{"id":153792,"url":"https://ivod.ly.gov.tw/Play/Clip/1M/153792","video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/065bcaf30f002e2b760726d9d4d36c64eab218bf194c2065f338aa976a9cb1d944c33f9589bb011c5ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"林憶君","委員發言時間":"16:03:17 - 16:34:48","影片長度":"00:31:31","會議時間":"2024-06-11T09:00:00+08:00","會議名稱":"第11屆第1會期第17次會議（事由：一、對行政院院長報告施政方針繼續質詢。 \n二、6月7日上午9時至10時為國是論壇時間。\n三、6月11日下午1時50分至2時30分為處理臨時提案時間。）","type":"Clip","date":"2024-06-11","start_time":"2024-06-11T16:03:17+08:00","end_time":"2024-06-11T16:34:48+08:00","duration":1891,"meet":{"tmpMeeting":null,"title":"立法院第11屆第1會期第17次會議","id":"院會-11-1-17","type":"院會","term":11,"sessionPeriod":1,"sessionTimes":17},"features":["ai-transcript","gazette"],"gazette":{"lineno":336,"blocks":[["林委員憶君：（16時3分）有請行政院卓榮泰院長。"],["主席：院長請備詢。"],["卓院長榮泰：林委員好。"],["林委員憶君：院長好。院長，我想請問一下，一個好山好水的花東地區，交通不方便，每逢颱風還有地震，都沒有順利回家的路，難道這是身為東部人的命運嗎？"],["卓院長榮泰：謝謝委員。花東鄉親因長期受限於地理環境與天然資源影響，在交通上確實是比較不方便。但是政府從過去到現在，也投入相當大的資源在解決花東的問題，只是受限於剛剛所說的地理環境、天然資源以及地質問題，以致很多事情做起來，人還是難以勝天。不過對於花東鄉親在其他，包括觀光發展、產業推動等等，政府一定會持續做很多事情，給花東鄉親一個更好的環境。"],["林委員憶君：好，正如院長說的，但每次遇到天災，還有道路中斷時，農民要運送農產品非常不方便，連生病的患者要就醫都求救無路，因為那一條路阻斷了，所以遊客進不來，花蓮人也出不去，難道花蓮人就要翻山越嶺嗎？難道花東人只要一條安全回家的道路有那麼困難嗎？所以我再次強調，花蓮不只是臺灣的後山，其實花東面對太平洋，應該是臺灣面向國際、走向國際的前哨站，請院長還有部長務必要正視花東地區交通的重要性，請你們要將心比心。"],["卓院長榮泰：好，謝謝委員，我一向主張臺灣轉向、面向海洋，花蓮將成為我們的大門。上次0403地震之後，針對清水斷橋，我們還是在最快時間內，交通部及工程會持續的努力，讓它在最短時間內可以順暢通車，就是為了讓大型卡車進出能得到紓解，要把貨都能運出來，這個我們已經如期達成了，當然後續還有很多要做的，交通部應該有更縝密的計畫。"],["李部長孟諺：跟委員報告，從這次0403的地震可以看得出來，過去蘇花改所做的這些隧道、橋梁的狀況都非常好，表示它的抗震、耐震能力是非常的好。這次我們也持續去推動蘇花安，要把整個快速路網系統連通，蘇花安也很快的在今年5月14號已經通過環評，所以我們現在開始進入相關的設計階段，如果順利的話，我們希望明年底以前可以辦理相關招標，這樣的話，整個路廊打通一直到新城，可以連接國5，整個花蓮就可以有一個安全、快速的道路。"],["林委員憶君：好，剛才院長說到0403，其實從花蓮地震到現在，我們花蓮人往返臺北的蘇花公路持續都有小小的餘震嘛，所以都還有落石和土石流，像上禮拜一大家可能都注意到基隆那邊的公園發生山崩，但其實在同一天，花蓮的蘇花公路崇德隧道北端的山壁也發生了嚴重的坍方，甚至有三層樓高的落石，所以我還是希望早日給我們花蓮人一條安全回家的路是絕對必要的。","剛才也講到了蘇花安，蘇花安作為花蓮人安全回家的最後一塊拼圖，可行性評估剛才也說過2月份通過了，現在進入環評階段，其實環境部在5月14號召開了台9線的蘇花公路安全提升計畫環境影響說明書專案小組第二次環評初審會議，也同意了本案通過初審。但是再回想之前，針對我們的規劃已經落後了2年，以前是119年就可以完工，現在變成以121年完工為目標，交通部公路總局的局長說，如果一切都順利的話，能在今年8月取得環評大會審查修正通過，希望年底建設計畫就能核定，明年提出設計規劃，明年8月開始取得用地，並同步執行都市計畫變更的程序，期待116年初就可以發包施工。照這樣的話，整個蘇花安的經費從原本的360億元到現在評估階段已經暴增了802億元，但是考慮到蘇花公路每年都是道路封閉，還有經濟上的損失，其實落石、土石流造成公路損害維修的費用，平均攤下來可能也不比興建蘇花安的費用節省多少。最主要是大家都知道，更重要的是人命是無價的。所以請問院長和部長，蘇花安到底什麼時候可以真正完工通車？你們可知道花蓮人其實已經等不及了，因為你們執政那麼久，花蓮人等到民心都已經失去了，真的有把握在116年能夠發包施工嗎？還是說那時候又要採取拖延戰術繼續欺騙花蓮人呢？因為過去民進黨選舉的時候都開了很多的支票，例如副總統蕭美琴過去競選花蓮區域立委的時候就提出高鐵東延、花東快鐵，現任外交部長林佳龍在擔任交通部長時也喊了西部高鐵、東部快鐵，以及2030年全國快速鐵路網的規劃，6小時我們就可以環台；前交通部長王國材也說環島高鐵不是夢，但是為什麼到現在花東的交通新建設一點動靜都沒有呢？民進黨執政8年來，多項交通政策現在都變成了空頭支票，所以我們想請院長還有部長可以儘快給予專業意見和看法，讓全國民眾瞭解，不是用政治語言欺騙大眾，企圖讓東部居民充滿期待，卻又讓社會大眾產生更多的誤解和對立。"],["卓院長榮泰：委員，如果這是一張空頭支票，就不會有今年5月14號環評初審的通過，那麼持續下來會做環境影響評估，再來就會進入更細部的計畫，我們會來……"],["林委員憶君：對，所以可以監督一下它的進度，因為我看到的是比之前的規劃已經慢了2年了，我不曉得後面還要慢多久！"],["卓院長榮泰：我們可以把速度加快，但這絕對不是一張空頭支票，我們一起來讓花東鄉親能夠安心，持續的往前做，這已經在程序當中了，現在會一步步地做下去。"],["林委員憶君：好。"],["李部長孟諺：跟委員報告，花東鐵路雙軌化也已經在陸續發包進行，這樣可以讓整個花東鐵路提速，現階段我們也把全國最好、最新的車廂都用在花東，像是EMU3000，太魯閣號的座位數是三百多個，它的座位數可以到五百多個，我們把運量最好、最大的車專門來跑花東線，所以這些都代表……"],["林委員憶君：是的，但是你知道，如果道路被阻斷的時候，其實火車票也是一票難求的。"],["李部長孟諺：是，所以這也代表政府持續對花東投入相當多經費跟關注，蘇花安目前就是，我想所有的交通建設最需要等待的就是環評，蘇花安很不容易的已經在5月14號環評初審通過，預計7月份大會或者8月份大會就可以正式核定，接著就是進入公建計畫的核定以及細設、設計的招標，我們114年底就可以陸續有工程來辦理招標。"],["林委員憶君：好，希望這個可以在進度裡面……"],["李部長孟諺：現在還有一個要突破的就是，整個蘇花安還有兩個部落需要諮商同意，部落擔心快速道路經過他們的部落反而會造成部落的人口流失或者是商機降低，這個在發包前要取得部落的同意，這是我們相關法規的規定，所以這個部分還要努力，目前大概唯一的變數是在這個地方。"],["林委員憶君：好，我再問一個問題，交通部在2020年的時候有重啟花東快速道路的可行性評估，預計要在8月的時候出爐，但是2020年到2024年耗時4年了，做了重大的評估，有把握在8月份可以做嗎？這可以解決花東人數十年來交通不便的痛苦，你們覺得在8月份出爐評估報告，部長，你覺得這個是有把握可以做嗎？"],["李部長孟諺：8月份是報告可以出來，當然還要經過一些審查的階段，現在大概幾個關鍵，一個就是整個投資的益本比是不是符合投資的效益，通常益本比要到1才會有投資效益。再來就是預算的容納，還有一個是環評，因為這是一條新的快速道路，所以要做二階的環評，環評是不是能夠讓它核准通過，能不能順利的approve這個部分。最後還有一個階段，就是在開工前，根據目前的瞭解，沿線一百七十幾公里有11個部落，這11個部落都要諮商同意後才可以來辦理發包，這是在發包前必須要取得同意，我想這些變數大概都是我們未來要再去持續突破的地方。"],["林委員憶君：好，所以其實政府不應該先畫大餅，之後又說不太可能，因為先操作東西區域不平衡的問題，之後再來說是國家財政的困難或是環評有窒礙難行的理由，然後逃避花東地區交通建設的責任。我是希望說，當然很期待，兩個月後8月份的時候，交通部的評估結果也會基於這樣的審查法案的預算，然後我們也會善盡立院監督行政部門以解決花東的交通、照顧人民的責任，所以希望請院長還有部長，務必讓我們花東重大交通的道路工程能夠儘早推動，給花東人一條安全快速可以回家的道路，一條幸福安全的回家大道。"],["卓院長榮泰：報告委員，這不是大餅，這是一條直線，全長179公里的直線，有17個交流道，總經費達到2,555億，當中還有剛剛部長說的，11個部落的同意諮商要去處理。跟剛剛那個一樣，我們跟部落的溝通一定要加強，我已經跟部長說過了，儘量去說服他們，希望他們能夠理解這個重大公共工程的重要性，能夠縮短互相溝通的時間，就能把這些報告早日完成，整個工程的期程才能夠更提前來完成，這是我們共同的目標。所以，這是一條直線的、179公里的長度，我們絕對不開空頭支票……"],["林委員憶君：好，謝謝院長，希望大家一起努力，因為這真的是花東人的期待，希望大家都能聽到花東人民的聲音。謝謝。"],["李部長孟諺：那也跟委員報告，因為目前政府各種法令都有規範做相關重大建設所應該要做的一些程序，所以不是我們去找困難來搪塞，而是相關的像環評法令、部落諮商的法令、水保的法令等等，都有一定的規範，我們必須要去遵守。"],["林委員憶君：我再問一下院長，因為院長在此次的施政報告中提到，你親自擔任0403花蓮地震專案小組的召集人。有關此次的地震，除了希望行政院能夠真正徹底執行震災復原的重建方案，解決花蓮災民的問題之外，臺灣東部第一所綜合大學國立東華大學，地震後學校的建物在強震中有受損，其中理工學院有一棟是整個燒毀的，宿舍有1,700床也沒有辦法使用，然後校方估計大約重建總經費是20億元。在這一次0403的花蓮地震，東華大學理工學院一館D棟的化學實驗室，因為地震發生火災，燒了20個小時，整棟全毀。雖然花蓮縣消防局也有馬上前往救援，但是因為現場內存放的都是禁水性的化學物質，不能用水來撲滅，所以消防人員進退兩難。","據瞭解，當時花蓮縣的消防局向宜蘭還有高雄請求化學災害處理車支援，但是台9線因為地震，已經山壁坍崩斷裂了，所以連最近的宜蘭消防局也沒有辦法前往，而高雄消防局的路途太遙遠了，所以結果就是花蓮縣消防局只有出動一般的化學消防車在那邊待命，等到整個實驗室的化學物品全部燃燒完畢之後，才能進入火場檢視。據瞭解，一般的化學消防車是用水混合泡沫進行救災，適用於油類火災的話，要用更高級的化學災害處理車，因為會配備A級防護車，還有濾毒罐的整個設備。其實此次東華大學實驗室存放的化學物質造成的火警，需要化學災害處理車來進行救援，所以顯示花東地區現在最大的缺乏就是化學災害處理消防車，如果天災發生的時候，道路中斷的時候，西部的消防車真的是遠水救不了近火，而無法在第一個時間產生救援的效果。","鄭文燦前副院長上一次在卸任前有到花蓮，在5月4號那一次有特別在花蓮召開0403震災復原重建專案會議，在那個會議中，我當時也有建議，提示要求東華大學化學實驗室儲放多種化學物質，強震導致化學物品引發大火，所以有關爭取相關所需要的化學搶救車等救災的車輛，有請內政部消防署統籌處理。請問院長，內政部在此是否可以允諾本席同意補助或直接提供花蓮縣還是臺東縣各兩臺乾粉或其他特別滅火藥劑的化學災害處理消防車呢？因為這可以因應特殊的化學物質所引發的火災，強化消防救災的效能，也避免花東地區再次發生這種設備不足而造成的遺憾事件。請問院長，你身為專案小組召集人，那可以答應補助嗎？"],["卓院長榮泰：謝謝委員，由我本人來擔任專案小組的召集人，請鄭麗君副院長來負責督導，我們要讓花蓮的鄉親真正看到政府的誠意跟決心，我們一定提高效率，對計劃及早核可，補助也及早的到位。有關於東華大學校舍的改建，工程會直接在現場負責，剛剛委員所說的化學消防車，我們在當天也有到學校，我也到了學校，我們也看到學校的狀況，校長也非常專業、誠懇地提出他的需求，內政部也已經有進度，請部長報告一下。"],["劉部長世芳：是，跟委員報告一下，其實卓院長在當時就已經有指示，我們在明年度會先補助一輛禁水性的化學災防消防車，其實花蓮縣政府還有當天參加會勘的委員都已經知道了。"],["林委員憶君：所以就是補助一輛就對了？"],["劉部長世芳：不是，因為禁水性的化學消防車沒有那麼容易，跟一般的化學泡沫消防車不太一樣，它必須要有特殊的救護機制，所以我們先用一輛，何況現在以花蓮或者是以臺東來講，需要用禁水性化學物質的量並沒有那麼多，如果未來還有需要的話，我們還可以再做中長程計畫的調整。"],["林委員憶君：其實東部真的是需要啦！因為在道路萬一有中斷的情況下，其實我們花東人民的性命還是很重要的。"],["卓院長榮泰：而且東華大樓那一棟出事的大樓要整棟拆除重建，工程會非常積極在處理。"],["陳主任委員金德：跟委員報告，D棟就是化學館，化學館整個要異地重建，那我們希望教育部在督導東華大學重建的過程，因為是化學館，所以內部整個意外災害的配置、救災的程序演練，那麼東華大學都必須事先來考慮之後再做設計。至於消防車是在每個縣市配置，但是不會配置在學校裡面，所以這個化學館將來化學藥品的分布、在遇到災害的時候應該怎麼救護，這些在重建的過程當中都必須要列入考慮。根據目前的進度，相關的重建跟部分的修復大概會在113年到115年陸續完成。"],["林委員憶君：好，謝謝。那我現在有請衛福部部長。"],["主席：衛福部部長請備詢。"],["邱部長泰源：委員好。"],["林委員憶君：院長、部長好，本席今天想要請教一個有關處方箋格式統一的問題，因為最近有很多基層的藥師特別跟本席陳情，他們說像臺北市立醫院有分為好幾個院區，就是今天有人到昆明院區去就醫，然後拿著醫生釋出的慢性處方箋到社區藥局去領藥，然後跟到林森院區去看病後，拿到醫生釋出的慢性處方箋到外面社區藥局去領藥，其實拿這兩個不同院區的處方箋領藥應該不會有不一樣的結果，對不對？"],["邱部長泰源：應該都要一致的。"],["林委員憶君：對，應該是都一樣的嘛！但是問題來了，自從84年開辦全民健保到現在，因為時空環境的轉變，很多家醫院已經開始整併了，然後各院區都有一個共用的醫事機構代碼，但是卻有不同的層級而會影響到部分負擔，因為我們在112年有做部分負擔的調整，就是依照我們醫院的層級，像基層診所、地區醫院、區域醫院還有醫學中心，然後我們在拿藥時的部分負擔是不一樣的。現在我想要問一個問題，就是像臺北市立聯合醫院是共用醫事機構代碼，然後地區和區域醫院、教學的層級所釋出的一般處方箋和慢性處方箋上面的機構代碼居然是一樣的。"],["邱部長泰源：我想門診交付處方箋是按照醫師法第十三條，各特約醫院院所應該要依法以及健保署公告的格式來開立處方，當然代碼有分為剛剛委員所講的，應該它是哪一級的醫院就是哪一個代碼嘛！"],["林委員憶君：對，因為這個我覺得很奇怪，像我們花蓮的門諾醫院，包括它的壽豐分院，還有其他的，每一個醫事代碼都不同。"],["邱部長泰源：會不會是因為它不同體系裡面也有區域醫院，也有地區醫院而有所不同，這個可能我們要來瞭解一下。"],["林委員憶君：我覺得更誇張的是，因為我在醫策會的醫療評鑑系統裡面去查昆明院區和林森院區，居然上面寫的是地區醫院喔！但是昆明院區居然收的藥費的部分負擔是收基層診所的收費規則，當然處方箋上面整個格式都沒有標明清楚，沒有標明清楚的時候，社區藥局會遺漏收了部分負擔，所以這個樣子就是說，健保藥物處方箋格式沒有統一還有不完全，其實是增加社區藥局藥師在登載健保申報系統的交付藥上面還有複合藥物的困難度。"],["邱部長泰源：是，如果沒有統一的話，我想我們要找所有的醫療院所來討論，希望能夠……"],["林委員憶君：對啊！部長，你可以看一下……"],["邱部長泰源：不然會造成取藥上面的困擾。"],["林委員憶君：因為我也覺得很奇怪，為什麼電腦上面寫這兩間是地區醫院？結果居然到了昆明院區，收費的時候是收基層診所的藥費的部分負擔，因為到時候到社區藥局去拿藥的時候，其實病人會反映，所以健保的處方箋一定要統一，而且它統一的時候，它一定要有一些……就是統一格式，它可能要將醫療院所的層級標明清楚。","現在社區藥局拿到一個藥、慢性處方箋的藥，他根本不知道這個……他要去查這個是區域醫院、地區醫院還是教學醫院，變成他要去查這些，然後像剛才我跟你說的，就是包括電腦查的都錯誤了，所以相對他會給病人收錯錢，當然病患就會反映。所以這個部分我覺得要把醫療院所的層級，還有部分負擔，還有福利身分，這些影響申報、收取部分負擔的欄位要全部補齊，當然全部補齊之後，大家來社區藥局拿藥的時候也可以降低藥師的複合藥物還有登載申報系統的困難。