{"id":154402,"url":"https://ivod.ly.gov.tw/Play/Clip/1M/154402","video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/1f04b26fe05fa65a33f565e67cf50c36fe28e669f0977b51bdae4078ad224fe81a911ee759332f825ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"陳菁徽","委員發言時間":"09:34:41 - 09:49:44","影片長度":"00:15:03","會議時間":"2024-07-01T09:00:00+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23次全體委員會議（事由：邀請衛生福利部部長就「有關健保合理支付、保障醫護人員收入、設置百億癌症基金及健康投資等事項」進行專題報告，並備質詢。）","type":"Clip","date":"2024-07-01","start_time":"2024-07-01T09:34:41+08:00","end_time":"2024-07-01T09:49:44+08:00","duration":903,"meet":{"tmpMeeting":null,"title":"第11屆第1會期社會福利及衛生環境委員會第23次全體委員會議","term":11,"type":"委員會","sessionPeriod":1,"sessionTimes":23,"committees":[26],"id":"委員會-11-1-26-23"},"features":["ai-transcript","gazette"],"gazette":{"lineno":206,"blocks":[["陳委員菁徽：（9時34分）主席、各位委員、各位官員早安，我想請邱部長，謝謝。"],["主席：請邱部長。"],["邱部長泰源：委員早。"],["陳委員菁徽：部長早安。你知道醫生週末就是參加醫學會嘛！"],["邱部長泰源：是。"],["陳委員菁徽：所以許許多多的外科醫師跟我反映這件事情，我們才剛去WHO跟大家說Taiwan Can Help！結果才不到1個月就發生了輸液事件，而且這個輸液事件看起來短期內無法結束，我也很遺憾，有跟食藥署討論過，7月、8月、9月、10月至少4個月，到10月我們還沒有辦法確認這個廠家有沒有辦法改善它的流程，因為它總共有63項的違規，現在很確定的是我們7、8、9、10這4個月要靠跟國外進口500cc，以兩到三倍的價格。另外一個很確定的事情是，我們沒有大規格的2公升、3公升的生理食鹽水。","這個週末我遇到我的同業，他現在如果要排子宮鏡手術，他都先取消了，沒辦法。我也在這邊示範給其他委員看、邱鎮軍委員看、其他官員看，你們很久沒有接觸醫療，你們可能有點忘記了，這個是500cc的生理食鹽水，就這麼一小包，我們現在只有這個，不管是進口或者是臺灣其他廠商做的，平常一個外科手術可能需要2公升或3公升，只要兩、三包就夠了，所以臨床上醫生開比較複雜的手術，他就這樣子換了三十幾包，不知道部長有沒有回憶起來，通常我們做手術的時候需要一個加壓器，要把生理食鹽水夾進去才會加壓，它才會滴注到病人的體內，所以這個加壓器打開再把它關起來就要好幾秒的時間，再來要把外面的包裝拆開再接外面輸液的頭，一台手術因為這樣子浪費了多少護理人員時間、麻醉科醫生的時間還有手術醫生的時間？因為光是在換輸液。","這件事情至少要4個月，而且還不知道10月的時候永豐有沒有辦法恢復2公升、3公升、1公升這樣的規格，你還不知道喔！所以現在有的機構是把需要大規格輸液的手術暫停，有一些就是這樣換。護理師跟他的老闆說：老闆，如果你要我站在加壓器旁邊，一路換30包，那我的手已經斷掉了，我等一下什麼事都不用做了。他們平常在手術中要做手術紀錄、他要聯絡下一台、他要記錄生命徵象等等，光是在那邊換輸液就好了。這也不是最大的重點，最大的重點是，這是一個國安危機啊！如果今天有很重大的公安意外或是天災，目前大家也很擔心我們的戰略位置很危險，我們沒有辦法做出自己的生理食鹽水，請問有三十幾家有藥證、願意復工的廠商，部長，您現在知道有哪些了嗎？