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00:00:07,198\n麻煩部長請邱部長部長早從一直在討論健保點子的時候常常就會被提到說因為醫護人員的薪資非常的低不過看起來就是說講他很低可是\n\n2\n00:00:29,990 --> 00:00:50,999\n實際上我們去整體看長久以來大概護理師的薪資大概都是由政府來主導調薪包括夜班的獎勵、繁重加給都是由衛福部來主導甚至在104年我們推動的醫護比跟健保的支付連動那實測結果也是降低醫護比有效薪資不知道為什麼\n\n3\n00:00:51,739 --> 00:01:11,253\n建保典子在講的時候都說應該要針對可是實際上看這個表格可以知道說基本上都是因為我們的薪資因為基本工資調的時候連動否則看到護理師的這樣的一個薪資跟我們醫療保健的業的平均薪資事實上是\n\n4\n00:01:11,758 --> 00:01:14,319\n有關這個部分是不是趙復師可以簡要回應一下\n\n5\n00:01:43,480 --> 00:01:53,706\n關於護理人員的薪資改善我們大概從幾個方面因為主要醫院還是直接的雇主所以我們現在三班互併比夜班獎勵的目的是讓專責夜班的能力可以固定那這個\n\n6\n00:02:01,209 --> 00:02:28,337\n也整體可以帶動這個護理人員行之?可是看起來沒有啊就說因為先保條件之後最後還是事實上我們就來看一個醫院收入跟支付是兩個不相關的程序所以政府要幫我們的護理人員加薪的話錢如果沒有指定用途的話或者是規定代收代付的話根本沒有辦法保證我們醫護人員所以想問部長說這樣的原因像是夜班的獎勵金繁重加急\n\n7\n00:02:28,997 --> 00:02:41,565\n未來你現在上任之後你應該還是會持續推動這個政策對吧這個是直接給護理人員的夜班獎勵是直接給護理人員對所以我說部長接下來你這些政策你會持續推動\n\n8\n00:02:42,335 --> 00:03:01,278\n我想我們已經有擬定了在今年的3月1號有擬行政院通過三個方向十二大目標我想這十二個目標我們目前非常積極在啟動包括當然就是夜班的這個部分改善工作環境\n\n9\n00:03:02,415 --> 00:03:02,475\n好．那\n\n10\n00:03:29,187 --> 00:03:53,479\n上現行醫院的自費項目幾乎是不被管理的那心理不准開刀健保給付19萬自費21萬那攝護腺肥大開刀健保給付9萬那自費16萬白內障開刀健保給付3萬可是自費的話一樣是3萬可是自費是一塊很大的收益這個全數的利益歸法人所有\n\n11\n00:03:54,298 --> 00:04:16,022\n那這是不是不太合理的應該是呈現在我們的薪資上跟所有的醫事人員共享所以想問一下本席要求衛福部推動自費收入列入管理那設定點子並將30%用於我們的薪資給付所以可不可以帶回去研議然後一個月內提出研議的結果你同意嗎\n\n12\n00:04:17,179 --> 00:04:20,580\n本席知道目前癌藥基金已經有預擬的方案所以想來問一下就是說這個計畫裡邊有提到財務衝擊評估的不確定\n\n13\n00:04:43,306 --> 00:05:02,502\n的藥品可以列入我們的暫時性支付如果其中兩三項的財務衝擊評估不確定的品項超出了預算超出的費用由藥商分攤這個制度設計的效果不是要由我們的藥商替負責做評估的HTA被黑鍋嗎而且投資風險這麼大部長你會覺得西藥代理商還會願意進口嗎因為你這邊寫了一個就計畫財務衝擊\n\n14\n00:05:12,110 --> 00:05:13,030\n可是這寫了這樣子的一個到底什麼叫財務衝擊評估不確定\n\n15\n00:05:37,802 --> 00:05:43,124\n跟委員說明這個不確定有兩種情形一種情形就是說我們官方我們委託的這個HTA科技醫藥科技評估報告跟廠商所提的這個報告中間的落差很大\n\n16\n00:06:04,390 --> 00:06:26,205\n這個就所謂的不確定就是等於各說各話那這個時候呢我們就會把它列入暫時性支付而沒有辦法直接進入到健保這是一種情況阿第二個是說我們評估起來如果我們按照它的價值來看也就是ISER值來看非常的高以英國為例它的ISER值呢它是定在大概在人年的藥費在3億\n\n17\n00:06:29,787 --> 00:06:33,370\n原來在健保的財務裡邊暫時性支付的費用大概20億那新藥大概40億\n\n18\n00:06:50,982 --> 00:07:17,263\n那現今要把暫時性支付從健保裡拉出來健保給付拉出來那連帶把新藥跟新適應症的藥品一起拉出來那成立我們的基金並增加40億的經費擴充到100億實際上用於癌症用藥的大概費用21到60億所以如果要達到我們總統降低我們的癌症死亡率三分之一的願景會不會打折\n\n19\n00:07:19,211 --> 00:07:35,313\n應該不會啦,因為我們依照實際上的需要,從20幾億,也許我們努力增加整個量能來到60億,我想3年應該就可以達到百億,也是會完成到這樣的一個百億基金。\n\n20\n00:07:37,018 --> 00:08:03,206\n本期期待為了強化我們的藥品供應鏈的韌性所以政府在新的制度還是要應該要扶持我們的國產製藥的思維原因在於我們臺灣本來就比較受地緣政治的影響如果供應鏈脆弱的話那學民藥跟國產藥的費用平均又只有我們進口藥的三分之一而且還可以增加品相所以想問一下國建署在我們的\n\n21\n00:08:03,962 --> 00:08:26,554\n健保藥物及負項目及支付標準修正案的討論當中一直有免除國產新藥廠商跟健保署簽訂MEA的那個責任所以在未來的基金規則裡邊應該要延續這個思維你同意嗎同意啊那盡量延長我們國內代理商收集臨床資料進行HTR的\n\n22\n00:08:29,025 --> 00:08:52,865\n平估期限讓廠商降低我們進口的風險提高代理意願部長同意嗎這個也可以考慮那再來就是一項有療效的藥品有時候為何遲遲不納入所以原因在於國健署跟藥商彼此費用都談不攏所以在有限的財源上要不要減少每預計年支付\n\n23\n00:08:53,385 --> 00:09:13,294\n我們的藥物的那個品項的數量要不就是增加財源這件事很重要早一天納入健保病友就早一天有得到存活的機會所以想問的是健保重大傷病免除部分負擔有沒有跟病友徵詢過是不是願意支付部分負擔用以減輕全額自費的壓力\n\n24\n00:09:15,026 --> 00:09:15,366\n主席主席\n\n25\n00:09:42,005 --> 00:09:42,387\n林月琴委員\n\n","tsv":"start\tend\ttext\n5457\t7198\t麻煩部長請邱部長部長早從一直在討論健保點子的時候常常就會被提到說因為醫護人員的薪資非常的低不過看起來就是說講他很低可是\n29990\t50999\t實際上我們去整體看長久以來大概護理師的薪資大概都是由政府來主導調薪包括夜班的獎勵、繁重加給都是由衛福部來主導甚至在104年我們推動的醫護比跟健保的支付連動那實測結果也是降低醫護比有效薪資不知道為什麼\n51739\t71253\t建保典子在講的時候都說應該要針對可是實際上看這個表格可以知道說基本上都是因為我們的薪資因為基本工資調的時候連動否則看到護理師的這樣的一個薪資跟我們醫療保健的業的平均薪資事實上是\n71758\t74319\t有關這個部分是不是趙復師可以簡要回應一下\n103480\t113706\t關於護理人員的薪資改善我們大概從幾個方面因為主要醫院還是直接的雇主所以我們現在三班互併比夜班獎勵的目的是讓專責夜班的能力可以固定那這個\n121209\t148337\t也整體可以帶動這個護理人員行之?可是看起來沒有啊就說因為先保條件之後最後還是事實上我們就來看一個醫院收入跟支付是兩個不相關的程序所以政府要幫我們的護理人員加薪的話錢如果沒有指定用途的話或者是規定代收代付的話根本沒有辦法保證我們醫護人員所以想問部長說這樣的原因像是夜班的獎勵金繁重加急\n148997\t161565\t未來你現在上任之後你應該還是會持續推動這個政策對吧這個是直接給護理人員的夜班獎勵是直接給護理人員對所以我說部長接下來你這些政策你會持續推動\n162335\t181278\t我想我們已經有擬定了在今年的3月1號有擬行政院通過三個方向十二大目標我想這十二個目標我們目前非常積極在啟動包括當然就是夜班的這個部分改善工作環境\n182415\t182475\t好．