{"id":150429,"url":"https://ivod.ly.gov.tw/Play/Clip/1M/150429","video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/f45bf982c29023eec5e8b88f5e1f029d8ac1d636ef3e2fe8f8ba9b0039caa7a6703828fa4814d4fd5ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"王正旭","委員發言時間":"15:34:11 - 15:49:51","影片長度":"00:15:40","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":940,"end_time":"2024-03-26T15:49:51+08:00","start_time":"2024-03-26T15:34:11+08:00","features":["ai-transcript","gazette"],"type":"Clip","gazette":{"lineno":286,"blocks":[["王委員正旭：（15時34分）謝謝韓院長，有請院長。"],["主席：麻煩再請陳院長備詢。"],["陳院長建仁：王委員午安。"],["王委員正旭：院長好。謝謝您當年給我的證書。這是幫助很多年輕學子進入到生命科學領域一本很重要的著作，特別令人感動的是在書本上閱讀到了您的父親在您晉升教授的時候，提供給您的期許和祝福，見證您後來在學術上擔任了中央研究院的院士，在政治上也擔任了副總統，現在又擔任行政院長的工作，相信大部分的民眾會和我一樣，衷心感謝您對臺灣人民全心全力的付出。您的父親應該也會讚許您的成就，或許他會捨不得您現在的辛苦，不過，我相信這一切都是值得的。"],["陳院長建仁：我仍然是以做公僕的心態來服務大家，希望能夠符合我爸爸的要求。"],["王委員正旭：接下來還是要利用這次總質詢的機會來就教您三個我認為的重要問題，一個是癌症防治的篩檢問題；一個是癌症新藥基金，這點已經有很多委員都提過；另外就是研議是否成立國家B肝防治辦公室這三個問題。","有關癌症防治，尤其在篩檢部分有其很重要的角色，您是這方面的專家，應該很清楚癌症已經是過去41年來對臺灣民眾最嚴重的生命致死疾病。依照2022年的數據告訴我們，當年就有5萬1,927個民眾因為癌症而死亡，占了當年四分之一的民眾死亡因素。所以，我們很努力希望能透過很多、很多好的方式，不管是醫藥的研究或醫藥的新進步，儘量減少癌症對民眾的死亡威脅。","我們也看得出，20年前的5年存活率為46.1%，到目前為止，已經提升到61.5%。也就是過去20年來其實已經把存活率提升了15.4%。但相較於韓國的5年存活率為70%、日本的65%，其實我們還有很大的進步空間。對於要進步的空間，我想身為醫師專業的賴清德總統當選人，他其實是非常有感受的，所以他很希望在打造健康臺灣的過程中，可以在2030年把癌症死亡率、死亡人數下降三分之一，這就是我們未來必須共同努力的方向。三分之一的概念，就是可能可以下降1萬5,000個的死亡人數，約略與2022年差不多是COVID的死亡人數，所以這是一個很大的目標。院長，你是這方面的專家，我們也知道在2003年癌症防治法成立以後，從2010年開始，比較大規模的癌症防治，包括篩檢部分，已經將近14年了。院長，你覺得或是你認同目前臺灣執行中的五大癌症篩檢是合乎我們目前的預設目標嗎？還有，你滿意這些成果嗎？"],["陳院長建仁：目前我們對這4個癌症的篩檢是2004年我當衛生署署長時所大力推動的，如同你這裡寫的一樣，實際上我們看到死亡率有在明顯的下降。我們跟美國國家癌症研究中心有做過相關的分析，我們覺得還需要再更加地普及相關篩檢，其中一個很重要的篩檢就是肺癌篩檢。我們在前兩、三年就開始推動肺癌篩檢，因為肺腺癌，特別是有家族史者得肺腺癌很高。現在肺癌的發生期數都比較高，如果能夠篩檢的話，就可以讓0期的、1期的被發現，像我自己一樣，這個時候存活率就會很高，這是我們該發展的另外一個部分。另外，有關篩檢方式也可以再精進，這部分委員是專家，我們會一起來努力。"],["王委員正旭：的確，使用低劑量檢查做肺癌篩檢，其實1個週年就能拯救500個家庭，這是一個很好的數字。我們也知道在這過程裡其實可以發揮更多的效益，因為這些透過篩檢檢查出來的病人，基本上都是很早期的癌症，經過適當的治療幾乎都是可以痊癒的。不過我們還是會擔心，我們看到的就是篩檢率，如果篩檢有這麼好的成果，我們的篩檢率能不能有辦法適度的再提升？因為我們看到其實民眾參與篩檢的，理論上我們希望更高，當然，相較於全球各國並不是比較差，可是我們希望，既然有這麼好的成果，有辦法再提升嗎？因為我們看到有40%的民眾符合條件，可是他來篩檢的機會就損失掉了，非常、非常可惜。我們也特別關注到到有一些民眾他是陽篩，所謂陽篩就是初步檢查看起來是需要持續做後續處理的，我們看到大腸癌陽篩的百分比相較於乳癌、子宮頸癌就真的差很多。這部分您是專家，目前到底有什麼樣的因素會讓我們民眾對於篩檢是不願意來充分參與，對於陽篩的後續追蹤也會有所畏懼，不知道您的看法？"],["陳院長建仁：篩檢率的增加就是怎麼讓它更普及，委員看的是單年的部分，如果以累積篩檢率來看，確實還有將近20%到30%的民眾沒有去參加篩檢。這個部分我們要加強宣導，而且讓它的篩檢能夠更普及，也希望各級醫院能夠來協助癌症篩檢的工作，這個部分我們國健署有在努力。","但是篩檢陽性的、陽追的部分也是一樣，怎麼樣讓篩檢陽性者能夠讓他去做更進一步的診療，這個就很重要。我想未來我們也希望衛福部能來提一個陽追的計畫，讓醫院能夠主動積極地來幫忙做陽追，這個部分可能可以做得更好。所以癌症篩檢也是剛才我們跟蘇委員在講的預防醫學的這一塊，我想我們來訂定一個計畫，看怎麼樣把陽追率能夠達到很高，要不的話篩檢就很可惜了，篩檢完沒有去做陽追很可惜。"],["王委員正旭：對，這真的是非常可惜。這邊我們瞭解到影響國人篩檢意願的可能因素就包括我們所列出來的這幾項，其中有一些是沒有時間，有一些是不方便，或者是說他很擔心，認為沒事檢查那個要幹嘛，這些都是讓民眾不願意參加篩檢的原因。很謝謝院長，也謝謝部長，這邊也期待透過國民健康署去擬定各種更好的方法，讓民眾知道癌症篩檢對他的幫助，在參與意願升高的同時能夠有更方便的方式。","我們也瞭解，其實以大腸癌篩檢為例，如果是陽篩的話，再過來就是要準備接受大腸鏡的檢查，大腸鏡的檢查對很多民眾來講是很難去理解，尤其是他的準備過程其實是很不方便的。另外，可能他做大腸鏡的過程即使是有健保給付，可是如果他很怕痛，可能就需要做無痛式的檢查，透過這種無痛式檢查來減輕他的不舒服，可是這是需要費用的。請問一下院長，您知道做一次無痛式大腸鏡需要花費多少費用嗎？"],["陳院長建仁：我印象中大概要三、四千塊錢。"],["王委員正旭：是，目前一般費用是四千到五千塊，這對民眾來講其實是一個負擔，一方面增加不方便，一方面他可能要請假，尤其是向公司請假，他要做先前的準備，又要自費負擔，所以我們很容易理解為什麼這一部分的陽追率是不如預期。請問部長或者院長，有什麼方式可以讓他們更有意願來接受大腸鏡的篩檢嗎？"],["薛部長瑞元：目前大概是這樣子，以前這種篩檢陽性的話，要找病人到醫院去，都是由篩檢者，也就是像衛生所、基層醫師去把他轉介過來，但是這樣的效果不會很好，所以我們目前作法是希望由醫院先把篩檢陽性的名單給醫院，由醫院去把他找來，找來的好處是他可以來安排時間，這樣比較能夠符合病人的需要。至於剛剛委員提到的無痛的麻醉費用，這個我們可以再來討論一下，看看是不是在這方面也可以做補助。當然也有一個部分可能跟勞動部相關，也就是請假的問題，這個看看能不能一起來做配合。"],["王委員正旭：好，謝謝。其實我們也很建議，如果能研議出一些節稅的措施，在減少他不方便的同時又能夠納入免稅額，也許是另外一種可行的方案。"],["陳院長建仁：醫療免稅。"],["王委員正旭：其實我們很期待企業界如果認為員工健康是企業最大資產的話，也許麻煩院長將來可以呼籲企業界從這方面幫助它的員工去做這方面的檢查，讓它的員工可以得到最大的照顧。"],["陳院長建仁：確實現在很多企業界有在這樣做，我們來努力推動。"],["王委員正旭：那就麻煩院長。其實我們知道，如果能夠再增加量能的話，當然就有機會去篩檢出更多的早期癌患，所以針對年齡限制，我們也期待透過一些相關專家學者的研議，讓這樣的年齡層可以達到更好或者是相對比較更有機會找到早期癌症的病人。