有幾家願意嗎？你們有給他誘因、有去輔導他們嗎？"],["邱部長泰源：我想輔導還有提供誘因是一直在做的，我也非常感謝委員提出醫療現場的一些非常重要的狀況，因為我也是臨床醫師，我很清楚有些手術真的會造成這樣的問題，整個衛福部的團隊在維護我們醫療品質、人民健康之下當然有它一定的規定，在這規定當中，有些配套措施需要再加強，這個我們一定都會去彌補，也希望醫療院所能夠先體諒有這樣的一個情況……"],["陳委員菁徽：有，他們有體諒。"],["邱部長泰源：我知道在管理上面，像臺大藥劑部主任也一直在跟我反映。在管理上，因為我們要分好幾個廠商等等的，其實大家真的都很辛苦，也拜託大家配合。至於1公升的部分，我想我們7月底就會來提供；2公升的，我相信到年底就會恢復正常。"],["陳委員菁徽：也是從永豐來的嗎？"],["邱部長泰源：1公升是專案輸入；2公升的應該還是要輔導永豐。"],["陳委員菁徽：好，這個部分我大概上個禮拜一就索資，但至今沒有任何的回復，我們也很想知道，近五年來衛福部有沒有掌握這些廠商違規的事件，還有他們的生理食鹽水市場占有率，因為很明顯的，為什麼我們今天會出現生理食鹽水大缺，就是因為一家廠商獨占了七、八成，然後沒有人要做，本來有三十幾家的人要做，最後只有一個人願意做；你們去年11月就發現它違規，那個時候你們沒有想到它有可能最後會做不出來，導致現在這樣子的狀況。","其實也非常多人關心，不管是輸液或者是一般的用藥，像腸胃藥、胃藥、胃潰瘍的藥、止痛藥、退燒藥，這些都是我們國家如果發生重大公安事件或是天災或是戰爭時，有可能一下就全部短缺，我也很希望跟你們索資，你們可不可以統計出來──不管是醫材或是輸液或是藥品，如果有什麼東西，因為你們的健保點值導致本來幾十家在做，現在只剩一、兩家，還占了七、八成，你怎麼知道今年是生理食鹽水，明年可能會是什麼？後年又是什麼？可見你們沒有去做風險管理，你們也沒有列出一個表，我們現在到底有哪些很緊急的重大醫材、藥品或是輸液，其實只剩一、兩家在做了，然後這一、兩家市占率又占了七、八成以上，你們也不知道嘛！對不對？你們知道嗎？"],["邱部長泰源：其實每6個月衛福部就會公告重要藥品批採的清單，如果有任何問題就趕快解決，如果這樣都還發生，我非常同意委員所提的，雞蛋也不要放在一個籃子……"],["陳委員菁徽：對，可是你們知道比例嗎？你們當然知道你們有提供給國防部或是退輔會一些重大的清單，在面臨緊急狀況下最需要哪些東西，但是你們知道他們現在廠商分布的比例嗎？"],["邱部長泰源：你是說現在的藥品還是……"],["陳委員菁徽：就是臨床上不可或缺的，你現在只知道永豐占了八成，你怎麼知道其他的會不會，不管是輸液或是其他的藥品，有沒有是一、兩家廠商獨占的？"],["邱部長泰源：有關於重要的藥品跟醫材，我們怎麼樣來管理才會比較安全，我請食藥署……"],["陳委員菁徽：另外，因為你們現在有專案輸入，所以你們找了七家，其中有一家叫做橫山，我們來看一下，這個橫山以前就被列在你們的網站上，是嚴重違反GDP的業者，即111年它列在你們網站上，說是嚴重影響GDP的名單之一；另外，臺中國軍總醫院在109年也有公布，它有部分爭議事件待解決，所以也暫緩簽約。我也滿想知道你們是怎麼決定是由這七家來進口高於現在兩、三倍價格的輸液，還有這家橫山為什麼會被你們列進去，尤其是你們在網站還曾經公開說它嚴重違反GDP。"],["邱部長泰源：好，謝謝，這個部分我請食藥署簡要回答一下。"],["王副署長德原：跟委員報告，過去如果曾經被我們列為有嚴重違反GDP的業者，我們都會要求它提出矯正措施的改善報告，如果這個業者已經提出改善報告，而且經過我們確認沒有問題的話，等於它的違規已經矯正，就是可以繼續執行。另外，剛剛委員提到有兩家專案輸入業者目前還沒確認的部分，因為我們目前在公開徵求的時候，第一個都會要求它的GMP要符合PIC/S GMP，就跟我國的GMP要求是一樣；第二個是在當地的國家要有上市的許可，然後相關檢驗規格要符合要點的規範，在這些條件都符合之下，我們才會允許它專案輸入。至於剛剛委員提到有兩家，但是目前還在洽談之中，就是正在確認它的生產可以提供的1公升有多少量、500c.c.有多少量，這個部分確認之後，我們就會核發專案輸入函，它就會繼續跟健保這邊去洽商，以上。"],["陳委員菁徽：但是你們現在有找到比較大容量的、願意進口的，你們有找到比較大容量且願意製作的嗎？