{"id":150410,"url":"https://ivod.ly.gov.tw/Play/Clip/1M/150410","video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/f45bf982c29023ee7fd7bacdc699860f8ac1d636ef3e2fe8f8ba9b0039caa7a6b6b03fad438834045ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"廖偉翔","委員發言時間":"09:24:20 - 09:40:15","影片長度":"00:15:55","會議時間":"2024-03-26T09:00:00+08:00","會議名稱":"第11屆第1會期第6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22日上午9時至10時為國是論壇時間。\n三、3月26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6次會議","id":"院會-11-1-6","type":"院會","term":11,"sessionPeriod":1,"sessionTimes":6},"date":"2024-03-26","duration":955,"end_time":"2024-03-26T09:40:15+08:00","start_time":"2024-03-26T09:24:20+08:00","features":["ai-transcript","gazette"],"type":"Clip","gazette":{"lineno":69,"blocks":[["廖委員偉翔：（9時24分）院長好，有請行政院陳院長及薛瑞元部長。"],["主席：麻煩請陳院長、衛福部備詢。"],["陳院長建仁：廖委員早安。"],["廖委員偉翔：院長早。院長、部長，健保開辦以來，這28年有極高的民意支持度，但是現在在這個高支持度的背後我們卻看到是由血汗醫護所支撐，甚至現在已經向下影響到整個醫療、教育，包含醫師公會理事長也說現在有很多學生看到醫療環境不佳，影響選擇醫學系的意願；我們統測衛生護理類報考從2019年開始更是年年降低，更加劇了護理人員的人員荒。事實上現在在醫療現場，前幾年的急重難罕、內外婦兒無一不缺，護理人力也流失嚴重，導致醫院有病床卻也無法開，許多病人只能夠塞在急診室一待就好幾天。所以想要請教院長、部長，我們的醫護人力荒有解嗎？"],["陳院長建仁：醫護人力的這一個部分，實際上你剛才講到醫師的報考人不多，這個不對啦！實際上醫學系現在還是第一高志願……"],["廖委員偉翔：院長，謝謝，等一下這個問題我們……"],["陳院長建仁：確實急重難罕比較不容易招到住院醫師，這是有……"],["廖委員偉翔：是，謝謝院長，我知道你是這方面的專家，但我們等一下可以慢慢討論，這是開頭而已。院長，除了缺人外，還有缺藥，缺藥的因素也有很多，在生產端，包含原料藥的來源供應不及，還有供應鏈不穩定、製造品質或法規要求改變以及藥商的商業考量，更別說賦形劑、膠囊殼，甚至物流因素等等都有可能造成缺藥。所以一顆小小的藥丸或是膠囊，它的產品鏈非常長，只要有一個小環節出狀況就容易造成缺藥。另外在需求面包括我們的庫存量管理不佳、突然增加的需求及季節需求因素等也會造成缺藥，所以缺藥的因素不一而足。但是缺藥也分短期缺藥跟長期缺藥，短期缺藥可以透過很多手段解決，但是如果是長期缺藥的話就要特別小心了。所以我想要問院長，您同意這樣的看法嗎？"],["陳院長建仁：我覺得缺藥的問題確實是需要很慎重來解決。"],["廖委員偉翔：是，謝謝院長。"],["陳院長建仁：但是衛福部也很用很大的心力來調整。"],["廖委員偉翔：院長、部長，所以面對缺藥問題，我之前有在委員會作出決議，包含同時符合三個條件下，就可以排除在每年藥價調整之外，或不受藥價調整影響，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，或者是藥事法第二十七條之二的必要藥品清單中之藥品；第二個是鼓勵在地製造，希望可以穩定我們的供應鏈；第三個就是3張以下的稀缺藥證。院長，這部分涉及修法，請問4月中之前，能否將此三項條件納入修法的內容之中？"],["陳院長建仁：這個部分我請衛福部回答。"],["薛部長瑞元：跟委員報告，委員所提出來這三個條件，除了第一個的醫學會認證，因為我們在列必要藥品品項的時候都有跟醫醫學會這邊，邀請他們確認過了，所以不一定需要再去寫醫學會認證。"],["廖委員偉翔：是，我後面也有講到醫事法的……"],["薛部長瑞元：其他這三個部分的話，我們都深表贊同。4月8日我們會召集相關團體做考量，然後送到健保的共擬會議，所以4月底之前要完成這個所謂的規定修改的話，有一點點困難，但是在上半年應該是沒有問題。"],["廖委員偉翔：好，那請部長也儘快加速進行。我的條件之一是，藥事法第二十七條之二的必要藥品清單嘛！"],["薛部長瑞元：對。"],["廖委員偉翔：既然是必要藥品，代表這些藥品是不可或缺的，目前總共是四百多項。但是院長，你們知道這份清單多久才檢討一次嗎？從食藥署的網頁，依照公告資料，最近一次是在去年11月，可是再上一次間隔了3年2個月，再之前大概平均約兩年。所以院長、部長，既然是必要的藥品清單，為何不能夠每年檢討一次？尤其是現在的狀況之下，因為國際上的供應鏈也仍然沒有很穩定，所以本席的具體建議是有沒有可能改成每年檢討一次？同時也在4月中之前，或是你剛剛說時程上的部分，可不可以提早完成這個修法的預告作業？"],["薛部長瑞元：如果是每年檢討，應該是可行，我們儘量朝這個方向做。"],["廖委員偉翔：好，謝謝。再來，院長、部長，我們醫療的價值要等於我們醫療的品質，也要等於我們醫療的點值，這樣的理念您認同嗎？"],["薛部長瑞元：最後一個有關健保的，是不是等於健保點值？因為我們現在是在總額預算的制度下去運作……"],["廖委員偉翔：是，知道。"],["薛部長瑞元：所以價量的關係……"],["廖委員偉翔：是。院長，但是健保的點值長年以來一直被貶值，造成現在醫療體系的困境，所以醫界為了生存而有過去大家常常聽到的藥價差、發展自費藥材，或者是最近的解除掛號費上限等等，這些都是醫界自救的手段。但也因為如此，整個醫療體系也會越來越扭曲，病患也不滿意，所以院長你知道嗎？醫療院所其實也不想這樣做，但是為了生存，也只能這麼做。所以院長、部長，健保點值這個老問題讓整個醫療體系不死不活，連臺大醫院院長都說，醫療本業的利潤剩下1%，如果他是企業的CEO，老早就被開除了。而你們現在還要調漲電價，請問院長，你認為臺大醫院吳院長所說1%的利潤還有可能嗎？"],["陳院長建仁：有關電價的調整如何影響臺大醫院的營運，我們需要再來評估電費所占的百分比是多少。"],["廖委員偉翔：是。"],["陳院長建仁：但是我想醫界大家所提出來的這些意見，我們都會做為檢討，可是……"],["廖委員偉翔：所以院長，醫院裡面的……"],["陳院長建仁：很重要的是，不要忘掉我們臺灣的健保在國人心目中還是很好的一個制度……"],["廖委員偉翔：是，這個我曉得。"],["陳院長建仁：要多方來考量。"],["廖委員偉翔：是。院長，因為醫院裡面的急診、加護病房、一般病房的空調也是不能夠中斷的，難不成醫院因為電價太高就要把它關掉嗎？"],["陳院長建仁：當然不會，也不應該。"],["廖委員偉翔：對嘛！所以是又要馬兒好，又要馬兒不吃草，我們是覺得這樣不太合理。","所以，院長，現在台灣醫院協會、醫師公會的全聯會、護理師公會的全聯會，還有台灣私立醫院協會、醫務管理學會等五大醫事團體聯合發出聲明，籲請不要調漲醫療院所的電價，請問院長，你們可以答應嗎？院長，下星期一就是4月1日調漲電價日喔，所以本席希望本週五前可以給醫界一個答復，好嗎？"],["陳院長建仁：這個部分我們要來瞭解，剛才我講過，醫療院所的電費占它所有經營的百分比是多少，我舉一個很簡單的例子，譬如說臺北捷運的話，我們調漲電價實際上對它的成本只影響百分之一，醫院的部分我們需要再做盤點，才有辦法來做，當然不可能今天中午以前答復，這個不可能，因為我們還沒有……"],["廖委員偉翔：我沒有說今天中午，我說這個禮拜五。"],["陳院長建仁：如果是這個禮拜五以前，我們來看我們盤點的情況，但是我要再次強調，醫院裡面的電費支出是多少需要做很好的盤點。"],["廖委員偉翔：院長，所以這個部分也要請您特別用心、特別留意或是更加的研議，因為你們的經濟部今天也承認他們沒有考量到烘焙機的成本，所以你們講出那個兩塊錢根本是瞎扯的，但是希望這個部分可以研議啦！"],["陳院長建仁：那是看店家的區位在哪裡，有用烘焙機的，它不會在700度裡面。"],["廖委員偉翔：我知道。院長，不好意思，我只是要表達這個東西也是茲事體大，還要請你們好好地研議。"],["陳院長建仁：我們當然會做更精細的盤點。"],["廖委員偉翔：院長，再來，健保制度的運作讓政府現在的醫療政策只能夠頭痛醫頭，腳痛醫腳，也因為這樣，所以我說現在的健保可能有三苦：病人痛苦、家屬辛苦、醫護命苦，但是最根本性的問題也是剛剛講的長期以來這個健保點值的問題。因為總額上限的問題造成許多醫院必須到處挖東牆、補西牆，院長、部長，這點你們同意嗎？"],["陳院長建仁：這個我不同意啦！你看看醫院裡面很多病人寫給醫護人員的，他們都是很感謝有健保、有醫護人員，所以他們在得病期間得到很好的照顧……"],["廖委員偉翔：是、是、是，但是這個點值浮動的問題……"],["陳院長建仁：你現在就故意講反面的話，我個人不贊成。"],["廖委員偉翔：我沒有講反面的話……"],["陳院長建仁：而且家屬有很多都是感謝我們醫護人員的努力……"],["廖委員偉翔：我知道，大家都感謝，但是現在醫護……"],["陳院長建仁：所以你製造對立，沒有辦法使臺灣的醫療產業有很好的……"],["廖委員偉翔：但現在是血汗醫護的問題。沒有，院長，我要跟你討論的是現在血汗醫護的問題。我要告訴你一個數據，這2年的健保浮動點值曾一度掉到0.8元以下，但我們要說，實際也有可能比這個更慘，因為總額之下還有一個分區總額，所以健保署的各分區業務組會跟它那個區域的各層級醫院訂定一個目標額，醫院可能也會想辦法減少病患的就診數，這就是醫界裡面有在講的「斷頭現象」，所以實際的醫療服務量可能根本沒有申報，這也就是醫院為什麼抱怨說做得越多領得越少，或者是虧得越多。院長，更動健保制度當然是茲事體大，所以必須要做好社會溝通，才能夠在最少的阻力之下進行改革，但是現在醫護人力短缺等問題，加上又要調漲電價，所以醫療體系崩潰在即。","我已經在上週正式提出健全醫療發展特別條例，希望幫我們臺灣的醫療打強心針，這裡面最核心的，也就是自本條例及本條例所編之特別預算通過後，合計健保各分區、各部門之總額浮動點值，平均未達0.95元者，應補足至0.95元。