當然這樣的話，我們給病人收錢的時候也不會引起爭議。因為常常拿到處方箋的時候都在看到底這家是地區醫院還是區域醫院，然後收費又不一樣，光是查這個就要很久，包括還要再登錄。還有一點，萬一那時候收錯了，病人又會去反映，所以我覺得這個可能是要檢討的地方哦！"],["卓院長榮泰：謝謝委員的提醒，臺北市聯合醫院有很多院區，是不是針對不同院區的規模，它有這樣內部的細分，抱歉，我倒是真的不清楚，但是為了要讓作業能夠一致化，尤其是市民、患者在拿取藥品的時候能夠覺得安心跟可以稽查，我想衛福部應該跟臺北市來瞭解一下，它的聯合醫院是不是有這種層級上不同的……"],["林委員憶君：對，我覺得是應該要瞭解，因為包括這樣處方箋會造成……"],["邱部長泰源：它是哪一級就應該是哪一級，要寫清楚。"],["林委員憶君：對、對、對，因為在電腦查的時候它是地區醫院，結果居然收費的時候是用基層診所，然後……"],["邱部長泰源：當然像臺北市過去傳統以來，有時候會有一些福利優待、特殊的族群，會不會跟這個稍微沒有把它分得很清楚……"],["林委員憶君：所以最好可以把處方箋統一格式，我們處方箋統一格式，包括以後我們推動的電子處方箋，我們都可以陸續統一格式，大家在登載方面，還有在我們給病患收費方面都非常的清楚，還有這個病人的身分方面，其實我覺得這個都是整個可能要一個統一處方箋……"],["邱部長泰源：好，這我們一定會來釐清，來統一、來釐清。"],["林委員憶君：好，謝謝部長。還有一個，當然我非常的肯定，最近這幾年衛福部在愛滋病防護政策上面，其實推動的成績非常好，我在這邊要給衛福部很大的肯定。但是因為最近社區藥局和疾病管制署他們有一個特約，就是針對人類免疫缺乏病毒指定藥局，就是HIV的部分，他們要去拿藥，那個藥局就叫做友善藥局。因為社區藥局它願意發愛滋病病人的藥，其實這個已經會有一點點就是說他們要發揮愛心啦！"],["邱部長泰源：對。"],["林委員憶君：因為當初這個政策要實施的時候，其實很多社區藥局不見得會願意，因為今天HIV的病人會來拿藥，而這些願意來服務這些病友的，我們都叫做友善藥局，到113年4月25號已經有111家友善藥局投入，但是現在重點來了，因為愛滋病慢箋藥物一個人一次的藥物是15,000元，其實它是非常昂貴的，而且廠商會要求友善藥局要支付現金，然後常常是隔月就要付款，我想購買藥物應該都知道就是這樣，但實際上健保暫付的成數，其實是在健保申報15天之後只有撥低於85%，剩下的金額要60天內才會付清，但這對現在社區友善藥局的金流是一個非常非常大的壓力，所以我在想是不是要麻煩衛福部可以提高愛滋健保處方箋的暫付成數？因為如果一個月有200個病人，其實它的負擔很重，金流壓得非常大，但是15天之後我們只暫付給他們低於85%，所以看可不可以將暫付成數改成暫付95%呢？這樣讓他們金流上的壓力沒那麼大，然後可以服務更多的病友，可以幫助更多愛滋病患者拿藥。"],["邱部長泰源：謝謝。我真的很感謝友善藥局願意來承擔這些，讓病友能夠更方便拿到藥，然後提升控制力，真的非常感謝。所有的行政作業理論上應該用到最方便，但是這個給付的問題其實是按照全民健保醫療費用申報與核付及醫療服務審查辦法第六條的規定辦理，如果這個項目要改變，可能整個所有項目都要改變，但是我們一定來檢討……"],["林委員憶君：可以將這個藥物切出來，因為這個藥物非常貴，它要一萬五嘛！但是他們幫助這些病友其實是負了很大的金流壓力，而且是馬上就要付錢，但我們只先給他們低於85%的錢，這樣我覺得是有點不太合理啦！所以是不是針對這個藥物，就是針對這111家的這個藥物，我們切出來，或許就先支付到95%，因為本來就是應該支付百分之百，只是說一個是60天後再付給他們，但我們就提高付給他們，讓他們不要有那麼大的金流壓力。"],["邱部長泰源：我想以紙本是八成五，但如果以電子的話，有時候是支付九成五啦，我想我們來想辦法付到更高。"],["林委員憶君：對啊！我看可不可以15天之後，大家都給低於85%，但是光這個藥物就好了，不見得是整個，就是只有這個藥物，因為這些藥局真的是幫助這些病友很多，我覺得他們自己也發了很大的愛心，所以這個情況不要再造成他們金流上面的壓力，是不是就光這個藥物，對這些藥局我們可以切開，不見得是整個，我知道你們的難處，但是光這個藥物，我們可以先補足到95%，讓他們能更願意服務這些病友，然後推動我們的政策。"],["卓院長榮泰：謝謝委員的體諒，我們在現行法律規定底下，我請衛福部如何對友善藥局能夠給它更友善的環境跟條件，我們往這個方向來想，才能夠遵照委員剛剛的指示，我們來做一個比較周延的研議，好不好？"],["邱部長泰源：是。"],["林委員憶君：好，謝謝。","院長、部長，你們知道洗腎或手術輸液使用最大的就是生理食鹽水，對不對？上個月臺灣輸液大廠有違規遭勒令關廠的問題，其餘藥廠產能也沒有辦法補足這個缺口。我們現在從這個問題來看，其實我認為我們必須要從國防外交的戰略角度來看從國內到國外原料鏈的資源布置，還有儲備，還有全面性找出供應斷鏈危機的問題，其實這個是怕兩岸關係萬一生變的時候，我們還是要有一個戰備管制藥品的安全存量。"],["卓院長榮泰：是，穩定的國內生產數量，跟像這次的專案進口，好像明天就會實際發生一個很好的結果，我們請衛福部能夠持續關注，而且緊盯不放。"],["林委員憶君：好，謝謝。"],["卓院長榮泰：謝謝委員。"],["主席：好，謝謝，謝謝林委員，謝謝卓院長。","下一位請王委員美惠質詢。"]],"agenda":{"page_end":173,"meet_id":"院會-11-1-17","speakers":["江啟臣","陳秀寳","葛如鈞","黃建賓","劉建國","柯志恩","沈伯洋","萬美玲","吳沛憶","王鴻薇","范雲","王育敏","李坤城","林憶君","王美惠","邱志偉"],"page_start":89,"meetingDate":["2024-06-11"],"gazette_id":"1135401","agenda_lcidc_ids":["1135401_00003","1135401_00004"],"meet_name":"立法院第11屆第1會期第17次會議紀錄","content":"施政質詢\n對行政院院長報告施政方針繼續質詢─ 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{\"word\": \"憶\"}, {\"word\": \"君\", \"start\": 547.191, \"end\": 547.211, \"score\": 0.0}]}, {\"start\": 564.1, \"end\": 584.629, \"text\": \"兩個部落需要諮商同意那這個部落他們擔心快速道路經過他們的部落反而會造成部落的人口流失或是商機降低所以這個還要這個在發包錢要取得部落的同意這是我們相關的法規的規定所以這個部分還要努力目前大概唯一的變數是在這個地方\", \"words\": [{\"word\": \"兩\"}, {\"word\": \"個\"}, {\"word\": \"部\", \"start\": 564.1, \"end\": 564.24, \"score\": 0.893}, {\"word\": \"落\", \"start\": 564.24, \"end\": 564.4, \"score\": 0.987}, {\"word\": \"需\", \"start\": 564.4, \"end\": 564.52, \"score\": 0.998}, {\"word\": \"要\", \"start\": 564.52, \"end\": 564.941, \"score\": 0.951}, {\"word\": \"諮\"}, {\"word\": \"商\", \"start\": 564.941, \"end\": 565.201, \"score\": 0.935}, {\"word\": \"同\", \"start\": 565.201, \"end\": 565.481, \"score\": 0.998}, {\"word\": \"意\", \"start\": 565.481, \"end\": 566.101, \"score\": 0.967}, {\"word\": \"那\", \"start\": 566.101, \"end\": 566.441, \"score\": 0.865}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"部\", \"start\": 566.441, \"end\": 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580.347, \"end\": 580.527, \"score\": 0.776}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"部\", \"start\": 580.527, \"end\": 580.627, \"score\": 0.8}, {\"word\": \"分\", \"start\": 580.627, \"end\": 580.827, \"score\": 0.8}, {\"word\": \"還\"}, {\"word\": \"要\", \"start\": 580.827, \"end\": 580.947, \"score\": 0.993}, {\"word\": \"努\", \"start\": 580.947, \"end\": 581.147, \"score\": 0.994}, {\"word\": \"力\", \"start\": 581.147, \"end\": 581.588, \"score\": 1.0}, {\"word\": \"目\", \"start\": 581.588, \"end\": 581.708, \"score\": 1.0}, {\"word\": \"前\", \"start\": 581.708, \"end\": 581.908, \"score\": 0.901}, {\"word\": \"大\", \"start\": 581.908, \"end\": 582.008, \"score\": 0.801}, {\"word\": \"概\", \"start\": 582.008, \"end\": 582.188, \"score\": 0.889}, {\"word\": \"唯\", \"start\": 582.188, \"end\": 582.328, \"score\": 0.997}, {\"word\": \"一\", \"start\": 582.328, \"end\": 582.468, \"score\": 1.0}, {\"word\": \"的\", \"start\": 582.468, \"end\": 583.668, \"score\": 0.953}, 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1024.546, \"end\": 1025.327, \"score\": 0.991}, {\"word\": \"計\"}, {\"word\": \"畫\"}, {\"word\": \"及\", \"start\": 1025.327, \"end\": 1026.388, \"score\": 0.943}, {\"word\": \"早\", \"start\": 1026.388, \"end\": 1026.588, \"score\": 0.996}, {\"word\": \"合\", \"start\": 1026.588, \"end\": 1026.768, \"score\": 0.955}, {\"word\": \"可\", \"start\": 1026.768, \"end\": 1026.788, \"score\": 0.957}]}, {\"start\": 1027.996, \"end\": 1028.957, \"text\": \"請部長報告一下\", \"words\": [{\"word\": \"請\"}, {\"word\": \"部\", \"start\": 1027.996, \"end\": 1028.156, \"score\": 0.875}, {\"word\": \"長\"}, {\"word\": \"報\"}, {\"word\": \"告\", \"start\": 1028.156, \"end\": 1028.857, \"score\": 0.971}, {\"word\": \"一\", \"start\": 1028.857, \"end\": 1028.937, \"score\": 0.75}, {\"word\": \"下\", \"start\": 1028.937, \"end\": 1028.957, \"score\": 0.0}]}, {\"start\": 1049.119, \"end\": 1064.271, \"text\": \"是,跟委員報告一下,其實卓院長在當時的時候已經有指示,我們在明年度的時候呢,會先補助一輛近水性的化學災防的消防車,那其實花蓮縣政府還有當天參加這個會刊的委員都已經知道了。\", \"words\": [{\"word\": 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{\"word\": \"呢\", \"start\": 1054.723, \"end\": 1055.604, \"score\": 0.954}, {\"word\": \",\"}, {\"word\": \"會\"}, {\"word\": \"先\", \"start\": 1055.604, \"end\": 1056.004, \"score\": 0.926}, {\"word\": \"補\"}, {\"word\": \"助\", \"start\": 1056.004, \"end\": 1056.165, \"score\": 0.974}, {\"word\": \"一\", \"start\": 1056.165, \"end\": 1057.005, \"score\": 0.974}, {\"word\": \"輛\"}, {\"word\": \"近\", \"start\": 1057.005, \"end\": 1057.225, \"score\": 0.926}, {\"word\": \"水\", \"start\": 1057.225, \"end\": 1057.405, \"score\": 1.0}, {\"word\": \"性\", \"start\": 1057.405, \"end\": 1057.566, \"score\": 0.935}, {\"word\": \"的\", \"start\": 1057.566, \"end\": 1057.706, \"score\": 0.998}, {\"word\": \"化\", \"start\": 1057.706, \"end\": 1057.906, \"score\": 0.995}, {\"word\": \"學\", \"start\": 1057.906, \"end\": 1058.326, \"score\": 0.905}, {\"word\": \"災\"}, {\"word\": \"防\", \"start\": 1058.326, \"end\": 1058.466, \"score\": 0.863}, {\"word\": \"的\", \"start\": 1058.466, \"end\": 1058.566, \"score\": 0.855}, {\"word\": \"消\", \"start\": 1058.566, \"end\": 1058.747, \"score\": 0.971}, {\"word\": \"防\", \"start\": 1058.747, \"end\": 1059.247, \"score\": 0.938}, {\"word\": \"車\"}, {\"word\": \",\"}, {\"word\": \"那\", \"start\": 1059.247, \"end\": 1059.527, \"score\": 0.997}, {\"word\": \"其\", \"start\": 1059.527, \"end\": 1059.947, \"score\": 0.952}, {\"word\": \"實\"}, {\"word\": \"花\", \"start\": 1059.947, \"end\": 1060.408, \"score\": 0.904}, {\"word\": \"蓮\"}, {\"word\": \"縣\"}, {\"word\": \"政\", \"start\": 1060.408, \"end\": 1060.568, \"score\": 0.887}, {\"word\": \"府\", \"start\": 1060.568, \"end\": 1060.828, \"score\": 0.859}, {\"word\": \"還\"}, {\"word\": \"有\", \"start\": 1060.828, \"end\": 1061.529, \"score\": 0.962}, {\"word\": \"當\"}, {\"word\": \"天\", \"start\": 1061.529, \"end\": 1062.149, \"score\": 0.906}, {\"word\": \"參\"}, {\"word\": \"加\", \"start\": 1062.149, \"end\": 1062.97, \"score\": 0.903}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"會\"}, {\"word\": \"刊\", \"start\": 1062.97, \"end\": 1063.15, \"score\": 0.985}, {\"word\": \"的\", \"start\": 1063.15, \"end\": 1063.27, \"score\": 0.997}, {\"word\": \"委\", \"start\": 1063.27, \"end\": 1063.57, \"score\": 0.904}, {\"word\": \"員\"}, {\"word\": \"都\", \"start\": 1063.57, \"end\": 1063.71, \"score\": 0.858}, {\"word\": \"已\", \"start\": 1063.71, \"end\": 1063.951, \"score\": 0.914}, {\"word\": \"經\"}, {\"word\": \"知\", \"start\": 1063.951, \"end\": 1064.071, \"score\": 0.945}, {\"word\": \"道\", \"start\": 1064.071, \"end\": 1064.251, \"score\": 0.975}, {\"word\": \"了\", \"start\": 1064.251, \"end\": 1064.271, \"score\": 0.992}, {\"word\": \"。