還是維持只有永豐？"],["王副署長德原：1公升的部分，目前國外有業者願意加強幫臺灣製造，這部分我們正在協調看它一個月可以增加的量……"],["陳委員菁徽：但是國內沒有人願意做？"],["王副署長德原：國內的話，目前1公升的量相當的少，因為能夠生產的廠商只有一家，目前是除了供應它自己原來的客戶之外，它也已經有幫忙協助增產。"],["陳委員菁徽：所以部長有沒有什麼想法，要怎麼樣讓大於一家的廠商願意製作手術非常需要的輸液？"],["邱部長泰源：好，我想我們會往這方面來研議，對於國安或者是像這次我們在找的，我有問過負責的林靜儀次長，這次他找了很多家，但這樣一來大家可能就比較不方便，因為輸液的造型不太一樣，在管理上要登記也不太一樣，但是他說這樣會比較公平，也比較安全，而且將來比較不會有爭議。"],["陳委員菁徽：部長，這可能都不是重點，重點是我們國家還是要有大於一家廠商做不同規格的輸液，而不是你現在花了多少錢進口、進口了多少家、有幾家願意進口，這個不是重點，也許你們未來還是要討論要用什麼方法才能讓每一種東西可以有大於一家來做，讓它市占率不要到達七、八成。"],["邱部長泰源：是，我們應該朝這個方向來努力。謝謝！"],["陳委員菁徽：另外，我也要幫基層醫療請命，2022年的時候疾管署曾經編列845億的後疫情防治經費，當時您是立委，所以您也有被拜訪過，但是您應該也知道2023年3月防疫指揮中心在沒有做社會溝通，也沒有做醫界溝通之下，突然公告COVID-19門診相關費用改由健保來給付，這個的確非常不公平，因為2023年的健保總額是在2022年就協商完成，但你2023年3月才說，又要把COVID的東西納入健保，這個很不合理。為什麼最近我們一定要解決這件事情，因為你也看到，從上個月開始確診達到10萬，死亡人數不斷地升高，所以基層醫療算一算，再加上攤扣今年第一季低於0.8的點值，第二季可能會更低；因為現在確診數一直上升，而且還缺藥，所以2023年的時候，我們有挹注240億元，當然這個金額跟2022年不能比，可是現在並沒有看到疫情有減緩；同時你規劃2024年要挹注200億，請問這200億什麼時候才會撥補下來？"],["邱部長泰源：我想這件事情我應該算很清楚的，過去一年來，非常努力地從去年第2季開始，也就是3月26號宣布以後，的確那個點值整個都下降，所以我們也做了各方面的努力，去年總共補了將近100億來讓點值達到0.9；這個部分說實在的，醫院方面大概也占了應該有七成，其他區域基層大概也有一部分，我想這個部分今年看起來第1季也是跟去年一樣，是相當的低，所以這個問題我想會再出現……"],["陳委員菁徽：上週五我們厚生會有舉辦了一個後疫情時代應該要如何因應的公聽會，而且衛福部今年10月、11月也要開始施打新變種的COVID疫苗，表示全世界都知道這件事情並沒有終止，所以你們後疫情的這些編列也不應該終止，你們不能認為好像COVID快結束了，所以我們再把它納回到健保，因為這些人有long COVID，也有一些後遺症需要處理，所以其實很確定的是，他們就是會占我們未來醫療很大一塊，這跟你一直提到的這些新藥基金、科技等等，都是一樣的意思啊！"],["邱部長泰源：我想這個部分，如果是因為一個嚴重疫情所產生的一個醫療負擔，我覺得不能全部由醫療院所來承擔，這樣點值會太低。"],["陳委員菁徽：最後我只是提醒部長……"],["邱部長泰源：所以可能要爭取相關的預算。"],["陳委員菁徽：我會再追蹤。最後只是跟部長稍微提醒，因為我總質詢時沒有聲音講話，所以沒有辦法很完整地表達。今年2月衛福部承諾白班護理津貼會撥下來，但5月時又說可能要到明年，我覺得這對於護理師也是個打擊、士氣的打擊。所以如果可以加快的話，我們也希望大家可以儘快地加快，謝謝。"],["邱部長泰源：好，我們一定全力來爭取，由各個角度、各個項目來爭取護理人員薪資最大的提升，以及工作環境的改善，這是我們每天都在努力的。"],["陳委員菁徽：謝謝。"],["邱部長泰源：謝謝委員指教。"],["主席：謝謝陳菁徽委員的發言。","接下來請邱鎮軍委員發言。"]],"agenda":{"page_end":118,"meet_id":"委員會-11-1-26-23","speakers":["黃秀芳","陳昭姿","林月琴","陳菁徽","邱鎮軍","王育敏","涂權吉","廖偉翔","蘇清泉","王正旭","鄭天財Sra 