢討論我們健保會健保應該要怎麼改革這是一個很大的議題好當時2015年的政見二落實分級醫療雙向轉診我們來比較這也是您提供的表格106年到112年醫學中心跟基層診所聞風不動10%、64%甚至基層診所的\n\n28:54.099 --> 29:17.113\n還下降欸,就醫比例還下降欸。委員選了這兩年是在疫情的期間欸。所以因為疫情打亂了你們六大政策的節奏。六大政策我也讀完了。打亂你們六大政策的節奏。現在很多數據,委員你是HopkinsBL,你是很專家啦。\n\n29:18.643 --> 29:18.723\n第三﹖\n\n29:42.932 --> 30:10.152\n當時說要建立一個專業調解的機制,由受過訓練的法律及醫療專業者提供公正的意見,縮短醫病認知差距。好,結果呢,108年出了一個醫療爭議事辦計劃。第一句是叫我們醫療爭議發生時若病方對醫療過程有疑議,可先與醫療院所溝通。這不就是我們一般人每天大家亂先跟誰溝通,跟里長嗎?\n\n30:11.684 --> 30:32.471\n當然這個是現實的狀況,不過跟委員報告,因為我們貴院也通過了一個醫療糾紛這個法律,今年要開始實施了。2015年的政見終於今年要開始實施了,真的很可惜我沒有機會檢視這個政見,有沒有辦法好好的落實。\n\n30:40.038 --> 30:40.643\n謝謝陳委員、菁威的質詢。\n\n","segments":[{"start":10.138,"end":11.479,"text":"陳委員午安,恭喜你當選議委,還有祝你婦女節快樂。"},{"start":29.049,"end":41.335,"text":"謝謝院長。 其實院長是我長期以來非常敬佩的一屆前輩、大佬。 不敢當。 我也是您美國研究所的學妹。 對。 但是我們今天各自在…… 你說Hopkins的光榮嗎?"},{"start":41.335,"end":51.2,"text":"對。 所以我們今天各自在這樣子的位置,我們就希望把我們分內的工作做好,理性的問政、理性的討論。 好,像Hopkins的時候的討論一樣。 謝謝。"},{"start":54.775,"end":76.804,"text":"第一個問題呢早上已經聽到非常多的委員同事有詢問臺灣的詐騙啊已經是指數型的成長所以2023年一整年民眾被詐騙的金額高達88億而且報案的件數呢幾乎直逼4萬件非常的誇張所以全民要"},{"start":77.244,"end":85.776,"text":"對﹖"},{"start":86.152,"end":108.251,"text":"我是所以呢我自從來這邊上班以後我很仔細的研究我們所有部會的網站我來看到了這個宣傳反詐騙的網站點閱率只有88他到底都在談些什麼還有什麼可以進步的空間呢等一下我想播放一段影片讓大家看一下這個網站的內容為何"},{"start":113.151,"end":124.69,"text":"好,我們先從這個反詐學堂按進去,你會發現裡面的影片是空白的,什麼都沒有。"},{"start":131.311,"end":143.117,"text":"再來我又按了第二個連結是所有防炸影片30秒短版影片裡面用我們政府預算花了很多錢請非常多的名人拍這樣子的短影片"},{"start":148.951,"end":149.731,"text":"請問我們行政院的資安是出了什麼問題?"},{"start":169.772,"end":192.871,"text":"這一個部分的話我想我們會請這是衛福部的網站我們請他們再來好好的check這個是內政部提供給各個所有部門的互相連結起來的材料我想我們這個再請我們打造辦公室來好好檢討一下看委員都發現這樣的疏失的話我們應該要來改進"},{"start":193.872,"end":213.61,"text":"但是委員剛才提到的這個打詐的成果,我也跟委員做一個簡單的報告。就像說我們這個近,你剛才講到有4萬通的詐騙嘛,4萬多的詐騙。但是我們在去年一整年,就是境外篡改的這個電話詐騙的阻止攔阻量就有1851萬通的電話。