\"}]}, {\"start\": 1065.485, \"end\": 1086.197, \"text\": \"所以就是補助儀量這樣就對了?不是,因為進水性的化學消防車沒有那麼容易,跟一般的化學消防車泡沫消防車不太一樣,所以它必須要有特殊的救護的機制,所以我們先用儀量,何況現在以花蓮或者是以台東來講,需要用進水性的化學物質的量沒有那麼多,那如果未來還有需要的話,我們還可以再做中長程計畫的調整。\", \"words\": [{\"word\": \"所\", \"start\": 1065.485, \"end\": 1065.625, \"score\": 0.864}, {\"word\": \"以\", \"start\": 1065.625, 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\"end\": 1205.818, \"text\": \"應該都要一致的。\", \"words\": [{\"word\": \"應\"}, {\"word\": \"該\"}, {\"word\": \"都\", \"start\": 1205.578, \"end\": 1205.638, \"score\": 0.667}, {\"word\": \"要\", \"start\": 1205.638, \"end\": 1205.658, \"score\": 0.0}, {\"word\": \"一\", \"start\": 1205.658, \"end\": 1205.678, \"score\": 0.0}, {\"word\": \"致\", \"start\": 1205.678, \"end\": 1205.798, \"score\": 0.833}, {\"word\": \"的\", \"start\": 1205.798, \"end\": 1205.818, \"score\": 0.0}, {\"word\": \"。\"}]}, {\"start\": 1219.209, \"end\": 1222.731, \"text\": \"對對對應該是都一樣的嘛但是這個就問題來了因為自從84年開辦全民健保到現在因為時空環境的轉變許多很多家醫院已經開始整病了然後各院區都有一個共用醫事機構代碼但是卻有不同的層級喔而會影響到部分負擔因為我們今天我們112年有一個部分負擔的調整嘛\", \"words\": [{\"word\": \"對\"}, {\"word\": \"對\"}, {\"word\": \"對\"}, {\"word\": \"應\"}, {\"word\": \"該\"}, {\"word\": \"是\", \"start\": 1219.209, \"end\": 1219.229, \"score\": 0.0}, {\"word\": \"都\", \"start\": 1219.229, \"end\": 1219.369, \"score\": 0.856}, {\"word\": \"一\", \"start\": 1219.369, \"end\": 1219.449, \"score\": 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{\"word\": \"以\", \"start\": 1270.945, \"end\": 1270.965, \"score\": 0.0}, {\"word\": \"及\", \"start\": 1270.965, \"end\": 1271.005, \"score\": 0.5}, {\"word\": \"健\", \"start\": 1271.005, \"end\": 1271.105, \"score\": 0.8}, {\"word\": \"保\", \"start\": 1271.105, \"end\": 1271.125, \"score\": 0.0}, {\"word\": \"署\", \"start\": 1271.125, \"end\": 1271.185, \"score\": 0.667}, {\"word\": \"公\", \"start\": 1271.185, \"end\": 1271.205, \"score\": 0.0}, {\"word\": \"告\", \"start\": 1271.205, \"end\": 1271.225, \"score\": 0.0}, {\"word\": \"的\", \"start\": 1271.225, \"end\": 1271.245, \"score\": 0.0}, {\"word\": \"格\", \"start\": 1271.245, \"end\": 1271.285, \"score\": 0.5}, {\"word\": \"式\", \"start\": 1271.285, \"end\": 1271.505, \"score\": 0.92}, {\"word\": \"來\"}, {\"word\": \"開\"}, {\"word\": \"立\", \"start\": 1271.505, \"end\": 1271.685, \"score\": 0.888}, {\"word\": \"處\"}, {\"word\": \"方\", \"start\": 1271.685, \"end\": 1271.826, \"score\": 0.857}, {\"word\": \"。\"}, {\"word\": \"那\", 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1822.152, \"score\": 0.002}, {\"word\": \"角\", \"start\": 1822.152, \"end\": 1822.172, \"score\": 0.0}, {\"word\": \"度\", \"start\": 1822.172, \"end\": 1822.292, \"score\": 0.833}, {\"word\": \"來\"}, {\"word\": \"看\", \"start\": 1822.292, \"end\": 1822.312, \"score\": 0.0}, {\"word\": \"這\"}, {\"word\": \"個\"}, {\"word\": \"從\"}, {\"word\": \"國\"}, {\"word\": \"內\"}, {\"word\": \"到\", \"start\": 1822.312, \"end\": 1822.352, \"score\": 0.051}, {\"word\": \"國\"}, {\"word\": \"外\", \"start\": 1822.352, \"end\": 1822.372, \"score\": 0.0}, {\"word\": \"的\", \"start\": 1822.372, \"end\": 1822.472, \"score\": 0.86}, {\"word\": \"原\", \"start\": 1822.472, \"end\": 1822.492, \"score\": 0.0}, {\"word\": \"料\", \"start\": 1822.492, \"end\": 1822.512, \"score\": 0.0}, {\"word\": \"鏈\"}, {\"word\": \"﹚\"}, {\"word\": \"林\", \"start\": 1841.237, \"end\": 1841.557, \"score\": 0.937}, {\"word\": \"憶\"}, {\"word\": \"君\", \"start\": 1841.557, \"end\": 1841.577, \"score\": 0.0}, {\"word\": \"﹚\"}, {\"word\": \"好\", \"start\": 1869.704, \"end\": 1871.668, \"score\": 0.949}, {\"word\": \",\"}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"。\"}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"林\", \"start\": 1871.668, \"end\": 1871.849, \"score\": 0.903}, {\"word\": \"委\", \"start\": 1871.849, \"end\": 1873.712, \"score\": 0.968}, {\"word\": \"員\"}, {\"word\": \"。\"}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"卓\", \"start\": 1873.712, \"end\": 1873.873, \"score\": 0.875}, {\"word\": \"院\", \"start\": 1873.873, \"end\": 1874.735, \"score\": 0.955}, {\"word\": \"長\"}, {\"word\": \"。\"}, {\"word\": \"下\", \"start\": 1874.735, \"end\": 1874.935, \"score\": 0.892}, {\"word\": \"一\", \"start\": 1874.935, \"end\": 1875.015, \"score\": 0.75}, {\"word\": \"位\", \"start\": 1875.015, \"end\": 1877.46, \"score\": 0.985}, {\"word\": \"請\"}, {\"word\": \"王\", \"start\": 1877.46, \"end\": 1877.701, \"score\": 0.996}, {\"word\": \"委\", \"start\": 1877.701, \"end\": 1878.021, \"score\": 0.937}, {\"word\": \"員\"}, {\"word\": \"美\", \"start\": 1878.021, \"end\": 1878.041, \"score\": 0.889}, {\"word\": \"會\"}, {\"word\": \"質\"}, {\"word\": \"詢\"}, {\"word\": \"。\"}], \"language\": \"zh\"}","srt":"1\n00:00:00,268 --> 00:00:00,449\n主席\n\n2\n00:00:35,382 --> 00:00:38,165\n有請行政院卓榮泰院長。來,院長請備詢。議員好。\n\n3\n00:00:50,302 --> 00:01:04,878\n院長好。院長我想請問一下,一個好山好水的花東地區,交通不方便,每逢颱風還有地震,都沒有順利回家的路,難道這是身為東部人的命運嗎?\n\n4\n00:01:07,209 --> 00:01:25,797\n謝謝委員花東的鄉親因為長期這個地理環境天然資源所受他這個交通上確實是比較不方便但是政府從過去到現在也投入相當大的資源在整個解決花東的問題但是受限剛剛所說的這個地理的環境\n\n5\n00:01:26,457 --> 00:01:28,558\n政府一定會持續地做很多事情來給花中的鄉親一個更好的環境。\n\n6\n00:01:47,768 --> 00:02:01,986\n好,是正如院長說的,但是每次遇到天災還有道路中斷的時候,然後農民要運送農產品非常的不方便,還有連生病的患者要就醫都求救無路,然後遊客又來條路。\n\n7\n00:02:03,188 --> 00:02:03,408\n﹚林憶君﹚\n\n8\n00:02:30,507 --> 00:02:31,849\n請你們要將心比心。\n\n9\n00:02:45,484 --> 00:02:45,504\n﹚廣告\n\n10\n00:03:01,894 --> 00:03:26,546\n這一次的0403的地震可以看得出來過去蘇花改蘇花改所做的這些隧道橋樑都非常的都還狀況非常的好表示他的抗震耐震的能力是非常的好所以這一次我們也持續的來推動蘇花安那要把把整個整個快速的入網的系統把它連通那蘇花安也很快在\n\n11\n00:03:27,226 --> 00:03:27,366\n﹚林憶君﹚\n\n12\n00:03:51,735 --> 00:04:12,792\n好,剛剛院長說04、03其實從花蓮地震到現在然後我們花蓮人往返臺北的舒花公路其實都有小小的餘震嘛所以都有落石還有土石流像上禮拜一大家可能都注意到基隆那邊的公園有山崩但其實在同一天花蓮的舒花公路其實從的隧道北端的山壁也發生了\n\n13\n00:04:13,092 --> 00:04:13,132\n﹚林憶君﹚\n\n14\n00:04:35,177 --> 00:04:52,953\n其實環境部在5月14日也召開了臺九縣的蘇花公路安全提升計畫環境影響說明書專案小組第二次的環評初審會議然後也同意了本案的通過的初審但是這樣在回想之前針對我們的規劃已經落後了兩年\n\n15\n00:04:56,716 --> 00:05:13,708\n所以但是現在是以前是119年就可以完工現在變成121年完工為目標那要交通部的公路的總局的局長說如果一切都順利的話能在今年的8月取得環評大會審查修正通過\n\n16\n00:05:14,508 --> 00:05:30,776\n希望年底建設計劃就能核定,明年提出設計的規劃,明年的8月開始取得用地,並同步執行都市計劃變更的程序,期待116年初就可以發包施工。如果照這樣的話,你看整個蘇花安本來經費從360億元到現在評估的階段已經暴增了802億元。\n\n17\n00:05:39,720 --> 00:05:58,919\n但是考慮到舒嬅公路每年都是道路封閉還有經濟上的損失落石土石流其實造成公路損害的維修的費用其實平均攤下來可能也不比新建舒嬅安的費用節省多少但是最主要大家都知道更重要的是人命是無價的\n\n18\n00:05:59,780 --> 00:06:21,916\n所以請問院長和部長,蘇花安到底什麼時候可以真正的完工通車?