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00:01:44,178\n這個週末呢我遇到我的同業他現在如果要排子宮鏡手術他先取消了沒辦法我也在這邊示範給其他委員看邱正軍委員看其他官員看沒有接觸醫療很久你們可能有點忘記了這個是500CC的生理食鹽水就這麼一小包我們現在只有這個不管是進口或者是台灣其他廠商做的\n\n5\n00:01:44,958 --> 00:02:10,114\n一個外科手術他可能需要平常兩公升或三公升兩三包就夠了所以臨床像我遇到醫生他開比較複雜的手術他就這樣子換了三十包三十幾包所以不知道部長有沒有回憶起來通常我們做手術的時候我們需要一個加壓器你要把身體食鹽水加進去他才會加壓嘛他才會滴注到病人的體內\n\n6\n00:02:11,856 --> 00:02:40,735\n所以這個加壓器打開你把它關起來就要好幾秒的時間再來你要把外面的包裝拆開接下來你要接這個外面輸液的頭欸所以你一台手術因為這樣子浪費了多少護理人員時間還有麻醉科醫生的時間還有手術醫生的時間因為光是在換輸液這件事情至少要4個月而且你還不知道10月的時候永豐有沒有辦法恢復2公升3公升1公升這樣子規格喔\n\n7\n00:02:41,295 --> 00:03:10,455\n你還不知道喔所以現在有的機構是把需要大規格輸液的手術暫停那有些他就這樣換護理師跟他老闆說老闆如果你要我站在這個加壓器旁邊一路換30包那我的手已經斷掉了我等一下什麼事都不用做了他平常在手術中他要做手術記錄他要聯絡下一台他要記錄生命真相等等他就光是在那邊換輸液就好了\n\n8\n00:03:11,556 --> 00:03:19,888\n這也不是最大的重點,最大的重點是這是一個國安危機啊,如果今天我們有很重大的公安意外\n\n9\n00:03:21,308 --> 00:03:41,454\n或是天災或是目前大家也很擔心我們的這個戰略位置很危險我們沒有辦法做出自己的生理鹹水請問有30幾家有藥證願意復工的部長您現在知道有哪些了嗎有幾家願意嗎你們有給他誘因你們有去輔導他嗎\n\n10\n00:03:43,513 --> 00:04:04,324\n我想這個輔導還有提供誘因是一直在做那我也非常感謝委員提出來的醫療現場的一些非常重要的狀況因為我也是臨床醫師我很清楚有些手術真的會造成這樣的一個問題那我想整個衛福部的團隊在維護我們醫療的品質\n\n11\n00:04:09,227 --> 00:04:31,141\n人民的健康之下當然有它一定的規定那在這規定當中有些配套措施需要再加強這個我們一定都去彌補那希望醫療院所能夠先體諒那個這樣的一個情況我知道管理上面像臺大的藥劑部主任一直在跟我反映\n\n12\n00:04:32,202 --> 00:04:52,651\n他管理上因為我們要分好幾個廠商等等的這些其實都是有真的大家辛苦拜託大家配合至於1公升的我想我們在7月底就可以來提供那2公升的我相信我們到年底就會來恢復正常也是從永豐嗎?永豐是2公升\n\n13\n00:05:04,449 --> 00:05:14,074\n所以這個是我大概上個禮拜一就所知但至今沒有任何的回覆我們也很想知道說您\n\n14\n00:05:14,894 --> 00:05:15,074\n陳菁徽\n\n15\n00:05:33,260 --> 00:05:47,410\n沒有人要做本來有30幾家的人要做最後只有一個人願意做好結果你們去年11月就發現他違規那個時候你們沒有想到說他有可能最後會做不出來導致現在這樣子的狀況\n\n16\n00:05:49,522 --> 00:06:07,140\n其實也非常多人關心不管是輸液、一般的用藥、腸胃藥、胃藥、胃潰瘍藥、止痛藥、退燒藥這些都是我們國家如果發生重大公安事件或是天災或是戰爭有可能一下就全部短缺\n\n17\n00:06:07,941 --> 00:06:26,657\n我這邊也很希望跟你們所知你們可不可以統計出來不管是醫材或是輸液或是藥品如果有什麼東西因為你們的健保點值導致本來幾十家在做現在只剩一兩家還佔了七八成如果這一兩家你怎麼知道今年是生理食鹽水\n\n18\n00:06:27,398 --> 00:06:45,277\n明年又是什麼後年又是什麼可是你們沒有去做風險管理啊你們也沒有列出一個表我們現在到底有哪些這些很緊急的重大的醫材藥品或是輸液其實只剩一兩家在做了然後一兩家又佔了七八成以上你們也不知道嘛對不對你們知道嗎\n\n19\n00:06:46,863 --> 00:07:02,637\n其實有6個月就會公告衛生部就會公告這個重要的藥品或醫材的清單那如果有任何問題就趕快解決那如果這樣都還我非常同意委員所提的雞蛋也不要放在一個\n\n20\n00:07:03,437 --> 00:07:16,568\n對,可是你們有知道比例嗎?