以大腸癌為例，如果我們在45歲就已經開始出現大量息肉產生的時候，事實上我們就可以利用這個機會把息肉處理掉，往後就不會變成大腸癌，這個部分也希望將來能透過一些研議方式，看看能不能適度地去放寬。","其實我們最擔心的還是經費的問題，因為大量篩檢以後，真的可以找到更多的早期病人，得到更好的5年存活率，可是經費怎麼辦呢？請問院長，我們知道現在每一年會有27億、28億的癌症篩檢費用，我們看到編列出來的預算，如果期待到2030年能真的把癌症死亡率減低三分之一的話，編列的經費就要逐年增加，甚至將近要100億。可是我們發現菸害基金已經越來越不足，不知道院長對這方面的預算編列有沒有什麼更充分、穩定的財源？"],["陳院長建仁：對於這個部分，我們也希望衛福部、特別是國健署，能夠編列一個比較有雄心的癌症防治計畫，特別在篩檢的部分，當然他們本身也要做更好的規劃，看怎麼樣來做。至於經費的話，如果要達到我們希望的死亡率下降三分之一的話，確實篩檢是扮演一個很重要、很重要的角色，預防當然也是很重要，在這個部分我想我們可以來責成衛福部還有國健署這邊特別提出更精進的癌症防治計畫，然後來編列相關的經費。"],["王委員正旭：好，謝謝。","再過來就是有關於新藥基金的部分，剛才部長也說明得很清楚，目前看起來，暫時性的專款應該是透過公務預算的撥補指定用途，然後經由健保署來統一運作，節省整個行政經費，跟俗稱的健保總額其實是沒有關聯的，所以這部分的運用將來應該會受到行政跟立法的監督，而不是跟健保委員會那邊是分開的，我的認知不知道是不是正確？"],["薛部長瑞元：我們的規劃的確是這樣子，因為行政院這邊如果預算撥補到健保基金裡面去的話，這個仍然是屬於公務預算，所以仍然要經過立法院這邊的審查，並沒有說要去迴避所謂的審查，只不過因為這是公務預算的本質，所以可能在健保會上面就是不能去左右啦。"],["王委員正旭：好，謝謝。有關於B肝辦公室的部分，書面資料再麻煩……"],["薛部長瑞元：目前B、C肝辦公室已經有了，所以現在是改成B肝、C肝辦公室。"],["王委員正旭：那書面資料就再麻煩部長。"],["委員王正旭書面資料：","◎癌症連續41年居國人死因首位　政府應積極重視癌症防治","依據衛福部最新統計，2022年度十大死因首位為惡性腫瘤（癌症），每十萬人口癌症死亡222.7人死亡率是第二排名心臟疾病死亡101.5人的一倍以上。癌症自1982年起已連續41年居國人死因首位。另外，2022年度癌症死亡率為每十萬人口222.7人，較上年上升1.2%，近10年平均年增率為1.6%。","而依死亡率排序，前十大癌症死因依序為肺癌、肝癌、直腸癌、乳癌、攝護腺癌、口腔癌、胰臟癌、胃癌、食道癌、卵巢癌。","WHO亦預估，2030年時全球癌症死亡人數將超過1,300萬人，較2008年成長45%，而2020年全世界近1,000萬（約六分之一的死亡個案）死於癌症，其中以乳癌、肺癌及大腸癌最為常見，而台灣因為肝炎及飲食文化等影響，造成肝癌比例較高。","◎癌症影響：生命損失、增加健保醫療支出、家庭負擔加劇","由於人口快速老化，國人罹癌人數逐年上升，癌症不僅造成國人生命年數損失，近年來隨著醫療科技進步，引進新的藥品與技術，如標靶、免疫療法等，造成癌症治療醫療費用升高，2021年癌症就診病患近80萬人，健保治療癌症醫療費用約1,301億元，其中癌藥費用支出約403億元，標靶藥物占62.6%，癌症醫療負擔及癌症新藥品恐加劇健保財務問題。而新藥及新療法的高額費用，也造成癌症病患家庭健保以外的醫療費用高升，家庭負擔加劇，形成癌症醫療的財務毒性，衍生更多社會問題，因此癌症的防治，需要政府更多的重視以及資源的挹注。","◎研究實證顯示，癌症篩檢可有效降低癌症死亡率","因應癌症歷年來居十大死因之首，我國自2005年起推動「國家癌症防治計畫」，目前已執行至第五期（2024-2030年），而第一期計畫對癌症防治工作提出全面向之基礎規劃，包含初段選擇健康生活、次段提供癌症篩檢、末段罹癌患者皆獲得治療，以及提高癌友生活品質，以降低癌症發生率及死亡率為長期目標。研究實證顯示，癌症篩檢可有效降低癌症死亡率。於2010年再推動「第二期國家癌症防治計畫─癌症篩檢」，以擴大提供癌症篩檢服務為主要策略，於民眾在癌前期病變或是癌症早期即予以診斷出，經適當治療而提升存活率，甚而預防癌症的發生。2014-2018年推動第三期國家癌症防治計畫，焦點將從過去的治療、早期發現，向上力溯至癌症風險因子源頭之預防。2019-2023年第四期國家癌症防治計畫，強調透過建置永續經營的癌症防治體系、強化民眾與癌症防治人員的健康識能、強化各項服務層面工作品質、持續推動癌症篩檢，發展個人化癌症精準預防健康服務、縮小癌症防治各領域的不平等，及應用數據與實證提升癌症防治成效。","這其中國民健康署自2010年第二期計畫起，全面推廣四大癌症篩檢服務，包含糞便潛血檢查、口腔黏膜檢查、乳房X光攝影檢查、子宮頸抹片檢查。","研究顯示，定期接受口腔黏膜檢查可降低有嚼檳榔或吸菸習慣之男性26%死亡風險，每2年1次糞便潛血檢查可降低35%大腸癌死亡率，每2年1次乳房X光攝影檢查可降低41%乳癌死亡率，子宮頸抹片檢查可降低70%子宮頸癌死亡率。","近20幾年來，國人癌症五年存活率逐漸增加，1995至1999國人癌症五年相對存活率為46.1%，到2016至2020已提升至61.5%顯示癌症防治已有成效。","◎癌症篩檢率及陽追率仍然偏低尚有許多努力空間","而目前四項癌症篩檢的篩檢率及曾篩檢率分別為40%及60%，而依據國建署報告，2022年度四癌篩檢陽性個案追蹤完成率，子宮頸癌篩檢陽追率90.5%、乳癌篩檢陽追率90.6%、大腸癌篩檢陽追率72.9%及口腔癌篩檢陽追率80.3%。為持續精進癌症防治，提升篩檢率，以及後續的陽性個案追蹤率，仍有許多努力空間。","以陽追率最低的大腸癌為例，因為糞便潛血檢查為陽性者，後續將以大腸鏡檢查追蹤，而大腸鏡檢查需要前一天清空腸道，在檢查當天要請假，若怕痛又要自掏腰包進行無痛式鏡檢。目前進行一次無痛式鏡檢腸鏡，一般的行情是4,000元到5,000元。這對社會大眾一般家庭是一個經濟負擔。因此政府應研究後續的陽追檢查，應給予公假並研議補助相關檢查費用，來設法提升陽追率。","另外，我國於2022年7月1日起開辦肺癌早期偵測計畫，截至2023年1月底，已針對肺癌高風險族群（50-74歲重度吸菸者、50-74歲男性/45-74歲女性，且具肺癌家族史）篩檢人數2萬3,351人，接受篩檢者2,602人判讀結果為疑似異常，有2,233人需定期追蹤或接受確診程序。","前述國家癌症防治計畫以及辦理癌症箭檢業務主要經費來源為菸捐所設立的「菸害防制及衛生保健基金」，惟近年來該基金收入逐年遞減，2023年度基金預算數呈短絀5億餘元，2024年度預算數基金更短絀17億餘元，在主要經費來源短缺情況下，政府若欲擴大目前四項癌症篩檢以及增加肺癌篩檢項目，則必須另籌經費來源。另外，在新藥以及新療法等新興技術的臨床療效評估以及高額的醫療費用，也都是未來政府將逐漸面臨的衝擊，如何確保健保的財務健全、減輕癌症家庭的負擔、提升國人醫療服務品質，在現階段應設法增加經費來源以及透過國內商業醫療保險的推動，以確保健保基金永續經營並有效減輕國人醫療負擔。","國民健康署","過去五年癌症篩檢預算、決算及成果，以及來年預算編列、預估人數及成效。","113年3月","單位：千元、人次","註：1.109年至111年受疫情衝擊，故篩檢人數較少。","2.108年至112年為實際篩檢人次。","3.113年為預估篩檢人次，預計於114年方能提供決算數及成效。","第五期國家癌症防治計畫（2024-2030）","2024年所需經費：4,172,042千元（原所需經費共計6,664,718千元，其中欲爭取之公務預算2,492,676千元未獲核准），另2025年至2030年計畫經行政院審核刪除「健康存摺推廣費」及「補充地方公共衛生人力」等2項目公務預算經費。","2025年所需經費：7,593,347千元","2026年所需經費：7,871,020千元","2027年所需經費：8,450,077千元","2028年所需經費：8,867,106千元","2029年所需經費：9,298,762千元","2030年所需經費：9,672,566千元","◎因應癌症防治需求及癌症新藥新療法的發展及進步各界呼籲推動成立癌症新藥基金","從上一屆立法委員邱泰源、邱議瑩、林淑芬、吳思瑤等委員推動修法成立癌症新藥基金，就是為了因應癌症防治以及癌症新藥及醫療新技術發展，期能讓癌症病患及早運用新藥治療，提升存活率，並且不影響健保基金的財務負擔，並能落實癌症篩檢及追蹤，促進醫療科技的發展。