基本上，也就是希望保障點值最基本要有0.95元，這個部分也是要呼應我們醫界的主張。另外，要解決我們護理人力不足的部分，我是針對地區級以上的醫院，執行急性病床以及特殊病床照護的護理人員，每月發給1萬元的津貼，而且要撥補100億成立新藥發展基金。這三個面向，基本上是希望能夠幫助解決整個醫療體系現在的困境。請問院長、部長你們同意嗎？"],["陳院長建仁：我覺得你完全不懂什麼叫做健保的點數，這一個健保的點值，本來就是在健保整個財務的運作裡面行之多年，你這樣的情形有點外行，我請我們部長回答。"],["廖委員偉翔：請部長回答。"],["薛部長瑞元：這個特別條例要去保障點值，是跟我們健保法裡面總額預算的整個制度是互相扞格的，萬一這一個特別條例通過的話，實務上面怎麼樣去運用兩個不同的制度，互相之間打架，這會產生很大的問題。"],["廖委員偉翔：部長，我想要跟你說的是，健全醫療發展特別條例其實只有3年，並且總額是3,800億，我的想法是在不動總額的前提下，另外用……"],["陳院長建仁：你不懂醫療的現況啦！"],["薛部長瑞元：3,800億是否是一個常設性的，那這個常設性的是公務預算，公務預算怎麼用到健保？要怎麼樣算？這個茲事體大，而且是否都能夠每年有這樣子所謂的3,800億，這個是非常有問題的。"],["陳院長建仁：委員，你要請教專家，更深入瞭解所有健保的財務，才能夠做很好的條例。"],["廖委員偉翔：院長、部長，其實在這中間我們都有跟這幾個醫師團體他們溝通，那我也是為他們發聲……"],["陳院長建仁：但是在溝通的時候，除了醫療團體以外，還有病人團體、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\"text\": \"那缺藥的因素也有很多,在生產端包含我們的原料藥的來源供應不急,還有供應鏈不穩定,製造品質或法規要求的改變,以及藥商的這個商業考量,更別說這個復型劑、膠囊殼甚至是物流因素等等都有可能造成缺藥,所以一顆小小的藥丸或是膠囊,它的產品鏈非常的長。\", \"words\": [{\"word\": \"那\", \"start\": 120.416, \"end\": 120.636, \"score\": 0.987}, {\"word\": \"缺\", \"start\": 120.636, \"end\": 120.976, \"score\": 0.91}, {\"word\": \"藥\"}, {\"word\": \"的\", \"start\": 120.976, \"end\": 121.036, \"score\": 0.997}, {\"word\": \"因\", \"start\": 121.036, \"end\": 121.196, \"score\": 0.932}, {\"word\": \"素\", \"start\": 121.196, \"end\": 121.337, \"score\": 0.923}, {\"word\": \"也\", \"start\": 121.337, \"end\": 121.437, \"score\": 0.999}, {\"word\": \"有\", \"start\": 121.437, \"end\": 121.537, \"score\": 0.826}, {\"word\": \"很\", \"start\": 121.537, \"end\": 121.737, \"score\": 1.0}, {\"word\": \"多\", \"start\": 121.737, \"end\": 122.017, \"score\": 0.995}, {\"word\": \",\"}, {\"word\": \"在\", \"start\": 122.017, \"end\": 122.157, \"score\": 0.997}, {\"word\": \"生\", \"start\": 122.157, \"end\": 122.557, \"score\": 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{\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"烘\", \"start\": 525.716, \"end\": 526.237, \"score\": 0.885}, {\"word\": \"焙\"}, {\"word\": \"機\"}, {\"word\": \"的\", \"start\": 526.237, \"end\": 526.637, \"score\": 0.899}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"成\", \"start\": 526.637, \"end\": 526.877, \"score\": 0.931}, {\"word\": \"本\", \"start\": 526.877, \"end\": 527.537, \"score\": 0.969}, {\"word\": \"所\", \"start\": 527.537, \"end\": 527.657, \"score\": 0.843}, {\"word\": \"以\", \"start\": 527.657, \"end\": 527.717, \"score\": 0.707}, {\"word\": \"你\", \"start\": 527.717, \"end\": 528.137, \"score\": 0.905}, {\"word\": \"們\"}, {\"word\": \"講\"}, {\"word\": \"出\", \"start\": 528.137, \"end\": 528.317, \"score\": 0.994}, {\"word\": \"那\", \"start\": 528.317, \"end\": 529.158, \"score\": 0.904}, {\"word\": \"個\"}, {\"word\": \"兩\"}, {\"word\": \"塊\"}, {\"word\": \"錢\"}, {\"word\": \"真\", \"start\": 529.158, \"end\": 529.258, \"score\": 0.831}, {\"word\": \"的\", \"start\": 529.258, \"end\": 529.378, \"score\": 0.833}, {\"word\": \"是\", \"start\": 529.378, \"end\": 529.638, \"score\": 0.999}, {\"word\": \"瞎\", \"start\": 529.638, \"end\": 529.858, \"score\": 0.988}, {\"word\": \"扯\", \"start\": 529.858, \"end\": 530.038, \"score\": 0.984}, {\"word\": \"的\", \"start\": 530.038, \"end\": 530.058, \"score\": 0.375}]}, {\"start\": 530.538, \"end\": 532.559, \"text\": \"建保制度的運作讓政府現在的醫療政策上只能夠頭痛一頭腳痛一腳。\", \"words\": [{\"word\": \"建\", \"start\": 530.538, \"end\": 530.618, \"score\": 0.75}, {\"word\": \"保\", \"start\": 530.618, \"end\": 530.738, \"score\": 0.833}, {\"word\": \"制\", \"start\": 530.738, \"end\": 530.758, \"score\": 0.0}, {\"word\": \"度\", \"start\": 530.758, \"end\": 530.918, \"score\": 0.87}, {\"word\": \"的\", \"start\": 530.918, \"end\": 531.359, \"score\": 0.954}, {\"word\": \"運\"}, {\"word\": \"作\", \"start\": 531.359, \"end\": 531.459, \"score\": 0.798}, {\"word\": \"讓\"}, {\"word\": \"政\", \"start\": 531.459, \"end\": 531.479, 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\"score\": 0.965}, {\"word\": \"本\", \"start\": 675.22, \"end\": 675.32, \"score\": 0.999}, {\"word\": \"上\", \"start\": 675.32, \"end\": 675.501, \"score\": 0.993}, {\"word\": \"也\", \"start\": 675.501, \"end\": 675.601, \"score\": 0.87}, {\"word\": \"就\", \"start\": 675.601, \"end\": 675.721, \"score\": 0.86}, {\"word\": \"是\", \"start\": 675.721, \"end\": 675.881, \"score\": 0.967}, {\"word\": \"希\", \"start\": 675.881, \"end\": 676.001, \"score\": 0.999}, {\"word\": \"望\", \"start\": 676.001, \"end\": 676.281, \"score\": 1.0}, {\"word\": \"保\", \"start\": 676.281, \"end\": 676.481, \"score\": 0.98}, {\"word\": \"障\", \"start\": 676.481, \"end\": 676.942, \"score\": 0.954}, {\"word\": \"點\"}, {\"word\": \"值\", \"start\": 676.942, \"end\": 677.602, \"score\": 0.94}, {\"word\": \"最\", \"start\": 677.602, \"end\": 677.842, \"score\": 0.999}, {\"word\": \"基\", \"start\": 677.842, \"end\": 678.043, \"score\": 0.918}, {\"word\": \"本\", \"start\": 678.043, \"end\": 678.203, \"score\": 0.995}, {\"word\": \"要\", \"start\": 678.203, \"end\": 678.443, \"score\": 0.919}, {\"word\": \"0\"}, {\"word\": \".