你們可知道花蓮人其實已經等不及了,因為你們執政那麼久,其實花蓮人都等到民心都已經失去了。真的有把握在116年能夠發包施工嗎?還是說那時候又要採取拖延戰術呢?繼續欺騙花蓮人呢?\n\n19\n00:06:24,818 --> 00:06:43,784\n因為過去民進黨執政選舉的時候都開了很多的支票,例如副總統蕭美琴過去競選花蓮區域立委的時候,她就提出高鐵東延還有花東快鐵,然後現任的外交部長林佳龍在擔任交通部長時也喊了,\n\n20\n00:06:44,384 --> 00:07:06,998\n西部高鐵還有東部快鐵以及2030年全國高快速鐵路網的規劃就說6小時我們就可以還臺還有前交通部長王國才也說環島高鐵不是夢但是為什麼到現在花東的交通的新建設一點的動靜都沒有呢\n\n21\n00:07:07,478 --> 00:07:32,868\n那樣民進黨執政8年來多項的交通政策現在都變成了空頭支票所以我們想請院長還有部長你們可以盡快給予專業的意見還有看法讓全國民眾了解說不是用政治語言來欺騙大眾企圖讓東部居民充滿了期待然後卻又造成社會大眾產生更多的誤解和對立\n\n22\n00:07:34,210 --> 00:08:03,576\n委員如果這是一張空投支票就不會有今年5月14號的環評出審的通過那麼持續下來會做這個環境影響評估再來就會進到更細部的計畫對所以是可以這種可以監督一下他這個進度因為我看比之前規劃已經慢了兩年了因為我不曉得後面還要慢多久這絕對不是一張空投支票我們一起來讓花東的鄉親能夠安心持續的往前做那已經在程序當中現在會一直一步一步的做下去\n\n23\n00:08:04,036 --> 00:08:31,378\n好,那也跟委員報告,其實包括花東的這個鐵路現在雙軌化已經也在陸續的在發包進行那這樣的話可以讓整個花東鐵路提速那現階段我們也把最好的全國最好的車廂最新的都用在花東所以EMU3000它的這個座位數從300多從像太魯閣號只有300多它可以到500多個座位那這個最好運量最好的這個最大的\n\n24\n00:08:32,259 --> 00:08:39,336\n是的,但是你知道如果入主段的時候其實火車票他也是一票籃球的\n\n25\n00:08:40,151 --> 00:09:05,910\n所以這個也代表政府其實持續對花東投入相當多的經費跟關注那這個蘇花安目前就是我想所有的交通建設大概最需要等待的就是環評那麼蘇花安很不容易的已經5月14號環評出審通過那預計在7月份大會或是8月份大會就可以來正式核定那接著我們就是進入計畫的\n\n26\n00:09:06,991 --> 00:09:07,211\n﹚林憶君\n\n27\n00:09:24,100 --> 00:09:44,629\n兩個部落需要諮商同意那這個部落他們擔心快速道路經過他們的部落反而會造成部落的人口流失或是商機降低所以這個還要這個在發包錢要取得部落的同意這是我們相關的法規的規定所以這個部分還要努力目前大概唯一的變數是在這個地方\n\n28\n00:09:45,529 --> 00:10:09,231\n我再問一個問題,就是說交通部在2020年的時候我們有重啟花東快速道路的可行性評估,然後預計要在8月的時候出爐。但是2020年到2024年,這耗時4年了,做了重大的評估。那樣有把握在8月份的時候可以做嗎?這可以解決花東人素食癌的交通不便的痛苦。\n\n29\n00:10:09,751 --> 00:10:14,713\n八月份是報告可以出來那當然他要經過一些的審查的階段那現在大概幾個關鍵一個就是說整個投資的一本筆\n\n30\n00:10:29,813 --> 00:10:52,200\n是不是符合投資的效益?通常我們一本筆要到一才會有一個投資的效益。再來就是預算的容納,還有一個是環評,因為這個是一個新的快速道路,所以他要做二階的環評。環評是不是能夠同意,能夠讓他核准通過,能不能順利的來approve這個部分。\n\n31\n00:10:52,980 --> 00:11:13,533\n最後還有一個階段就在開工前他沿線我們目前的了解170幾公里有11個部落這11個部落都要同意資商同意才可以來辦理發包那這是在發包前必須要取得同意我想這些變數大概都是我們未來要再去持續的突破的地方\n\n32\n00:11:14,840 --> 00:11:29,669\n所以其實政府不應該畫大餅然後之後又說不太可能這樣因為先操作東西區域的不平衡問題然後之後再來覺得說是國家財政的困難還是還品有自愛難行的理由\n\n33\n00:11:30,089 --> 00:11:30,129\n﹚林憶君﹚\n\n34\n00:11:56,656 --> 00:11:57,117\n報告委員這不是大餅這是一條直線\n\n35\n00:12:07,406 --> 00:12:30,481\n全場179公里的直線有17個交流道總經費達到2555億當中還有剛剛部長說的11個部落他的同意資商要去處理跟剛剛那個一樣我們跟部落的溝通一定要加強我已經跟部長說過了盡量去說服他們希望他們能夠理解這個重大公共工程的重要性那麼能夠縮短互相溝通的時間就能把這些報告\n\n36\n00:12:31,383 --> 00:12:32,825\n希望大家都能聽到花東人民的聲音。\n\n37\n00:12:48,783 --> 00:13:09,375\n那也跟委員報告因為目前政府各種法令都有規範我們做相關重大建設所應該要做的一些程序所以這個不是我們去找困難來搪塞而是相關像環評法令部落諮商的法令水保的法令等等都有一定的規範我們必須要去遵守\n\n38\n00:13:11,787 --> 00:13:26,115\n我再問一下院長就是說因為院長你在此次的施政報告裡面你是親自擔任0403花蓮地震專案小組的召集人有關此次的地震除了希望行政院能夠真正的徹底\n\n39\n00:13:26,975 --> 00:13:50,930\n執行政災復原的重建方案解決花蓮災民的問題之外就是有一個臺灣東部就是第一所綜合大學國立東華大學然後地震後學校的建物在強震中有受損其中理工學院有一棟是整個燒毀的宿舍有1700床也沒有辦法使用然後校方有估計大約重建總經費是20億元\n\n40\n00:13:53,191 --> 00:14:19,453\n然後在這一次04、03的花蓮地震其實針對東華大學這個理工學院那一管低洞的話還有一個化學實驗室然後地震發生火災然後燒了20個小時整棟全毀然後花蓮縣的消防局然後他們也有馬上前往救援但是因為現場內存放的都是進水性的化學物質所以不能用水來撲滅然後消防人員就是進退兩難\n\n41\n00:14:20,954 --> 00:14:40,376\n據瞭解當時花蓮縣的消防局向宜蘭還有向高雄請求化學災害處理車支援但是臺九縣因為地震所以已經山壁攤分斷裂了所以連最近的宜蘭消防局也沒有辦法前往而高雄的消防局的路途太遙遠了\n\n42\n00:14:41,377 --> 00:14:41,417\n﹚林憶君﹚\n\n43\n00:15:22,631 --> 00:15:23,771\n在5月4日那一次有特別在花蓮召開0403\n\n44\n00:15:50,362 --> 00:16:17,846\n正在復原重建專案會議中。然後在那個會議中我也有當時也有建議提示要求中華大學化學實驗室除放多種化學的物質強震導致化學物品引發的大火所以有關爭取相關所需要的化學搶救車救災的車輛有請內政部消防署有統籌處理那請問院長那內政部就是否有在此\n\n45\n00:16:18,366 --> 00:16:44,725\n可以允若本席同意補助或直接提供花蓮縣還是台東縣各兩台乾粉或其他特別面火的藥劑的化學災害處理消防車呢?因為這可以因應特殊的化學物質所引發的火災,強化消防救災的效能,以免花東地區再次發生這種設備不足而造成的遺憾事件。\n\n46\n00:16:45,586 --> 00:17:06,788\n那請問院長你身為專案小組召集人那可以答應補助嗎?謝謝委員由我本人來擔任專案小組的召集人請鄭麗君副院長來負責督導是我們要讓花蓮鄉親真正看到政府的誠意跟決心我們已經提高效率計畫及早合可\n\n47\n00:17:07,996 --> 00:17:08,957\n請部長報告一下\n\n48\n00:17:29,119 --> 00:17:44,271\n是,跟委員報告一下,其實卓院長在當時的時候已經有指示,我們在明年度的時候呢,會先補助一輛近水性的化學災防的消防車,那其實花蓮縣政府還有當天參加這個會刊的委員都已經知道了。\n\n49\n00:17:45,485 --> 00:18:06,197\n所以就是補助儀量這樣就對了?不是,因為進水性的化學消防車沒有那麼容易,跟一般的化學消防車泡沫消防車不太一樣,所以它必須要有特殊的救護的機制,所以我們先用儀量,何況現在以花蓮或者是以台東來講,需要用進水性的化學物質的量沒有那麼多,那如果未來還有需要的話,我們還可以再做中長程計畫的調整。\n\n50\n00:18:07,378 --> 00:18:35,587\n其實東部市真的是需要啦,因為真的是道路上面的萬一有中斷的情況下,其實我們花東的人的性命還是很重要的。是,而且東華大學那一棟出事的大樓,整棟的材質重建工程會非常積極在處理。好,跟委員報告,就是第一棟就是化學館,那化學館它整個要異地重建,那我們希望教育部在督導東華大學重建的過程,因為是化學館,所以那內部的整個\n\n51\n00:18:36,886 --> 00:18:36,926\n﹝發言委員﹞\n\n52\n00:19:06,749 --> 00:19:07,329\n衛福部部長\n\n53\n00:19:39,052 --> 00:20:04,878\n委員長部長好我想問一下就是本席今天想要請教一個問一個就是有關處方簽格式統一的問題因為最近很多基層的藥師特別跟本席陳情他們說像在臺北市立醫院有分為好幾個院區就是說今天有人到昆明院區去就醫然後拿著醫生釋出的慢性處方簽到社區藥局去領藥然後跟到林森院區去看病後拿到醫生\n\n54\n00:20:05,578 --> 00:20:05,818\n應該都要一致的。\n\n55\n00:20:19,209 --> 00:20:22,731\n對對對應該是都一樣的嘛但是這個就問題來了因為自從84年開辦全民健保到現在因為時空環境的轉變許多很多家醫院已經開始整病了然後各院區都有一個共用醫事機構代碼但是卻有不同的層級喔而會影響到部分負擔因為我們今天我們112年有一個部分負擔的調整嘛\n\n56\n00:21:03,763 --> 00:21:12,046\n同樣居然地區和區域醫院教學的成績居然釋出了一般的處方簽和慢性處方簽,它的機構代碼居然是一樣的。我想這個門診交付處方簽這個是按照醫師法第13條,各特別醫院院首應該要按照這個法,按醫法跟以及健保署公告的格式來開立處方。那它當然代碼有分為\n\n57\n00:21:34,351 --> 00:21:54,196\n剛剛為人所講的,那應該他是哪一級的醫院就是哪一個代碼嗎?對,因為這個我覺得很奇怪,像我們花蓮的門諾醫院的話,他包括他受封分院還有其他的每一個醫室代碼都不同的。會不會是因為他不同體系裡面也有區醫院也有地區醫院而援手不同,這可能我們要來了解一下。\n\n58\n00:21:54,676 --> 00:21:54,836\n﹚林憶君﹚\n\n59\n00:22:14,482 --> 00:22:36,400\n當然處方簽上面整個格式都沒有標明的清楚,沒標明的清楚的時候社區藥局會遺漏收了部分負擔。所以這個樣子就是說健保藥物處方簽格式沒有統一還有不完全,其實是增加社區藥局藥師在登載健保申報系統的交付藥上面還有複合藥物的困難度。\n\n60\n00:22:37,708 --> 00:23:03,578\n好,是,如果沒有統一的話,我想我們要來找這個所有的醫療院所來討論,希望能夠...對啊,部長你可以看一下,因為我也覺得很奇怪,為什麼電腦上面寫這兩間是寫地區醫院,然後結果居然到了庫比醫院區的時候,收費的時候是收基層診所的藥費的部分負擔,因為這個到時候到社區藥局去拿藥的時候,其實病人會反應。\n\n61\n00:23:04,858 --> 00:23:04,878\n拜訪議員\n\n62\n00:23:50,255 --> 00:24:14,913\n當然全部補齊的時候大家來社區藥局拿藥的時候也可以降低藥師的複合藥物還有登載申報系統的困難然後當然這樣的話我們給病人收錢的時候給病人收錢的時候也不會引起爭議啊因為常常拿到藥物的拿到處方簽的時候都在看說這到底這一家是地區醫院呢還是還是那個區醫院呢然後收費又不一樣\n\n63\n00:24:15,774 --> 00:24:24,190\n然後光在查這個就要很久包括還要再登錄還有一點就是說萬一那時候收錯了病人又會去反應\n\n64\n00:24:29,760 --> 00:24:46,534\n臺北市聯合醫院有很多的院區,是不是針對不同院區的規模它有這樣內部的細分,抱歉我倒是真的不清楚。但是為了要讓作業能夠一致化,尤其是市民患者在拿取藥品的時候能夠覺得安心跟可以稽查。\n\n65\n00:24:47,014 --> 00:25:04,025\n我想那個衛福部應該跟臺北市來瞭解一下他的聯合醫院是不是有這種層級上不同的對我覺得是應該要瞭解因為包括這樣處罰金會造成哪一級就應該是哪一級要寫清楚對對對因為他電腦查的時候是地區醫院結果居然收費的時候是用基層診所\n\n66\n00:25:05,126 --> 00:25:21,118\n那是不是當然像台北市這種過去傳統以來有時候會有一些福利優待特殊的族群會不會跟這個稍微沒有把它分得很清楚。所以最好是可以把處方簽統一格式我們處方簽統一格式包括以後我們推動的電子處方簽我們都可以陸續統一格式那大家在登載方面還有在我們在給病患收費方面都非常的清楚還有這個病人的身份方面其實我覺得這個都是\n\n67\n00:25:41,751 --> 00:25:58,880\n我非常肯定最近這幾年衛福部在愛滋病防復政策上面其實成績推動得非常好然後我在這邊給衛福部很大肯定但是因為最近社區藥局和疾病管理署他們有一個特約就是針對人類免疫缺乏病毒\n\n68\n00:25:59,560 --> 00:25:59,600\n﹚林憶君\n\n69\n00:26:16,027 --> 00:26:16,227\n﹚林憶君﹚林憶君﹚\n\n70\n00:26:36,699 --> 00:26:36,799\n﹚林憶君\n\n71\n00:26:59,918 --> 00:27:27,907\n站覆的陳述其實在健保申報15天之後只有波低於85%剩下的金額要60天內才會付清但是現在這個對現在的社區藥局友善藥局其實對他們的金流是一個非常非常大的壓力所以我在想說是不是要麻煩那個衛福部就是說因為可以提高愛知健保處方簽的站覆陳述因為他們本來就是像他如果200個病人\n\n72\n00:27:29,087 --> 00:27:30,268\n謝謝,我真的很感謝我們友善藥局N1來\n\n73\n00:27:56,075 --> 00:27:56,335\n﹚林憶君﹚\n\n74\n00:28:20,472 --> 00:28:20,512\n﹚林憶君﹚\n\n75\n00:28:46,454 --> 00:29:12,750\n這樣我覺得是有點不太合理啦所以是不是針對這個藥物就是這111家針對這一個藥物我們來切磋或許是我們就先補負到他95%嘛因為他本來就是應該100%嘛只是說一個是60天後再負給他這樣啊我們就提高給他們不要那麼大的金流壓力如果以電子的話有時候是負9乘5所以我想我們來想辦法\n\n76\n00:29:13,530 --> 00:29:13,730\n﹚林憶君﹚\n\n77\n00:29:35,805 --> 00:29:43,555\n我們可以切開不見得是整個嘛我知道你們的難處但是光這個藥物我們可以先補足到他他95%讓他們能更願意來服務這些病友這樣然後推動我們的政策\n\n78\n00:29:50,026 --> 00:29:50,126\n好,是。\n\n79\n00:30:11,909 --> 00:30:22,512\n那現在就是院長部長你們知道洗腎或手術的輸液是使用最大的就是那個生理食鹽水嗎對不對然後上個月應該臺灣輸液大廠的時候有違規遭勒令官場的問題嗎所以就是有一些其藥廠產人沒有辦法補足這個缺口嗎所以我們現在從這個問題來看其實我認為我們必須要從國防外交的戰略的角度來看這個從國內到國外的原料鏈\n\n80\n00:30:41,237 --> 00:30:41,577\n﹚林憶君﹚\n\n81\n00:31:09,704 --> 00:31:18,041\n好,謝謝。謝謝林委員。謝謝卓院長。下一位請王委員美會質詢。\n\n","tsv":"start\tend\ttext\n268\t449\t主席\n35382\t38165\t有請行政院卓榮泰院長。來,院長請備詢。議員好。\n50302\t64878\t院長好。 院長我想請問一下,一個好山好水的花東地區,交通不方便,每逢颱風還有地震,都沒有順利回家的路,難道這是身為東部人的命運嗎?\n67209\t85797\t謝謝委員 花東的鄉親因為長期這個地理環境天然資源所受他這個交通上確實是比較不方便但是政府從過去到現在也投入相當大的資源在整個解決花東的問題但是受限剛剛所說的這個地理的環境\n86457\t88558\t政府一定會持續地做很多事情來給花中的鄉親一個更好的環境。