但因為尚有經費來源、基金定位以及財務規劃方面的課題需要克服，因此無法順利的在上會期結束前推動完成。但是各界的共識都是認為應該要朝向這個目標努力，並且去年（2023年）5月，健保署石崇良署長、國健署吳昭軍署長也前往英國考察，針對英國癌症藥品基金（CDF）的運作模式、醫療科技評估以及財務控管等議題做交流及經驗的借鏡。會後並與英國國家健康暨照護卓越研究院（National Institute for Health and Care Excellence, NICE）簽署合作協議。","依據健保署及國健署考察英國CDF的報告指出，英國2011年與台灣目前情境相同，癌症病友極力希望即時獲得新癌藥治療，英國政府於2011年4月正式成立CDF，惟因缺乏明確給付退場機制，實施後致預算嚴重超支；於2016年7月起，執行二代CDF，訂定明確進場原則及退場評估機制，並透過建立ICER閾值（2-3萬英鎊，如符合end of life care drugs為5萬英鎊）作為與廠商議價基礎，並藉由財務管控機制（ECM），超過編列預算之藥費由參與廠商依使用比率分攤，以降低財務風險。","並且該報告最後的心得與建議提到，綜觀英國癌症基金及創新藥品基金運作，可供借鏡如下：","一、建立CDF：健保資源極為有限，且為總額預算制度，若我國建立CDF，是否透過爭取獨立預算設癌藥基金或健保基金下之專款，將持續收集各界意見凝聚共識。","二、平行送審：針對臨床迫切需求（Unmet medical need）、具突破創新性（Breakthrough）等新藥，為加速作業，將改採「平行審查」，即廠商送食藥署查驗登記時同時送健保署建議收載給付，節省過去等待許可證審查核准時間，並以一年給付為目標，讓病友儘快使用到新藥。","三、成立台灣NICE ：我國健保給付需有醫療科技評估機構作為後盾，以精準給付，有效運用資源。透過本次與NICE簽訂夥伴合作協議，將與NICE舉辦工作坊進行相關人才培訓及跨國RWE（Real world evidence份享，強化我國醫療科技評估實力，以設立台灣NICE為目標，有效掌握新藥療效證據及效益，加速新藥收載決策，以利接軌國際治療指引。","從英國CDF成功的經驗，國內朝野共識一致希望成立癌症新藥基金，且許多病友也盼望政府的有效改革能夠讓健保給付加速新藥的納入，因此希望行政院能夠全力來支持，加速成立癌症新藥基金，或者參考英國CDF精神，每年編列專款投入健保基金運作，同時現階段衛福部應可立即規劃平行送審機制，以期讓病友加速使用到新藥。","◎應將有生育需求癌症病友生育保存機制納入健保或補助","由於癌症的治療過程中，尤其化療、放療對於病友的生育能力造成相當大的影響，尤其針對適合生育年齡的病友，應有生育保存機制，例如凍卵等醫療納入健保或補助，這將有助於病友癒後人生規劃。","◎重視下一代的健康兒童癌症質子治療盡速評估納入健保給付","兒童癌症的治療過程中，尤其是化學治療及放射治療會造成兒童正常組織的傷害，由於小朋友的身體組成及生理機能和成年人不同，且由於處於快速生長發育階段，他們的器官較成年人更易受放射線影響。例如幼兒的腦部在0至3歲間發展成熟最為迅速，年紀越小接受放療，5年內智商下降幅度越大。質子治療可以在對腫瘤的治療效果不打折的情況下，降低對正常組織的傷害。質子射束進入人體後，可以在穿透腫瘤區後停住，減少腫瘤區後面的正常組織傷害。因此質子治療對於年紀小的病童來說，是比較好的治療選項。考量到兒童的未來人生還很長遠，在治療的同時能夠降低長遠的副作用，是大家所樂見的，也是我們共同努力的方向，因此請衛福部能夠支持，重視下一代的健康，將質子治療納入兒童癌症治療的健保給付項目。","◎成立B肝國家辦公室全力推動B肝的治療、篩檢及預防，期能根除國病","過去慢性肝炎及肝硬化持續高居國人十大死因之一，因此政府特別重視肝炎的治療、篩檢及預防，政府並於2016年12月8日成立C肝國家辦公室，全力推動C肝的口服抗病毒藥物治療，篩檢及預防，目前成績最為斐然，預計2025年提前5年達成世界衛生組織2030年全球消滅病毒性肝炎的計畫。而向稱「國病」的B型肝炎，自1986年率先全球於新生兒全面施打B肝疫苗，至今成果亮眼，1984-86年以後（40歲以下）接受過疫苗注射的國人（覆蓋率97%）B型肝炎表面抗原（HBsAg）帶原率已降至1%以下，但目前全台感染B肝的人數仍約有180萬，其中約有四成病人會引起反覆性肝炎發作，有可能需要抗病毒藥物治療。","近期國內有醫學中心的研究針對1,087位服用口服抗病毒藥物的B肝相關肝硬化病人進行長期追蹤研究，其中494位為固定療程組，593位為長期服藥組，在平均追蹤10年後結果顯示，固定療程組的肝癌發生率比長期服藥組降低50%（15.7%比26.8%）>肝病死亡風險亦減少67%，同時固定療程組的HBsAg消失率也高過長期服藥組12.8倍。這項研究發表在今年3月頂級的國際期刊肝臟學（Hepatology），這結果給了固定療程B肝治療重量級的證據，比起長期服用藥物，姑不論金錢的耗用，長期服藥的不便，光是可大幅減少肝癌，增加病毒清除及增加病人存活，就值得國家重視。","目前國際上新藥開發，估計十年內尚難有類似C型肝炎短期服用即可痊癒的藥物，唯有更積極地善用目前的診療，才能更接近世衛組織訂定的防治目標。更重要的是台灣現有近200萬帶原者中約50%未接受篩檢，不知自己是否為B型肝炎表面抗原帶原者，因此錯失治療及定期篩檢肝癌的機會。","因此，建議在現有疫苗的接種和藥物治療的優良基礎上，比照C肝成立B肝國家辦公室，以更高的位階及視野來全力推動B肝的治療、篩檢及預防，期待能早日根除國病，並至少達到世衛組織2030年前肝病死亡率下降65%的目標。"],["主席：謝謝王委員正旭的質詢。王委員正旭所提出的資料，麻煩請衛福部準備，也謝謝陳院長。","接下來請登記第16號邱委員議瑩質詢。"]],"agenda":{"page_end":219,"meet_id":"院會-11-1-6","speakers":["韓國瑜","吳宗憲","廖偉翔","陳昭姿","林憶君","賴士葆","劉建國","吳春城","王世堅","李彥秀","謝龍介","黃捷","游顥","蘇清泉","李坤城","蘇巧慧","王正旭","邱議瑩","洪申翰","鄭正鈐","涂權吉","徐巧芯"],"page_start":133,"meetingDate":["2024-03-26"],"gazette_id":"1131401","agenda_lcidc_ids":["1131401_00004","1131401_00005"],"meet_name":"立法院第11屆第1會期第6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─ 詢答完畢─","agenda_id":"1131401_00004"}},"transcript":{"id":"150429","pyannote":{"name":"ronny","tool":"pyannote","data":{"url":"https://ivod.ly.gov.tw/Play/Clip/1M/150429","tool":"pyannote","id":"150429-pyannote"},"job_id":"NuD1Bvwth0fXobqa","queued_at":"2024-06-01 19:45:29","status":"done","log":[{"time":"2024-06-01 19:45:29","msg":"downloading https://ivod.ly.gov.tw/Play/Clip/1M/150429"},{"time":"2024-06-01 19:45:30","msg":"downloading https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/f45bf982c29023eec5e8b88f5e1f029d8ac1d636ef3e2fe886695701d999525fab4f16a3dcf70bd65ea18f28b6918d91.mp4/playlist.m3u8"},{"time":"2024-06-01 19:45:57","msg":"converting mp4 to wav"},{"time":"2024-06-01 19:46:00","msg":"running pyannote"},{"time":"2024-06-01 19:46:13","msg":"status: 