\"}, {\"word\": \"9\"}, {\"word\": \"5\"}, {\"word\": \"元\", \"start\": 678.443, \"end\": 678.463, \"score\": 0.0}]}, {\"start\": 679.925, \"end\": 682.757, \"text\": \"那這個部分也是要呼應我們一屆的主張\", \"words\": [{\"word\": \"那\", \"start\": 679.925, \"end\": 680.306, \"score\": 0.895}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"部\", \"start\": 680.306, \"end\": 680.487, \"score\": 1.0}, {\"word\": \"分\", \"start\": 680.487, \"end\": 680.648, \"score\": 0.983}, {\"word\": \"也\", \"start\": 680.648, \"end\": 680.788, \"score\": 1.0}, {\"word\": \"是\", \"start\": 680.788, \"end\": 680.889, \"score\": 0.999}, {\"word\": \"要\", \"start\": 680.889, \"end\": 681.09, \"score\": 0.997}, {\"word\": \"呼\", \"start\": 681.09, \"end\": 681.813, \"score\": 0.945}, {\"word\": \"應\"}, {\"word\": \"我\", \"start\": 681.813, \"end\": 682.034, \"score\": 0.909}, {\"word\": \"們\"}, {\"word\": 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\"建保的點子本來就是在建保整個的財務的運作裡面行之多年你這樣的情形有點外行我請我們部長回答這個特別條例要去保障點子是跟我們建保法裡面的總額預算的整個的制度是互相焊隔的所以如果萬一這一個特別條例通過的話\", \"words\": [{\"word\": \"建\", \"start\": 714.565, \"end\": 714.825, \"score\": 0.956}, {\"word\": \"保\", \"start\": 714.825, \"end\": 715.125, \"score\": 0.996}, {\"word\": \"的\", \"start\": 715.125, \"end\": 717.487, \"score\": 0.915}, {\"word\": \"點\"}, {\"word\": \"子\", \"start\": 717.487, \"end\": 717.747, \"score\": 0.983}, {\"word\": \"本\", \"start\": 717.747, \"end\": 718.087, \"score\": 0.941}, {\"word\": \"來\"}, {\"word\": \"就\", \"start\": 718.087, \"end\": 718.227, \"score\": 1.0}, {\"word\": \"是\", \"start\": 718.227, \"end\": 718.327, \"score\": 1.0}, {\"word\": \"在\", \"start\": 718.327, \"end\": 718.547, \"score\": 1.0}, {\"word\": \"建\", \"start\": 718.547, \"end\": 718.787, \"score\": 0.933}, {\"word\": \"保\", \"start\": 718.787, \"end\": 719.047, \"score\": 0.995}, {\"word\": \"整\", \"start\": 719.047, \"end\": 719.388, \"score\": 0.939}, {\"word\": \"個\"}, 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\"end\": 947.828, \"score\": 0.0}, {\"word\": \"二\", \"start\": 947.828, \"end\": 947.868, \"score\": 0.5}, {\"word\": \"號\"}, {\"word\": \"陳\"}, {\"word\": \"委\", \"start\": 947.868, \"end\": 948.028, \"score\": 0.881}, {\"word\": \"員\"}, {\"word\": \"昭\", \"start\": 948.028, \"end\": 948.208, \"score\": 0.889}, {\"word\": \"之\", \"start\": 948.208, \"end\": 948.368, \"score\": 0.875}, {\"word\": \"子\", \"start\": 948.368, \"end\": 948.388, \"score\": 0.16}], \"language\": \"zh\"}","srt":"1\n00:00:18,114 --> 00:00:23,617\n質詢。院長好,有請我們行政院院長陳院長以及我們的薛瑞元學部長。麻煩請陳院長衛福部備詢,謝謝。\n\n2\n00:00:30,376 --> 00:00:32,004\n廖委員早安。院長早。\n\n3\n00:00:38,023 --> 00:00:59,670\n部長,健保開辦以來28年有極高的民意支持度但現在在這個高支持度的背後我們卻看到是由我們血汗醫護所支撐甚至現在已經向下影響到整個醫療教育以及我們包含我們醫師公會理事長也說現在有很多學生看到我們醫療環境不佳影響選擇醫學系的意願\n\n4\n00:01:01,511 --> 00:01:27,747\n那包含我們統策衛生護理類報告也從2019年開始更是年年降低更是加劇了我們護理人員的人員荒那事實上現在在醫療現場前幾年的這個擊中南海然後內外婦兒無一不缺護理人力也流失嚴重導致醫院有病床卻也無法開許多病人就只能夠塞在急診室一待好幾天\n\n5\n00:01:28,527 --> 00:01:32,672\n所以想要請教院長部長我們的醫護人力荒有解嗎?\n\n6\n00:01:34,090 --> 00:01:36,050\n院長除了缺人和缺藥但是還有缺藥\n\n7\n00:02:00,416 --> 00:02:21,107\n那缺藥的因素也有很多,在生產端包含我們的原料藥的來源供應不急,還有供應鏈不穩定,製造品質或法規要求的改變,以及藥商的這個商業考量,更別說這個復型劑、膠囊殼甚至是物流因素等等都有可能造成缺藥,所以一顆小小的藥丸或是膠囊,它的產品鏈非常的長。\n\n8\n00:02:21,732 --> 00:02:21,792\n﹝廖偉翔﹞\n\n9\n00:02:38,434 --> 00:03:03,223\n短期缺藥是可以透過很多手段解決但是如果是長期缺藥的話就要特別小心了所以我想問院長您同意這樣的看法嗎我覺得這個缺藥的問題確實是需要來很慎重的來解決但是衛福部也很用很大的心力來調整院長部長所以面對缺藥問題我之前有在委員會有做出決議包含說同時符合三個條件下\n\n10\n00:03:19,767 --> 00:03:37,015\n的藥品清單中的藥品。第二個是鼓勵在地製造是希望可以穩定我們的供應鏈。那第三個就是三張以下的稀缺藥證。那院長這部分涉及修法請問4月中之前能否將此三項條件納入修法中的內容之中。\n\n11\n00:03:38,562 --> 00:03:59,600\n這一個部分我請衛福部來回答跟委員報告那委員所提出來這三個條件除了第一個那個醫學會認證因為我們在列這一個必要藥品的品項的時候都有跟醫學會這邊邀請他們確認過所以不一定需要再去寫一個說醫學會認證其他這三個部分的話我們都聲表贊同\n\n12\n00:04:05,124 --> 00:04:29,112\n現在是4月8日我們會召集相關的團體會做一個考量然後會送到健保的共理會議去所以4月底之前要完成這個所謂的規定的修改的話有一點點困難但是在上半年應該是沒有問題是好那請這個部長也盡快的加速進行\n\n13\n00:04:29,952 --> 00:04:42,422\n那我的條件之一是要釋法的二期之二的必要藥品清單嘛那既然是必要藥品代表這些藥品是不可或缺的目前總共是400多項但是院長你們知道這份清單多久才檢討一次嗎?\n\n14\n00:04:43,973 --> 00:05:10,394\n院長這個從食藥署的網頁依照我們公告的資料最近一次是去年的11月可是再上一次間隔了三年兩個月那在之前大概是平均約兩年所以院長部長既然是必要的藥品清單為何不能夠每年檢討一次尤其是現在的狀況之下因為現在國際上的供應鏈也仍然沒有很穩定所以我的具體建議本席的具體建議是說有沒有可能改成每年檢討一次\n\n15\n00:05:11,115 --> 00:05:38,976\n同時也在4月中之前或者是大概您剛才說時間時程上的部分可不可以提早的這個完成這個修法的預告作業?