\n107768\t121986\t好,是正如院長說的,但是每次遇到天災還有道路中斷的時候,然後農民要運送農產品非常的不方便,還有連生病的患者要就醫都求救無路,然後遊客又來條路。\n123188\t123408\t﹚林憶君﹚\n150507\t151849\t請你們要將心比心。\n165484\t165504\t﹚廣告\n181894\t206546\t這一次的0403的地震可以看得出來過去蘇花改蘇花改所做的這些隧道橋樑都非常的都還狀況非常的好表示他的抗震耐震的能力是非常的好所以這一次我們也持續的來推動蘇花安那要把把整個整個快速的入網的系統把它連通那蘇花安也很快在\n207226\t207366\t﹚林憶君﹚\n231735\t252792\t好,剛剛院長說04、03其實從花蓮地震到現在然後我們花蓮人往返臺北的舒花公路其實都有小小的餘震嘛所以都有落石還有土石流像上禮拜一大家可能都注意到基隆那邊的公園有山崩但其實在同一天花蓮的舒花公路其實從的隧道北端的山壁也發生了\n253092\t253132\t﹚林憶君﹚\n275177\t292953\t其實環境部在5月14日也召開了臺九縣的蘇花公路安全提升計畫環境影響說明書專案小組第二次的環評初審會議然後也同意了本案的通過的初審但是這樣在回想之前針對我們的規劃已經落後了兩年\n296716\t313708\t所以但是現在是以前是119年就可以完工現在變成121年完工為目標那要交通部的公路的總局的局長說如果一切都順利的話能在今年的8月取得環評大會審查修正通過\n314508\t330776\t希望年底建設計劃就能核定,明年提出設計的規劃,明年的8月開始取得用地,並同步執行都市計劃變更的程序,期待116年初就可以發包施工。如果照這樣的話,你看整個蘇花安本來經費從360億元到現在評估的階段已經暴增了802億元。\n339720\t358919\t但是考慮到舒嬅公路每年都是道路封閉還有經濟上的損失落石土石流其實造成公路損害的維修的費用其實平均攤下來可能也不比新建舒嬅安的費用節省多少但是最主要大家都知道更重要的是人命是無價的\n359780\t381916\t所以請問院長和部長,蘇花安到底什麼時候可以真正的完工通車?你們可知道花蓮人其實已經等不及了,因為你們執政那麼久,其實花蓮人都等到民心都已經失去了。真的有把握在116年能夠發包施工嗎?還是說那時候又要採取拖延戰術呢?繼續欺騙花蓮人呢?\n384818\t403784\t因為過去民進黨執政選舉的時候都開了很多的支票,例如副總統蕭美琴過去競選花蓮區域立委的時候,她就提出高鐵東延還有花東快鐵,然後現任的外交部長林佳龍在擔任交通部長時也喊了,\n404384\t426998\t西部高鐵還有東部快鐵以及2030年全國高快速鐵路網的規劃就說6小時我們就可以還臺還有前交通部長王國才也說環島高鐵不是夢但是為什麼到現在花東的交通的新建設一點的動靜都沒有呢\n427478\t452868\t那樣民進黨執政8年來多項的交通政策現在都變成了空頭支票所以我們想請院長還有部長你們可以盡快給予專業的意見還有看法讓全國民眾了解說不是用政治語言來欺騙大眾企圖讓東部居民充滿了期待然後卻又造成社會大眾產生更多的誤解和對立\n454210\t483576\t委員如果這是一張空投支票就不會有今年5月14號的環評出審的通過那麼持續下來會做這個環境影響評估再來就會進到更細部的計畫對所以是可以這種可以監督一下他這個進度因為我看比之前規劃已經慢了兩年了因為我不曉得後面還要慢多久這絕對不是一張空投支票我們一起來讓花東的鄉親能夠安心持續的往前做那已經在程序當中現在會一直一步一步的做下去\n484036\t511378\t好,那也跟委員報告,其實包括花東的這個鐵路現在雙軌化已經也在陸續的在發包進行那這樣的話可以讓整個花東鐵路提速那現階段我們也把最好的全國最好的車廂最新的都用在花東所以EMU3000它的這個座位數從300多從像太魯閣號只有300多它可以到500多個座位那這個最好運量最好的這個最大的\n512259\t519336\t是的,但是你知道如果入主段的時候其實火車票他也是一票籃球的\n520151\t545910\t所以這個也代表政府其實持續對花東投入相當多的經費跟關注那這個蘇花安目前就是我想所有的交通建設大概最需要等待的就是環評那麼蘇花安很不容易的已經5月14號環評出審通過那預計在7月份大會或是8月份大會就可以來正式核定那接著我們就是進入計畫的\n546991\t547211\t﹚林憶君\n564100\t584629\t兩個部落需要諮商同意那這個部落他們擔心快速道路經過他們的部落反而會造成部落的人口流失或是商機降低所以這個還要這個在發包錢要取得部落的同意這是我們相關的法規的規定所以這個部分還要努力目前大概唯一的變數是在這個地方\n585529\t609231\t我再問一個問題,就是說交通部在2020年的時候我們有重啟花東快速道路的可行性評估,然後預計要在8月的時候出爐。但是2020年到2024年,這耗時4年了,做了重大的評估。那樣有把握在8月份的時候可以做嗎?這可以解決花東人素食癌的交通不便的痛苦。\n609751\t614713\t八月份是報告可以出來那當然他要經過一些的審查的階段那現在大概幾個關鍵一個就是說整個投資的一本筆\n629813\t652200\t是不是符合投資的效益?通常我們一本筆要到一才會有一個投資的效益。再來就是預算的容納,還有一個是環評,因為這個是一個新的快速道路,所以他要做二階的環評。環評是不是能夠同意,能夠讓他核准通過,能不能順利的來 approve 這個部分。\n652980\t673533\t最後還有一個階段就在開工前他沿線我們目前的了解170幾公里有11個部落這11個部落都要同意資商同意才可以來辦理發包那這是在發包前必須要取得同意我想這些變數大概都是我們未來要再去持續的突破的地方\n674840\t689669\t所以其實政府不應該畫大餅然後之後又說不太可能這樣因為先操作東西區域的不平衡問題然後之後再來覺得說是國家財政的困難還是還品有自愛難行的理由\n690089\t690129\t﹚林憶君﹚\n716656\t717117\t報告委員這不是大餅這是一條直線\n727406\t750481\t全場179公里的直線有17個交流道總經費達到2555億當中還有剛剛部長說的11個部落他的同意資商要去處理跟剛剛那個一樣我們跟部落的溝通一定要加強我已經跟部長說過了盡量去說服他們希望他們能夠理解這個重大公共工程的重要性那麼能夠縮短互相溝通的時間就能把這些報告\n751383\t752825\t希望大家都能聽到花東人民的聲音。\n768783\t789375\t那也跟委員報告因為目前政府各種法令都有規範我們做相關重大建設所應該要做的一些程序所以這個不是我們去找困難來搪塞而是相關像環評法令部落諮商的法令水保的法令等等都有一定的規範我們必須要去遵守\n791787\t806115\t我再問一下院長就是說因為院長你在此次的施政報告裡面你是親自擔任0403花蓮地震專案小組的召集人有關此次的地震除了希望行政院能夠真正的徹底\n806975\t830930\t執行政災復原的重建方案解決花蓮災民的問題之外就是有一個臺灣東部就是第一所綜合大學國立東華大學然後地震後學校的建物在強震中有受損其中理工學院有一棟是整個燒毀的宿舍有1700床也沒有辦法使用然後校方有估計大約重建總經費是20億元\n833191\t859453\t然後在這一次04、03的花蓮地震其實針對東華大學這個理工學院那一管低洞的話還有一個化學實驗室然後地震發生火災然後燒了20個小時整棟全毀然後花蓮縣的消防局然後他們也有馬上前往救援但是因為現場內存放的都是進水性的化學物質所以不能用水來撲滅然後消防人員就是進退兩難\n860954\t880376\t據瞭解當時花蓮縣的消防局向宜蘭還有向高雄請求化學災害處理車支援但是臺九縣因為地震所以已經山壁攤分斷裂了所以連最近的宜蘭消防局也沒有辦法前往而高雄的消防局的路途太遙遠了\n881377\t881417\t﹚林憶君﹚\n903831\t922432\t﹏﹏\n922631\t923771\t在5月4日那一次有特別在花蓮召開0403\n950362\t977846\t正在復原重建專案會議中。然後在那個會議中我也有當時也有建議提示要求中華大學化學實驗室除放多種化學的物質強震導致化學物品引發的大火所以有關爭取相關所需要的化學搶救車救災的車輛有請內政部消防署有統籌處理那請問院長那內政部就是否有在此\n978366\t1004725\t可以允若本席同意補助或直接提供花蓮縣還是台東縣各兩台乾粉或其他特別面火的藥劑的化學災害處理消防車呢?因為這可以因應特殊的化學物質所引發的火災,強化消防救災的效能,以免花東地區再次發生這種設備不足而造成的遺憾事件。\n1005586\t1026788\t那請問院長你身為專案小組召集人那可以答應補助嗎?謝謝委員由我本人來擔任專案小組的召集人請鄭麗君副院長來負責督導是我們要讓花蓮鄉親真正看到政府的誠意跟決心我們已經提高效率計畫及早合可\n1027996\t1028957\t請部長報告一下\n1049119\t1064271\t是,跟委員報告一下,其實卓院長在當時的時候已經有指示,我們在明年度的時候呢,會先補助一輛近水性的化學災防的消防車,那其實花蓮縣政府還有當天參加這個會刊的委員都已經知道了。\n1065485\t1086197\t所以就是補助儀量這樣就對了?不是,因為進水性的化學消防車沒有那麼容易,跟一般的化學消防車泡沫消防車不太一樣,所以它必須要有特殊的救護的機制,所以我們先用儀量,何況現在以花蓮或者是以台東來講,需要用進水性的化學物質的量沒有那麼多,那如果未來還有需要的話,我們還可以再做中長程計畫的調整。\n1087378\t1115587\t其實東部市真的是需要啦,因為真的是道路上面的萬一有中斷的情況下,其實我們花東的人的性命還是很重要的。 是,而且東華大學那一棟出事的大樓,整棟的材質重建工程會非常積極在處理。 好,跟委員報告,就是第一棟就是化學館,那化學館它整個要異地重建,那我們希望教育部在督導東華大學重建的過程,因為是化學館,所以那內部的整個\n1116886\t1116926\t﹝發言委員﹞\n1146749\t1147329\t衛福部部長\n1179052\t1204878\t委員長部長好我想問一下就是本席今天想要請教一個問一個就是有關處方簽格式統一的問題因為最近很多基層的藥師特別跟本席陳情他們說像在臺北市立醫院有分為好幾個院區就是說今天有人到昆明院區去就醫然後拿著醫生釋出的慢性處方簽到社區藥局去領藥然後跟到林森院區去看病後拿到醫生\n1205578\t1205818\t應該都要一致的。\n1219209\t1222731\t對對對應該是都一樣的嘛但是這個就問題來了因為自從84年開辦全民健保到現在因為時空環境的轉變許多很多家醫院已經開始整病了然後各院區都有一個共用醫事機構代碼但是卻有不同的層級喔而會影響到部分負擔因為我們今天我們112年有一個部分負擔的調整嘛\n1241920\t1263643\t﹗\n1263763\t1272046\t同樣居然地區和區域醫院教學的成績居然釋出了一般的處方簽和慢性處方簽,它的機構代碼居然是一樣的。我想這個門診交付處方簽這個是按照醫師法第13條,各特別醫院院首應該要按照這個法,按醫法跟以及健保署公告的格式來開立處方。那它當然代碼有分為\n1294351\t1314196\t剛剛為人所講的,那應該他是哪一級的醫院就是哪一個代碼嗎?對,因為這個我覺得很奇怪,像我們花蓮的門諾醫院的話,他包括他受封分院還有其他的每一個醫室代碼都不同的。會不會是因為他不同體系裡面也有區醫院也有地區醫院而援手不同,這可能我們要來了解一下。\n1314676\t1314836\t﹚林憶君﹚\n1334482\t1356400\t當然處方簽上面整個格式都沒有標明的清楚,沒標明的清楚的時候社區藥局會遺漏收了部分負擔。 所以這個樣子就是說健保藥物處方簽格式沒有統一還有不完全,其實是增加社區藥局藥師在登載健保申報系統的交付藥上面還有複合藥物的困難度。\n1357708\t1383578\t好,是,如果沒有統一的話,我想我們要來找這個所有的醫療院所來討論,希望能夠...對啊,部長你可以看一下,因為我也覺得很奇怪,為什麼電腦上面寫這兩間是寫地區醫院,然後結果居然到了庫比醫院區的時候,收費的時候是收基層診所的藥費的部分負擔,因為這個到時候到社區藥局去拿藥的時候,其實病人會反應。\n1384858\t1384878\t拜訪議員\n1404855\t1429735\t﹏﹏\n1430255\t1454913\t當然全部補齊的時候大家來社區藥局拿藥的時候也可以降低藥師的複合藥物還有登載申報系統的困難然後當然這樣的話我們給病人收錢的時候給病人收錢的時候也不會引起爭議啊因為常常拿到藥物的拿到處方簽的時候都在看說這到底這一家是地區醫院呢還是還是那個區醫院呢然後收費又不一樣\n1455774\t1464190\t然後光在查這個就要很久包括還要再登錄還有一點就是說萬一那時候收錯了病人又會去反應\n1469760\t1486534\t臺北市聯合醫院有很多的院區,是不是針對不同院區的規模它有這樣內部的細分,抱歉我倒是真的不清楚。但是為了要讓作業能夠一致化,尤其是市民患者在拿取藥品的時候能夠覺得安心跟可以稽查。\n1487014\t1504025\t我想那個衛福部應該跟臺北市來瞭解一下他的聯合醫院是不是有這種層級上不同的對我覺得是應該要瞭解因為包括這樣處罰金會造成哪一級就應該是哪一級要寫清楚對對對因為他電腦查的時候是地區醫院結果居然收費的時候是用基層診所\n1505126\t1521118\t那是不是當然像台北市這種過去傳統以來有時候會有一些福利優待特殊的族群會不會跟這個稍微沒有把它分得很清楚。 所以最好是可以把處方簽統一格式我們處方簽統一格式包括以後我們推動的電子處方簽我們都可以陸續統一格式那大家在登載方面還有在我們在給病患收費方面都非常的清楚還有這個病人的身份方面其實我覺得這個都是\n1541751\t1558880\t我非常肯定最近這幾年衛福部在愛滋病防復政策上面其實成績推動得非常好然後我在這邊給衛福部很大肯定但是因為最近社區藥局和疾病管理署他們有一個特約就是針對人類免疫缺乏病毒\n1559560\t1559600\t﹚林憶君\n1576027\t1576227\t﹚林憶君﹚林憶君﹚\n1596699\t1596799\t﹚林憶君\n1619918\t1647907\t站覆的陳述其實在健保申報15天之後只有波低於85%剩下的金額要60天內才會付清但是現在這個對現在的社區藥局友善藥局其實對他們的金流是一個非常非常大的壓力所以我在想說是不是要麻煩那個衛福部就是說因為可以提高愛知健保處方簽的站覆陳述因為他們本來就是像他如果200個病人\n1649087\t1650268\t謝謝,我真的很感謝我們友善藥局N1來\n1676075\t1676335\t﹚林憶君﹚\n1700472\t1700512\t﹚林憶君﹚\n1726454\t1752750\t這樣我覺得是有點不太合理啦所以是不是針對這個藥物就是這111家針對這一個藥物我們來切磋或許是我們就先補負到他95%嘛因為他本來就是應該100%嘛只是說一個是60天後再負給他這樣啊我們就提高給他們不要那麼大的金流壓力如果以電子的話有時候是負9乘5所以我想我們來想辦法\n1753530\t1753730\t﹚林憶君﹚\n1775805\t1783555\t我們可以切開不見得是整個嘛我知道你們的難處但是光這個藥物我們可以先補足到他他95%讓他們能更願意來服務這些病友這樣然後推動我們的政策\n1790026\t1790126\t好,是。\n1811909\t1822512\t那現在就是院長部長你們知道洗腎或手術的輸液是使用最大的就是那個生理食鹽水嗎對不對然後上個月應該臺灣輸液大廠的時候有違規遭勒令官場的問題嗎所以就是有一些其藥廠產人沒有辦法補足這個缺口嗎所以我們現在從這個問題來看其實我認為我們必須要從國防外交的戰略的角度來看這個從國內到國外的原料鏈\n1841237\t1841577\t﹚林憶君﹚\n1869704\t1878041\t好,謝謝。謝謝林委員。謝謝卓院長。下一位請王委員美會質詢。\n","txt":"主席\n有請行政院卓榮泰院長。來,院長請備詢。議員好。\n院長好。 院長我想請問一下,一個好山好水的花東地區,交通不方便,每逢颱風還有地震,都沒有順利回家的路,難道這是身為東部人的命運嗎?\n謝謝委員 花東的鄉親因為長期這個地理環境天然資源所受他這個交通上確實是比較不方便但是政府從過去到現在也投入相當大的資源在整個解決花東的問題但是受限剛剛所說的這個地理的環境\n政府一定會持續地做很多事情來給花中的鄉親一個更好的環境。\n好,是正如院長說的,但是每次遇到天災還有道路中斷的時候,然後農民要運送農產品非常的不方便,還有連生病的患者要就醫都求救無路,然後遊客又來條路。\n﹚林憶君﹚\n請你們要將心比心。\n﹚廣告\n這一次的0403的地震可以看得出來過去蘇花改蘇花改所做的這些隧道橋樑都非常的都還狀況非常的好表示他的抗震耐震的能力是非常的好所以這一次我們也持續的來推動蘇花安那要把把整個整個快速的入網的系統把它連通那蘇花安也很快在\n﹚林憶君﹚\n好,剛剛院長說04、03其實從花蓮地震到現在然後我們花蓮人往返臺北的舒花公路其實都有小小的餘震嘛所以都有落石還有土石流像上禮拜一大家可能都注意到基隆那邊的公園有山崩但其實在同一天花蓮的舒花公路其實從的隧道北端的山壁也發生了\n﹚林憶君﹚\n其實環境部在5月14日也召開了臺九縣的蘇花公路安全提升計畫環境影響說明書專案小組第二次的環評初審會議然後也同意了本案的通過的初審但是這樣在回想之前針對我們的規劃已經落後了兩年\n所以但是現在是以前是119年就可以完工現在變成121年完工為目標那要交通部的公路的總局的局長說如果一切都順利的話能在今年的8月取得環評大會審查修正通過\n希望年底建設計劃就能核定,明年提出設計的規劃,明年的8月開始取得用地,並同步執行都市計劃變更的程序,期待116年初就可以發包施工。