那\n209187\t233479\t上現行醫院的自費項目幾乎是不被管理的那心理不准開刀健保給付19萬自費21萬那攝護腺肥大開刀健保給付9萬那自費16萬白內障開刀健保給付3萬可是自費的話一樣是3萬可是自費是一塊很大的收益這個全數的利益歸法人所有\n234298\t256022\t那這是不是不太合理的應該是呈現在我們的薪資上跟所有的醫事人員共享所以想問一下本席要求衛福部推動自費收入列入管理那設定點子並將30%用於我們的薪資給付所以可不可以帶回去研議然後一個月內提出研議的結果你同意嗎\n257179\t260580\t本席知道目前癌藥基金已經有預擬的方案所以想來問一下就是說這個計畫裡邊有提到財務衝擊評估的不確定\n283306\t302502\t的藥品可以列入我們的暫時性支付如果其中兩三項的財務衝擊評估不確定的品項超出了預算超出的費用由藥商分攤這個制度設計的效果不是要由我們的藥商替負責做評估的HTA被黑鍋嗎而且投資風險這麼大部長你會覺得西藥代理商還會願意進口嗎因為你這邊寫了一個就計畫財務衝擊\n312110\t313030\t可是這寫了這樣子的一個到底什麼叫財務衝擊評估不確定\n337802\t343124\t跟委員說明這個不確定有兩種情形一種情形就是說我們官方我們委託的這個HTA科技醫藥科技評估報告跟廠商所提的這個報告中間的落差很大\n364390\t386205\t這個就所謂的不確定就是等於各說各話那這個時候呢我們就會把它列入暫時性支付而沒有辦法直接進入到健保這是一種情況阿第二個是說我們評估起來如果我們按照它的價值來看也就是ISER值來看非常的高以英國為例它的ISER值呢它是定在大概在人年的藥費在3億\n389787\t393370\t原來在健保的財務裡邊暫時性支付的費用大概20億那新藥大概40億\n410982\t437263\t那現今要把暫時性支付從健保裡拉出來健保給付拉出來那連帶把新藥跟新適應症的藥品一起拉出來那成立我們的基金並增加40億的經費擴充到100億實際上用於癌症用藥的大概費用21到60億所以如果要達到我們總統降低我們的癌症死亡率三分之一的願景會不會打折\n439211\t455313\t應該不會啦,因為我們依照實際上的需要,從20幾億,也許我們努力增加整個量能來到60億,我想3年應該就可以達到百億,也是會完成到這樣的一個百億基金。\n457018\t483206\t本期期待為了強化我們的藥品供應鏈的韌性所以政府在新的制度還是要應該要扶持我們的國產製藥的思維原因在於我們臺灣本來就比較受地緣政治的影響如果供應鏈脆弱的話那學民藥跟國產藥的費用平均又只有我們進口藥的三分之一而且還可以增加品相所以想問一下國建署在我們的\n483962\t506554\t健保藥物及負項目及支付標準修正案的討論當中一直有免除國產新藥廠商跟健保署簽訂MEA的那個責任所以在未來的基金規則裡邊應該要延續這個思維你同意嗎同意啊那盡量延長我們國內代理商收集臨床資料進行HTR的\n509025\t532865\t平估期限讓廠商降低我們進口的風險提高代理意願部長同意嗎這個也可以考慮那再來就是一項有療效的藥品有時候為何遲遲不納入所以原因在於國健署跟藥商彼此費用都談不攏所以在有限的財源上要不要減少每預計年支付\n533385\t553294\t我們的藥物的那個品項的數量要不就是增加財源這件事很重要早一天納入健保病友就早一天有得到存活的機會所以想問的是健保重大傷病免除部分負擔有沒有跟病友徵詢過是不是願意支付部分負擔用以減輕全額自費的壓力\n555026\t555366\t主席主席\n582005\t582387\t林月琴委員\n","txt":"麻煩部長請邱部長部長早從一直在討論健保點子的時候常常就會被提到說因為醫護人員的薪資非常的低不過看起來就是說講他很低可是\n實際上我們去整體看長久以來大概護理師的薪資大概都是由政府來主導調薪包括夜班的獎勵、繁重加給都是由衛福部來主導甚至在104年我們推動的醫護比跟健保的支付連動那實測結果也是降低醫護比有效薪資不知道為什麼\n建保典子在講的時候都說應該要針對可是實際上看這個表格可以知道說基本上都是因為我們的薪資因為基本工資調的時候連動否則看到護理師的這樣的一個薪資跟我們醫療保健的業的平均薪資事實上是\n有關這個部分是不是趙復師可以簡要回應一下\n關於護理人員的薪資改善我們大概從幾個方面因為主要醫院還是直接的雇主所以我們現在三班互併比夜班獎勵的目的是讓專責夜班的能力可以固定那這個\n也整體可以帶動這個護理人員行之?