如果是每年檢討應該是可行的,那我們盡量來朝這個方向來做。好,謝謝。那再來院長部長,這個我們醫療的價值要等於我們醫療的品質也要等於我們醫療的點值,這樣的理念您認同嗎?\n\n16\n00:05:40,537 --> 00:06:00,128\n最後一個健保的是不是等於健保點值因為我們現在是在總額預算的制度下去運作所以這個加量的關係所以是院長但是健保的點值長年以來一直被貶值造成現在醫療的困境醫療體系的困境那所以我們醫界為了生存\n\n17\n00:06:01,363 --> 00:06:15,996\n過去常常大家聽到的這個藥價差、發展自費藥材、或者是最近的解除掛號費上限等等,我想這都是一介自救的手段。但也因為如此,我想整個醫療體系也會越來越扭曲,病患也不滿意。\n\n18\n00:06:16,937 --> 00:06:38,634\n所以院長你知道嗎醫療院所其實也不想這樣做但是這是為了生存也只能這麼做所以院長部長健保點值的這個老問題我想整個醫療體系不死不活那連我們台大院長都說醫療本業的利潤剩下1%如果他是企業的CEO他老早就被開除了請問院長你們現在還要調漲電價你認為台大吳院長所說的1%的利潤還有可能嗎\n\n19\n00:06:45,114 --> 00:07:11,799\n我想這個電價的調整如何來影響臺大醫院的營運我們需要再來評估電費所佔的百分比是多少但是呢我想我們依借大家所提出來的這些意見我們都會來作為檢討可是很重要的不要忘掉我們臺灣的健保還是在國人心目中是很好的一個制度要多方來考量\n\n20\n00:07:12,239 --> 00:07:23,385\n是,院長因為醫院裡面的急診加護病房一般病房的空調也是不能夠中斷的難不成醫院因為電價太高就要把它關掉嗎當然不會嘛,也不應該所以我們要馬兒好又要馬兒不吃草\n\n21\n00:07:24,349 --> 00:07:43,675\n我們是覺得這樣不太合理所以院長像現在臺灣醫院協會醫事公會的全聯會護理師公會的全聯會還有我們臺灣私立醫院協會醫務管理學會等五大醫事團體聯合發出聲明欲請不要調漲醫療院所的電價請問院長你們可以答應嗎\n\n22\n00:07:45,075 --> 00:08:07,964\n院長下星期一就是4月1日這個調漲電價日所以我們希望本席希望本週五前是否可以給醫界一個答覆好嗎?這一個部分的話我們要來了解剛才我講過醫療院所的電費占他所有經營的這個百分比是多少我舉一個很簡單的例子比如說臺北捷運的話那我們調漲電價實際上對他的成本只影響1%\n\n23\n00:08:09,685 --> 00:08:10,905\n院長所以這個部分也要請你特別用心喔。\n\n24\n00:08:35,433 --> 00:08:50,058\n因為要請您特別留意或是更加的嚴議因為你們的經濟部講出來今天也承認說他的這個沒有考量到這個烘焙機這個烘焙機的這個成本所以你們講出那個兩塊錢真的是瞎扯的\n\n25\n00:08:50,538 --> 00:08:52,559\n建保制度的運作讓政府現在的醫療政策上只能夠頭痛一頭腳痛一腳。\n\n26\n00:09:11,857 --> 00:09:31,145\n那也因為這樣所以我說現在的健保可能有三苦病人痛苦家屬辛苦那醫護命苦但是最根本的性的問題也是剛剛在講的長期以來這個健保點值的問題因為總而上限的問題造成許多醫院必須到處挖東牆補西牆那院長部長這個你們同意嗎\n\n27\n00:09:32,598 --> 00:09:58,275\n這個我不同意啦我們的病人齁你看看醫院裡面很多的病人寫給醫護人員的他都是很感謝有健保有醫護人員所以他們在病的時間得到很好的照顧所以你現在就故意講反面的話我個人不贊成而且家屬有很多都是感謝我們醫護人員的努力所以你製造對立沒有辦法使得台灣的醫療產業得很好的運氣沒有院長我要跟您討論的是現在血汗醫護的問題喔\n\n28\n00:10:02,537 --> 00:10:26,392\n我要告訴你一個數據這兩年的健保浮動點值曾一度掉到0.8元以下但我們要說實際也有可能比這個更慘因為總額之下還有一個分區總額所以健保署的各分區業務組會跟他那個區域的各層級的醫院訂定一個目標額所以醫院也會想辦法可能會想辦法減少我們病患的就診數這就是所謂醫界裡面有在講的斷頭現象\n\n29\n00:10:28,433 --> 00:10:49,701\n所以實際的醫療服務量是可能根本沒有申報。這也就是醫院為什麼抱怨說做得越多領得越少或者是虧得越多。院長更動健保制度當然是知識體大所以必須要做好社會溝通才能夠在最少的阻力之下進行改革。但是現在醫護人力短缺等問題加上又要調漲電價所以這個醫療體系崩潰在極。\n\n30\n00:10:52,822 --> 00:11:18,463\n我已經在上週正式提出這個健全醫療發展特別條例是希望幫我們臺灣的醫療打強心針那這裡面最核心的也就是資本條例及本條例所編之特別預算通過後格計現保各分區各部門之總額浮動點值平均為打0.95元者應補足至0.95元基本上也就是希望保障點值最基本要0.95元\n\n31\n00:11:19,925 --> 00:11:22,757\n那這個部分也是要呼應我們一屆的主張\n\n32\n00:11:24,622 --> 00:11:53,224\n那另外要解決我們護理人力不足的部分我是針對地區級以上的醫院執行這個急性病床以及特殊病床照護的護理人員每月發給1萬元的津貼而且要撥補100億成立這個新藥發展基金這三個面向基本上是希望能夠幫助解決整個醫療體系現在的困境希望請問院長你們同意嗎部長同意嗎我覺得你完全不懂什麼叫做\n\n33\n00:11:54,565 --> 00:12:19,919\n建保的點子本來就是在建保整個的財務的運作裡面行之多年你這樣的情形有點外行我請我們部長回答這個特別條例要去保障點子是跟我們建保法裡面的總額預算的整個的制度是互相焊隔的所以如果萬一這一個特別條例通過的話\n\n34\n00:12:21,274 --> 00:12:39,367\n那實務上面怎麼樣去運用兩個不同的制度互相之間打架,這會產生很大的問題。是,部長我想跟你說的是健全醫療法人特別條例其實只有三年了,並且總額是3800億,我的想法是在不動總額的前提下,另外用這三年中的總額來補貼。你3800億是否是一個長期性的,\n\n35\n00:12:45,931 --> 00:12:58,997\n那這個常設性的是公務預算。公務預算怎麼用到健保的這個要怎麼樣算這個知識體大。而且是否都能夠每年有這樣子所謂的3800億這個是非常有問題的。\n\n36\n00:13:02,359 --> 00:13:10,125\n委員你一定要請教專家更深入了解這一個所有健保的財務才能夠做很好的調理。但是在溝通的時候除了醫療團體以外還有病人團體消費者團體還有學者專家通通要來考慮期望不要只針對單一的團體\n\n37\n00:13:25,657 --> 00:13:28,058\n也請這個院長部長先針對這個健保墊值常常在浮動的這個狀況。我剛剛提出的其實不只是這個部分。墊值就是會浮動。\n\n38\n00:13:52,833 --> 00:14:12,470\n對,但是他們現在需要是,是院長,因為我要跟你算的事情是這樣子啊,在疫情前平均是0.92的情況之下,大多數的一個層級的醫療院所,他們的獲利大概不到是5%,那其實他們對他們來講也很痛苦,在很多情況之下他也很難留財攬財,甚至也不敢做到這個醫療發展的部分喔。\n\n39\n00:14:12,870 --> 00:14:41,599\n所以這個部分是我希望說可以跟透過這樣子的聲音讓院長跟部長就是可以了解到有這樣的狀況然後也希望說有這樣子的特別條例也希望行政院如果你們有更好的版本如果你們可以提出來解決這樣的問題的話那本席也會支持喔所以我希望的是這件事情也要讓院長部長請你們好好的去理解最後我也想要花一點時間跟院長快問快答一下台中人口有多少\n\n40\n00:14:43,322 --> 00:15:03,188\n台中人口大概200多萬吧。284萬。那高雄人口有多少?這裡你已經有答案了。273萬。那高雄前瞻預算拿多少?這一個前瞻預算。1265億。院長我們這是快問快答好不好。台中前瞻預算拿多少?\n\n41\n00:15:04,775 --> 00:15:16,972\n228億好不好高雄巨蛋中央補助有多少7.5億台中巨蛋中央補助多少0元會展中心東側也是0元高雄捷運中央補助多少\n\n42\n00:15:18,069 --> 00:15:18,249\n﹚廖偉翔﹚\n\n43\n00:15:46,926 --> 00:15:48,388\n謝謝廖委員偉翔的質詢,也謝謝陳院長的備詢。接下來我們請登記第二號陳委員昭之子\n\n","tsv":"start\tend\ttext\n18114\t23617\t質詢。院長好,有請我們行政院院長陳院長以及我們的薛瑞元學部長。麻煩請陳院長衛福部備詢,謝謝。\n30376\t32004\t廖委員早安。 院長早。\n38023\t59670\t部長,健保開辦以來28年有極高的民意支持度但現在在這個高支持度的背後我們卻看到是由我們血汗醫護所支撐甚至現在已經向下影響到整個醫療教育以及我們包含我們醫師公會理事長也說現在有很多學生看到我們醫療環境不佳影響選擇醫學系的意願\n61511\t87747\t那包含我們統策衛生護理類報告也從2019年開始更是年年降低更是加劇了我們護理人員的人員荒那事實上現在在醫療現場前幾年的這個擊中南海然後內外婦兒無一不缺護理人力也流失嚴重導致醫院有病床卻也無法開許多病人就只能夠塞在急診室一待好幾天\n88527\t92672\t所以想要請教院長部長我們的醫護人力荒有解嗎?\n94090\t96050\t院長除了缺人和缺藥但是還有缺藥\n120416\t141107\t那缺藥的因素也有很多,在生產端包含我們的原料藥的來源供應不急,還有供應鏈不穩定,製造品質或法規要求的改變,以及藥商的這個商業考量,更別說這個復型劑、膠囊殼甚至是物流因素等等都有可能造成缺藥,所以一顆小小的藥丸或是膠囊,它的產品鏈非常的長。\n141732\t141792\t﹝廖偉翔﹞\n158434\t183223\t短期缺藥是可以透過很多手段解決但是如果是長期缺藥的話就要特別小心了所以我想問院長您同意這樣的看法嗎我覺得這個缺藥的問題確實是需要來很慎重的來解決但是衛福部也很用很大的心力來調整院長部長所以面對缺藥問題我之前有在委員會有做出決議包含說同時符合三個條件下\n183763\t199667\t﹚議員﹚\n199767\t217015\t的藥品清單中的藥品。