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887.409, \"text\": \"然後經由健保署來統一運作節省整個行政的經費跟俗稱的健保總額其實是沒有關聯的所以這部分的運用將來應該會受到行政跟立法的監督而不是跟健保委員會那邊是分開的我的認知知道是不是正確我們的規劃的確是這樣\", \"words\": [{\"word\": \"然\", \"start\": 863.513, \"end\": 864.153, \"score\": 0.939}, {\"word\": \"後\", \"start\": 864.153, \"end\": 864.394, \"score\": 0.915}, {\"word\": \"經\"}, {\"word\": \"由\", \"start\": 864.394, \"end\": 864.714, \"score\": 0.999}, {\"word\": \"健\", \"start\": 864.714, \"end\": 864.894, \"score\": 0.932}, {\"word\": \"保\", \"start\": 864.894, \"end\": 865.114, \"score\": 0.998}, {\"word\": \"署\", \"start\": 865.114, \"end\": 865.815, \"score\": 0.919}, {\"word\": \"來\"}, {\"word\": \"統\"}, {\"word\": \"一\", \"start\": 865.815, \"end\": 866.255, \"score\": 0.953}, {\"word\": \"運\"}, {\"word\": \"作\", \"start\": 866.255, \"end\": 867.235, \"score\": 0.979}, {\"word\": \"節\"}, {\"word\": \"省\", \"start\": 867.235, \"end\": 867.436, \"score\": 0.999}, {\"word\": \"整\", \"start\": 867.436, \"end\": 867.876, \"score\": 0.912}, {\"word\": \"個\"}, 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\"zh\"}","srt":"1\n00:00:01,370 --> 00:00:29,124\n麻煩再請陳院長備詢。謝謝您當年給我的證書。這是幫助很多年輕學子進入到這個生命科學領域一本很重要的著作。特別令人感動的就是在書本上有閱讀到了您的父親\n\n2\n00:00:30,083 --> 00:00:50,900\n在您晉升教授的時候提供給您的期許和祝福,見證您後來在學術上擔任的中央研究院的院士,在政治上也擔任的副總統,現在又擔任行政院長的工作。相信大部分的民眾會和我一樣\n\n3\n00:00:52,073 --> 00:01:10,685\n我衷心的感謝您對台灣人民的全心全力的付出。您的父親應該也會讚許您的成就。或許他也會捨不得您現在的辛苦。不過我相信這一切都是值得的。\n\n4\n00:01:11,876 --> 00:01:25,753\n我仍然是以做公僕的心態來服務大家希望能夠符合我爸爸的要求接下來還是要利用這次總質詢的機會來就教您三個認為是重要的問題\n\n5\n00:01:27,503 --> 00:01:54,029\n一個是癌症防治的篩檢問題一個是癌症信號基金已經有很多委員都提過另外就是我們可以研議是否能夠成立國家B肝防治辦公室這三個問題那癌症防治尤其在篩檢的部分是有它很重要的角色您是這方面的專家應該很清楚癌症已經是過去41年來對台灣民眾\n\n6\n00:01:56,792 --> 00:01:56,812\n韓國瑜議員\n\n7\n00:02:26,769 --> 00:02:54,689\n一、二的新進步能夠盡量的來減少還正對民眾的死亡的威脅。那我們也看得出來從過去20年前的5年的存活率46.1%到目前為止我們已經提升到61.5%也就是說過去25年來20年來其實已經有把這個存活率提升到了15.4個百分比可是\n\n8\n00:02:55,779 --> 00:03:20,615\n相較於韓國他的五年存活率是70%日本是65%所以我們其實還是有很大的要進步的空間那要進步的空間我想身為這個醫師專業的戴清德總統當選人他其實非常有感受所以他很希望打造健康台灣的過程要把這個\n\n9\n00:03:21,718 --> 00:03:33,433\n到2030年要把這個癌症死亡率死亡人數可以下降三分之一那這個就是我們未來必須要共同努力的方向那三分之一的概念就是\n\n10\n00:03:35,046 --> 00:03:35,066\n委員長\n\n11\n00:04:05,407 --> 00:04:09,597\n你覺得或者是你認同目前臺灣執行中的這個五大癌症的篩檢\n\n12\n00:04:10,708 --> 00:04:34,720\n他是有合乎我們目前預設的目標還有你滿意這些成果嗎?在目前為止我們大口如指這個四個癌症的篩檢是2024年我在當衛生署署長的時候大力在推動。推動的時候就如同你這裡寫的一樣實際上我們看到死亡率是有在明顯的下降。我們跟美國國家癌症研究中心有做過\n\n13\n00:04:35,760 --> 00:04:35,780\n韓國瑜議員\n\n14\n00:05:00,137 --> 00:05:02,218\n的確肺癌篩檢用使用這個低劑量的這個檢查\n\n15\n00:05:25,819 --> 00:05:52,982\n其實在一個週年就能夠拯救了500個家庭這是一個很好的數字我們也知道在這個過程裡面其實它可以發揮更多的效益出來因為這些透過篩檢檢查出來的病人基本上都是一個很早期的癌症經過適當的治療幾乎他都可以痊癒的不過我們還是會擔心我們看到的就是篩檢率\n\n16\n00:05:54,246 --> 00:06:23,056\n如果篩檢有這麼好的成果那為什麼我們的篩檢率能不能夠有辦法適度的再提升因為我們看到其實民眾參與這個篩檢的理論上我們希望更高當然相較於全球各國並不是比較差可是我們希望既然有這麼好的成果那有辦法再提升嗎因為我們看到了其實只有40%的民眾他符合條件可是呢他\n\n17\n00:06:24,519 --> 00:06:49,852\n來篩檢的這個機會就損失掉了,非常非常的可惜。那我們也特別關注到有一些民眾他是陽篩所謂陽篩就是初步檢查看起來是需要再持續做後續處理的那大腸癌的這個陽篩的我們看到的百分比相較於乳癌相較於子宮頸癌就真的差很多那這部分\n\n18\n00:06:51,212 --> 00:06:56,580\n您是專家那目前到底有什麼樣的因素會讓我們的民眾對於篩檢\n\n19\n00:06:58,681 --> 00:06:59,822\n韓國瑜主席\n\n20\n00:07:25,644 --> 00:07:25,664\n韓國瑜議員\n\n21\n00:07:48,689 --> 00:07:50,109\n對,這真的是非常可惜那這邊我們也了解到\n\n22\n00:08:18,277 --> 00:08:45,638\n其實影響國人篩檢意願的可能因素就包括我們所列出來的這幾項其中有一些是沒有時間有一些是不方便或者是說他很擔心不然事情要檢查要做什麼這個都是會讓民眾不願意參加篩檢的原因那很謝謝院長還有謝謝部長這邊也期待透過國民健康署去擬定各種更好的方法來讓民眾知道\n\n23\n00:08:46,209 --> 00:08:46,229\n韓國瑜\n\n24\n00:09:12,022 --> 00:09:13,883\n我印象中大概要30千塊錢目前\n\n25\n00:09:41,789 --> 00:10:06,514\n一般的費用是4000到5000塊,那這個對民眾來講它其實是一個負擔,因為它一方面增加不方便,一方面它可能請假,尤其是在公司請假,它要做先前的準備,又要自費的負擔,所以我們很容易理解為什麼這一部分它的這個揚罪率是不如預期,那請問部長或\n\n26\n00:10:07,841 --> 00:10:09,282\n目前大概是這樣子的以前的話這種篩檢陽性的話那要\n\n27\n00:10:23,263 --> 00:10:45,336\n找這個病人到醫院去,都是由篩檢者,也就是說像是衛生所、基層的醫師去把他轉介過來。