你們當然知道說你們有提供給國防部或是退府會一些重大的清單我們面臨緊急狀況最需要哪些東西但是你們知道他們現在廠商分布的比例嗎?你說現在的藥品嗎?還是對,就是臨床上不可或缺的\n\n21\n00:07:27,147 --> 00:07:49,774\n你現在只知道永豐佔了八成啊你怎麼知道其他的不管是其他的書藝或是其他的藥品有沒有是一兩家廠商獨佔的有關你重要的藥品跟醫材怎麼樣我們來管理真的是比較安全另外呢因為我們現在專案所以你們找了七家其中有一家叫做恆山我們來看一下\n\n22\n00:07:50,894 --> 00:07:51,515\n臺中國軍總醫院109年公布\n\n23\n00:08:11,173 --> 00:08:13,535\n好,謝謝,這個部分是不是請石教授回答,請錢念回答是,跟委員報告\n\n24\n00:08:35,271 --> 00:08:52,649\n過去曾經如果有被我們說有嚴重違反GDP的業者我們都會要求他提出矯正措施的改善報告那如果這個業者已經提出改善報告而且經過我們確認沒有問題的話那這等於他的違規已經矯正那就是可以繼續的執行那另外剛剛委員提到有兩家專案輸入業者目前還沒確認的部分\n\n25\n00:08:53,109 --> 00:09:21,427\n因為我們目前在公開徵求的時候第一個都會要求他的GMP要符合PIXGMP就跟我國的GMP要求是一樣第二個是在當地的國家要有上市的許可然後要有相關的這些檢驗規格要符合要點的規範這些條件符合之下我們才會允許他專案輸入那至於說剛剛委員提到有兩家那是目前還在洽談之中就是在確認他的生產是不是可以提供1L有多少量500cc多少量這個部分確認之後我們就會核發專案輸入函那他就會繼續跟健保那邊去洽商以上\n\n26\n00:09:21,547 --> 00:09:49,787\n但是你們現在有找到比較大容量的願意進口的?你們有找到比較大容量願意製作的嗎?還是要維持只有原封?報告委員1L的部分目前國外有業者是願意可以加強來幫台灣製造那這部分我們就在協調看他一個月可以增加的量但是國內沒有人願意做了?國內的話目前1L的量相當的少因為能夠生產的廠商只有一家那他目前已經除了供應他自己的這個原來的客戶之外他已經有幫忙協助增產\n\n27\n00:09:50,680 --> 00:10:15,235\n所以部長你有沒有什麼想法要怎麼樣讓大於一家的廠商願意製作這個手術非常需要的輸益?好,我想我們會往這方面來研議啦,這樣對國安啦,或者是說像這一次我們在找的,我有問過在負責的林靜儀次長我去找這幾間,大家知道比較不方便啦\n\n28\n00:10:15,695 --> 00:10:17,477\n部長這可能都不是重點,重點是我們國家還是要有大於一家廠商做不同規格的輸易\n\n29\n00:10:35,999 --> 00:10:36,379\n主席主席主席\n\n30\n00:10:54,324 --> 00:11:21,144\n是另外這邊我也希望要幫基層醫療請命這個2022年的時候疾管署曾經編列845億的後疫情防治經費當時您是立委所以您也有被拜訪過但是您應該也知道2023年3月防疫指揮中心在沒有做社會溝通也沒有醫界溝通之下突然公告COVID-19門診相關費用改由健保來給付\n\n31\n00:11:22,725 --> 00:11:46,452\n那因為這個的確非常不公平因為2023年的健保總額是在2022年就協商完成所以你2023年3月才說我又要把COVID的東西納入健保這個很不合理那為什麼最近我們一定要解決這件事情是因為你也看到從上個月開始確診達到10萬死亡人數不斷的升高所以呢\n\n32\n00:11:47,432 --> 00:12:11,621\n精神醫療算一算再加上攤扣今年的第一劑低於0.8的點值第二劑可能會更低因為現在確診數一直上升還缺藥所以2023年的時候我們有預注241元當然這個金額跟2022年不能比可是你現在並沒有看到疫情有減緩那同時你規劃2024年要預注200億請問這200億什麼時候才會撥補下來\n\n33\n00:12:21,574 --> 00:12:47,040\n我想這件事情我應該算很清楚的過去一年來非常努力在去年從第二季開始也就是說26號宣布以後的確點子整個都下降所以我們也做了各方面的努力\n\n34\n00:12:48,920 --> 00:13:10,959\n所以大概去年總共補了大概將近100億來達到點值0.9那這個部分說實在的醫院方面大概也佔了應該有七成那其他西醫基層大概也有一部分那我想這個部分今年看起來\n\n35\n00:13:12,968 --> 00:13:39,557\n第一劑也是跟去年一樣相當的低所以這個問題我想會再出現上週五我們後生會有舉辦了一個後疫情時代應該要如何因應而且衛福部其實今年10月11月也要開始打新的變種的COVID疫苗表示全世界都知道這件事情沒有終止所以你們的後疫情的這些編列也不應該終止\n\n36\n00:13:41,345 --> 00:14:02,893\n你們不能像是好像COVID快結束了所以我們再把它納回到納回到健保因為這些人也有LongCOVID也有一些後遺症需要處理所以其實你是很確定的是他們就是會佔我們未來的醫療很大一塊跟你一直提到的這些新藥基金科技一樣啊一樣的意思啊\n\n37\n00:14:04,068 --> 00:14:18,292\n是,我想這個部分應該,如果他因為一個嚴重的疫情所產生的一個醫療的負擔,我覺得不能全部由醫療院所來承擔,這樣點子會太低。所以可能要來爭取相關的意想。\n\n38\n00:14:21,693 --> 00:14:44,202\n會再追蹤最後只是跟部長稍微提醒因為那次我總諮詢沒有聲音所以沒有辦法很完整的表達今年2月衛福部承諾白班護理津貼會撥下來但是5月的時候又說可能要到明年我覺得這個對於護理師也是是個打擊啊士氣的打擊所以如果可以加快的話我們也希望大家可以盡快的加快謝謝\n\n39\n00:14:45,333 --> 00:15:02,351\n好,我們一定用全力來爭取由各個角度、各個項目來爭取護理人員最大的一個薪資的提升以及他的工作環境的改善這是我們每天都在努力的好,謝謝委員指教\n\n","tsv":"start\tend\ttext\n4588\t8434\t主席、各位委員、各位官員早安。我也想請邱部長,謝謝。我們先到第一張。\n21803\t46060\t部長早安這個是非常多因為你知道醫生週末就是參加醫學會所以許許多多的外科醫師跟我反映這件事情我們才剛去WHO跟大家說臺灣can help結果才不到一個月我們就發生了輸疫事件而且這個輸疫看起來短期內是無法結束我也很遺憾有跟食藥署討論過\n47761\t76667\t7月、8月、9月、10月現在至少4個月而且10月我們還沒有辦法確認這個廠家有沒有辦法改善他的流程因為他總共有63項的違規現在很確定的是7、8、9、14個月我們要靠跟國外進口兩到三倍的價格500CC另外一個很確定的事情是大規格的2公升、3公升的生理食品水沒有\n78568\t104178\t這個週末呢我遇到我的同業他現在如果要排子宮鏡手術他先取消了沒辦法我也在這邊示範給其他委員看邱正軍委員看其他官員看沒有接觸醫療很久你們可能有點忘記了這個是500CC的生理食鹽水就這麼一小包我們現在只有這個不管是進口或者是台灣其他廠商做的\n104958\t130114\t一個外科手術他可能需要平常兩公升或三公升兩三包就夠了所以臨床像我遇到醫生他開比較複雜的手術他就這樣子換了三十包三十幾包所以不知道部長有沒有回憶起來通常我們做手術的時候我們需要一個加壓器你要把身體食鹽水加進去他才會加壓嘛他才會滴注到病人的體內\n131856\t160735\t所以這個加壓器打開你把它關起來就要好幾秒的時間再來你要把外面的包裝拆開接下來你要接這個外面輸液的頭欸所以你一台手術因為這樣子浪費了多少護理人員時間還有麻醉科醫生的時間還有手術醫生的時間因為光是在換輸液這件事情至少要4個月而且你還不知道10月的時候永豐有沒有辦法恢復2公升3公升1公升這樣子規格喔\n161295\t190455\t你還不知道喔所以現在有的機構是把需要大規格輸液的手術暫停那有些他就這樣換護理師跟他老闆說老闆如果你要我站在這個加壓器旁邊一路換30包那我的手已經斷掉了