第二個是鼓勵在地製造是希望可以穩定我們的供應鏈。那第三個就是三張以下的稀缺藥證。那院長這部分涉及修法請問4月中之前能否將此三項條件納入修法中的內容之中。\n218562\t239600\t這一個部分我請衛福部來回答跟委員報告那委員所提出來這三個條件除了第一個那個醫學會認證因為我們在列這一個必要藥品的品項的時候都有跟醫學會這邊邀請他們確認過所以不一定需要再去寫一個說醫學會認證其他這三個部分的話我們都聲表贊同\n245124\t269112\t現在是4月8日我們會召集相關的團體會做一個考量然後會送到健保的共理會議去所以4月底之前要完成這個所謂的規定的修改的話有一點點困難但是在上半年應該是沒有問題是好那請這個部長也盡快的加速進行\n269952\t282422\t那我的條件之一是要釋法的二期之二的必要藥品清單嘛那既然是必要藥品代表這些藥品是不可或缺的目前總共是400多項但是院長你們知道這份清單多久才檢討一次嗎?\n283973\t310394\t院長這個從食藥署的網頁依照我們公告的資料最近一次是去年的11月可是再上一次間隔了三年兩個月那在之前大概是平均約兩年所以院長部長既然是必要的藥品清單為何不能夠每年檢討一次尤其是現在的狀況之下因為現在國際上的供應鏈也仍然沒有很穩定所以我的具體建議本席的具體建議是說有沒有可能改成每年檢討一次\n311115\t338976\t同時也在4月中之前或者是大概您剛才說時間時程上的部分可不可以提早的這個完成這個修法的預告作業?如果是每年檢討應該是可行的,那我們盡量來朝這個方向來做。好,謝謝。那再來院長部長,這個我們醫療的價值要等於我們醫療的品質也要等於我們醫療的點值,這樣的理念您認同嗎?\n340537\t360128\t最後一個健保的是不是等於健保點值因為我們現在是在總額預算的制度下去運作所以這個加量的關係所以是院長但是健保的點值長年以來一直被貶值造成現在醫療的困境醫療體系的困境那所以我們醫界為了生存\n361363\t375996\t過去常常大家聽到的這個藥價差、發展自費藥材、或者是最近的解除掛號費上限等等,我想這都是一介自救的手段。但也因為如此,我想整個醫療體系也會越來越扭曲,病患也不滿意。\n376937\t398634\t所以院長你知道嗎醫療院所其實也不想這樣做但是這是為了生存也只能這麼做所以院長部長健保點值的這個老問題我想整個醫療體系不死不活那連我們台大院長都說醫療本業的利潤剩下1%如果他是企業的CEO他老早就被開除了請問院長你們現在還要調漲電價你認為台大吳院長所說的1%的利潤還有可能嗎\n405114\t431799\t我想這個電價的調整如何來影響臺大醫院的營運我們需要再來評估電費所佔的百分比是多少但是呢我想我們依借大家所提出來的這些意見我們都會來作為檢討可是很重要的不要忘掉我們臺灣的健保還是在國人心目中是很好的一個制度要多方來考量\n432239\t443385\t是,院長因為醫院裡面的急診加護病房一般病房的空調也是不能夠中斷的難不成醫院因為電價太高就要把它關掉嗎當然不會嘛,也不應該所以我們要馬兒好又要馬兒不吃草\n444349\t463675\t我們是覺得這樣不太合理所以院長像現在臺灣醫院協會醫事公會的全聯會護理師公會的全聯會還有我們臺灣私立醫院協會醫務管理學會等五大醫事團體聯合發出聲明欲請不要調漲醫療院所的電價請問院長你們可以答應嗎\n465075\t487964\t院長下星期一就是4月1日這個調漲電價日所以我們希望本席希望本週五前是否可以給醫界一個答覆好嗎?這一個部分的話我們要來了解剛才我講過醫療院所的電費占他所有經營的這個百分比是多少我舉一個很簡單的例子比如說臺北捷運的話那我們調漲電價實際上對他的成本只影響1%\n489685\t490905\t院長所以這個部分也要請你特別用心喔。\n515433\t530058\t因為要請您特別留意或是更加的嚴議因為你們的經濟部講出來今天也承認說他的這個沒有考量到這個烘焙機這個烘焙機的這個成本所以你們講出那個兩塊錢真的是瞎扯的\n530538\t532559\t建保制度的運作讓政府現在的醫療政策上只能夠頭痛一頭腳痛一腳。\n551857\t571145\t那也因為這樣所以我說現在的健保可能有三苦病人痛苦家屬辛苦那醫護命苦但是最根本的性的問題也是剛剛在講的長期以來這個健保點值的問題因為總而上限的問題造成許多醫院必須到處挖東牆補西牆那院長部長這個你們同意嗎\n572598\t598275\t這個我不同意啦我們的病人齁你看看醫院裡面很多的病人寫給醫護人員的他都是很感謝有健保有醫護人員所以他們在病的時間得到很好的照顧所以你現在就故意講反面的話我個人不贊成而且家屬有很多都是感謝我們醫護人員的努力所以你製造對立沒有辦法使得台灣的醫療產業得很好的運氣沒有院長我要跟您討論的是現在血汗醫護的問題喔\n602537\t626392\t我要告訴你一個數據這兩年的健保浮動點值曾一度掉到0.8元以下但我們要說實際也有可能比這個更慘因為總額之下還有一個分區總額所以健保署的各分區業務組會跟他那個區域的各層級的醫院訂定一個目標額所以醫院也會想辦法可能會想辦法減少我們病患的就診數這就是所謂醫界裡面有在講的斷頭現象\n628433\t649701\t所以實際的醫療服務量是可能根本沒有申報。這也就是醫院為什麼抱怨說做得越多領得越少或者是虧得越多。院長更動健保制度當然是知識體大所以必須要做好社會溝通才能夠在最少的阻力之下進行改革。但是現在醫護人力短缺等問題加上又要調漲電價所以這個醫療體系崩潰在極。\n652822\t678463\t我已經在上週正式提出這個健全醫療發展特別條例是希望幫我們臺灣的醫療打強心針那這裡面最核心的也就是資本條例及本條例所編之特別預算通過後格計現保各分區各部門之總額浮動點值平均為打0.95元者應補足至0.95元基本上也就是希望保障點值最基本要0.95元\n679925\t682757\t那這個部分也是要呼應我們一屆的主張\n684622\t713224\t那另外要解決我們護理人力不足的部分我是針對地區級以上的醫院執行這個急性病床以及特殊病床照護的護理人員每月發給1萬元的津貼而且要撥補100億成立這個新藥發展基金這三個面向基本上是希望能夠幫助解決整個醫療體系現在的困境希望請問院長你們同意嗎部長同意嗎我覺得你完全不懂什麼叫做\n714565\t739919\t建保的點子本來就是在建保整個的財務的運作裡面行之多年你這樣的情形有點外行我請我們部長回答這個特別條例要去保障點子是跟我們建保法裡面的總額預算的整個的制度是互相焊隔的所以如果萬一這一個特別條例通過的話\n741274\t759367\t那實務上面怎麼樣去運用兩個不同的制度互相之間打架,這會產生很大的問題。是,部長我想跟你說的是健全醫療法人特別條例其實只有三年了,並且總額是3800億,我的想法是在不動總額的前提下,另外用這三年中的總額來補貼。你3800億是否是一個長期性的,\n765931\t778997\t那這個常設性的是公務預算。公務預算怎麼用到健保的這個要怎麼樣算這個知識體大。而且是否都能夠每年有這樣子所謂的3800億這個是非常有問題的。\n782359\t790125\t委員你一定要請教專家更深入了解這一個所有健保的財務才能夠做很好的調理。但是在溝通的時候除了醫療團體以外還有病人團體消費者團體還有學者專家通通要來考慮期望不要只針對單一的團體\n805657\t808058\t也請這個院長部長先針對這個健保墊值常常在浮動的這個狀況。我剛剛提出的其實不只是這個部分。墊值就是會浮動。\n832833\t852470\t對,但是他們現在需要是,是院長,因為我要跟你算的事情是這樣子啊,在疫情前平均是0.92的情況之下,大多數的一個層級的醫療院所,他們的獲利大概不到是5%,那其實他們對他們來講也很痛苦,在很多情況之下他也很難留財攬財,甚至也不敢做到這個醫療發展的部分喔。\n852870\t881599\t所以這個部分是我希望說可以跟透過這樣子的聲音讓院長跟部長就是可以了解到有這樣的狀況然後也希望說有這樣子的特別條例也希望行政院如果你們有更好的版本如果你們可以提出來解決這樣的問題的話那本席也會支持喔所以我希望的是這件事情也要讓院長部長請你們好好的去理解最後我也想要花一點時間跟院長快問快答一下台中人口有多少\n883322\t903188\t台中人口大概200多萬吧。284萬。那高雄人口有多少?這裡你已經有答案了。273萬。那高雄前瞻預算拿多少?這一個前瞻預算。1265億。院長我們這是快問快答好不好。台中前瞻預算拿多少?\n904775\t916972\t228億好不好高雄巨蛋中央補助有多少7.5億台中巨蛋中央補助多少0元會展中心東側也是0元高雄捷運中央補助多少\n918069\t918249\t﹚廖偉翔﹚\n946926\t948388\t謝謝廖委員偉翔的質詢,也謝謝陳院長的備詢。接下來我們請登記第二號陳委員昭之子\n","txt":"質詢。院長好,有請我們行政院院長陳院長以及我們的薛瑞元學部長。麻煩請陳院長衛福部備詢,謝謝。\n廖委員早安。 院長早。\n部長,健保開辦以來28年有極高的民意支持度但現在在這個高支持度的背後我們卻看到是由我們血汗醫護所支撐甚至現在已經向下影響到整個醫療教育以及我們包含我們醫師公會理事長也說現在有很多學生看到我們醫療環境不佳影響選擇醫學系的意願\n那包含我們統策衛生護理類報告也從2019年開始更是年年降低更是加劇了我們護理人員的人員荒那事實上現在在醫療現場前幾年的這個擊中南海然後內外婦兒無一不缺護理人力也流失嚴重導致醫院有病床卻也無法開許多病人就只能夠塞在急診室一待好幾天\n所以想要請教院長部長我們的醫護人力荒有解嗎?\n院長除了缺人和缺藥但是還有缺藥\n那缺藥的因素也有很多,在生產端包含我們的原料藥的來源供應不急,還有供應鏈不穩定,製造品質或法規要求的改變,以及藥商的這個商業考量,更別說這個復型劑、膠囊殼甚至是物流因素等等都有可能造成缺藥,所以一顆小小的藥丸或是膠囊,它的產品鏈非常的長。\n﹝廖偉翔﹞\n短期缺藥是可以透過很多手段解決但是如果是長期缺藥的話就要特別小心了所以我想問院長您同意這樣的看法嗎我覺得這個缺藥的問題確實是需要來很慎重的來解決但是衛福部也很用很大的心力來調整院長部長所以面對缺藥問題我之前有在委員會有做出決議包含說同時符合三個條件下\n﹚議員﹚\n的藥品清單中的藥品。第二個是鼓勵在地製造是希望可以穩定我們的供應鏈。那第三個就是三張以下的稀缺藥證。那院長這部分涉及修法請問4月中之前能否將此三項條件納入修法中的內容之中。