但是這樣子是效果不會很好,所以我們目前的做法是我們希望由醫院先把這個篩檢陽性的名單給醫院,由醫院去把他找來。\n\n28\n00:10:46,460 --> 00:11:13,366\n那找來的好處就是他就可以安排時間是比較能夠符合病人的需要的那至於剛剛委員提到的無痛的麻醉的費用的話這我們可以再來討論一下看看是不是在這方面也有做補助那當然有一個部分的話是可能跟勞動部相關的也就請假了這個問題那這個看看能不能要一起來做配合\n\n29\n00:11:14,434 --> 00:11:33,537\n好,謝謝。其實我們也很建議如果能夠有研議出一些節稅的措施來減少他的這個不方便同時又能夠讓他納入為一個免稅額的話那也許也是另外一種可行的方案。其實我們很期待企業界如果他是\n\n30\n00:11:54,224 --> 00:11:54,244\n﹚廣告\n\n31\n00:12:11,332 --> 00:12:11,512\n﹚王正旭\n\n32\n00:12:40,842 --> 00:12:40,862\n請問院長\n\n33\n00:12:51,563 --> 00:13:13,945\n現在我們知道每一年會有27億28億的癌症篩檢費用那我們看到的編列出來如果要到2030年期待能夠真的把這個癌症死亡率減低三分之一的話我們看到了這個編列的經費就要逐年增加甚至將近100億可是我們發現這個陰害的基金已經越來越不足\n\n34\n00:13:14,725 --> 00:13:30,277\n不知道院長在這方面在預算的編列有沒有什麼更充分的穩定的裁員。在這個部分我們也希望這個衛福部特別是國建署他能夠編列一個比較有\n\n35\n00:13:32,414 --> 00:13:55,345\n響聲的這個癌症防治計畫特別在篩檢的部分那當然他們本身也要做更好的規劃看怎麼樣來做那這個經費的話如果要達到我們要死亡率下降三分之一的話確實篩檢扮演一個很重要很重要的一個角色然後預防當然也是很重要那在這一個部分我想我們可以來責成\n\n36\n00:13:56,425 --> 00:14:22,699\n我們衛福部還有國建署這邊特別提出這一個好更精進的這個癌症防治計畫然後來編列相關的經費。好謝謝那再過來就有關的信用基金的部分那剛剛部長也說明了很清楚其實目前看起來這個暫時性的專管應該是透過這個公務預算的撥補指定用途\n\n37\n00:14:23,513 --> 00:14:47,409\n然後經由健保署來統一運作節省整個行政的經費跟俗稱的健保總額其實是沒有關聯的所以這部分的運用將來應該會受到行政跟立法的監督而不是跟健保委員會那邊是分開的我的認知知道是不是正確我們的規劃的確是這樣\n\n38\n00:14:50,951 --> 00:15:15,116\n行政院這邊如果預算撥補到健保基金裡面去的話這個仍然是屬於公務預算所以仍然要經過立法院這邊的審查所以並沒有說要去迴避這所謂的審查只不過因為這是公務預算的本質所以可能在健保會上面的話那就是沒有就是說不能去左右\n\n39\n00:15:23,067 --> 00:15:23,167\n第16屆秋委員會議\n\n","tsv":"start\tend\ttext\n1370\t29124\t麻煩再請陳院長備詢。謝謝您當年給我的證書。這是幫助很多年輕學子進入到這個生命科學領域一本很重要的著作。特別令人感動的就是在書本上有閱讀到了您的父親\n30083\t50900\t在您晉升教授的時候提供給您的期許和祝福,見證您後來在學術上擔任的中央研究院的院士,在政治上也擔任的副總統,現在又擔任行政院長的工作。相信大部分的民眾會和我一樣\n52073\t70685\t我衷心的感謝您對台灣人民的全心全力的付出。您的父親應該也會讚許您的成就。或許他也會捨不得您現在的辛苦。不過我相信這一切都是值得的。\n71876\t85753\t我仍然是以做公僕的心態來服務大家希望能夠符合我爸爸的要求接下來還是要利用這次總質詢的機會來就教您三個認為是重要的問題\n87503\t114029\t一個是癌症防治的篩檢問題一個是癌症信號基金已經有很多委員都提過另外就是我們可以研議是否能夠成立國家B肝防治辦公室這三個問題那癌症防治尤其在篩檢的部分是有它很重要的角色您是這方面的專家應該很清楚癌症已經是過去41年來對台灣民眾\n116792\t116812\t韓國瑜議員\n146769\t174689\t一、二的新進步能夠盡量的來減少還正對民眾的死亡的威脅。那我們也看得出來從過去20年前的5年的存活率46.1%到目前為止我們已經提升到61.5%也就是說過去25年來20年來其實已經有把這個存活率提升到了15.4個百分比可是\n175779\t200615\t相較於韓國他的五年存活率是70%日本是65%所以我們其實還是有很大的要進步的空間那要進步的空間我想身為這個醫師專業的戴清德總統當選人他其實非常有感受所以他很希望打造健康台灣的過程要把這個\n201718\t213433\t到2030年要把這個癌症死亡率死亡人數可以下降三分之一那這個就是我們未來必須要共同努力的方向那三分之一的概念就是\n215046\t215066\t委員長\n245407\t249597\t你覺得或者是你認同目前臺灣執行中的這個五大癌症的篩檢\n250708\t274720\t他是有合乎我們目前預設的目標還有你滿意這些成果嗎?在目前為止我們大口如指這個四個癌症的篩檢是2024年我在當衛生署署長的時候大力在推動。推動的時候就如同你這裡寫的一樣實際上我們看到死亡率是有在明顯的下降。我們跟美國國家癌症研究中心有做過\n275760\t275780\t韓國瑜議員\n300137\t302218\t的確肺癌篩檢用使用這個低劑量的這個檢查\n325819\t352982\t其實在一個週年就能夠拯救了500個家庭這是一個很好的數字我們也知道在這個過程裡面其實它可以發揮更多的效益出來因為這些透過篩檢檢查出來的病人基本上都是一個很早期的癌症經過適當的治療幾乎他都可以痊癒的不過我們還是會擔心我們看到的就是篩檢率\n354246\t383056\t如果篩檢有這麼好的成果那為什麼我們的篩檢率能不能夠有辦法適度的再提升因為我們看到其實民眾參與這個篩檢的理論上我們希望更高當然相較於全球各國並不是比較差可是我們希望既然有這麼好的成果那有辦法再提升嗎因為我們看到了其實只有40%的民眾他符合條件可是呢他\n384519\t409852\t來篩檢的這個機會就損失掉了,非常非常的可惜。那我們也特別關注到有一些民眾他是陽篩所謂陽篩就是初步檢查看起來是需要再持續做後續處理的那大腸癌的這個陽篩的我們看到的百分比相較於乳癌相較於子宮頸癌就真的差很多那這部分\n411212\t416580\t您是專家那目前到底有什麼樣的因素會讓我們的民眾對於篩檢\n418681\t419822\t韓國瑜主席\n445644\t445664\t韓國瑜議員\n468689\t470109\t對,這真的是非常可惜那這邊我們也了解到\n498277\t525638\t其實影響國人篩檢意願的可能因素就包括我們所列出來的這幾項其中有一些是沒有時間有一些是不方便或者是說他很擔心不然事情要檢查要做什麼這個都是會讓民眾不願意參加篩檢的原因那很謝謝院長還有謝謝部長這邊也期待透過國民健康署去擬定各種更好的方法來讓民眾知道\n526209\t526229\t韓國瑜\n552022\t553883\t我印象中大概要30千塊錢目前\n581789\t606514\t一般的費用是4000到5000塊,那這個對民眾來講它其實是一個負擔,因為它一方面增加不方便,一方面它可能請假,尤其是在公司請假,它要做先前的準備,又要自費的負擔,所以我們很容易理解為什麼這一部分它的這個揚罪率是不如預期,那請問部長或\n607841\t609282\t目前大概是這樣子的以前的話這種篩檢陽性的話那要\n623263\t645336\t找這個病人到醫院去,都是由篩檢者,也就是說像是衛生所、基層的醫師去把他轉介過來。但是這樣子是效果不會很好,所以我們目前的做法是我們希望由醫院先把這個篩檢陽性的名單給醫院,由醫院去把他找來。\n646460\t673366\t那找來的好處就是他就可以安排時間是比較能夠符合病人的需要的那至於剛剛委員提到的無痛的麻醉的費用的話這我們可以再來討論一下看看是不是在這方面也有做補助那當然有一個部分的話是可能跟勞動部相關的也就請假了這個問題那這個看看能不能要一起來做配合\n674434\t693537\t好,謝謝。其實我們也很建議如果能夠有研議出一些節稅的措施來減少他的這個不方便同時又能夠讓他納入為一個免稅額的話那也許也是另外一種可行的方案。