可是看起來沒有啊就說因為先保條件之後最後還是事實上我們就來看一個醫院收入跟支付是兩個不相關的程序所以政府要幫我們的護理人員加薪的話錢如果沒有指定用途的話或者是規定代收代付的話根本沒有辦法保證我們醫護人員所以想問部長說這樣的原因像是夜班的獎勵金繁重加急\n未來你現在上任之後你應該還是會持續推動這個政策對吧這個是直接給護理人員的夜班獎勵是直接給護理人員對所以我說部長接下來你這些政策你會持續推動\n我想我們已經有擬定了在今年的3月1號有擬行政院通過三個方向十二大目標我想這十二個目標我們目前非常積極在啟動包括當然就是夜班的這個部分改善工作環境\n好．那\n上現行醫院的自費項目幾乎是不被管理的那心理不准開刀健保給付19萬自費21萬那攝護腺肥大開刀健保給付9萬那自費16萬白內障開刀健保給付3萬可是自費的話一樣是3萬可是自費是一塊很大的收益這個全數的利益歸法人所有\n那這是不是不太合理的應該是呈現在我們的薪資上跟所有的醫事人員共享所以想問一下本席要求衛福部推動自費收入列入管理那設定點子並將30%用於我們的薪資給付所以可不可以帶回去研議然後一個月內提出研議的結果你同意嗎\n本席知道目前癌藥基金已經有預擬的方案所以想來問一下就是說這個計畫裡邊有提到財務衝擊評估的不確定\n的藥品可以列入我們的暫時性支付如果其中兩三項的財務衝擊評估不確定的品項超出了預算超出的費用由藥商分攤這個制度設計的效果不是要由我們的藥商替負責做評估的HTA被黑鍋嗎而且投資風險這麼大部長你會覺得西藥代理商還會願意進口嗎因為你這邊寫了一個就計畫財務衝擊\n可是這寫了這樣子的一個到底什麼叫財務衝擊評估不確定\n跟委員說明這個不確定有兩種情形一種情形就是說我們官方我們委託的這個HTA科技醫藥科技評估報告跟廠商所提的這個報告中間的落差很大\n這個就所謂的不確定就是等於各說各話那這個時候呢我們就會把它列入暫時性支付而沒有辦法直接進入到健保這是一種情況阿第二個是說我們評估起來如果我們按照它的價值來看也就是ISER值來看非常的高以英國為例它的ISER值呢它是定在大概在人年的藥費在3億\n原來在健保的財務裡邊暫時性支付的費用大概20億那新藥大概40億\n那現今要把暫時性支付從健保裡拉出來健保給付拉出來那連帶把新藥跟新適應症的藥品一起拉出來那成立我們的基金並增加40億的經費擴充到100億實際上用於癌症用藥的大概費用21到60億所以如果要達到我們總統降低我們的癌症死亡率三分之一的願景會不會打折\n應該不會啦,因為我們依照實際上的需要,從20幾億,也許我們努力增加整個量能來到60億,我想3年應該就可以達到百億,也是會完成到這樣的一個百億基金。\n本期期待為了強化我們的藥品供應鏈的韌性所以政府在新的制度還是要應該要扶持我們的國產製藥的思維原因在於我們臺灣本來就比較受地緣政治的影響如果供應鏈脆弱的話那學民藥跟國產藥的費用平均又只有我們進口藥的三分之一而且還可以增加品相所以想問一下國建署在我們的\n健保藥物及負項目及支付標準修正案的討論當中一直有免除國產新藥廠商跟健保署簽訂MEA的那個責任所以在未來的基金規則裡邊應該要延續這個思維你同意嗎同意啊那盡量延長我們國內代理商收集臨床資料進行HTR的\n平估期限讓廠商降低我們進口的風險提高代理意願部長同意嗎這個也可以考慮那再來就是一項有療效的藥品有時候為何遲遲不納入所以原因在於國健署跟藥商彼此費用都談不攏所以在有限的財源上要不要減少每預計年支付\n我們的藥物的那個品項的數量要不就是增加財源這件事很重要早一天納入健保病友就早一天有得到存活的機會所以想問的是健保重大傷病免除部分負擔有沒有跟病友徵詢過是不是願意支付部分負擔用以減輕全額自費的壓力\n主席主席\n林月琴委員\n","vtt":"WEBVTT\n\n00:05.457 --> 00:07.198\n麻煩部長請邱部長部長早從一直在討論健保點子的時候常常就會被提到說因為醫護人員的薪資非常的低不過看起來就是說講他很低可是\n\n00:29.990 --> 00:50.999\n實際上我們去整體看長久以來大概護理師的薪資大概都是由政府來主導調薪包括夜班的獎勵、繁重加給都是由衛福部來主導甚至在104年我們推動的醫護比跟健保的支付連動那實測結果也是降低醫護比有效薪資不知道為什麼\n\n00:51.739 --> 01:11.253\n建保典子在講的時候都說應該要針對可是實際上看這個表格可以知道說基本上都是因為我們的薪資因為基本工資調的時候連動否則看到護理師的這樣的一個薪資跟我們醫療保健的業的平均薪資事實上是\n\n01:11.758 --> 01:14.319\n有關這個部分是不是趙復師可以簡要回應一下\n\n01:43.480 --> 01:53.706\n關於護理人員的薪資改善我們大概從幾個方面因為主要醫院還是直接的雇主所以我們現在三班互併比夜班獎勵的目的是讓專責夜班的能力可以固定那這個\n\n02:01.209 --> 02:28.337\n也整體可以帶動這個護理人員行之?可是看起來沒有啊就說因為先保條件之後最後還是事實上我們就來看一個醫院收入跟支付是兩個不相關的程序所以政府要幫我們的護理人員加薪的話錢如果沒有指定用途的話或者是規定代收代付的話根本沒有辦法保證我們醫護人員所以想問部長說這樣的原因像是夜班的獎勵金繁重加急\n\n02:28.997 --> 02:41.565\n未來你現在上任之後你應該還是會持續推動這個政策對吧這個是直接給護理人員的夜班獎勵是直接給護理人員對所以我說部長接下來你這些政策你會持續推動\n\n02:42.335 --> 03:01.278\n我想我們已經有擬定了在今年的3月1號有擬行政院通過三個方向十二大目標我想這十二個目標我們目前非常積極在啟動包括當然就是夜班的這個部分改善工作環境\n\n03:02.415 --> 03:02.475\n好．那\n\n03:29.187 --> 03:53.479\n上現行醫院的自費項目幾乎是不被管理的那心理不准開刀健保給付19萬自費21萬那攝護腺肥大開刀健保給付9萬那自費16萬白內障開刀健保給付3萬可是自費的話一樣是3萬可是自費是一塊很大的收益這個全數的利益歸法人所有\n\n03:54.298 --> 04:16.022\n那這是不是不太合理的應該是呈現在我們的薪資上跟所有的醫事人員共享所以想問一下本席要求衛福部推動自費收入列入管理那設定點子並將30%用於我們的薪資給付所以可不可以帶回去研議然後一個月內提出研議的結果你同意嗎\n\n04:17.179 --> 04:20.580\n本席知道目前癌藥基金已經有預擬的方案所以想來問一下就是說這個計畫裡邊有提到財務衝擊評估的不確定\n\n04:43.306 --> 05:02.502\n的藥品可以列入我們的暫時性支付如果其中兩三項的財務衝擊評估不確定的品項超出了預算超出的費用由藥商分攤這個制度設計的效果不是要由我們的藥商替負責做評估的HTA被黑鍋嗎而且投資風險這麼大部長你會覺得西藥代理商還會願意進口嗎因為你這邊寫了一個就計畫財務衝擊\n\n05:12.110 --> 05:13.030\n可是這寫了這樣子的一個到底什麼叫財務衝擊評估不確定\n\n05:37.802 --> 05:43.124\n跟委員說明這個不確定有兩種情形一種情形就是說我們官方我們委託的這個HTA科技醫藥科技評估報告跟廠商所提的這個報告中間的落差很大\n\n06:04.390 --> 06:26.205\n這個就所謂的不確定就是等於各說各話那這個時候呢我們就會把它列入暫時性支付而沒有辦法直接進入到健保這是一種情況阿第二個是說我們評估起來如果我們按照它的價值來看也就是ISER值來看非常的高以英國為例它的ISER值呢它是定在大概在人年的藥費在3億\n\n06:29.787 --> 06:33.370\n原來在健保的財務裡邊暫時性支付的費用大概20億那新藥大概40億\n\n06:50.982 --> 07:17.263\n那現今要把暫時性支付從健保裡拉出來健保給付拉出來那連帶把新藥跟新適應症的藥品一起拉出來那成立我們的基金並增加40億的經費擴充到100億實際上用於癌症用藥的大概費用21到60億所以如果要達到我們總統降低我們的癌症死亡率三分之一的願景會不會打折\n\n07:19.211 --> 07:35.313\n應該不會啦,因為我們依照實際上的需要,從20幾億,也許我們努力增加整個量能來到60億,我想3年應該就可以達到百億,也是會完成到這樣的一個百億基金。