然後惡意簡訊就攔阻了這個801萬則的簡訊。"},{"start":220.316,"end":220.356,"text":"﹚陳菁徽﹚"},{"start":248.796,"end":276.852,"text":"謝謝院長謝謝感覺現在我們打架的進度還有這個上升的幅度是趨緩趨緩最近各部門都很喜歡用這個字所以我覺得趨緩好也是一個好的趨勢再來我在這個網站呢繼續看有什麼素材是讓我們全民可以欣賞的可以學習的更令人驚訝的是在反詐騙的網站這個素材裡面竟然有"},{"start":282.964,"end":304.555,"text":"民眾黨柯文哲主席競選總統時候的所有錄音檔案怎麼會發生這種奇怪的事情?雞蛋的供給是數學問題出問題是腦袋不好雞蛋的品質是食安問題出問題是政客的良性不足我承諾當選總統將積極輔導升級養雞產業"},{"start":310.162,"end":313.885,"text":"我跟辦公室同仁一開始聽到這樣子的影檔的時候我嚇一跳你也嚇一跳我們可以再聽一次"},{"start":340.629,"end":344.41,"text":"雞蛋的供給是數學問題,出問題是腦袋不好。雞蛋的品質是食安問題,出問題是政客的良心不足。我承諾當選總統將積極輔導升級養雞產業。"},{"start":373.396,"end":385.776,"text":"我作為本年的台北市長,藉由今天570天,民進黨這場議會面對問題,只能開心而已。防疫預算貴重失敗,就夠大行就欠,欠水安,欠疫苗,欠..."},{"start":388.547,"end":409.481,"text":"我相信這個錄音檔柯文哲的競選錄音檔在上面應該不是暗指他是正面教材或者是負面教材吧?我想這個一定要來好好查,為什麼政部為了這樣?那應該也不是指他是打詐高手或者是他自己是這些音檔是詐騙集團吧?應該也不是這個意思啦!"},{"start":410.581,"end":425.686,"text":"我想大概不會是詐騙的做法,但是這一定裡面在內政部的宣導這個詐騙的影片的資料檔一定要好好的檢討。當然我在走進這個議場都還親身操作過一次,現在相信很多線上的朋友也發現了。"},{"start":428.39,"end":453.762,"text":"本院很多的委員其實都有經營自己的頻道也有自己的粉專、社群等等我們要如何去檢視我們宣傳的證件或是我們的短片等等的是不是有跟著人民的方向其實對一般的民意代表來說你一直回頭去審視自己上線的這些素材是非常重要的因為你可以調整你的腳步"},{"start":454.462,"end":455.603,"text":"這個委員是不是請容我們查一下,因為這個看起來怪怪的。"},{"start":485.576,"end":491.781,"text":"這個科批的那個競選廣告在這個上面不過這個並不是網站喔這個看起來應該是一個這是你給的連結因為這個應該是一個雲但是這個對不起"},{"start":503.487,"end":518.761,"text":"你給了反詐防詐請大家幫忙宣導的公文發到這些各級的學校各單位包括退福會小學大學等等每個人都很用力幫你在貼耶我們來瞭解一下好不好結果點進去是這樣子"},{"start":520.854,"end":529.135,"text":"這個禮拜大家也在炒數位身分證嗎?我們的資安到底有沒有辦法被嚴格的把關?看起來連行政院的資安好像數位部長都沒有幫大家做好一些教育訓練。部長沒有,我只是稍微提到而已。"},{"start":549.239,"end":572.953,"text":"所以這部分的話也希望大概一週內看可不可以給個書面的解釋未來你們應該要如何改善還有這件事情到底是怎麼發生的我想就如同委員所說的我們大概一週內一定得要來完整的了解那我們也會請數位部來幫忙我們各個部會來檢查那等一下也請委員給我們"},{"start":575.315,"end":599.316,"text":"現在大家用手機上去看應該也有不過我是怕有一些網民已經惡搞把它刪除了但沒有關係所以呢比較有可能的是你們的協力廠商出包我們當然比較不去懷疑你們內部的人是不是違反了任何行政中立但是最終呢"},{"start":600.117,"end":621.156,"text":"我們來檢討你做宣傳的內容是不是有越覽那是不是有資安的問題甚至有牽涉到這個柯主席的隱私部分這些都要通盤的檢討所以未來也期待你們宣傳這些反詐的素材都可以在後續的去追到底這些素材有沒有發揮他應該要有的效果好嗎"},{"start":621.997,"end":628.83,"text":"這應該要做的,謝謝你的指教,我們一定來請相關的部會一定要在一個禮拜內完全了解。"