我等一下什麼事都不用做了他平常在手術中他要做手術記錄他要聯絡下一台他要記錄生命真相等等他就光是在那邊換輸液就好了\n191556\t199888\t這也不是最大的重點,最大的重點是這是一個國安危機啊,如果今天我們有很重大的公安意外\n201308\t221454\t或是天災或是目前大家也很擔心我們的這個戰略位置很危險我們沒有辦法做出自己的生理鹹水請問有30幾家有藥證願意復工的部長您現在知道有哪些了嗎有幾家願意嗎你們有給他誘因你們有去輔導他嗎\n223513\t244324\t我想這個輔導還有提供誘因是一直在做那我也非常感謝委員提出來的醫療現場的一些非常重要的狀況因為我也是臨床醫師我很清楚有些手術真的會造成這樣的一個問題那我想整個衛福部的團隊在維護我們醫療的品質\n249227\t271141\t人民的健康之下當然有它一定的規定那在這規定當中有些配套措施需要再加強這個我們一定都去彌補那希望醫療院所能夠先體諒那個這樣的一個情況我知道管理上面像臺大的藥劑部主任一直在跟我反映\n272202\t292651\t他管理上因為我們要分好幾個廠商等等的這些其實都是有真的大家辛苦拜託大家配合至於1公升的我想我們在7月底就可以來提供那2公升的我相信我們到年底就會來恢復正常也是從永豐嗎?永豐是2公升\n304449\t314074\t所以這個是我大概上個禮拜一就所知但至今沒有任何的回覆我們也很想知道說您\n314894\t315074\t陳菁徽\n333260\t347410\t沒有人要做本來有30幾家的人要做最後只有一個人願意做好結果你們去年11月就發現他違規那個時候你們沒有想到說他有可能最後會做不出來導致現在這樣子的狀況\n349522\t367140\t其實也非常多人關心不管是輸液、一般的用藥、腸胃藥、胃藥、胃潰瘍藥、止痛藥、退燒藥這些都是我們國家如果發生重大公安事件或是天災或是戰爭有可能一下就全部短缺\n367941\t386657\t我這邊也很希望跟你們所知你們可不可以統計出來不管是醫材或是輸液或是藥品如果有什麼東西因為你們的健保點值導致本來幾十家在做現在只剩一兩家還佔了七八成如果這一兩家你怎麼知道今年是生理食鹽水\n387398\t405277\t明年又是什麼後年又是什麼可是你們沒有去做風險管理啊你們也沒有列出一個表我們現在到底有哪些這些很緊急的重大的醫材藥品或是輸液其實只剩一兩家在做了然後一兩家又佔了七八成以上你們也不知道嘛對不對你們知道嗎\n406863\t422637\t其實有6個月就會公告衛生部就會公告這個重要的藥品或醫材的清單那如果有任何問題就趕快解決那如果這樣都還我非常同意委員所提的雞蛋也不要放在一個\n423437\t436568\t對,可是你們有知道比例嗎?你們當然知道說你們有提供給國防部或是退府會一些重大的清單我們面臨緊急狀況最需要哪些東西但是你們知道他們現在廠商分布的比例嗎?你說現在的藥品嗎?還是對,就是臨床上不可或缺的\n447147\t469774\t你現在只知道永豐佔了八成啊你怎麼知道其他的不管是其他的書藝或是其他的藥品有沒有是一兩家廠商獨佔的有關你重要的藥品跟醫材怎麼樣我們來管理真的是比較安全另外呢因為我們現在專案所以你們找了七家其中有一家叫做恆山我們來看一下\n470894\t471515\t臺中國軍總醫院109年公布\n491173\t493535\t好,謝謝,這個部分是不是請石教授回答,請錢念回答是,跟委員報告\n515271\t532649\t過去曾經如果有被我們說有嚴重違反GDP的業者我們都會要求他提出矯正措施的改善報告那如果這個業者已經提出改善報告而且經過我們確認沒有問題的話那這等於他的違規已經矯正那就是可以繼續的執行那另外剛剛委員提到有兩家專案輸入業者目前還沒確認的部分\n533109\t561427\t因為我們目前在公開徵求的時候第一個都會要求他的GMP要符合PIX GMP就跟我國的GMP要求是一樣第二個是在當地的國家要有上市的許可然後要有相關的這些檢驗規格要符合要點的規範這些條件符合之下我們才會允許他專案輸入那至於說剛剛委員提到有兩家那是目前還在洽談之中就是在確認他的生產是不是可以提供1L有多少量500cc多少量這個部分確認之後我們就會核發專案輸入函那他就會繼續跟健保那邊去洽商以上\n561547\t589787\t但是你們現在有找到比較大容量的願意進口的?你們有找到比較大容量願意製作的嗎?