\n\n07:37.018 --> 08:03.206\n本期期待為了強化我們的藥品供應鏈的韌性所以政府在新的制度還是要應該要扶持我們的國產製藥的思維原因在於我們臺灣本來就比較受地緣政治的影響如果供應鏈脆弱的話那學民藥跟國產藥的費用平均又只有我們進口藥的三分之一而且還可以增加品相所以想問一下國建署在我們的\n\n08:03.962 --> 08:26.554\n健保藥物及負項目及支付標準修正案的討論當中一直有免除國產新藥廠商跟健保署簽訂MEA的那個責任所以在未來的基金規則裡邊應該要延續這個思維你同意嗎同意啊那盡量延長我們國內代理商收集臨床資料進行HTR的\n\n08:29.025 --> 08:52.865\n平估期限讓廠商降低我們進口的風險提高代理意願部長同意嗎這個也可以考慮那再來就是一項有療效的藥品有時候為何遲遲不納入所以原因在於國健署跟藥商彼此費用都談不攏所以在有限的財源上要不要減少每預計年支付\n\n08:53.385 --> 09:13.294\n我們的藥物的那個品項的數量要不就是增加財源這件事很重要早一天納入健保病友就早一天有得到存活的機會所以想問的是健保重大傷病免除部分負擔有沒有跟病友徵詢過是不是願意支付部分負擔用以減輕全額自費的壓力\n\n09:15.026 --> 09:15.366\n主席主席\n\n09:42.005 --> 09:42.387\n林月琴委員\n\n","segments":[{"start":5.457,"end":7.198,"text":"麻煩部長請邱部長部長早從一直在討論健保點子的時候常常就會被提到說因為醫護人員的薪資非常的低不過看起來就是說講他很低可是"},{"start":29.99,"end":50.999,"text":"實際上我們去整體看長久以來大概護理師的薪資大概都是由政府來主導調薪包括夜班的獎勵、繁重加給都是由衛福部來主導甚至在104年我們推動的醫護比跟健保的支付連動那實測結果也是降低醫護比有效薪資不知道為什麼"},{"start":51.739,"end":71.253,"text":"建保典子在講的時候都說應該要針對可是實際上看這個表格可以知道說基本上都是因為我們的薪資因為基本工資調的時候連動否則看到護理師的這樣的一個薪資跟我們醫療保健的業的平均薪資事實上是"},{"start":71.758,"end":74.319,"text":"有關這個部分是不是趙復師可以簡要回應一下"},{"start":103.48,"end":113.706,"text":"關於護理人員的薪資改善我們大概從幾個方面因為主要醫院還是直接的雇主所以我們現在三班互併比夜班獎勵的目的是讓專責夜班的能力可以固定那這個"},{"start":121.209,"end":148.337,"text":"也整體可以帶動這個護理人員行之?可是看起來沒有啊就說因為先保條件之後最後還是事實上我們就來看一個醫院收入跟支付是兩個不相關的程序所以政府要幫我們的護理人員加薪的話錢如果沒有指定用途的話或者是規定代收代付的話根本沒有辦法保證我們醫護人員所以想問部長說這樣的原因像是夜班的獎勵金繁重加急"},{"start":148.997,"end":161.565,"text":"未來你現在上任之後你應該還是會持續推動這個政策對吧這個是直接給護理人員的夜班獎勵是直接給護理人員對所以我說部長接下來你這些政策你會持續推動"},{"start":162.335,"end":181.278,"text":"我想我們已經有擬定了在今年的3月1號有擬行政院通過三個方向十二大目標我想這十二個目標我們目前非常積極在啟動包括當然就是夜班的這個部分改善工作環境"},{"start":182.415,"end":182.475,"text":"好．