其實我們很期待企業界如果他是\n694070\t714224\t﹚議員﹚\n714224\t714244\t﹚廣告\n731332\t731512\t﹚王正旭\n760842\t760862\t請問院長\n771563\t793945\t現在我們知道每一年會有27億28億的癌症篩檢費用那我們看到的編列出來如果要到2030年期待能夠真的把這個癌症死亡率減低三分之一的話我們看到了這個編列的經費就要逐年增加甚至將近100億可是我們發現這個陰害的基金已經越來越不足\n794725\t810277\t不知道院長在這方面在預算的編列有沒有什麼更充分的穩定的裁員。在這個部分我們也希望這個衛福部特別是國建署他能夠編列一個比較有\n812414\t835345\t響聲的這個癌症防治計畫特別在篩檢的部分那當然他們本身也要做更好的規劃看怎麼樣來做那這個經費的話如果要達到我們要死亡率下降三分之一的話確實篩檢扮演一個很重要很重要的一個角色然後預防當然也是很重要那在這一個部分我想我們可以來責成\n836425\t862699\t我們衛福部還有國建署這邊特別提出這一個好更精進的這個癌症防治計畫然後來編列相關的經費。好謝謝那再過來就有關的信用基金的部分那剛剛部長也說明了很清楚其實目前看起來這個暫時性的專管應該是透過這個公務預算的撥補指定用途\n863513\t887409\t然後經由健保署來統一運作節省整個行政的經費跟俗稱的健保總額其實是沒有關聯的所以這部分的運用將來應該會受到行政跟立法的監督而不是跟健保委員會那邊是分開的我的認知知道是不是正確我們的規劃的確是這樣\n890951\t915116\t行政院這邊如果預算撥補到健保基金裡面去的話這個仍然是屬於公務預算所以仍然要經過立法院這邊的審查所以並沒有說要去迴避這所謂的審查只不過因為這是公務預算的本質所以可能在健保會上面的話那就是沒有就是說不能去左右\n923067\t923167\t第16屆秋委員會議\n","txt":"麻煩再請陳院長備詢。謝謝您當年給我的證書。這是幫助很多年輕學子進入到這個生命科學領域一本很重要的著作。特別令人感動的就是在書本上有閱讀到了您的父親\n在您晉升教授的時候提供給您的期許和祝福,見證您後來在學術上擔任的中央研究院的院士,在政治上也擔任的副總統,現在又擔任行政院長的工作。相信大部分的民眾會和我一樣\n我衷心的感謝您對台灣人民的全心全力的付出。您的父親應該也會讚許您的成就。或許他也會捨不得您現在的辛苦。不過我相信這一切都是值得的。\n我仍然是以做公僕的心態來服務大家希望能夠符合我爸爸的要求接下來還是要利用這次總質詢的機會來就教您三個認為是重要的問題\n一個是癌症防治的篩檢問題一個是癌症信號基金已經有很多委員都提過另外就是我們可以研議是否能夠成立國家B肝防治辦公室這三個問題那癌症防治尤其在篩檢的部分是有它很重要的角色您是這方面的專家應該很清楚癌症已經是過去41年來對台灣民眾\n韓國瑜議員\n一、二的新進步能夠盡量的來減少還正對民眾的死亡的威脅。那我們也看得出來從過去20年前的5年的存活率46.1%到目前為止我們已經提升到61.5%也就是說過去25年來20年來其實已經有把這個存活率提升到了15.4個百分比可是\n相較於韓國他的五年存活率是70%日本是65%所以我們其實還是有很大的要進步的空間那要進步的空間我想身為這個醫師專業的戴清德總統當選人他其實非常有感受所以他很希望打造健康台灣的過程要把這個\n到2030年要把這個癌症死亡率死亡人數可以下降三分之一那這個就是我們未來必須要共同努力的方向那三分之一的概念就是\n委員長\n你覺得或者是你認同目前臺灣執行中的這個五大癌症的篩檢\n他是有合乎我們目前預設的目標還有你滿意這些成果嗎?在目前為止我們大口如指這個四個癌症的篩檢是2024年我在當衛生署署長的時候大力在推動。推動的時候就如同你這裡寫的一樣實際上我們看到死亡率是有在明顯的下降。我們跟美國國家癌症研究中心有做過\n韓國瑜議員\n的確肺癌篩檢用使用這個低劑量的這個檢查\n其實在一個週年就能夠拯救了500個家庭這是一個很好的數字我們也知道在這個過程裡面其實它可以發揮更多的效益出來因為這些透過篩檢檢查出來的病人基本上都是一個很早期的癌症經過適當的治療幾乎他都可以痊癒的不過我們還是會擔心我們看到的就是篩檢率\n如果篩檢有這麼好的成果那為什麼我們的篩檢率能不能夠有辦法適度的再提升因為我們看到其實民眾參與這個篩檢的理論上我們希望更高當然相較於全球各國並不是比較差可是我們希望既然有這麼好的成果那有辦法再提升嗎因為我們看到了其實只有40%的民眾他符合條件可是呢他\n來篩檢的這個機會就損失掉了,非常非常的可惜。那我們也特別關注到有一些民眾他是陽篩所謂陽篩就是初步檢查看起來是需要再持續做後續處理的那大腸癌的這個陽篩的我們看到的百分比相較於乳癌相較於子宮頸癌就真的差很多那這部分\n您是專家那目前到底有什麼樣的因素會讓我們的民眾對於篩檢\n韓國瑜主席\n韓國瑜議員\n對,這真的是非常可惜那這邊我們也了解到\n其實影響國人篩檢意願的可能因素就包括我們所列出來的這幾項其中有一些是沒有時間有一些是不方便或者是說他很擔心不然事情要檢查要做什麼這個都是會讓民眾不願意參加篩檢的原因那很謝謝院長還有謝謝部長這邊也期待透過國民健康署去擬定各種更好的方法來讓民眾知道\n韓國瑜\n我印象中大概要30千塊錢目前\n一般的費用是4000到5000塊,那這個對民眾來講它其實是一個負擔,因為它一方面增加不方便,一方面它可能請假,尤其是在公司請假,它要做先前的準備,又要自費的負擔,所以我們很容易理解為什麼這一部分它的這個揚罪率是不如預期,那請問部長或\n目前大概是這樣子的以前的話這種篩檢陽性的話那要\n找這個病人到醫院去,都是由篩檢者,也就是說像是衛生所、基層的醫師去把他轉介過來。但是這樣子是效果不會很好,所以我們目前的做法是我們希望由醫院先把這個篩檢陽性的名單給醫院,由醫院去把他找來。\n那找來的好處就是他就可以安排時間是比較能夠符合病人的需要的那至於剛剛委員提到的無痛的麻醉的費用的話這我們可以再來討論一下看看是不是在這方面也有做補助那當然有一個部分的話是可能跟勞動部相關的也就請假了這個問題那這個看看能不能要一起來做配合\n好,謝謝。其實我們也很建議如果能夠有研議出一些節稅的措施來減少他的這個不方便同時又能夠讓他納入為一個免稅額的話那也許也是另外一種可行的方案。其實我們很期待企業界如果他是\n﹚議員﹚\n﹚廣告\n﹚王正旭\n請問院長\n現在我們知道每一年會有27億28億的癌症篩檢費用那我們看到的編列出來如果要到2030年期待能夠真的把這個癌症死亡率減低三分之一的話我們看到了這個編列的經費就要逐年增加甚至將近100億可是我們發現這個陰害的基金已經越來越不足\n不知道院長在這方面在預算的編列有沒有什麼更充分的穩定的裁員。在這個部分我們也希望這個衛福部特別是國建署他能夠編列一個比較有\n響聲的這個癌症防治計畫特別在篩檢的部分那當然他們本身也要做更好的規劃看怎麼樣來做那這個經費的話如果要達到我們要死亡率下降三分之一的話確實篩檢扮演一個很重要很重要的一個角色然後預防當然也是很重要那在這一個部分我想我們可以來責成\n我們衛福部還有國建署這邊特別提出這一個好更精進的這個癌症防治計畫然後來編列相關的經費。好謝謝那再過來就有關的信用基金的部分那剛剛部長也說明了很清楚其實目前看起來這個暫時性的專管應該是透過這個公務預算的撥補指定用途\n然後經由健保署來統一運作節省整個行政的經費跟俗稱的健保總額其實是沒有關聯的所以這部分的運用將來應該會受到行政跟立法的監督而不是跟健保委員會那邊是分開的我的認知知道是不是正確我們的規劃的確是這樣\n行政院這邊如果預算撥補到健保基金裡面去的話這個仍然是屬於公務預算所以仍然要經過立法院這邊的審查所以並沒有說要去迴避這所謂的審查只不過因為這是公務預算的本質所以可能在健保會上面的話那就是沒有就是說不能去左右\n第16屆秋委員會議\n","vtt":"WEBVTT\n\n00:01.370 --> 00:29.124\n麻煩再請陳院長備詢。謝謝您當年給我的證書。這是幫助很多年輕學子進入到這個生命科學領域一本很重要的著作。特別令人感動的就是在書本上有閱讀到了您的父親\n\n00:30.083 --> 00:50.900\n在您晉升教授的時候提供給您的期許和祝福,見證您後來在學術上擔任的中央研究院的院士,在政治上也擔任的副總統,現在又擔任行政院長的工作。相信大部分的民眾會和我一樣\n\n00:52.073 --> 01:10.685\n我衷心的感謝您對台灣人民的全心全力的付出。您的父親應該也會讚許您的成就。或許他也會捨不得您現在的辛苦。不過我相信這一切都是值得的。