\n這一個部分我請衛福部來回答跟委員報告那委員所提出來這三個條件除了第一個那個醫學會認證因為我們在列這一個必要藥品的品項的時候都有跟醫學會這邊邀請他們確認過所以不一定需要再去寫一個說醫學會認證其他這三個部分的話我們都聲表贊同\n現在是4月8日我們會召集相關的團體會做一個考量然後會送到健保的共理會議去所以4月底之前要完成這個所謂的規定的修改的話有一點點困難但是在上半年應該是沒有問題是好那請這個部長也盡快的加速進行\n那我的條件之一是要釋法的二期之二的必要藥品清單嘛那既然是必要藥品代表這些藥品是不可或缺的目前總共是400多項但是院長你們知道這份清單多久才檢討一次嗎?\n院長這個從食藥署的網頁依照我們公告的資料最近一次是去年的11月可是再上一次間隔了三年兩個月那在之前大概是平均約兩年所以院長部長既然是必要的藥品清單為何不能夠每年檢討一次尤其是現在的狀況之下因為現在國際上的供應鏈也仍然沒有很穩定所以我的具體建議本席的具體建議是說有沒有可能改成每年檢討一次\n同時也在4月中之前或者是大概您剛才說時間時程上的部分可不可以提早的這個完成這個修法的預告作業?如果是每年檢討應該是可行的,那我們盡量來朝這個方向來做。好,謝謝。那再來院長部長,這個我們醫療的價值要等於我們醫療的品質也要等於我們醫療的點值,這樣的理念您認同嗎?\n最後一個健保的是不是等於健保點值因為我們現在是在總額預算的制度下去運作所以這個加量的關係所以是院長但是健保的點值長年以來一直被貶值造成現在醫療的困境醫療體系的困境那所以我們醫界為了生存\n過去常常大家聽到的這個藥價差、發展自費藥材、或者是最近的解除掛號費上限等等,我想這都是一介自救的手段。但也因為如此,我想整個醫療體系也會越來越扭曲,病患也不滿意。\n所以院長你知道嗎醫療院所其實也不想這樣做但是這是為了生存也只能這麼做所以院長部長健保點值的這個老問題我想整個醫療體系不死不活那連我們台大院長都說醫療本業的利潤剩下1%如果他是企業的CEO他老早就被開除了請問院長你們現在還要調漲電價你認為台大吳院長所說的1%的利潤還有可能嗎\n我想這個電價的調整如何來影響臺大醫院的營運我們需要再來評估電費所佔的百分比是多少但是呢我想我們依借大家所提出來的這些意見我們都會來作為檢討可是很重要的不要忘掉我們臺灣的健保還是在國人心目中是很好的一個制度要多方來考量\n是,院長因為醫院裡面的急診加護病房一般病房的空調也是不能夠中斷的難不成醫院因為電價太高就要把它關掉嗎當然不會嘛,也不應該所以我們要馬兒好又要馬兒不吃草\n我們是覺得這樣不太合理所以院長像現在臺灣醫院協會醫事公會的全聯會護理師公會的全聯會還有我們臺灣私立醫院協會醫務管理學會等五大醫事團體聯合發出聲明欲請不要調漲醫療院所的電價請問院長你們可以答應嗎\n院長下星期一就是4月1日這個調漲電價日所以我們希望本席希望本週五前是否可以給醫界一個答覆好嗎?這一個部分的話我們要來了解剛才我講過醫療院所的電費占他所有經營的這個百分比是多少我舉一個很簡單的例子比如說臺北捷運的話那我們調漲電價實際上對他的成本只影響1%\n院長所以這個部分也要請你特別用心喔。\n因為要請您特別留意或是更加的嚴議因為你們的經濟部講出來今天也承認說他的這個沒有考量到這個烘焙機這個烘焙機的這個成本所以你們講出那個兩塊錢真的是瞎扯的\n建保制度的運作讓政府現在的醫療政策上只能夠頭痛一頭腳痛一腳。\n那也因為這樣所以我說現在的健保可能有三苦病人痛苦家屬辛苦那醫護命苦但是最根本的性的問題也是剛剛在講的長期以來這個健保點值的問題因為總而上限的問題造成許多醫院必須到處挖東牆補西牆那院長部長這個你們同意嗎\n這個我不同意啦我們的病人齁你看看醫院裡面很多的病人寫給醫護人員的他都是很感謝有健保有醫護人員所以他們在病的時間得到很好的照顧所以你現在就故意講反面的話我個人不贊成而且家屬有很多都是感謝我們醫護人員的努力所以你製造對立沒有辦法使得台灣的醫療產業得很好的運氣沒有院長我要跟您討論的是現在血汗醫護的問題喔\n我要告訴你一個數據這兩年的健保浮動點值曾一度掉到0.8元以下但我們要說實際也有可能比這個更慘因為總額之下還有一個分區總額所以健保署的各分區業務組會跟他那個區域的各層級的醫院訂定一個目標額所以醫院也會想辦法可能會想辦法減少我們病患的就診數這就是所謂醫界裡面有在講的斷頭現象\n所以實際的醫療服務量是可能根本沒有申報。這也就是醫院為什麼抱怨說做得越多領得越少或者是虧得越多。院長更動健保制度當然是知識體大所以必須要做好社會溝通才能夠在最少的阻力之下進行改革。但是現在醫護人力短缺等問題加上又要調漲電價所以這個醫療體系崩潰在極。\n我已經在上週正式提出這個健全醫療發展特別條例是希望幫我們臺灣的醫療打強心針那這裡面最核心的也就是資本條例及本條例所編之特別預算通過後格計現保各分區各部門之總額浮動點值平均為打0.95元者應補足至0.95元基本上也就是希望保障點值最基本要0.95元\n那這個部分也是要呼應我們一屆的主張\n那另外要解決我們護理人力不足的部分我是針對地區級以上的醫院執行這個急性病床以及特殊病床照護的護理人員每月發給1萬元的津貼而且要撥補100億成立這個新藥發展基金這三個面向基本上是希望能夠幫助解決整個醫療體系現在的困境希望請問院長你們同意嗎部長同意嗎我覺得你完全不懂什麼叫做\n建保的點子本來就是在建保整個的財務的運作裡面行之多年你這樣的情形有點外行我請我們部長回答這個特別條例要去保障點子是跟我們建保法裡面的總額預算的整個的制度是互相焊隔的所以如果萬一這一個特別條例通過的話\n那實務上面怎麼樣去運用兩個不同的制度互相之間打架,這會產生很大的問題。是,部長我想跟你說的是健全醫療法人特別條例其實只有三年了,並且總額是3800億,我的想法是在不動總額的前提下,另外用這三年中的總額來補貼。你3800億是否是一個長期性的,\n那這個常設性的是公務預算。公務預算怎麼用到健保的這個要怎麼樣算這個知識體大。而且是否都能夠每年有這樣子所謂的3800億這個是非常有問題的。\n委員你一定要請教專家更深入了解這一個所有健保的財務才能夠做很好的調理。但是在溝通的時候除了醫療團體以外還有病人團體消費者團體還有學者專家通通要來考慮期望不要只針對單一的團體\n也請這個院長部長先針對這個健保墊值常常在浮動的這個狀況。我剛剛提出的其實不只是這個部分。墊值就是會浮動。\n對,但是他們現在需要是,是院長,因為我要跟你算的事情是這樣子啊,在疫情前平均是0.92的情況之下,大多數的一個層級的醫療院所,他們的獲利大概不到是5%,那其實他們對他們來講也很痛苦,在很多情況之下他也很難留財攬財,甚至也不敢做到這個醫療發展的部分喔。\n所以這個部分是我希望說可以跟透過這樣子的聲音讓院長跟部長就是可以了解到有這樣的狀況然後也希望說有這樣子的特別條例也希望行政院如果你們有更好的版本如果你們可以提出來解決這樣的問題的話那本席也會支持喔所以我希望的是這件事情也要讓院長部長請你們好好的去理解最後我也想要花一點時間跟院長快問快答一下台中人口有多少\n台中人口大概200多萬吧。284萬。那高雄人口有多少?這裡你已經有答案了。273萬。那高雄前瞻預算拿多少?這一個前瞻預算。1265億。院長我們這是快問快答好不好。台中前瞻預算拿多少?\n228億好不好高雄巨蛋中央補助有多少7.5億台中巨蛋中央補助多少0元會展中心東側也是0元高雄捷運中央補助多少\n﹚廖偉翔﹚\n謝謝廖委員偉翔的質詢,也謝謝陳院長的備詢。接下來我們請登記第二號陳委員昭之子\n","vtt":"WEBVTT\n\n00:18.114 --> 00:23.617\n質詢。院長好,有請我們行政院院長陳院長以及我們的薛瑞元學部長。麻煩請陳院長衛福部備詢,謝謝。\n\n00:30.376 --> 00:32.004\n廖委員早安。院長早。\n\n00:38.023 --> 00:59.670\n部長,健保開辦以來28年有極高的民意支持度但現在在這個高支持度的背後我們卻看到是由我們血汗醫護所支撐甚至現在已經向下影響到整個醫療教育以及我們包含我們醫師公會理事長也說現在有很多學生看到我們醫療環境不佳影響選擇醫學系的意願\n\n01:01.511 --> 01:27.747\n那包含我們統策衛生護理類報告也從2019年開始更是年年降低更是加劇了我們護理人員的人員荒那事實上現在在醫療現場前幾年的這個擊中南海然後內外婦兒無一不缺護理人力也流失嚴重導致醫院有病床卻也無法開許多病人就只能夠塞在急診室一待好幾天\n\n01:28.527 --> 01:32.672\n所以想要請教院長部長我們的醫護人力荒有解嗎?\n\n01:34.090 --> 01:36.050\n院長除了缺人和缺藥但是還有缺藥\n\n02:00.416 --> 02:21.107\n那缺藥的因素也有很多,在生產端包含我們的原料藥的來源供應不急,還有供應鏈不穩定,製造品質或法規要求的改變,以及藥商的這個商業考量,更別說這個復型劑、膠囊殼甚至是物流因素等等都有可能造成缺藥,所以一顆小小的藥丸或是膠囊,它的產品鏈非常的長。\n\n02:21.732 --> 02:21.792\n﹝廖偉翔﹞\n\n02:38.434 --> 03:03.223\n短期缺藥是可以透過很多手段解決但是如果是長期缺藥的話就要特別小心了所以我想問院長您同意這樣的看法嗎我覺得這個缺藥的問題確實是需要來很慎重的來解決但是衛福部也很用很大的心力來調整院長部長所以面對缺藥問題我之前有在委員會有做出決議包含說同時符合三個條件下\n\n03:19.767 --> 03:37.015\n的藥品清單中的藥品。第二個是鼓勵在地製造是希望可以穩定我們的供應鏈。那第三個就是三張以下的稀缺藥證。那院長這部分涉及修法請問4月中之前能否將此三項條件納入修法中的內容之中。\n\n03:38.562 --> 03:59.600\n這一個部分我請衛福部來回答跟委員報告那委員所提出來這三個條件除了第一個那個醫學會認證因為我們在列這一個必要藥品的品項的時候都有跟醫學會這邊邀請他們確認過所以不一定需要再去寫一個說醫學會認證其他這三個部分的話我們都聲表贊同\n\n04:05.124 --> 04:29.112\n現在是4月8日我們會召集相關的團體會做一個考量然後會送到健保的共理會議去所以4月底之前要完成這個所謂的規定的修改的話有一點點困難但是在上半年應該是沒有問題是好那請這個部長也盡快的加速進行\n\n04:29.952 --> 04:42.422\n那我的條件之一是要釋法的二期之二的必要藥品清單嘛那既然是必要藥品代表這些藥品是不可或缺的目前總共是400多項但是院長你們知道這份清單多久才檢討一次嗎?\n\n04:43.973 --> 05:10.394\n院長這個從食藥署的網頁依照我們公告的資料最近一次是去年的11月可是再上一次間隔了三年兩個月那在之前大概是平均約兩年所以院長部長既然是必要的藥品清單為何不能夠每年檢討一次尤其是現在的狀況之下因為現在國際上的供應鏈也仍然沒有很穩定所以我的具體建議本席的具體建議是說有沒有可能改成每年檢討一次\n\n05:11.115 --> 05:38.976\n同時也在4月中之前或者是大概您剛才說時間時程上的部分可不可以提早的這個完成這個修法的預告作業?