如果照這樣的話,你看整個蘇花安本來經費從360億元到現在評估的階段已經暴增了802億元。\n但是考慮到舒嬅公路每年都是道路封閉還有經濟上的損失落石土石流其實造成公路損害的維修的費用其實平均攤下來可能也不比新建舒嬅安的費用節省多少但是最主要大家都知道更重要的是人命是無價的\n所以請問院長和部長,蘇花安到底什麼時候可以真正的完工通車?你們可知道花蓮人其實已經等不及了,因為你們執政那麼久,其實花蓮人都等到民心都已經失去了。真的有把握在116年能夠發包施工嗎?還是說那時候又要採取拖延戰術呢?繼續欺騙花蓮人呢?\n因為過去民進黨執政選舉的時候都開了很多的支票,例如副總統蕭美琴過去競選花蓮區域立委的時候,她就提出高鐵東延還有花東快鐵,然後現任的外交部長林佳龍在擔任交通部長時也喊了,\n西部高鐵還有東部快鐵以及2030年全國高快速鐵路網的規劃就說6小時我們就可以還臺還有前交通部長王國才也說環島高鐵不是夢但是為什麼到現在花東的交通的新建設一點的動靜都沒有呢\n那樣民進黨執政8年來多項的交通政策現在都變成了空頭支票所以我們想請院長還有部長你們可以盡快給予專業的意見還有看法讓全國民眾了解說不是用政治語言來欺騙大眾企圖讓東部居民充滿了期待然後卻又造成社會大眾產生更多的誤解和對立\n委員如果這是一張空投支票就不會有今年5月14號的環評出審的通過那麼持續下來會做這個環境影響評估再來就會進到更細部的計畫對所以是可以這種可以監督一下他這個進度因為我看比之前規劃已經慢了兩年了因為我不曉得後面還要慢多久這絕對不是一張空投支票我們一起來讓花東的鄉親能夠安心持續的往前做那已經在程序當中現在會一直一步一步的做下去\n好,那也跟委員報告,其實包括花東的這個鐵路現在雙軌化已經也在陸續的在發包進行那這樣的話可以讓整個花東鐵路提速那現階段我們也把最好的全國最好的車廂最新的都用在花東所以EMU3000它的這個座位數從300多從像太魯閣號只有300多它可以到500多個座位那這個最好運量最好的這個最大的\n是的,但是你知道如果入主段的時候其實火車票他也是一票籃球的\n所以這個也代表政府其實持續對花東投入相當多的經費跟關注那這個蘇花安目前就是我想所有的交通建設大概最需要等待的就是環評那麼蘇花安很不容易的已經5月14號環評出審通過那預計在7月份大會或是8月份大會就可以來正式核定那接著我們就是進入計畫的\n﹚林憶君\n兩個部落需要諮商同意那這個部落他們擔心快速道路經過他們的部落反而會造成部落的人口流失或是商機降低所以這個還要這個在發包錢要取得部落的同意這是我們相關的法規的規定所以這個部分還要努力目前大概唯一的變數是在這個地方\n我再問一個問題,就是說交通部在2020年的時候我們有重啟花東快速道路的可行性評估,然後預計要在8月的時候出爐。但是2020年到2024年,這耗時4年了,做了重大的評估。那樣有把握在8月份的時候可以做嗎?這可以解決花東人素食癌的交通不便的痛苦。\n八月份是報告可以出來那當然他要經過一些的審查的階段那現在大概幾個關鍵一個就是說整個投資的一本筆\n是不是符合投資的效益?通常我們一本筆要到一才會有一個投資的效益。再來就是預算的容納,還有一個是環評,因為這個是一個新的快速道路,所以他要做二階的環評。環評是不是能夠同意,能夠讓他核准通過,能不能順利的來 approve 這個部分。\n最後還有一個階段就在開工前他沿線我們目前的了解170幾公里有11個部落這11個部落都要同意資商同意才可以來辦理發包那這是在發包前必須要取得同意我想這些變數大概都是我們未來要再去持續的突破的地方\n所以其實政府不應該畫大餅然後之後又說不太可能這樣因為先操作東西區域的不平衡問題然後之後再來覺得說是國家財政的困難還是還品有自愛難行的理由\n﹚林憶君﹚\n報告委員這不是大餅這是一條直線\n全場179公里的直線有17個交流道總經費達到2555億當中還有剛剛部長說的11個部落他的同意資商要去處理跟剛剛那個一樣我們跟部落的溝通一定要加強我已經跟部長說過了盡量去說服他們希望他們能夠理解這個重大公共工程的重要性那麼能夠縮短互相溝通的時間就能把這些報告\n希望大家都能聽到花東人民的聲音。\n那也跟委員報告因為目前政府各種法令都有規範我們做相關重大建設所應該要做的一些程序所以這個不是我們去找困難來搪塞而是相關像環評法令部落諮商的法令水保的法令等等都有一定的規範我們必須要去遵守\n我再問一下院長就是說因為院長你在此次的施政報告裡面你是親自擔任0403花蓮地震專案小組的召集人有關此次的地震除了希望行政院能夠真正的徹底\n執行政災復原的重建方案解決花蓮災民的問題之外就是有一個臺灣東部就是第一所綜合大學國立東華大學然後地震後學校的建物在強震中有受損其中理工學院有一棟是整個燒毀的宿舍有1700床也沒有辦法使用然後校方有估計大約重建總經費是20億元\n然後在這一次04、03的花蓮地震其實針對東華大學這個理工學院那一管低洞的話還有一個化學實驗室然後地震發生火災然後燒了20個小時整棟全毀然後花蓮縣的消防局然後他們也有馬上前往救援但是因為現場內存放的都是進水性的化學物質所以不能用水來撲滅然後消防人員就是進退兩難\n據瞭解當時花蓮縣的消防局向宜蘭還有向高雄請求化學災害處理車支援但是臺九縣因為地震所以已經山壁攤分斷裂了所以連最近的宜蘭消防局也沒有辦法前往而高雄的消防局的路途太遙遠了\n﹚林憶君﹚\n﹏﹏\n在5月4日那一次有特別在花蓮召開0403\n正在復原重建專案會議中。然後在那個會議中我也有當時也有建議提示要求中華大學化學實驗室除放多種化學的物質強震導致化學物品引發的大火所以有關爭取相關所需要的化學搶救車救災的車輛有請內政部消防署有統籌處理那請問院長那內政部就是否有在此\n可以允若本席同意補助或直接提供花蓮縣還是台東縣各兩台乾粉或其他特別面火的藥劑的化學災害處理消防車呢?因為這可以因應特殊的化學物質所引發的火災,強化消防救災的效能,以免花東地區再次發生這種設備不足而造成的遺憾事件。\n那請問院長你身為專案小組召集人那可以答應補助嗎?謝謝委員由我本人來擔任專案小組的召集人請鄭麗君副院長來負責督導是我們要讓花蓮鄉親真正看到政府的誠意跟決心我們已經提高效率計畫及早合可\n請部長報告一下\n是,跟委員報告一下,其實卓院長在當時的時候已經有指示,我們在明年度的時候呢,會先補助一輛近水性的化學災防的消防車,那其實花蓮縣政府還有當天參加這個會刊的委員都已經知道了。\n所以就是補助儀量這樣就對了?不是,因為進水性的化學消防車沒有那麼容易,跟一般的化學消防車泡沫消防車不太一樣,所以它必須要有特殊的救護的機制,所以我們先用儀量,何況現在以花蓮或者是以台東來講,需要用進水性的化學物質的量沒有那麼多,那如果未來還有需要的話,我們還可以再做中長程計畫的調整。\n其實東部市真的是需要啦,因為真的是道路上面的萬一有中斷的情況下,其實我們花東的人的性命還是很重要的。 是,而且東華大學那一棟出事的大樓,整棟的材質重建工程會非常積極在處理。 好,跟委員報告,就是第一棟就是化學館,那化學館它整個要異地重建,那我們希望教育部在督導東華大學重建的過程,因為是化學館,所以那內部的整個\n﹝發言委員﹞\n衛福部部長\n委員長部長好我想問一下就是本席今天想要請教一個問一個就是有關處方簽格式統一的問題因為最近很多基層的藥師特別跟本席陳情他們說像在臺北市立醫院有分為好幾個院區就是說今天有人到昆明院區去就醫然後拿著醫生釋出的慢性處方簽到社區藥局去領藥然後跟到林森院區去看病後拿到醫生\n應該都要一致的。\n對對對應該是都一樣的嘛但是這個就問題來了因為自從84年開辦全民健保到現在因為時空環境的轉變許多很多家醫院已經開始整病了然後各院區都有一個共用醫事機構代碼但是卻有不同的層級喔而會影響到部分負擔因為我們今天我們112年有一個部分負擔的調整嘛\n﹗\n同樣居然地區和區域醫院教學的成績居然釋出了一般的處方簽和慢性處方簽,它的機構代碼居然是一樣的。我想這個門診交付處方簽這個是按照醫師法第13條,各特別醫院院首應該要按照這個法,按醫法跟以及健保署公告的格式來開立處方。那它當然代碼有分為\n剛剛為人所講的,那應該他是哪一級的醫院就是哪一個代碼嗎?對,因為這個我覺得很奇怪,像我們花蓮的門諾醫院的話,他包括他受封分院還有其他的每一個醫室代碼都不同的。會不會是因為他不同體系裡面也有區醫院也有地區醫院而援手不同,這可能我們要來了解一下。\n﹚林憶君﹚\n當然處方簽上面整個格式都沒有標明的清楚,沒標明的清楚的時候社區藥局會遺漏收了部分負擔。 所以這個樣子就是說健保藥物處方簽格式沒有統一還有不完全,其實是增加社區藥局藥師在登載健保申報系統的交付藥上面還有複合藥物的困難度。\n好,是,如果沒有統一的話,我想我們要來找這個所有的醫療院所來討論,希望能夠...對啊,部長你可以看一下,因為我也覺得很奇怪,為什麼電腦上面寫這兩間是寫地區醫院,然後結果居然到了庫比醫院區的時候,收費的時候是收基層診所的藥費的部分負擔,因為這個到時候到社區藥局去拿藥的時候,其實病人會反應。\n拜訪議員\n﹏﹏\n當然全部補齊的時候大家來社區藥局拿藥的時候也可以降低藥師的複合藥物還有登載申報系統的困難然後當然這樣的話我們給病人收錢的時候給病人收錢的時候也不會引起爭議啊因為常常拿到藥物的拿到處方簽的時候都在看說這到底這一家是地區醫院呢還是還是那個區醫院呢然後收費又不一樣\n然後光在查這個就要很久包括還要再登錄還有一點就是說萬一那時候收錯了病人又會去反應\n臺北市聯合醫院有很多的院區,是不是針對不同院區的規模它有這樣內部的細分,抱歉我倒是真的不清楚。但是為了要讓作業能夠一致化,尤其是市民患者在拿取藥品的時候能夠覺得安心跟可以稽查。\n我想那個衛福部應該跟臺北市來瞭解一下他的聯合醫院是不是有這種層級上不同的對我覺得是應該要瞭解因為包括這樣處罰金會造成哪一級就應該是哪一級要寫清楚對對對因為他電腦查的時候是地區醫院結果居然收費的時候是用基層診所\n那是不是當然像台北市這種過去傳統以來有時候會有一些福利優待特殊的族群會不會跟這個稍微沒有把它分得很清楚。 所以最好是可以把處方簽統一格式我們處方簽統一格式包括以後我們推動的電子處方簽我們都可以陸續統一格式那大家在登載方面還有在我們在給病患收費方面都非常的清楚還有這個病人的身份方面其實我覺得這個都是\n我非常肯定最近這幾年衛福部在愛滋病防復政策上面其實成績推動得非常好然後我在這邊給衛福部很大肯定但是因為最近社區藥局和疾病管理署他們有一個特約就是針對人類免疫缺乏病毒\n﹚林憶君\n﹚林憶君﹚林憶君﹚\n﹚林憶君\n站覆的陳述其實在健保申報15天之後只有波低於85%剩下的金額要60天內才會付清但是現在這個對現在的社區藥局友善藥局其實對他們的金流是一個非常非常大的壓力所以我在想說是不是要麻煩那個衛福部就是說因為可以提高愛知健保處方簽的站覆陳述因為他們本來就是像他如果200個病人\n謝謝,我真的很感謝我們友善藥局N1來\n﹚林憶君﹚\n﹚林憶君﹚\n這樣我覺得是有點不太合理啦所以是不是針對這個藥物就是這111家針對這一個藥物我們來切磋或許是我們就先補負到他95%嘛因為他本來就是應該100%嘛只是說一個是60天後再負給他這樣啊我們就提高給他們不要那麼大的金流壓力如果以電子的話有時候是負9乘5所以我想我們來想辦法\n﹚林憶君﹚\n我們可以切開不見得是整個嘛我知道你們的難處但是光這個藥物我們可以先補足到他他95%讓他們能更願意來服務這些病友這樣然後推動我們的政策\n好,是。\n那現在就是院長部長你們知道洗腎或手術的輸液是使用最大的就是那個生理食鹽水嗎對不對然後上個月應該臺灣輸液大廠的時候有違規遭勒令官場的問題嗎所以就是有一些其藥廠產人沒有辦法補足這個缺口嗎所以我們現在從這個問題來看其實我認為我們必須要從國防外交的戰略的角度來看這個從國內到國外的原料鏈\n﹚林憶君﹚\n好,謝謝。謝謝林委員。謝謝卓院長。下一位請王委員美會質詢。\n","vtt":"WEBVTT\n\n00:00.268 --> 00:00.449\n主席\n\n00:35.382 --> 00:38.165\n有請行政院卓榮泰院長。來,院長請備詢。議員好。\n\n00:50.302 --> 01:04.878\n院長好。院長我想請問一下,一個好山好水的花東地區,交通不方便,每逢颱風還有地震,都沒有順利回家的路,難道這是身為東部人的命運嗎?\n\n01:07.209 --> 01:25.797\n謝謝委員花東的鄉親因為長期這個地理環境天然資源所受他這個交通上確實是比較不方便但是政府從過去到現在也投入相當大的資源在整個解決花東的問題但是受限剛剛所說的這個地理的環境\n\n01:26.457 --> 01:28.558\n政府一定會持續地做很多事情來給花中的鄉親一個更好的環境。\n\n01:47.768 --> 02:01.986\n好,是正如院長說的,但是每次遇到天災還有道路中斷的時候,然後農民要運送農產品非常的不方便,還有連生病的患者要就醫都求救無路,然後遊客又來條路。\n\n02:03.188 --> 02:03.408\n﹚林憶君﹚\n\n02:30.507 --> 02:31.849\n請你們要將心比心。\n\n02:45.484 --> 02:45.504\n﹚廣告\n\n03:01.894 --> 03:26.546\n這一次的0403的地震可以看得出來過去蘇花改蘇花改所做的這些隧道橋樑都非常的都還狀況非常的好表示他的抗震耐震的能力是非常的好所以這一次我們也持續的來推動蘇花安那要把把整個整個快速的入網的系統把它連通那蘇花安也很快在\n\n03:27.226 --> 03:27.366\n﹚林憶君﹚\n\n03:51.735 --> 04:12.792\n好,剛剛院長說04、03其實從花蓮地震到現在然後我們花蓮人往返臺北的舒花公路其實都有小小的餘震嘛所以都有落石還有土石流像上禮拜一大家可能都注意到基隆那邊的公園有山崩但其實在同一天花蓮的舒花公路其實從的隧道北端的山壁也發生了\n\n04:13.092 --> 04:13.132\n﹚林憶君﹚\n\n04:35.177 --> 04:52.953\n其實環境部在5月14日也召開了臺九縣的蘇花公路安全提升計畫環境影響說明書專案小組第二次的環評初審會議然後也同意了本案的通過的初審但是這樣在回想之前針對我們的規劃已經落後了兩年\n\n04:56.716 --> 05:13.708\n所以但是現在是以前是119年就可以完工現在變成121年完工為目標那要交通部的公路的總局的局長說如果一切都順利的話能在今年的8月取得環評大會審查修正通過\n\n05:14.508 --> 05:30.776\n希望年底建設計劃就能核定,明年提出設計的規劃,明年的8月開始取得用地,並同步執行都市計劃變更的程序,期待116年初就可以發包施工。如果照這樣的話,你看整個蘇花安本來經費從360億元到現在評估的階段已經暴增了802億元。\n\n05:39.720 --> 05:58.919\n但是考慮到舒嬅公路每年都是道路封閉還有經濟上的損失落石土石流其實造成公路損害的維修的費用其實平均攤下來可能也不比新建舒嬅安的費用節省多少但是最主要大家都知道更重要的是人命是無價的\n\n05:59.780 --> 06:21.916\n所以請問院長和部長,蘇花安到底什麼時候可以真正的完工通車?你們可知道花蓮人其實已經等不及了,因為你們執政那麼久,其實花蓮人都等到民心都已經失去了。真的有把握在116年能夠發包施工嗎?還是說那時候又要採取拖延戰術呢?繼續欺騙花蓮人呢?\n\n06:24.818 --> 06:43.784\n因為過去民進黨執政選舉的時候都開了很多的支票,例如副總統蕭美琴過去競選花蓮區域立委的時候,她就提出高鐵東延還有花東快鐵,然後現任的外交部長林佳龍在擔任交通部長時也喊了,\n\n06:44.384 --> 07:06.998\n西部高鐵還有東部快鐵以及2030年全國高快速鐵路網的規劃就說6小時我們就可以還臺還有前交通部長王國才也說環島高鐵不是夢但是為什麼到現在花東的交通的新建設一點的動靜都沒有呢\n\n07:07.478 --> 07:32.868\n那樣民進黨執政8年來多項的交通政策現在都變成了空頭支票所以我們想請院長還有部長你們可以盡快給予專業的意見還有看法讓全國民眾了解說不是用政治語言來欺騙大眾企圖讓東部居民充滿了期待然後卻又造成社會大眾產生更多的誤解和對立\n\n07:34.210 --> 08:03.576\n委員如果這是一張空投支票就不會有今年5月14號的環評出審的通過那麼持續下來會做這個環境影響評估再來就會進到更細部的計畫對所以是可以這種可以監督一下他這個進度因為我看比之前規劃已經慢了兩年了因為我不曉得後面還要慢多久這絕對不是一張空投支票我們一起來讓花東的鄉親能夠安心持續的往前做那已經在程序當中現在會一直一步一步的做下去\n\n08:04.036 --> 08:31.378\n好,那也跟委員報告,其實包括花東的這個鐵路現在雙軌化已經也在陸續的在發包進行那這樣的話可以讓整個花東鐵路提速那現階段我們也把最好的全國最好的車廂最新的都用在花東所以EMU3000它的這個座位數從300多從像太魯閣號只有300多它可以到500多個座位那這個最好運量最好的這個最大的\n\n08:32.259 --> 08:39.336\n是的,但是你知道如果入主段的時候其實火車票他也是一票籃球的\n\n08:40.151 --> 09:05.910\n所以這個也代表政府其實持續對花東投入相當多的經費跟關注那這個蘇花安目前就是我想所有的交通建設大概最需要等待的就是環評那麼蘇花安很不容易的已經5月14號環評出審通過那預計在7月份大會或是8月份大會就可以來正式核定那接著我們就是進入計畫的\n\n09:06.991 --> 09:07.211\n﹚林憶君\n\n09:24.100 --> 09:44.629\n兩個部落需要諮商同意那這個部落他們擔心快速道路經過他們的部落反而會造成部落的人口流失或是商機降低所以這個還要這個在發包錢要取得部落的同意這是我們相關的法規的規定所以這個部分還要努力目前大概唯一的變數是在這個地方\n\n09:45.529 --> 10:09.231\n我再問一個問題,就是說交通部在2020年的時候我們有重啟花東快速道路的可行性評估,然後預計要在8月的時候出爐。