\n\n01:11.876 --> 01:25.753\n我仍然是以做公僕的心態來服務大家希望能夠符合我爸爸的要求接下來還是要利用這次總質詢的機會來就教您三個認為是重要的問題\n\n01:27.503 --> 01:54.029\n一個是癌症防治的篩檢問題一個是癌症信號基金已經有很多委員都提過另外就是我們可以研議是否能夠成立國家B肝防治辦公室這三個問題那癌症防治尤其在篩檢的部分是有它很重要的角色您是這方面的專家應該很清楚癌症已經是過去41年來對台灣民眾\n\n01:56.792 --> 01:56.812\n韓國瑜議員\n\n02:26.769 --> 02:54.689\n一、二的新進步能夠盡量的來減少還正對民眾的死亡的威脅。那我們也看得出來從過去20年前的5年的存活率46.1%到目前為止我們已經提升到61.5%也就是說過去25年來20年來其實已經有把這個存活率提升到了15.4個百分比可是\n\n02:55.779 --> 03:20.615\n相較於韓國他的五年存活率是70%日本是65%所以我們其實還是有很大的要進步的空間那要進步的空間我想身為這個醫師專業的戴清德總統當選人他其實非常有感受所以他很希望打造健康台灣的過程要把這個\n\n03:21.718 --> 03:33.433\n到2030年要把這個癌症死亡率死亡人數可以下降三分之一那這個就是我們未來必須要共同努力的方向那三分之一的概念就是\n\n03:35.046 --> 03:35.066\n委員長\n\n04:05.407 --> 04:09.597\n你覺得或者是你認同目前臺灣執行中的這個五大癌症的篩檢\n\n04:10.708 --> 04:34.720\n他是有合乎我們目前預設的目標還有你滿意這些成果嗎?在目前為止我們大口如指這個四個癌症的篩檢是2024年我在當衛生署署長的時候大力在推動。推動的時候就如同你這裡寫的一樣實際上我們看到死亡率是有在明顯的下降。我們跟美國國家癌症研究中心有做過\n\n04:35.760 --> 04:35.780\n韓國瑜議員\n\n05:00.137 --> 05:02.218\n的確肺癌篩檢用使用這個低劑量的這個檢查\n\n05:25.819 --> 05:52.982\n其實在一個週年就能夠拯救了500個家庭這是一個很好的數字我們也知道在這個過程裡面其實它可以發揮更多的效益出來因為這些透過篩檢檢查出來的病人基本上都是一個很早期的癌症經過適當的治療幾乎他都可以痊癒的不過我們還是會擔心我們看到的就是篩檢率\n\n05:54.246 --> 06:23.056\n如果篩檢有這麼好的成果那為什麼我們的篩檢率能不能夠有辦法適度的再提升因為我們看到其實民眾參與這個篩檢的理論上我們希望更高當然相較於全球各國並不是比較差可是我們希望既然有這麼好的成果那有辦法再提升嗎因為我們看到了其實只有40%的民眾他符合條件可是呢他\n\n06:24.519 --> 06:49.852\n來篩檢的這個機會就損失掉了,非常非常的可惜。那我們也特別關注到有一些民眾他是陽篩所謂陽篩就是初步檢查看起來是需要再持續做後續處理的那大腸癌的這個陽篩的我們看到的百分比相較於乳癌相較於子宮頸癌就真的差很多那這部分\n\n06:51.212 --> 06:56.580\n您是專家那目前到底有什麼樣的因素會讓我們的民眾對於篩檢\n\n06:58.681 --> 06:59.822\n韓國瑜主席\n\n07:25.644 --> 07:25.664\n韓國瑜議員\n\n07:48.689 --> 07:50.109\n對,這真的是非常可惜那這邊我們也了解到\n\n08:18.277 --> 08:45.638\n其實影響國人篩檢意願的可能因素就包括我們所列出來的這幾項其中有一些是沒有時間有一些是不方便或者是說他很擔心不然事情要檢查要做什麼這個都是會讓民眾不願意參加篩檢的原因那很謝謝院長還有謝謝部長這邊也期待透過國民健康署去擬定各種更好的方法來讓民眾知道\n\n08:46.209 --> 08:46.229\n韓國瑜\n\n09:12.022 --> 09:13.883\n我印象中大概要30千塊錢目前\n\n09:41.789 --> 10:06.514\n一般的費用是4000到5000塊,那這個對民眾來講它其實是一個負擔,因為它一方面增加不方便,一方面它可能請假,尤其是在公司請假,它要做先前的準備,又要自費的負擔,所以我們很容易理解為什麼這一部分它的這個揚罪率是不如預期,那請問部長或\n\n10:07.841 --> 10:09.282\n目前大概是這樣子的以前的話這種篩檢陽性的話那要\n\n10:23.263 --> 10:45.336\n找這個病人到醫院去,都是由篩檢者,也就是說像是衛生所、基層的醫師去把他轉介過來。但是這樣子是效果不會很好,所以我們目前的做法是我們希望由醫院先把這個篩檢陽性的名單給醫院,由醫院去把他找來。\n\n10:46.460 --> 11:13.366\n那找來的好處就是他就可以安排時間是比較能夠符合病人的需要的那至於剛剛委員提到的無痛的麻醉的費用的話這我們可以再來討論一下看看是不是在這方面也有做補助那當然有一個部分的話是可能跟勞動部相關的也就請假了這個問題那這個看看能不能要一起來做配合\n\n11:14.434 --> 11:33.537\n好,謝謝。其實我們也很建議如果能夠有研議出一些節稅的措施來減少他的這個不方便同時又能夠讓他納入為一個免稅額的話那也許也是另外一種可行的方案。其實我們很期待企業界如果他是\n\n11:54.224 --> 11:54.244\n﹚廣告\n\n12:11.332 --> 12:11.512\n﹚王正旭\n\n12:40.842 --> 12:40.862\n請問院長\n\n12:51.563 --> 13:13.945\n現在我們知道每一年會有27億28億的癌症篩檢費用那我們看到的編列出來如果要到2030年期待能夠真的把這個癌症死亡率減低三分之一的話我們看到了這個編列的經費就要逐年增加甚至將近100億可是我們發現這個陰害的基金已經越來越不足\n\n13:14.725 --> 13:30.277\n不知道院長在這方面在預算的編列有沒有什麼更充分的穩定的裁員。在這個部分我們也希望這個衛福部特別是國建署他能夠編列一個比較有\n\n13:32.414 --> 13:55.345\n響聲的這個癌症防治計畫特別在篩檢的部分那當然他們本身也要做更好的規劃看怎麼樣來做那這個經費的話如果要達到我們要死亡率下降三分之一的話確實篩檢扮演一個很重要很重要的一個角色然後預防當然也是很重要那在這一個部分我想我們可以來責成\n\n13:56.425 --> 14:22.699\n我們衛福部還有國建署這邊特別提出這一個好更精進的這個癌症防治計畫然後來編列相關的經費。好謝謝那再過來就有關的信用基金的部分那剛剛部長也說明了很清楚其實目前看起來這個暫時性的專管應該是透過這個公務預算的撥補指定用途\n\n14:23.513 --> 14:47.409\n然後經由健保署來統一運作節省整個行政的經費跟俗稱的健保總額其實是沒有關聯的所以這部分的運用將來應該會受到行政跟立法的監督而不是跟健保委員會那邊是分開的我的認知知道是不是正確我們的規劃的確是這樣\n\n14:50.951 --> 15:15.116\n行政院這邊如果預算撥補到健保基金裡面去的話這個仍然是屬於公務預算所以仍然要經過立法院這邊的審查所以並沒有說要去迴避這所謂的審查只不過因為這是公務預算的本質所以可能在健保會上面的話那就是沒有就是說不能去左右\n\n15:23.067 --> 15:23.167\n第16屆秋委員會議\n\n","segments":[{"start":1.37,"end":29.124,"text":"麻煩再請陳院長備詢。謝謝您當年給我的證書。這是幫助很多年輕學子進入到這個生命科學領域一本很重要的著作。特別令人感動的就是在書本上有閱讀到了您的父親"},{"start":30.083,"end":50.9,"text":"在您晉升教授的時候提供給您的期許和祝福,見證您後來在學術上擔任的中央研究院的院士,在政治上也擔任的副總統,現在又擔任行政院長的工作。相信大部分的民眾會和我一樣"},{"start":52.073,"end":70.685,"text":"我衷心的感謝您對台灣人民的全心全力的付出。您的父親應該也會讚許您的成就。或許他也會捨不得您現在的辛苦。不過我相信這一切都是值得的。"