如果是每年檢討應該是可行的,那我們盡量來朝這個方向來做。好,謝謝。那再來院長部長,這個我們醫療的價值要等於我們醫療的品質也要等於我們醫療的點值,這樣的理念您認同嗎?\n\n05:40.537 --> 06:00.128\n最後一個健保的是不是等於健保點值因為我們現在是在總額預算的制度下去運作所以這個加量的關係所以是院長但是健保的點值長年以來一直被貶值造成現在醫療的困境醫療體系的困境那所以我們醫界為了生存\n\n06:01.363 --> 06:15.996\n過去常常大家聽到的這個藥價差、發展自費藥材、或者是最近的解除掛號費上限等等,我想這都是一介自救的手段。但也因為如此,我想整個醫療體系也會越來越扭曲,病患也不滿意。\n\n06:16.937 --> 06:38.634\n所以院長你知道嗎醫療院所其實也不想這樣做但是這是為了生存也只能這麼做所以院長部長健保點值的這個老問題我想整個醫療體系不死不活那連我們台大院長都說醫療本業的利潤剩下1%如果他是企業的CEO他老早就被開除了請問院長你們現在還要調漲電價你認為台大吳院長所說的1%的利潤還有可能嗎\n\n06:45.114 --> 07:11.799\n我想這個電價的調整如何來影響臺大醫院的營運我們需要再來評估電費所佔的百分比是多少但是呢我想我們依借大家所提出來的這些意見我們都會來作為檢討可是很重要的不要忘掉我們臺灣的健保還是在國人心目中是很好的一個制度要多方來考量\n\n07:12.239 --> 07:23.385\n是,院長因為醫院裡面的急診加護病房一般病房的空調也是不能夠中斷的難不成醫院因為電價太高就要把它關掉嗎當然不會嘛,也不應該所以我們要馬兒好又要馬兒不吃草\n\n07:24.349 --> 07:43.675\n我們是覺得這樣不太合理所以院長像現在臺灣醫院協會醫事公會的全聯會護理師公會的全聯會還有我們臺灣私立醫院協會醫務管理學會等五大醫事團體聯合發出聲明欲請不要調漲醫療院所的電價請問院長你們可以答應嗎\n\n07:45.075 --> 08:07.964\n院長下星期一就是4月1日這個調漲電價日所以我們希望本席希望本週五前是否可以給醫界一個答覆好嗎?這一個部分的話我們要來了解剛才我講過醫療院所的電費占他所有經營的這個百分比是多少我舉一個很簡單的例子比如說臺北捷運的話那我們調漲電價實際上對他的成本只影響1%\n\n08:09.685 --> 08:10.905\n院長所以這個部分也要請你特別用心喔。\n\n08:35.433 --> 08:50.058\n因為要請您特別留意或是更加的嚴議因為你們的經濟部講出來今天也承認說他的這個沒有考量到這個烘焙機這個烘焙機的這個成本所以你們講出那個兩塊錢真的是瞎扯的\n\n08:50.538 --> 08:52.559\n建保制度的運作讓政府現在的醫療政策上只能夠頭痛一頭腳痛一腳。\n\n09:11.857 --> 09:31.145\n那也因為這樣所以我說現在的健保可能有三苦病人痛苦家屬辛苦那醫護命苦但是最根本的性的問題也是剛剛在講的長期以來這個健保點值的問題因為總而上限的問題造成許多醫院必須到處挖東牆補西牆那院長部長這個你們同意嗎\n\n09:32.598 --> 09:58.275\n這個我不同意啦我們的病人齁你看看醫院裡面很多的病人寫給醫護人員的他都是很感謝有健保有醫護人員所以他們在病的時間得到很好的照顧所以你現在就故意講反面的話我個人不贊成而且家屬有很多都是感謝我們醫護人員的努力所以你製造對立沒有辦法使得台灣的醫療產業得很好的運氣沒有院長我要跟您討論的是現在血汗醫護的問題喔\n\n10:02.537 --> 10:26.392\n我要告訴你一個數據這兩年的健保浮動點值曾一度掉到0.8元以下但我們要說實際也有可能比這個更慘因為總額之下還有一個分區總額所以健保署的各分區業務組會跟他那個區域的各層級的醫院訂定一個目標額所以醫院也會想辦法可能會想辦法減少我們病患的就診數這就是所謂醫界裡面有在講的斷頭現象\n\n10:28.433 --> 10:49.701\n所以實際的醫療服務量是可能根本沒有申報。這也就是醫院為什麼抱怨說做得越多領得越少或者是虧得越多。院長更動健保制度當然是知識體大所以必須要做好社會溝通才能夠在最少的阻力之下進行改革。但是現在醫護人力短缺等問題加上又要調漲電價所以這個醫療體系崩潰在極。\n\n10:52.822 --> 11:18.463\n我已經在上週正式提出這個健全醫療發展特別條例是希望幫我們臺灣的醫療打強心針那這裡面最核心的也就是資本條例及本條例所編之特別預算通過後格計現保各分區各部門之總額浮動點值平均為打0.95元者應補足至0.95元基本上也就是希望保障點值最基本要0.95元\n\n11:19.925 --> 11:22.757\n那這個部分也是要呼應我們一屆的主張\n\n11:24.622 --> 11:53.224\n那另外要解決我們護理人力不足的部分我是針對地區級以上的醫院執行這個急性病床以及特殊病床照護的護理人員每月發給1萬元的津貼而且要撥補100億成立這個新藥發展基金這三個面向基本上是希望能夠幫助解決整個醫療體系現在的困境希望請問院長你們同意嗎部長同意嗎我覺得你完全不懂什麼叫做\n\n11:54.565 --> 12:19.919\n建保的點子本來就是在建保整個的財務的運作裡面行之多年你這樣的情形有點外行我請我們部長回答這個特別條例要去保障點子是跟我們建保法裡面的總額預算的整個的制度是互相焊隔的所以如果萬一這一個特別條例通過的話\n\n12:21.274 --> 12:39.367\n那實務上面怎麼樣去運用兩個不同的制度互相之間打架,這會產生很大的問題。是,部長我想跟你說的是健全醫療法人特別條例其實只有三年了,並且總額是3800億,我的想法是在不動總額的前提下,另外用這三年中的總額來補貼。你3800億是否是一個長期性的,\n\n12:45.931 --> 12:58.997\n那這個常設性的是公務預算。公務預算怎麼用到健保的這個要怎麼樣算這個知識體大。而且是否都能夠每年有這樣子所謂的3800億這個是非常有問題的。\n\n13:02.359 --> 13:10.125\n委員你一定要請教專家更深入了解這一個所有健保的財務才能夠做很好的調理。但是在溝通的時候除了醫療團體以外還有病人團體消費者團體還有學者專家通通要來考慮期望不要只針對單一的團體\n\n13:25.657 --> 13:28.058\n也請這個院長部長先針對這個健保墊值常常在浮動的這個狀況。我剛剛提出的其實不只是這個部分。墊值就是會浮動。\n\n13:52.833 --> 14:12.470\n對,但是他們現在需要是,是院長,因為我要跟你算的事情是這樣子啊,在疫情前平均是0.92的情況之下,大多數的一個層級的醫療院所,他們的獲利大概不到是5%,那其實他們對他們來講也很痛苦,在很多情況之下他也很難留財攬財,甚至也不敢做到這個醫療發展的部分喔。\n\n14:12.870 --> 14:41.599\n所以這個部分是我希望說可以跟透過這樣子的聲音讓院長跟部長就是可以了解到有這樣的狀況然後也希望說有這樣子的特別條例也希望行政院如果你們有更好的版本如果你們可以提出來解決這樣的問題的話那本席也會支持喔所以我希望的是這件事情也要讓院長部長請你們好好的去理解最後我也想要花一點時間跟院長快問快答一下台中人口有多少\n\n14:43.322 --> 15:03.188\n台中人口大概200多萬吧。284萬。那高雄人口有多少?這裡你已經有答案了。273萬。那高雄前瞻預算拿多少?這一個前瞻預算。1265億。院長我們這是快問快答好不好。台中前瞻預算拿多少?\n\n15:04.775 --> 15:16.972\n228億好不好高雄巨蛋中央補助有多少7.5億台中巨蛋中央補助多少0元會展中心東側也是0元高雄捷運中央補助多少\n\n15:18.069 --> 15:18.249\n﹚廖偉翔﹚\n\n15:46.926 --> 15:48.388\n謝謝廖委員偉翔的質詢,也謝謝陳院長的備詢。接下來我們請登記第二號陳委員昭之子\n\n","segments":[{"start":18.114,"end":23.617,"text":"質詢。院長好,有請我們行政院院長陳院長以及我們的薛瑞元學部長。麻煩請陳院長衛福部備詢,謝謝。"},{"start":30.376,"end":32.004,"text":"廖委員早安。 院長早。"},{"start":38.023,"end":59.67,"text":"部長,健保開辦以來28年有極高的民意支持度但現在在這個高支持度的背後我們卻看到是由我們血汗醫護所支撐甚至現在已經向下影響到整個醫療教育以及我們包含我們醫師公會理事長也說現在有很多學生看到我們醫療環境不佳影響選擇醫學系的意願"},{"start":61.511,"end":87.747,"text":"那包含我們統策衛生護理類報告也從2019年開始更是年年降低更是加劇了我們護理人員的人員荒那事實上現在在醫療現場前幾年的這個擊中南海然後內外婦兒無一不缺護理人力也流失嚴重導致醫院有病床卻也無法開許多病人就只能夠塞在急診室一待好幾天"},{"start":88.527,"end":92.672,"text":"所以想要請教院長部長我們的醫護人力荒有解嗎?"},{"start":94.09,"end":96.05,"text":"院長除了缺人和缺藥但是還有缺藥"},{"start":120.416,"end":141.107,"text":"那缺藥的因素也有很多,在生產端包含我們的原料藥的來源供應不急,還有供應鏈不穩定,製造品質或法規要求的改變,以及藥商的這個商業考量,更別說這個復型劑、膠囊殼甚至是物流因素等等都有可能造成缺藥,所以一顆小小的藥丸或是膠囊,它的產品鏈非常的長。"},{"start":141.732,"end":141.792,"text":"﹝廖偉翔﹞"},{"start":158.434,"end":183.223,"text":"短期缺藥是可以透過很多手段解決但是如果是長期缺藥的話就要特別小心了所以我想問院長您同意這樣的看法嗎我覺得這個缺藥的問題確實是需要來很慎重的來解決但是衛福部也很用很大的心力來調整院長部長所以面對缺藥問題我之前有在委員會有做出決議包含說同時符合三個條件下"},{"start":183.763,"end":199.667,"text":"﹚議員﹚"},{"start":199.767,"end":217.015,"text":"的藥品清單中的藥品。