但是2020年到2024年,這耗時4年了,做了重大的評估。那樣有把握在8月份的時候可以做嗎?這可以解決花東人素食癌的交通不便的痛苦。\n\n10:09.751 --> 10:14.713\n八月份是報告可以出來那當然他要經過一些的審查的階段那現在大概幾個關鍵一個就是說整個投資的一本筆\n\n10:29.813 --> 10:52.200\n是不是符合投資的效益?通常我們一本筆要到一才會有一個投資的效益。再來就是預算的容納,還有一個是環評,因為這個是一個新的快速道路,所以他要做二階的環評。環評是不是能夠同意,能夠讓他核准通過,能不能順利的來approve這個部分。\n\n10:52.980 --> 11:13.533\n最後還有一個階段就在開工前他沿線我們目前的了解170幾公里有11個部落這11個部落都要同意資商同意才可以來辦理發包那這是在發包前必須要取得同意我想這些變數大概都是我們未來要再去持續的突破的地方\n\n11:14.840 --> 11:29.669\n所以其實政府不應該畫大餅然後之後又說不太可能這樣因為先操作東西區域的不平衡問題然後之後再來覺得說是國家財政的困難還是還品有自愛難行的理由\n\n11:30.089 --> 11:30.129\n﹚林憶君﹚\n\n11:56.656 --> 11:57.117\n報告委員這不是大餅這是一條直線\n\n12:07.406 --> 12:30.481\n全場179公里的直線有17個交流道總經費達到2555億當中還有剛剛部長說的11個部落他的同意資商要去處理跟剛剛那個一樣我們跟部落的溝通一定要加強我已經跟部長說過了盡量去說服他們希望他們能夠理解這個重大公共工程的重要性那麼能夠縮短互相溝通的時間就能把這些報告\n\n12:31.383 --> 12:32.825\n希望大家都能聽到花東人民的聲音。\n\n12:48.783 --> 13:09.375\n那也跟委員報告因為目前政府各種法令都有規範我們做相關重大建設所應該要做的一些程序所以這個不是我們去找困難來搪塞而是相關像環評法令部落諮商的法令水保的法令等等都有一定的規範我們必須要去遵守\n\n13:11.787 --> 13:26.115\n我再問一下院長就是說因為院長你在此次的施政報告裡面你是親自擔任0403花蓮地震專案小組的召集人有關此次的地震除了希望行政院能夠真正的徹底\n\n13:26.975 --> 13:50.930\n執行政災復原的重建方案解決花蓮災民的問題之外就是有一個臺灣東部就是第一所綜合大學國立東華大學然後地震後學校的建物在強震中有受損其中理工學院有一棟是整個燒毀的宿舍有1700床也沒有辦法使用然後校方有估計大約重建總經費是20億元\n\n13:53.191 --> 14:19.453\n然後在這一次04、03的花蓮地震其實針對東華大學這個理工學院那一管低洞的話還有一個化學實驗室然後地震發生火災然後燒了20個小時整棟全毀然後花蓮縣的消防局然後他們也有馬上前往救援但是因為現場內存放的都是進水性的化學物質所以不能用水來撲滅然後消防人員就是進退兩難\n\n14:20.954 --> 14:40.376\n據瞭解當時花蓮縣的消防局向宜蘭還有向高雄請求化學災害處理車支援但是臺九縣因為地震所以已經山壁攤分斷裂了所以連最近的宜蘭消防局也沒有辦法前往而高雄的消防局的路途太遙遠了\n\n14:41.377 --> 14:41.417\n﹚林憶君﹚\n\n15:22.631 --> 15:23.771\n在5月4日那一次有特別在花蓮召開0403\n\n15:50.362 --> 16:17.846\n正在復原重建專案會議中。然後在那個會議中我也有當時也有建議提示要求中華大學化學實驗室除放多種化學的物質強震導致化學物品引發的大火所以有關爭取相關所需要的化學搶救車救災的車輛有請內政部消防署有統籌處理那請問院長那內政部就是否有在此\n\n16:18.366 --> 16:44.725\n可以允若本席同意補助或直接提供花蓮縣還是台東縣各兩台乾粉或其他特別面火的藥劑的化學災害處理消防車呢?因為這可以因應特殊的化學物質所引發的火災,強化消防救災的效能,以免花東地區再次發生這種設備不足而造成的遺憾事件。\n\n16:45.586 --> 17:06.788\n那請問院長你身為專案小組召集人那可以答應補助嗎?謝謝委員由我本人來擔任專案小組的召集人請鄭麗君副院長來負責督導是我們要讓花蓮鄉親真正看到政府的誠意跟決心我們已經提高效率計畫及早合可\n\n17:07.996 --> 17:08.957\n請部長報告一下\n\n17:29.119 --> 17:44.271\n是,跟委員報告一下,其實卓院長在當時的時候已經有指示,我們在明年度的時候呢,會先補助一輛近水性的化學災防的消防車,那其實花蓮縣政府還有當天參加這個會刊的委員都已經知道了。\n\n17:45.485 --> 18:06.197\n所以就是補助儀量這樣就對了?不是,因為進水性的化學消防車沒有那麼容易,跟一般的化學消防車泡沫消防車不太一樣,所以它必須要有特殊的救護的機制,所以我們先用儀量,何況現在以花蓮或者是以台東來講,需要用進水性的化學物質的量沒有那麼多,那如果未來還有需要的話,我們還可以再做中長程計畫的調整。\n\n18:07.378 --> 18:35.587\n其實東部市真的是需要啦,因為真的是道路上面的萬一有中斷的情況下,其實我們花東的人的性命還是很重要的。是,而且東華大學那一棟出事的大樓,整棟的材質重建工程會非常積極在處理。好,跟委員報告,就是第一棟就是化學館,那化學館它整個要異地重建,那我們希望教育部在督導東華大學重建的過程,因為是化學館,所以那內部的整個\n\n18:36.886 --> 18:36.926\n﹝發言委員﹞\n\n19:06.749 --> 19:07.329\n衛福部部長\n\n19:39.052 --> 20:04.878\n委員長部長好我想問一下就是本席今天想要請教一個問一個就是有關處方簽格式統一的問題因為最近很多基層的藥師特別跟本席陳情他們說像在臺北市立醫院有分為好幾個院區就是說今天有人到昆明院區去就醫然後拿著醫生釋出的慢性處方簽到社區藥局去領藥然後跟到林森院區去看病後拿到醫生\n\n20:05.578 --> 20:05.818\n應該都要一致的。\n\n20:19.209 --> 20:22.731\n對對對應該是都一樣的嘛但是這個就問題來了因為自從84年開辦全民健保到現在因為時空環境的轉變許多很多家醫院已經開始整病了然後各院區都有一個共用醫事機構代碼但是卻有不同的層級喔而會影響到部分負擔因為我們今天我們112年有一個部分負擔的調整嘛\n\n21:03.763 --> 21:12.046\n同樣居然地區和區域醫院教學的成績居然釋出了一般的處方簽和慢性處方簽,它的機構代碼居然是一樣的。我想這個門診交付處方簽這個是按照醫師法第13條,各特別醫院院首應該要按照這個法,按醫法跟以及健保署公告的格式來開立處方。那它當然代碼有分為\n\n21:34.351 --> 21:54.196\n剛剛為人所講的,那應該他是哪一級的醫院就是哪一個代碼嗎?對,因為這個我覺得很奇怪,像我們花蓮的門諾醫院的話,他包括他受封分院還有其他的每一個醫室代碼都不同的。會不會是因為他不同體系裡面也有區醫院也有地區醫院而援手不同,這可能我們要來了解一下。\n\n21:54.676 --> 21:54.836\n﹚林憶君﹚\n\n22:14.482 --> 22:36.400\n當然處方簽上面整個格式都沒有標明的清楚,沒標明的清楚的時候社區藥局會遺漏收了部分負擔。所以這個樣子就是說健保藥物處方簽格式沒有統一還有不完全,其實是增加社區藥局藥師在登載健保申報系統的交付藥上面還有複合藥物的困難度。\n\n22:37.708 --> 23:03.578\n好,是,如果沒有統一的話,我想我們要來找這個所有的醫療院所來討論,希望能夠...對啊,部長你可以看一下,因為我也覺得很奇怪,為什麼電腦上面寫這兩間是寫地區醫院,然後結果居然到了庫比醫院區的時候,收費的時候是收基層診所的藥費的部分負擔,因為這個到時候到社區藥局去拿藥的時候,其實病人會反應。\n\n23:04.858 --> 23:04.878\n拜訪議員\n\n23:50.255 --> 24:14.913\n當然全部補齊的時候大家來社區藥局拿藥的時候也可以降低藥師的複合藥物還有登載申報系統的困難然後當然這樣的話我們給病人收錢的時候給病人收錢的時候也不會引起爭議啊因為常常拿到藥物的拿到處方簽的時候都在看說這到底這一家是地區醫院呢還是還是那個區醫院呢然後收費又不一樣\n\n24:15.774 --> 24:24.190\n然後光在查這個就要很久包括還要再登錄還有一點就是說萬一那時候收錯了病人又會去反應\n\n24:29.760 --> 24:46.534\n臺北市聯合醫院有很多的院區,是不是針對不同院區的規模它有這樣內部的細分,抱歉我倒是真的不清楚。但是為了要讓作業能夠一致化,尤其是市民患者在拿取藥品的時候能夠覺得安心跟可以稽查。\n\n24:47.014 --> 25:04.025\n我想那個衛福部應該跟臺北市來瞭解一下他的聯合醫院是不是有這種層級上不同的對我覺得是應該要瞭解因為包括這樣處罰金會造成哪一級就應該是哪一級要寫清楚對對對因為他電腦查的時候是地區醫院結果居然收費的時候是用基層診所\n\n25:05.126 --> 25:21.118\n那是不是當然像台北市這種過去傳統以來有時候會有一些福利優待特殊的族群會不會跟這個稍微沒有把它分得很清楚。所以最好是可以把處方簽統一格式我們處方簽統一格式包括以後我們推動的電子處方簽我們都可以陸續統一格式那大家在登載方面還有在我們在給病患收費方面都非常的清楚還有這個病人的身份方面其實我覺得這個都是\n\n25:41.751 --> 25:58.880\n我非常肯定最近這幾年衛福部在愛滋病防復政策上面其實成績推動得非常好然後我在這邊給衛福部很大肯定但是因為最近社區藥局和疾病管理署他們有一個特約就是針對人類免疫缺乏病毒\n\n25:59.560 --> 25:59.600\n﹚林憶君\n\n26:16.027 --> 26:16.227\n﹚林憶君﹚林憶君﹚\n\n26:36.699 --> 26:36.799\n﹚林憶君\n\n26:59.918 --> 27:27.907\n站覆的陳述其實在健保申報15天之後只有波低於85%剩下的金額要60天內才會付清但是現在這個對現在的社區藥局友善藥局其實對他們的金流是一個非常非常大的壓力所以我在想說是不是要麻煩那個衛福部就是說因為可以提高愛知健保處方簽的站覆陳述因為他們本來就是像他如果200個病人\n\n27:29.087 --> 27:30.268\n謝謝,我真的很感謝我們友善藥局N1來\n\n27:56.075 --> 27:56.335\n﹚林憶君﹚\n\n28:20.472 --> 28:20.512\n﹚林憶君﹚\n\n28:46.454 --> 29:12.750\n這樣我覺得是有點不太合理啦所以是不是針對這個藥物就是這111家針對這一個藥物我們來切磋或許是我們就先補負到他95%嘛因為他本來就是應該100%嘛只是說一個是60天後再負給他這樣啊我們就提高給他們不要那麼大的金流壓力如果以電子的話有時候是負9乘5所以我想我們來想辦法\n\n29:13.530 --> 29:13.730\n﹚林憶君﹚\n\n29:35.805 --> 29:43.555\n我們可以切開不見得是整個嘛我知道你們的難處但是光這個藥物我們可以先補足到他他95%讓他們能更願意來服務這些病友這樣然後推動我們的政策\n\n29:50.026 --> 29:50.126\n好,是。\n\n30:11.909 --> 30:22.512\n那現在就是院長部長你們知道洗腎或手術的輸液是使用最大的就是那個生理食鹽水嗎對不對然後上個月應該臺灣輸液大廠的時候有違規遭勒令官場的問題嗎所以就是有一些其藥廠產人沒有辦法補足這個缺口嗎所以我們現在從這個問題來看其實我認為我們必須要從國防外交的戰略的角度來看這個從國內到國外的原料鏈\n\n30:41.237 --> 30:41.577\n﹚林憶君﹚\n\n31:09.704 --> 31:18.041\n好,謝謝。謝謝林委員。謝謝卓院長。下一位請王委員美會質詢。\n\n","segments":[{"start":0.268,"end":0.449,"text":"主席"},{"start":35.382,"end":38.165,"text":"有請行政院卓榮泰院長。來,院長請備詢。議員好。"},{"start":50.302,"end":64.878,"text":"院長好。 院長我想請問一下,一個好山好水的花東地區,交通不方便,每逢颱風還有地震,都沒有順利回家的路,難道這是身為東部人的命運嗎?"},{"start":67.209,"end":85.797,"text":"謝謝委員 花東的鄉親因為長期這個地理環境天然資源所受他這個交通上確實是比較不方便但是政府從過去到現在也投入相當大的資源在整個解決花東的問題但是受限剛剛所說的這個地理的環境"},{"start":86.457,"end":88.558,"text":"政府一定會持續地做很多事情來給花中的鄉親一個更好的環境。"},{"start":107.768,"end":121.986,"text":"好,是正如院長說的,但是每次遇到天災還有道路中斷的時候,然後農民要運送農產品非常的不方便,還有連生病的患者要就醫都求救無路,然後遊客又來條路。"},{"start":123.188,"end":123.408,"text":"﹚林憶君﹚"},{"start":150.507,"end":151.849,"text":"請你們要將心比心。"},{"start":165.484,"end":165.504,"text":"﹚廣告"},{"start":181.894,"end":206.546,"text":"這一次的0403的地震可以看得出來過去蘇花改蘇花改所做的這些隧道橋樑都非常的都還狀況非常的好表示他的抗震耐震的能力是非常的好所以這一次我們也持續的來推動蘇花安那要把把整個整個快速的入網的系統把它連通那蘇花安也很快在"},{"start":207.226,"end":207.366,"text":"﹚林憶君﹚"},{"start":231.735,"end":252.792,"text":"好,剛剛院長說04、03其實從花蓮地震到現在然後我們花蓮人往返臺北的舒花公路其實都有小小的餘震嘛所以都有落石還有土石流像上禮拜一大家可能都注意到基隆那邊的公園有山崩但其實在同一天花蓮的舒花公路其實從的隧道北端的山壁也發生了"},{"start":253.092,"end":253.132,"text":"﹚林憶君﹚"},{"start":275.177,"end":292.953,"text":"其實環境部在5月14日也召開了臺九縣的蘇花公路安全提升計畫環境影響說明書專案小組第二次的環評初審會議然後也同意了本案的通過的初審但是這樣在回想之前針對我們的規劃已經落後了兩年"},{"start":296.716,"end":313.708,"text":"所以但是現在是以前是119年就可以完工現在變成121年完工為目標那要交通部的公路的總局的局長說如果一切都順利的話能在今年的8月取得環評大會審查修正通過"},{"start":314.508,"end":330.776,"text":"希望年底建設計劃就能核定,明年提出設計的規劃,明年的8月開始取得用地,並同步執行都市計劃變更的程序,期待116年初就可以發包施工。如果照這樣的話,你看整個蘇花安本來經費從360億元到現在評估的階段已經暴增了802億元。"},{"start":339.72,"end":358.919,"text":"但是考慮到舒嬅公路每年都是道路封閉還有經濟上的損失落石土石流其實造成公路損害的維修的費用其實平均攤下來可能也不比新建舒嬅安的費用節省多少但是最主要大家都知道更重要的是人命是無價的"},{"start":359.78,"end":381.916,"text":"所以請問院長和部長,蘇花安到底什麼時候可以真正的完工通車?你們可知道花蓮人其實已經等不及了,因為你們執政那麼久,其實花蓮人都等到民心都已經失去了。真的有把握在116年能夠發包施工嗎?還是說那時候又要採取拖延戰術呢?