},{"start":632.093,"end":656.008,"text":"接下來我也希望請院長看這份草案文件您是否有覺得似曾相識呢?確實因為在我擔任衛生署署長的時候呢當時代理孕母的事情我們現在的陳肇志委員就有提出很多的這個建議我們也召開了公民共識會議公民審議會議之後呢是有條件開放確實當時是"},{"start":660.191,"end":660.692,"text":"臨時提案時間"},{"start":675.388,"end":691.501,"text":"這份文件的第一行為因應不孕夫妻生育需求保障人權保護代孕子女代孕者及委託夫妻的權益特制定本法這段話讓人非常非常的感動而且在民國93年"},{"start":693.741,"end":700.676,"text":"實任陳署長就這樣子高瞻遠見而且先進的進步價值是非常值得令人"},{"start":704.471,"end":728.404,"text":"再來我從立法院的圖書館發現9393年前兩年91年賴準總統當選人在當時是賴清德委員的時候也曾經提出了代理育母的修法草案而且當時賴清德委員他研究了世界各國的現況他還分析了"},{"start":729.104,"end":742.585,"text":"﹗"},{"start":742.828,"end":767.127,"text":"衛生署後來編衛福部拍了多少的公聽會專家學者會議公民審議會議以及無數的民意調查接下來呢第幾屆的立委紛紛推出自己的版本第10屆不分朝野藍、綠、白全部都有提案包括代理任務到第11屆就是本屆呢"},{"start":769.175,"end":797.656,"text":"很奇怪的三位民進黨委員就把代理運母的篇章拿掉了我們開了這麼多的公民會議還有這麼多的公聽會但是一而不絕絕而不行說實在的把這麼多的學者專家倡議團體召集在一起還有各位的官員是消耗極大的社會成本我給大家看一下這個"},{"start":799.133,"end":818.607,"text":"這是我形容的需要代理孕母個案他們的無間地獄啊,因為這是一個迴轉壽司的火車,永遠轉不出去,從公聽會、學者專家會、性品會、法規會、部長合定、預告草案、行政院審議,繞不出這個圈子,就這樣30年繞不出這個圈子。"},{"start":819.52,"end":840.161,"text":"對於有代理孕婦需求,比如您剛提到的陳昭芝委員,這二、三十年簡直就是一個精神的臨時啊。 我自己有臨床案例,她流產了14次,她本來算不清楚,我回去看病歷加一加14次,她只好出國找代理孕婦,生了第一個小孩。"},{"start":840.942,"end":850.722,"text":"好,他希望有第二個小孩結果他存錢存了10年才有辦法再生第二個小孩所以他現在剛生完第二個小孩回來"},{"start":851.721,"end":878.137,"text":"我有患者因為先天五月經被我診斷出臺大的女學生吳子工跟陳昭芝委員一樣。自從第一天被診斷出來他媽媽就告訴他你絕對不可以把這件事情告訴任何一個你交往的對象以免對方的家庭反對因此他現在染上了重度的憂鬱並且有一些傷害自己身體的行為我看了也非常的於心不忍"},{"start":879.485,"end":904.778,"text":"二十年前的陳署長在舉辦完國建署的公民會議報告記者會上表示說公民會議的共識極具知識性、合理性、可行性是一個歷史創舉也為延宕近十年的代理業母立法問題提供許多重要的參考。