},{"start":71.876,"end":85.753,"text":"我仍然是以做公僕的心態來服務大家希望能夠符合我爸爸的要求接下來還是要利用這次總質詢的機會來就教您三個認為是重要的問題"},{"start":87.503,"end":114.029,"text":"一個是癌症防治的篩檢問題一個是癌症信號基金已經有很多委員都提過另外就是我們可以研議是否能夠成立國家B肝防治辦公室這三個問題那癌症防治尤其在篩檢的部分是有它很重要的角色您是這方面的專家應該很清楚癌症已經是過去41年來對台灣民眾"},{"start":116.792,"end":116.812,"text":"韓國瑜議員"},{"start":146.769,"end":174.689,"text":"一、二的新進步能夠盡量的來減少還正對民眾的死亡的威脅。那我們也看得出來從過去20年前的5年的存活率46.1%到目前為止我們已經提升到61.5%也就是說過去25年來20年來其實已經有把這個存活率提升到了15.4個百分比可是"},{"start":175.779,"end":200.615,"text":"相較於韓國他的五年存活率是70%日本是65%所以我們其實還是有很大的要進步的空間那要進步的空間我想身為這個醫師專業的戴清德總統當選人他其實非常有感受所以他很希望打造健康台灣的過程要把這個"},{"start":201.718,"end":213.433,"text":"到2030年要把這個癌症死亡率死亡人數可以下降三分之一那這個就是我們未來必須要共同努力的方向那三分之一的概念就是"},{"start":215.046,"end":215.066,"text":"委員長"},{"start":245.407,"end":249.597,"text":"你覺得或者是你認同目前臺灣執行中的這個五大癌症的篩檢"},{"start":250.708,"end":274.72,"text":"他是有合乎我們目前預設的目標還有你滿意這些成果嗎?在目前為止我們大口如指這個四個癌症的篩檢是2024年我在當衛生署署長的時候大力在推動。推動的時候就如同你這裡寫的一樣實際上我們看到死亡率是有在明顯的下降。我們跟美國國家癌症研究中心有做過"},{"start":275.76,"end":275.78,"text":"韓國瑜議員"},{"start":300.137,"end":302.218,"text":"的確肺癌篩檢用使用這個低劑量的這個檢查"},{"start":325.819,"end":352.982,"text":"其實在一個週年就能夠拯救了500個家庭這是一個很好的數字我們也知道在這個過程裡面其實它可以發揮更多的效益出來因為這些透過篩檢檢查出來的病人基本上都是一個很早期的癌症經過適當的治療幾乎他都可以痊癒的不過我們還是會擔心我們看到的就是篩檢率"},{"start":354.246,"end":383.056,"text":"如果篩檢有這麼好的成果那為什麼我們的篩檢率能不能夠有辦法適度的再提升因為我們看到其實民眾參與這個篩檢的理論上我們希望更高當然相較於全球各國並不是比較差可是我們希望既然有這麼好的成果那有辦法再提升嗎因為我們看到了其實只有40%的民眾他符合條件可是呢他"},{"start":384.519,"end":409.852,"text":"來篩檢的這個機會就損失掉了,非常非常的可惜。那我們也特別關注到有一些民眾他是陽篩所謂陽篩就是初步檢查看起來是需要再持續做後續處理的那大腸癌的這個陽篩的我們看到的百分比相較於乳癌相較於子宮頸癌就真的差很多那這部分"},{"start":411.212,"end":416.58,"text":"您是專家那目前到底有什麼樣的因素會讓我們的民眾對於篩檢"},{"start":418.681,"end":419.822,"text":"韓國瑜主席"},{"start":445.644,"end":445.664,"text":"韓國瑜議員"},{"start":468.689,"end":470.109,"text":"對,這真的是非常可惜那這邊我們也了解到"},{"start":498.277,"end":525.638,"text":"其實影響國人篩檢意願的可能因素就包括我們所列出來的這幾項其中有一些是沒有時間有一些是不方便或者是說他很擔心不然事情要檢查要做什麼這個都是會讓民眾不願意參加篩檢的原因那很謝謝院長還有謝謝部長這邊也期待透過國民健康署去擬定各種更好的方法來讓民眾知道"},{"start":526.209,"end":526.229,"text":"韓國瑜"},{"start":552.022,"end":553.883,"text":"我印象中大概要30千塊錢目前"},{"start":581.789,"end":606.514,"text":"一般的費用是4000到5000塊,那這個對民眾來講它其實是一個負擔,因為它一方面增加不方便,一方面它可能請假,尤其是在公司請假,它要做先前的準備,又要自費的負擔,所以我們很容易理解為什麼這一部分它的這個揚罪率是不如預期,那請問部長或"},{"start":607.841,"end":609.282,"text":"目前大概是這樣子的以前的話這種篩檢陽性的話那要"},{"start":623.263,"end":645.336,"text":"找這個病人到醫院去,都是由篩檢者,也就是說像是衛生所、基層的醫師去把他轉介過來。但是這樣子是效果不會很好,所以我們目前的做法是我們希望由醫院先把這個篩檢陽性的名單給醫院,由醫院去把他找來。"},{"start":646.46,"end":673.366,"text":"那找來的好處就是他就可以安排時間是比較能夠符合病人的需要的那至於剛剛委員提到的無痛的麻醉的費用的話這我們可以再來討論一下看看是不是在這方面也有做補助那當然有一個部分的話是可能跟勞動部相關的也就請假了這個問題那這個看看能不能要一起來做配合"},{"start":674.434,"end":693.537,"text":"好,謝謝。其實我們也很建議如果能夠有研議出一些節稅的措施來減少他的這個不方便同時又能夠讓他納入為一個免稅額的話那也許也是另外一種可行的方案。其實我們很期待企業界如果他是"},{"start":694.07,"end":714.224,"text":"﹚議員﹚"},{"start":714.224,"end":714.244,"text":"﹚廣告"},{"start":731.332,"end":731.512,"text":"﹚王正旭"},{"start":760.842,"end":760.862,"text":"請問院長"},{"start":771.563,"end":793.945,"text":"現在我們知道每一年會有27億28億的癌症篩檢費用那我們看到的編列出來如果要到2030年期待能夠真的把這個癌症死亡率減低三分之一的話我們看到了這個編列的經費就要逐年增加甚至將近100億可是我們發現這個陰害的基金已經越來越不足"},{"start":794.725,"end":810.277,"text":"不知道院長在這方面在預算的編列有沒有什麼更充分的穩定的裁員。在這個部分我們也希望這個衛福部特別是國建署他能夠編列一個比較有"},{"start":812.414,"end":835.345,"text":"響聲的這個癌症防治計畫特別在篩檢的部分那當然他們本身也要做更好的規劃看怎麼樣來做那這個經費的話如果要達到我們要死亡率下降三分之一的話確實篩檢扮演一個很重要很重要的一個角色然後預防當然也是很重要那在這一個部分我想我們可以來責成"},{"start":836.425,"end":862.699,"text":"我們衛福部還有國建署這邊特別提出這一個好更精進的這個癌症防治計畫然後來編列相關的經費。好謝謝那再過來就有關的信用基金的部分那剛剛部長也說明了很清楚其實目前看起來這個暫時性的專管應該是透過這個公務預算的撥補指定用途"},{"start":863.513,"end":887.409,"text":"然後經由健保署來統一運作節省整個行政的經費跟俗稱的健保總額其實是沒有關聯的所以這部分的運用將來應該會受到行政跟立法的監督而不是跟健保委員會那邊是分開的我的認知知道是不是正確我們的規劃的確是這樣"},{"start":890.951,"end":915.116,"text":"行政院這邊如果預算撥補到健保基金裡面去的話這個仍然是屬於公務預算所以仍然要經過立法院這邊的審查所以並沒有說要去迴避這所謂的審查只不過因為這是公務預算的本質所以可能在健保會上面的話那就是沒有就是說不能去左右"},{"start":923.067,"end":923.167,"text":"第16屆秋委員會議"}]}}}}