{"id":152115,"url":"https://ivod.ly.gov.tw/Play/Clip/1M/152115","video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/6f015fe8e6787db1573dd57fff0b7bd9d575e50b9cd8685a55be169921a0a717620d634c767349af5ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"賴惠員","委員發言時間":"12:25:33 - 12:31:39","影片長度":"00:06:06","會議時間":"2024-05-02T09:00:00+08:00","會議名稱":"立法院第11屆第1會期社會福利及衛生環境委員會第14次全體委員會議（事由：審查\n一、委員王育敏等19人擬具「全民健康保險法第六十二條條文修正草案」案。\n二、委員蘇清泉等28人擬具「全民健康保險法第六十二條條文修正草案」案。\n三、國民黨黨團擬具「全民健康保險法第六十二條條文修正草案」案。\n【以上議案，如經復議則不予審查】）","date":"2024-05-02","meet":{"tmpMeeting":null,"title":"第11屆第1會期社會福利及衛生環境委員會第14次全體委員會議","term":11,"type":"委員會","sessionPeriod":1,"sessionTimes":14,"committees":[26],"id":"委員會-11-1-26-14"},"duration":366,"end_time":"2024-05-02T12:31:39+08:00","start_time":"2024-05-02T12:25:33+08:00","features":["ai-transcript","gazette"],"type":"Clip","gazette":{"lineno":1074,"blocks":[["賴委員惠員：（12時25分）謝謝主席，有請石署長。"],["主席：好，請署長。"],["石署長崇良：賴委員好。"],["賴委員惠員：署長，從84年開始，我們的健保實施到現在已經接近30年了，這個30年當中，其實在基層醫界的點值長期是沒有調整的，沒有調整的過程當中，我們看這一次醫師公會的統計，去年第三季基層醫療院所的點值除了臺北的東區高於1以外，其他的分區都是沒有達到點值1，甚至在臺北的0.81是最低的，我相信署長對這個議題向來不陌生，就是基層醫院所非常難生存，尤其在不斷的通膨的狀況之下，我想跟署長討論一下這個議題。","我們都知道基層醫療院所是在整個醫療的第一線，我要特別謝謝衛福部部長及署長，剛才提到燈塔式的獨立總額，其實你們兩位就是醫界的燈塔，我們也希望看到明亮的地方。基層醫療院所長期存在的困境就是點值沒有辦法調升，甚至去年新冠肺炎降級以後，衛福部的專案補助不見了，回歸到健保的總額，之後我們發現更大的困難就是點值大幅下降，請教署長這個問題有沒有改善的方式呢？"],["石署長崇良：跟委員報告，去年點值會大幅下降，一方面是因為疫情的關係，所以後面就用健保基金去補點值，最終都是保證到0.9，這是一個。另外，我們在整個分析之後，如果跟疫情前相比，有發現兩個現象造成點值下降的影響因素，第一個就是支付標準的調整，因為點數都上來了。第二個就是慢性病病人的移動，持慢性處方箋在基層就醫的情形有增加，過去以簡表也就是日劑藥費支付方式會有很大的藥費落差，因為慢性病病人的藥費是比較高的，所以就會影響到整個基層的總額。所以也就是說未來在整個總額的設算上，特別是基層總額的部分，我們也要另外再有一些調整的機制。"],["賴委員惠員：謝謝署長，慢箋的用藥調整在疫情降級以後，點值的部分引起基層上很大的恐慌，我們有做到很好的預備就是補償，針對我們的預算預估不準確，是不是應該要調整計算的機制？111年的總額到112年的總額，我們適用在113年預算的預估值的話，那我們有沒有機會做一個比較好的計算機制，可以對健保有比較彈性的調整空間，有沒有思考過這樣的問題？"],["石署長崇良：我們也有在思考讓總額有點彈性，其實我們在沒有更好的管理機制之前，總額還是必行之務，但是總額也不要讓它那麼僵硬，可以有一些彈性，大家都可以更進一步來探討。"],["賴委員惠員：署長，因應這一次調漲電價，2.4億是用在地區醫院的補貼，對300多家地區醫院的補貼，2.4億已經核定了，至於1萬多家基層醫療院所的電費補貼，現行的狀況是怎麼樣？"],["郭專門委員威中：電費補貼是在3月27號由行政院……"],["賴委員惠員：請你大聲一點好不好？"],["郭專門委員威中：在3月27號行政院有一個協商會議……"],["賴委員惠員：基層醫療院所？"],["郭專門委員威中：目前那個部分是說列入明年的總額，就是整個醫療機構裡面列入……"],["賴委員惠員：列入明年的總額？所以就表示是沒有的？"],["郭專門委員威中：對。"],["賴委員惠員：表示是沒有的，所以我在這裡也要跟署長、部長請命，我們都知道基層醫療院所有其特殊的醫療服務，站在第一線上，我覺得基本上是要照顧他們的，因為你知道所有的醫療補貼全部都是跟著上來，基層醫療院所其實被照顧是比較不足的，以上是跟署長、部長做一個提醒，謝謝。"],["主席：謝謝賴委員。","接下來請顏寬恒、顏寬恒、顏寬恒委員不在。","請楊委員曜發言。"]],"agenda":{"page_end":242,"meet_id":"委員會-11-1-26-14","speakers":["王育敏","蘇清泉","陳昭姿","陳菁徽","林月琴","黃秀芳","邱鎮軍","涂權吉","廖偉翔","劉建國","王正旭","林淑芬","林德福","賴士葆","李彥秀","盧縣一","楊瓊瓔","黃國昌","賴惠員","陳瑩","楊曜"],"page_start":167,"meetingDate":["2024-05-02"],"gazette_id":"1133901","agenda_lcidc_ids":["1133901_00004"],"meet_name":"立法院第11屆第1會期社會福利及衛生環境委員會第14次全體委員會議紀錄","content":"審查一、委員王育敏等18人擬具「全民健康保險法第六十二條條文修正草案」案；二、委員蘇清\n泉等27人擬具「全民健康保險法第六十二條條文修正草案」案；三、國民黨黨團擬具「全民健康\n保險法第六十二條條文修正草案」案","agenda_id":"1133901_00003"}},"transcript":{"id":"152115","pyannote":{"name":"ronny","tool":"pyannote","data":{"url":"https://ivod.ly.gov.tw/Play/Clip/1M/152115","tool":"pyannote","id":"152115-pyannote"},"job_id":"FmrRpRBwiZ8NnCGu","queued_at":"2024-05-31 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00:06:00,114\n謝謝賴委員\n\n","tsv":"start\tend\ttext\n6256\t31438\t謝謝主席,有請那個是署長,好請,是署長。好,署長,那個謝謝。延續就是從84年開始,就是我們的健保實施到現在已經接近了30年了。那這個30年的當中其實在基層醫界的一個點子長期是沒有調整的。\n32039\t50043\t�\n50043\t68524\t�\n68524\t94224\t�\n94224\t120674\t\n120774\t149810\tadequ�的一個問題我要請教署長有沒有一個改善的方式呢?跟委員報告當然去年的這個點值會有大幅的下降一方面是因為疫情的關係所以那個後面就用這個我們的一個健保基金去補那個點值所以最終都是把它保證到0.9這是一個那第二個我們在整個分析之後如果跟疫情前相比\n150430\t154991\tbicyn 此慢性處方簽在基層就醫的情形有增加。 bicyn 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