繼續欺騙花蓮人呢?"},{"start":384.818,"end":403.784,"text":"因為過去民進黨執政選舉的時候都開了很多的支票,例如副總統蕭美琴過去競選花蓮區域立委的時候,她就提出高鐵東延還有花東快鐵,然後現任的外交部長林佳龍在擔任交通部長時也喊了,"},{"start":404.384,"end":426.998,"text":"西部高鐵還有東部快鐵以及2030年全國高快速鐵路網的規劃就說6小時我們就可以還臺還有前交通部長王國才也說環島高鐵不是夢但是為什麼到現在花東的交通的新建設一點的動靜都沒有呢"},{"start":427.478,"end":452.868,"text":"那樣民進黨執政8年來多項的交通政策現在都變成了空頭支票所以我們想請院長還有部長你們可以盡快給予專業的意見還有看法讓全國民眾了解說不是用政治語言來欺騙大眾企圖讓東部居民充滿了期待然後卻又造成社會大眾產生更多的誤解和對立"},{"start":454.21,"end":483.576,"text":"委員如果這是一張空投支票就不會有今年5月14號的環評出審的通過那麼持續下來會做這個環境影響評估再來就會進到更細部的計畫對所以是可以這種可以監督一下他這個進度因為我看比之前規劃已經慢了兩年了因為我不曉得後面還要慢多久這絕對不是一張空投支票我們一起來讓花東的鄉親能夠安心持續的往前做那已經在程序當中現在會一直一步一步的做下去"},{"start":484.036,"end":511.378,"text":"好,那也跟委員報告,其實包括花東的這個鐵路現在雙軌化已經也在陸續的在發包進行那這樣的話可以讓整個花東鐵路提速那現階段我們也把最好的全國最好的車廂最新的都用在花東所以EMU3000它的這個座位數從300多從像太魯閣號只有300多它可以到500多個座位那這個最好運量最好的這個最大的"},{"start":512.259,"end":519.336,"text":"是的,但是你知道如果入主段的時候其實火車票他也是一票籃球的"},{"start":520.151,"end":545.91,"text":"所以這個也代表政府其實持續對花東投入相當多的經費跟關注那這個蘇花安目前就是我想所有的交通建設大概最需要等待的就是環評那麼蘇花安很不容易的已經5月14號環評出審通過那預計在7月份大會或是8月份大會就可以來正式核定那接著我們就是進入計畫的"},{"start":546.991,"end":547.211,"text":"﹚林憶君"},{"start":564.1,"end":584.629,"text":"兩個部落需要諮商同意那這個部落他們擔心快速道路經過他們的部落反而會造成部落的人口流失或是商機降低所以這個還要這個在發包錢要取得部落的同意這是我們相關的法規的規定所以這個部分還要努力目前大概唯一的變數是在這個地方"},{"start":585.529,"end":609.231,"text":"我再問一個問題,就是說交通部在2020年的時候我們有重啟花東快速道路的可行性評估,然後預計要在8月的時候出爐。但是2020年到2024年,這耗時4年了,做了重大的評估。那樣有把握在8月份的時候可以做嗎?這可以解決花東人素食癌的交通不便的痛苦。"},{"start":609.751,"end":614.713,"text":"八月份是報告可以出來那當然他要經過一些的審查的階段那現在大概幾個關鍵一個就是說整個投資的一本筆"},{"start":629.813,"end":652.2,"text":"是不是符合投資的效益?通常我們一本筆要到一才會有一個投資的效益。再來就是預算的容納,還有一個是環評,因為這個是一個新的快速道路,所以他要做二階的環評。環評是不是能夠同意,能夠讓他核准通過,能不能順利的來 approve 這個部分。"},{"start":652.98,"end":673.533,"text":"最後還有一個階段就在開工前他沿線我們目前的了解170幾公里有11個部落這11個部落都要同意資商同意才可以來辦理發包那這是在發包前必須要取得同意我想這些變數大概都是我們未來要再去持續的突破的地方"},{"start":674.84,"end":689.669,"text":"所以其實政府不應該畫大餅然後之後又說不太可能這樣因為先操作東西區域的不平衡問題然後之後再來覺得說是國家財政的困難還是還品有自愛難行的理由"},{"start":690.089,"end":690.129,"text":"﹚林憶君﹚"},{"start":716.656,"end":717.117,"text":"報告委員這不是大餅這是一條直線"},{"start":727.406,"end":750.481,"text":"全場179公里的直線有17個交流道總經費達到2555億當中還有剛剛部長說的11個部落他的同意資商要去處理跟剛剛那個一樣我們跟部落的溝通一定要加強我已經跟部長說過了盡量去說服他們希望他們能夠理解這個重大公共工程的重要性那麼能夠縮短互相溝通的時間就能把這些報告"},{"start":751.383,"end":752.825,"text":"希望大家都能聽到花東人民的聲音。"},{"start":768.783,"end":789.375,"text":"那也跟委員報告因為目前政府各種法令都有規範我們做相關重大建設所應該要做的一些程序所以這個不是我們去找困難來搪塞而是相關像環評法令部落諮商的法令水保的法令等等都有一定的規範我們必須要去遵守"},{"start":791.787,"end":806.115,"text":"我再問一下院長就是說因為院長你在此次的施政報告裡面你是親自擔任0403花蓮地震專案小組的召集人有關此次的地震除了希望行政院能夠真正的徹底"},{"start":806.975,"end":830.93,"text":"執行政災復原的重建方案解決花蓮災民的問題之外就是有一個臺灣東部就是第一所綜合大學國立東華大學然後地震後學校的建物在強震中有受損其中理工學院有一棟是整個燒毀的宿舍有1700床也沒有辦法使用然後校方有估計大約重建總經費是20億元"},{"start":833.191,"end":859.453,"text":"然後在這一次04、03的花蓮地震其實針對東華大學這個理工學院那一管低洞的話還有一個化學實驗室然後地震發生火災然後燒了20個小時整棟全毀然後花蓮縣的消防局然後他們也有馬上前往救援但是因為現場內存放的都是進水性的化學物質所以不能用水來撲滅然後消防人員就是進退兩難"},{"start":860.954,"end":880.376,"text":"據瞭解當時花蓮縣的消防局向宜蘭還有向高雄請求化學災害處理車支援但是臺九縣因為地震所以已經山壁攤分斷裂了所以連最近的宜蘭消防局也沒有辦法前往而高雄的消防局的路途太遙遠了"},{"start":881.377,"end":881.417,"text":"﹚林憶君﹚"},{"start":903.831,"end":922.432,"text":"﹏﹏"},{"start":922.631,"end":923.771,"text":"在5月4日那一次有特別在花蓮召開0403"},{"start":950.362,"end":977.846,"text":"正在復原重建專案會議中。然後在那個會議中我也有當時也有建議提示要求中華大學化學實驗室除放多種化學的物質強震導致化學物品引發的大火所以有關爭取相關所需要的化學搶救車救災的車輛有請內政部消防署有統籌處理那請問院長那內政部就是否有在此"},{"start":978.366,"end":1004.725,"text":"可以允若本席同意補助或直接提供花蓮縣還是台東縣各兩台乾粉或其他特別面火的藥劑的化學災害處理消防車呢?因為這可以因應特殊的化學物質所引發的火災,強化消防救災的效能,以免花東地區再次發生這種設備不足而造成的遺憾事件。"},{"start":1005.586,"end":1026.788,"text":"那請問院長你身為專案小組召集人那可以答應補助嗎?謝謝委員由我本人來擔任專案小組的召集人請鄭麗君副院長來負責督導是我們要讓花蓮鄉親真正看到政府的誠意跟決心我們已經提高效率計畫及早合可"},{"start":1027.996,"end":1028.957,"text":"請部長報告一下"},{"start":1049.119,"end":1064.271,"text":"是,跟委員報告一下,其實卓院長在當時的時候已經有指示,我們在明年度的時候呢,會先補助一輛近水性的化學災防的消防車,那其實花蓮縣政府還有當天參加這個會刊的委員都已經知道了。"},{"start":1065.485,"end":1086.197,"text":"所以就是補助儀量這樣就對了?不是,因為進水性的化學消防車沒有那麼容易,跟一般的化學消防車泡沫消防車不太一樣,所以它必須要有特殊的救護的機制,所以我們先用儀量,何況現在以花蓮或者是以台東來講,需要用進水性的化學物質的量沒有那麼多,那如果未來還有需要的話,我們還可以再做中長程計畫的調整。"},{"start":1087.378,"end":1115.587,"text":"其實東部市真的是需要啦,因為真的是道路上面的萬一有中斷的情況下,其實我們花東的人的性命還是很重要的。 是,而且東華大學那一棟出事的大樓,整棟的材質重建工程會非常積極在處理。 好,跟委員報告,就是第一棟就是化學館,那化學館它整個要異地重建,那我們希望教育部在督導東華大學重建的過程,因為是化學館,所以那內部的整個"},{"start":1116.886,"end":1116.926,"text":"﹝發言委員﹞"},{"start":1146.749,"end":1147.329,"text":"衛福部部長"},{"start":1179.052,"end":1204.878,"text":"委員長部長好我想問一下就是本席今天想要請教一個問一個就是有關處方簽格式統一的問題因為最近很多基層的藥師特別跟本席陳情他們說像在臺北市立醫院有分為好幾個院區就是說今天有人到昆明院區去就醫然後拿著醫生釋出的慢性處方簽到社區藥局去領藥然後跟到林森院區去看病後拿到醫生"},{"start":1205.578,"end":1205.818,"text":"應該都要一致的。"},{"start":1219.209,"end":1222.731,"text":"對對對應該是都一樣的嘛但是這個就問題來了因為自從84年開辦全民健保到現在因為時空環境的轉變許多很多家醫院已經開始整病了然後各院區都有一個共用醫事機構代碼但是卻有不同的層級喔而會影響到部分負擔因為我們今天我們112年有一個部分負擔的調整嘛"},{"start":1241.92,"end":1263.643,"text":"﹗"},{"start":1263.763,"end":1272.046,"text":"同樣居然地區和區域醫院教學的成績居然釋出了一般的處方簽和慢性處方簽,它的機構代碼居然是一樣的。我想這個門診交付處方簽這個是按照醫師法第13條,各特別醫院院首應該要按照這個法,按醫法跟以及健保署公告的格式來開立處方。那它當然代碼有分為"},{"start":1294.351,"end":1314.196,"text":"剛剛為人所講的,那應該他是哪一級的醫院就是哪一個代碼嗎?對,因為這個我覺得很奇怪,像我們花蓮的門諾醫院的話,他包括他受封分院還有其他的每一個醫室代碼都不同的。會不會是因為他不同體系裡面也有區醫院也有地區醫院而援手不同,這可能我們要來了解一下。"},{"start":1314.676,"end":1314.836,"text":"﹚林憶君﹚"},{"start":1334.482,"end":1356.4,"text":"當然處方簽上面整個格式都沒有標明的清楚,沒標明的清楚的時候社區藥局會遺漏收了部分負擔。 所以這個樣子就是說健保藥物處方簽格式沒有統一還有不完全,其實是增加社區藥局藥師在登載健保申報系統的交付藥上面還有複合藥物的困難度。"},{"start":1357.708,"end":1383.578,"text":"好,是,如果沒有統一的話,我想我們要來找這個所有的醫療院所來討論,希望能夠...對啊,部長你可以看一下,因為我也覺得很奇怪,為什麼電腦上面寫這兩間是寫地區醫院,然後結果居然到了庫比醫院區的時候,收費的時候是收基層診所的藥費的部分負擔,因為這個到時候到社區藥局去拿藥的時候,其實病人會反應。"},{"start":1384.858,"end":1384.878,"text":"拜訪議員"},{"start":1404.855,"end":1429.735,"text":"﹏﹏"},{"start":1430.255,"end":1454.913,"text":"當然全部補齊的時候大家來社區藥局拿藥的時候也可以降低藥師的複合藥物還有登載申報系統的困難然後當然這樣的話我們給病人收錢的時候給病人收錢的時候也不會引起爭議啊因為常常拿到藥物的拿到處方簽的時候都在看說這到底這一家是地區醫院呢還是還是那個區醫院呢然後收費又不一樣"},{"start":1455.774,"end":1464.19,"text":"然後光在查這個就要很久包括還要再登錄還有一點就是說萬一那時候收錯了病人又會去反應"},{"start":1469.76,"end":1486.534,"text":"臺北市聯合醫院有很多的院區,是不是針對不同院區的規模它有這樣內部的細分,抱歉我倒是真的不清楚。但是為了要讓作業能夠一致化,尤其是市民患者在拿取藥品的時候能夠覺得安心跟可以稽查。"},{"start":1487.014,"end":1504.025,"text":"我想那個衛福部應該跟臺北市來瞭解一下他的聯合醫院是不是有這種層級上不同的對我覺得是應該要瞭解因為包括這樣處罰金會造成哪一級就應該是哪一級要寫清楚對對對因為他電腦查的時候是地區醫院結果居然收費的時候是用基層診所"},{"start":1505.126,"end":1521.118,"text":"那是不是當然像台北市這種過去傳統以來有時候會有一些福利優待特殊的族群會不會跟這個稍微沒有把它分得很清楚。 所以最好是可以把處方簽統一格式我們處方簽統一格式包括以後我們推動的電子處方簽我們都可以陸續統一格式那大家在登載方面還有在我們在給病患收費方面都非常的清楚還有這個病人的身份方面其實我覺得這個都是"},{"start":1541.751,"end":1558.88,"text":"我非常肯定最近這幾年衛福部在愛滋病防復政策上面其實成績推動得非常好然後我在這邊給衛福部很大肯定但是因為最近社區藥局和疾病管理署他們有一個特約就是針對人類免疫缺乏病毒"},{"start":1559.56,"end":1559.6,"text":"﹚林憶君"},{"start":1576.027,"end":1576.227,"text":"﹚林憶君﹚林憶君﹚"},{"start":1596.699,"end":1596.799,"text":"﹚林憶君"},{"start":1619.918,"end":1647.907,"text":"站覆的陳述其實在健保申報15天之後只有波低於85%剩下的金額要60天內才會付清但是現在這個對現在的社區藥局友善藥局其實對他們的金流是一個非常非常大的壓力所以我在想說是不是要麻煩那個衛福部就是說因為可以提高愛知健保處方簽的站覆陳述因為他們本來就是像他如果200個病人"},{"start":1649.087,"end":1650.268,"text":"謝謝,我真的很感謝我們友善藥局N1來"},{"start":1676.075,"end":1676.335,"text":"﹚林憶君﹚"},{"start":1700.472,"end":1700.512,"text":"﹚林憶君﹚"},{"start":1726.454,"end":1752.75,"text":"這樣我覺得是有點不太合理啦所以是不是針對這個藥物就是這111家針對這一個藥物我們來切磋或許是我們就先補負到他95%嘛因為他本來就是應該100%嘛只是說一個是60天後再負給他這樣啊我們就提高給他們不要那麼大的金流壓力如果以電子的話有時候是負9乘5所以我想我們來想辦法"},{"start":1753.53,"end":1753.73,"text":"﹚林憶君﹚"},{"start":1775.805,"end":1783.555,"text":"我們可以切開不見得是整個嘛我知道你們的難處但是光這個藥物我們可以先補足到他他95%讓他們能更願意來服務這些病友這樣然後推動我們的政策"},{"start":1790.026,"end":1790.126,"text":"好,是。"},{"start":1811.909,"end":1822.512,"text":"那現在就是院長部長你們知道洗腎或手術的輸液是使用最大的就是那個生理食鹽水嗎對不對然後上個月應該臺灣輸液大廠的時候有違規遭勒令官場的問題嗎所以就是有一些其藥廠產人沒有辦法補足這個缺口嗎所以我們現在從這個問題來看其實我認為我們必須要從國防外交的戰略的角度來看這個從國內到國外的原料鏈"},{"start":1841.237,"end":1841.577,"text":"﹚林憶君﹚"},{"start":1869.704,"end":1878.041,"text":"好,謝謝。謝謝林委員。謝謝卓院長。下一位請王委員美會質詢。"}]}}}}