第二個是鼓勵在地製造是希望可以穩定我們的供應鏈。那第三個就是三張以下的稀缺藥證。那院長這部分涉及修法請問4月中之前能否將此三項條件納入修法中的內容之中。"},{"start":218.562,"end":239.6,"text":"這一個部分我請衛福部來回答跟委員報告那委員所提出來這三個條件除了第一個那個醫學會認證因為我們在列這一個必要藥品的品項的時候都有跟醫學會這邊邀請他們確認過所以不一定需要再去寫一個說醫學會認證其他這三個部分的話我們都聲表贊同"},{"start":245.124,"end":269.112,"text":"現在是4月8日我們會召集相關的團體會做一個考量然後會送到健保的共理會議去所以4月底之前要完成這個所謂的規定的修改的話有一點點困難但是在上半年應該是沒有問題是好那請這個部長也盡快的加速進行"},{"start":269.952,"end":282.422,"text":"那我的條件之一是要釋法的二期之二的必要藥品清單嘛那既然是必要藥品代表這些藥品是不可或缺的目前總共是400多項但是院長你們知道這份清單多久才檢討一次嗎?"},{"start":283.973,"end":310.394,"text":"院長這個從食藥署的網頁依照我們公告的資料最近一次是去年的11月可是再上一次間隔了三年兩個月那在之前大概是平均約兩年所以院長部長既然是必要的藥品清單為何不能夠每年檢討一次尤其是現在的狀況之下因為現在國際上的供應鏈也仍然沒有很穩定所以我的具體建議本席的具體建議是說有沒有可能改成每年檢討一次"},{"start":311.115,"end":338.976,"text":"同時也在4月中之前或者是大概您剛才說時間時程上的部分可不可以提早的這個完成這個修法的預告作業?如果是每年檢討應該是可行的,那我們盡量來朝這個方向來做。好,謝謝。那再來院長部長,這個我們醫療的價值要等於我們醫療的品質也要等於我們醫療的點值,這樣的理念您認同嗎?"},{"start":340.537,"end":360.128,"text":"最後一個健保的是不是等於健保點值因為我們現在是在總額預算的制度下去運作所以這個加量的關係所以是院長但是健保的點值長年以來一直被貶值造成現在醫療的困境醫療體系的困境那所以我們醫界為了生存"},{"start":361.363,"end":375.996,"text":"過去常常大家聽到的這個藥價差、發展自費藥材、或者是最近的解除掛號費上限等等,我想這都是一介自救的手段。但也因為如此,我想整個醫療體系也會越來越扭曲,病患也不滿意。"},{"start":376.937,"end":398.634,"text":"所以院長你知道嗎醫療院所其實也不想這樣做但是這是為了生存也只能這麼做所以院長部長健保點值的這個老問題我想整個醫療體系不死不活那連我們台大院長都說醫療本業的利潤剩下1%如果他是企業的CEO他老早就被開除了請問院長你們現在還要調漲電價你認為台大吳院長所說的1%的利潤還有可能嗎"},{"start":405.114,"end":431.799,"text":"我想這個電價的調整如何來影響臺大醫院的營運我們需要再來評估電費所佔的百分比是多少但是呢我想我們依借大家所提出來的這些意見我們都會來作為檢討可是很重要的不要忘掉我們臺灣的健保還是在國人心目中是很好的一個制度要多方來考量"},{"start":432.239,"end":443.385,"text":"是,院長因為醫院裡面的急診加護病房一般病房的空調也是不能夠中斷的難不成醫院因為電價太高就要把它關掉嗎當然不會嘛,也不應該所以我們要馬兒好又要馬兒不吃草"},{"start":444.349,"end":463.675,"text":"我們是覺得這樣不太合理所以院長像現在臺灣醫院協會醫事公會的全聯會護理師公會的全聯會還有我們臺灣私立醫院協會醫務管理學會等五大醫事團體聯合發出聲明欲請不要調漲醫療院所的電價請問院長你們可以答應嗎"},{"start":465.075,"end":487.964,"text":"院長下星期一就是4月1日這個調漲電價日所以我們希望本席希望本週五前是否可以給醫界一個答覆好嗎?這一個部分的話我們要來了解剛才我講過醫療院所的電費占他所有經營的這個百分比是多少我舉一個很簡單的例子比如說臺北捷運的話那我們調漲電價實際上對他的成本只影響1%"},{"start":489.685,"end":490.905,"text":"院長所以這個部分也要請你特別用心喔。"},{"start":515.433,"end":530.058,"text":"因為要請您特別留意或是更加的嚴議因為你們的經濟部講出來今天也承認說他的這個沒有考量到這個烘焙機這個烘焙機的這個成本所以你們講出那個兩塊錢真的是瞎扯的"},{"start":530.538,"end":532.559,"text":"建保制度的運作讓政府現在的醫療政策上只能夠頭痛一頭腳痛一腳。"},{"start":551.857,"end":571.145,"text":"那也因為這樣所以我說現在的健保可能有三苦病人痛苦家屬辛苦那醫護命苦但是最根本的性的問題也是剛剛在講的長期以來這個健保點值的問題因為總而上限的問題造成許多醫院必須到處挖東牆補西牆那院長部長這個你們同意嗎"},{"start":572.598,"end":598.275,"text":"這個我不同意啦我們的病人齁你看看醫院裡面很多的病人寫給醫護人員的他都是很感謝有健保有醫護人員所以他們在病的時間得到很好的照顧所以你現在就故意講反面的話我個人不贊成而且家屬有很多都是感謝我們醫護人員的努力所以你製造對立沒有辦法使得台灣的醫療產業得很好的運氣沒有院長我要跟您討論的是現在血汗醫護的問題喔"},{"start":602.537,"end":626.392,"text":"我要告訴你一個數據這兩年的健保浮動點值曾一度掉到0.8元以下但我們要說實際也有可能比這個更慘因為總額之下還有一個分區總額所以健保署的各分區業務組會跟他那個區域的各層級的醫院訂定一個目標額所以醫院也會想辦法可能會想辦法減少我們病患的就診數這就是所謂醫界裡面有在講的斷頭現象"},{"start":628.433,"end":649.701,"text":"所以實際的醫療服務量是可能根本沒有申報。這也就是醫院為什麼抱怨說做得越多領得越少或者是虧得越多。院長更動健保制度當然是知識體大所以必須要做好社會溝通才能夠在最少的阻力之下進行改革。但是現在醫護人力短缺等問題加上又要調漲電價所以這個醫療體系崩潰在極。"},{"start":652.822,"end":678.463,"text":"我已經在上週正式提出這個健全醫療發展特別條例是希望幫我們臺灣的醫療打強心針那這裡面最核心的也就是資本條例及本條例所編之特別預算通過後格計現保各分區各部門之總額浮動點值平均為打0.95元者應補足至0.95元基本上也就是希望保障點值最基本要0.95元"},{"start":679.925,"end":682.757,"text":"那這個部分也是要呼應我們一屆的主張"},{"start":684.622,"end":713.224,"text":"那另外要解決我們護理人力不足的部分我是針對地區級以上的醫院執行這個急性病床以及特殊病床照護的護理人員每月發給1萬元的津貼而且要撥補100億成立這個新藥發展基金這三個面向基本上是希望能夠幫助解決整個醫療體系現在的困境希望請問院長你們同意嗎部長同意嗎我覺得你完全不懂什麼叫做"},{"start":714.565,"end":739.919,"text":"建保的點子本來就是在建保整個的財務的運作裡面行之多年你這樣的情形有點外行我請我們部長回答這個特別條例要去保障點子是跟我們建保法裡面的總額預算的整個的制度是互相焊隔的所以如果萬一這一個特別條例通過的話"},{"start":741.274,"end":759.367,"text":"那實務上面怎麼樣去運用兩個不同的制度互相之間打架,這會產生很大的問題。是,部長我想跟你說的是健全醫療法人特別條例其實只有三年了,並且總額是3800億,我的想法是在不動總額的前提下,另外用這三年中的總額來補貼。你3800億是否是一個長期性的,"},{"start":765.931,"end":778.997,"text":"那這個常設性的是公務預算。公務預算怎麼用到健保的這個要怎麼樣算這個知識體大。而且是否都能夠每年有這樣子所謂的3800億這個是非常有問題的。"},{"start":782.359,"end":790.125,"text":"委員你一定要請教專家更深入了解這一個所有健保的財務才能夠做很好的調理。但是在溝通的時候除了醫療團體以外還有病人團體消費者團體還有學者專家通通要來考慮期望不要只針對單一的團體"},{"start":805.657,"end":808.058,"text":"也請這個院長部長先針對這個健保墊值常常在浮動的這個狀況。我剛剛提出的其實不只是這個部分。墊值就是會浮動。"},{"start":832.833,"end":852.47,"text":"對,但是他們現在需要是,是院長,因為我要跟你算的事情是這樣子啊,在疫情前平均是0.92的情況之下,大多數的一個層級的醫療院所,他們的獲利大概不到是5%,那其實他們對他們來講也很痛苦,在很多情況之下他也很難留財攬財,甚至也不敢做到這個醫療發展的部分喔。"},{"start":852.87,"end":881.599,"text":"所以這個部分是我希望說可以跟透過這樣子的聲音讓院長跟部長就是可以了解到有這樣的狀況然後也希望說有這樣子的特別條例也希望行政院如果你們有更好的版本如果你們可以提出來解決這樣的問題的話那本席也會支持喔所以我希望的是這件事情也要讓院長部長請你們好好的去理解最後我也想要花一點時間跟院長快問快答一下台中人口有多少"},{"start":883.322,"end":903.188,"text":"台中人口大概200多萬吧。284萬。那高雄人口有多少?這裡你已經有答案了。273萬。那高雄前瞻預算拿多少?這一個前瞻預算。1265億。院長我們這是快問快答好不好。台中前瞻預算拿多少?"},{"start":904.775,"end":916.972,"text":"228億好不好高雄巨蛋中央補助有多少7.5億台中巨蛋中央補助多少0元會展中心東側也是0元高雄捷運中央補助多少"},{"start":918.069,"end":918.249,"text":"﹚廖偉翔﹚"},{"start":946.926,"end":948.388,"text":"謝謝廖委員偉翔的質詢,也謝謝陳院長的備詢。接下來我們請登記第二號陳委員昭之子"}]}}}}