好"},{"start":906.339,"end":924.533,"text":"當時是延宕10年喔,當時陳署長覺得已經延宕10年,至今已經延宕30年了,當時的歷史創舉現在也已經30幾國通過代理運母,iPhone都不知道出了幾代,我想我們還能再等幾個,30年了。"},{"start":927.861,"end":946.398,"text":"最近呢我把所有關於代理育母的文件全部看完。近期部長發表過草案已經逐漸成型了提出版本很可能包含代理育母這樣子人民才能有更多的選擇更多的選擇在生育上兩次很公正"},{"start":947.85,"end":971.685,"text":"官方民調也發現說支持代理孕母的比例一次是過半一次是86%大家都認同說因病或者是身體真的沒有辦法的應該要這樣子有人權的法案支持他們但是啊為什麼陳院長今天要問你解零還需繫零人啊"},{"start":972.822,"end":995.282,"text":"陳院長你就是那個解鈴人剛看到無間地獄的這個循環裡面有非常多都在行政院的性評會裡面但內部的人都知道性評會的共識始終沒有辦法達成而且一樣的論點已經爭吵了30年其實啊從第一次的論點這樣子爭吵"},{"start":996.983,"end":998.985,"text":"您是否可以回到您20年前的初衷?"},{"start":1022.608,"end":1035.756,"text":"我想我對代理運母的態度大家都很清楚但是一個法案要通過在早期的時候不瞞您說確實在大院這邊在有些討論的時候就有一些委員反對後來"},{"start":1038.557,"end":1040.819,"text":"其實衛福部表明的態度是"},{"start":1063.004,"end":1089.913,"text":"雖然支持,但次長那天說沒有立場,所以我也還沒有機會問到比長。是沒有既定的立場,因為不管怎麼樣這一個案子會到立法院來討論。縱然如果說行政院的院本沒有去討論,就是說沒有把代理任務放進來的話,到立法院也一定會有委員的版本是有這一個代理任務,所以避免不了要做討論。"},{"start":1091.374,"end":1115.354,"text":"但院長他現在卡關他其實始終出不了行政院以您的在公衛界醫界的聲望還有您的高度其實您在姓平會當一個召集人調和頂讓至少我們要讓這些苦等代理孕母的人知道說好我們國家的方向到底是做還是不做對吧"},{"start":1115.774,"end":1116.855,"text":"我會來注意這個法案現在進行的進度。 是。"},{"start":1136.59,"end":1146.738,"text":"少子化大家都知道國安危機少子化就是一個國家的慢性自我毀滅少子化就是一個國家的慢性自我毀滅您認同嗎"},{"start":1149.653,"end":1175.607,"text":"少子化的原因有很多一個國家確實是需要維持人口的這個適度的這個成長是人口永續但少子化我們會來繼續改進所以我們來放寬人工生殖法甚至代理孕母就是人工生殖法的一個延伸去幫助這些想生生不出來的人生育對因為人工生殖法一開始的初衷有點幫助了"},{"start":1176.627,"end":1206.087,"text":"可是對於掃紙化的解決好像這個是﹖他是其中的一塊拼圖也是您讓我很感動的一句話9393年您說這是一個保障人權的法案﹖對所以第一次公聽會我有參加當時次長也說3月中旬下旬會有第二次公聽會而且在14個工作天以前會通知大家我算了一下14個工作天以前其實就是下個禮拜一"},{"start":1206.667,"end":1235.394,"text":"下個禮拜一請問我們會收到第二次公聽會的議程內容還有與會的名單嗎?我回去再確定一下,應該就在差不多這個時候。我們希望下週我們可以看到下一次公聽會的進度。我跟委員報告人工生殖法這一次要修正也不是只有處理代理運沫。瞭解、理解。因為有好幾個議題要去處理的。好,我們期待大家一起努力,為臺灣人口永續而努力。"