那"},{"start":209.187,"end":233.479,"text":"上現行醫院的自費項目幾乎是不被管理的那心理不准開刀健保給付19萬自費21萬那攝護腺肥大開刀健保給付9萬那自費16萬白內障開刀健保給付3萬可是自費的話一樣是3萬可是自費是一塊很大的收益這個全數的利益歸法人所有"},{"start":234.298,"end":256.022,"text":"那這是不是不太合理的應該是呈現在我們的薪資上跟所有的醫事人員共享所以想問一下本席要求衛福部推動自費收入列入管理那設定點子並將30%用於我們的薪資給付所以可不可以帶回去研議然後一個月內提出研議的結果你同意嗎"},{"start":257.179,"end":260.58,"text":"本席知道目前癌藥基金已經有預擬的方案所以想來問一下就是說這個計畫裡邊有提到財務衝擊評估的不確定"},{"start":283.306,"end":302.502,"text":"的藥品可以列入我們的暫時性支付如果其中兩三項的財務衝擊評估不確定的品項超出了預算超出的費用由藥商分攤這個制度設計的效果不是要由我們的藥商替負責做評估的HTA被黑鍋嗎而且投資風險這麼大部長你會覺得西藥代理商還會願意進口嗎因為你這邊寫了一個就計畫財務衝擊"},{"start":312.11,"end":313.03,"text":"可是這寫了這樣子的一個到底什麼叫財務衝擊評估不確定"},{"start":337.802,"end":343.124,"text":"跟委員說明這個不確定有兩種情形一種情形就是說我們官方我們委託的這個HTA科技醫藥科技評估報告跟廠商所提的這個報告中間的落差很大"},{"start":364.39,"end":386.205,"text":"這個就所謂的不確定就是等於各說各話那這個時候呢我們就會把它列入暫時性支付而沒有辦法直接進入到健保這是一種情況阿第二個是說我們評估起來如果我們按照它的價值來看也就是ISER值來看非常的高以英國為例它的ISER值呢它是定在大概在人年的藥費在3億"},{"start":389.787,"end":393.37,"text":"原來在健保的財務裡邊暫時性支付的費用大概20億那新藥大概40億"},{"start":410.982,"end":437.263,"text":"那現今要把暫時性支付從健保裡拉出來健保給付拉出來那連帶把新藥跟新適應症的藥品一起拉出來那成立我們的基金並增加40億的經費擴充到100億實際上用於癌症用藥的大概費用21到60億所以如果要達到我們總統降低我們的癌症死亡率三分之一的願景會不會打折"},{"start":439.211,"end":455.313,"text":"應該不會啦,因為我們依照實際上的需要,從20幾億,也許我們努力增加整個量能來到60億,我想3年應該就可以達到百億,也是會完成到這樣的一個百億基金。"},{"start":457.018,"end":483.206,"text":"本期期待為了強化我們的藥品供應鏈的韌性所以政府在新的制度還是要應該要扶持我們的國產製藥的思維原因在於我們臺灣本來就比較受地緣政治的影響如果供應鏈脆弱的話那學民藥跟國產藥的費用平均又只有我們進口藥的三分之一而且還可以增加品相所以想問一下國建署在我們的"},{"start":483.962,"end":506.554,"text":"健保藥物及負項目及支付標準修正案的討論當中一直有免除國產新藥廠商跟健保署簽訂MEA的那個責任所以在未來的基金規則裡邊應該要延續這個思維你同意嗎同意啊那盡量延長我們國內代理商收集臨床資料進行HTR的"},{"start":509.025,"end":532.865,"text":"平估期限讓廠商降低我們進口的風險提高代理意願部長同意嗎這個也可以考慮那再來就是一項有療效的藥品有時候為何遲遲不納入所以原因在於國健署跟藥商彼此費用都談不攏所以在有限的財源上要不要減少每預計年支付"},{"start":533.385,"end":553.294,"text":"我們的藥物的那個品項的數量要不就是增加財源這件事很重要早一天納入健保病友就早一天有得到存活的機會所以想問的是健保重大傷病免除部分負擔有沒有跟病友徵詢過是不是願意支付部分負擔用以減輕全額自費的壓力"},{"start":555.026,"end":555.366,"text":"主席主席"},{"start":582.005,"end":582.387,"text":"林月琴委員"}]}}}}