},{"start":1236.674,"end":1262.159,"text":"再來呢這一段話描述臺灣的醫療問題比如分級轉整沒有落實分工做得不好醫療人員的勞動條件惡化OECD國家相比我們醫療支出中公部門的比例真的相對比較低基層醫療資源匱乏偏向醫療不均請問陳院長你覺得這形容的中肯嗎"},{"start":1264.997,"end":1265.338,"text":"還有很多空間。"},{"start":1273.16,"end":1295.311,"text":"但是對於OECD的這個醫療保健支出公部門的比例是不是偏低這一個要看我們現在的需要做盤點因為在上一個會期我們就對那個health expenditure的部分national health expenditure有一些討論等一下我會給大家看一下您講的health expenditure的數據"},{"start":1297.714,"end":1316.128,"text":"剛剛這段話是您2015年競選總統副總統時所提出的醫療證件2015年啊現在已經2023、2024年了我怎麼還是濃濃的即視感我以為我看到這段話的時候我以為在講今天欸"},{"start":1317.645,"end":1331.358,"text":"今天去年我相信大家記憶猶新啊黑十字醫護人員喔已經20幾年沒有走上街頭了居然又走上街頭去年11月護理師職業人數"},{"start":1332.839,"end":1362.041,"text":"每一個月不斷地在下降職業比率只剩58.4%每一個護理師職業6年就quit不做了如果大家有機會到急診室看一下急診目前的亂象那個醫療品質以及衛福部長自己都說臺灣重症兒童10年後可能要送出國舊我們剛還在討論少子化我們還希望大家多聲一點結果你跟大家說10年後可能沒有重症的兒科醫師"},{"start":1363.842,"end":1387.349,"text":"對於兒童這部分我們已經有對策,而且這一個行政院也已經核定了。所以這一個部分在最近我們就會把整個的對策是announce出來,對於兒科醫師的保障。至於委員這一個護理人員之約,這是每一年從1月到2月、3月、4月、5月都會下降,然後6月以後會上升。"},{"start":1389.437,"end":1390.998,"text":"所以這個問題有一個很大的因素是在於他要職業班"},{"start":1409.344,"end":1411.585,"text":"接下來我們就談剛您的醫療2015醫療政見有哪一些還做得不足的有講到說"},{"start":1432.233,"end":1448.302,"text":"建保支出只佔GDP的3.3%我當然肯定你們有增加支出可是很顯然還是不夠因為我們的建保已經快要破產了可是總額成長率卻是下降的"},{"start":1449.042,"end":1475.55,"text":"我很認同你們剛講的Health Expenditure衛福部很會算CHE、MHE一被發現說醫療支出只佔6.6%,GDP 6.6%趕快東加西加加起來就7.5%這是按照OECD的規定昨天部長跟我們衛環委員會的人說我們的目標是要追上韓國嘛你還要找一個訪問團去OECD"},{"start":1477.631,"end":1479.194,"text":"可是韓國現在在暴動欸"},{"start":1481.205,"end":1506.945,"text":"韓國暴動另外一回事,但是我們必須要在這個國際比較的時候要能夠精確。那也跟委員報告,即使用佔GDP的多少去做評估的話,也不是很準確。因為我們的GDP成長很大、很快。這幾年很好。沒關係。GDP我們如果是縮減它成長的話,當然比例就高起來了。"},{"start":1508.626,"end":1513.689,"text":"請不要只跟韓國靠近嘛,我們也要跟其他世界先進公關至少10嘛,10到12之間嘛。"},{"start":1520.711,"end":1538.654,"text":"所以2015年蔡總統說跟其他國家比較我們醫療公部門比例真的相對比較低好我們看右邊這是衛福部自己整理出來的表格2020年公部門經常性醫療支出佔經常性醫療支出比"},{"start":1539.633,"end":1539.853,"text":"所以我們從2015年到現在"},{"start":1553.61,"end":1568.727,"text":"我們公部門的支出到底是還是相對比較低還是又趨緩了?好,委員我跟你講,這也是我們在上個會期的時候有很多的討論,因為這個比較是OECD公部的這個資料。"},{"start":1571.59,"end":1591.975,"text":"那在OECD的資料裡面你說我們就給他加多一點,不是啦,因為OECD的資料裡面像長照就應該要加進來等等。 你意思是說這個表還沒加長照。 對,所以我們還有另外一件事情也很重要,就是說公家醫院的那個設施或者是"},{"start":1593.115,"end":1596.157,"text":"希望不是從倒數第二變成倒數第三還是第四之類的。"},{"start":1616.147,"end":1642.477,"text":"再來呢蔡總統2015年安撫我們全國的醫護人員說健保給各位點值一直在打折我們感謝醫護人員守護國人的健康所付出的犧牲未來我們要檢討健保支付標準表結果現在是2012年北部最慘北部是0.7、0.8打8折打8折是大家的常態"},{"start":1643.797,"end":1665.347,"text":"那個是浮動點值的部分,因為也有一些是固定點值,所以一般來算的話用平均點值,平均點值大概在0.9多。部長您昨天也收了執政黨林俊憲委員的提案,他也同時提到您真的應該要再調整浮動點值至少到1.0.95塊吧?"},{"start":1667.768,"end":1682.637,"text":"沒有,跟委員報告,你如果要能夠這樣調整的話,因為點子是跟量是有關的。我們就是用總額預算制度,所以變成要去修法。我真的很期待,因為你們提到疫情的影響啊等等啊。"},{"start":1683.237,"end":1706.284,"text":"未來還是有很多新型傳染病嗎?所以我們要把這些因素考慮進去。這些特殊的狀況我們都有特殊去做處理,但是基本上要拉到點子1.1元的話,我們就要有很強的手段去控制它的量。這個對醫界也不一定是好的,因為整個總額就是那麼多錢,也不會從天上再掉下來。"},{"start":1706.544,"end":1727.082,"text":"我們之後再來慢慢討論我們健保會健保應該要怎麼改革這是一個很大的議題好當時2015年的政見二落實分級醫療雙向轉診我們來比較這也是您提供的表格106年到112年醫學中心跟基層診所聞風不動10%、64%甚至基層診所的"},{"start":1734.099,"end":1757.113,"text":"還下降欸,就醫比例還下降欸。委員選了這兩年是在疫情的期間欸。所以因為疫情打亂了你們六大政策的節奏。六大政策我也讀完了。打亂你們六大政策的節奏。現在很多數據,委員你是Hopkins BL,你是很專家啦。"},{"start":1758.643,"end":1758.723,"text":"第三﹖"},{"start":1782.932,"end":1810.152,"text":"當時說要建立一個專業調解的機制,由受過訓練的法律及醫療專業者提供公正的意見,縮短醫病認知差距。好,結果呢,108年出了一個醫療爭議事辦計劃。第一句是叫我們醫療爭議發生時若病方對醫療過程有疑議,可先與醫療院所溝通。這不就是我們一般人每天大家亂先跟誰溝通,跟里長嗎?"},{"start":1811.684,"end":1832.471,"text":"當然這個是現實的狀況,不過跟委員報告,因為我們貴院也通過了一個醫療糾紛這個法律,今年要開始實施了。2015年的政見終於今年要開始實施了,真的很可惜我沒有機會檢視這個政見,有沒有辦法好好的落實。"},{"start":1840.038,"end":1840.643,"text":"謝謝陳委員、菁威的質詢。"}]}}}}