還是要維持只有原封?報告委員1L的部分目前國外有業者是願意可以加強來幫台灣製造那這部分我們就在協調看他一個月可以增加的量但是國內沒有人願意做了?國內的話目前1L的量相當的少因為能夠生產的廠商只有一家那他目前已經除了供應他自己的這個原來的客戶之外他已經有幫忙協助增產\n590680\t615235\t所以部長你有沒有什麼想法要怎麼樣讓大於一家的廠商願意製作這個手術非常需要的輸益?好,我想我們會往這方面來研議啦,這樣對國安啦,或者是說像這一次我們在找的,我有問過在負責的林靜儀次長我去找這幾間,大家知道比較不方便啦\n615695\t617477\t部長這可能都不是重點,重點是我們國家還是要有大於一家廠商做不同規格的輸易\n635999\t636379\t主席主席主席\n654324\t681144\t是另外這邊我也希望要幫基層醫療請命這個2022年的時候 疾管署曾經編列845億的後疫情防治經費當時您是立委所以您也有被拜訪過但是您應該也知道2023年3月防疫指揮中心在沒有做社會溝通也沒有醫界溝通之下突然公告COVID-19門診相關費用改由健保來給付\n682725\t706452\t那因為這個的確非常不公平因為2023年的健保總額是在2022年就協商完成所以你2023年3月才說我又要把COVID的東西納入健保這個很不合理那為什麼最近我們一定要解決這件事情是因為你也看到從上個月開始確診達到10萬死亡人數不斷的升高所以呢\n707432\t731621\t精神醫療算一算再加上攤扣今年的第一劑低於0.8的點值第二劑可能會更低因為現在確診數一直上升還缺藥所以2023年的時候我們有預注241元當然這個金額跟2022年不能比可是你現在並沒有看到疫情有減緩那同時你規劃2024年要預注200億請問這200億什麼時候才會撥補下來\n741574\t767040\t我想這件事情我應該算很清楚的過去一年來非常努力在去年從第二季開始也就是說26號宣布以後的確點子整個都下降所以我們也做了各方面的努力\n768920\t790959\t所以大概去年總共補了大概將近100億來達到點值0.9那這個部分說實在的醫院方面大概也佔了應該有七成那其他西醫基層大概也有一部分那我想這個部分今年看起來\n792968\t819557\t第一劑也是跟去年一樣相當的低所以這個問題我想會再出現上週五我們後生會有舉辦了一個後疫情時代應該要如何因應而且衛福部其實今年10月11月也要開始打新的變種的COVID疫苗表示全世界都知道這件事情沒有終止所以你們的後疫情的這些編列也不應該終止\n821345\t842893\t你們不能像是好像COVID快結束了所以我們再把它納回到納回到健保因為這些人也有Long COVID也有一些後遺症需要處理所以其實你是很確定的是他們就是會佔我們未來的醫療很大一塊跟你一直提到的這些新藥基金科技一樣啊一樣的意思啊\n844068\t858292\t是,我想這個部分應該,如果他因為一個嚴重的疫情所產生的一個醫療的負擔,我覺得不能全部由醫療院所來承擔,這樣點子會太低。所以可能要來爭取相關的意想。\n861693\t884202\t會再追蹤 最後只是跟部長稍微提醒因為那次我總諮詢沒有聲音所以沒有辦法很完整的表達今年2月衛福部承諾白班護理津貼會撥下來但是5月的時候又說可能要到明年我覺得這個對於護理師也是是個打擊啊 士氣的打擊所以如果可以加快的話我們也希望大家可以盡快的加快 謝謝\n885333\t902351\t好,我們一定用全力來爭取由各個角度、各個項目來爭取護理人員最大的一個薪資的提升以及他的工作環境的改善這是我們每天都在努力的好,謝謝委員指教\n","txt":"主席、各位委員、各位官員早安。我也想請邱部長,謝謝。我們先到第一張。\n部長早安這個是非常多因為你知道醫生週末就是參加醫學會所以許許多多的外科醫師跟我反映這件事情我們才剛去WHO跟大家說臺灣can help結果才不到一個月我們就發生了輸疫事件而且這個輸疫看起來短期內是無法結束我也很遺憾有跟食藥署討論過\n7月、8月、9月、10月現在至少4個月而且10月我們還沒有辦法確認這個廠家有沒有辦法改善他的流程因為他總共有63項的違規現在很確定的是7、8、9、14個月我們要靠跟國外進口兩到三倍的價格500CC另外一個很確定的事情是大規格的2公升、3公升的生理食品水沒有\n這個週末呢我遇到我的同業他現在如果要排子宮鏡手術他先取消了沒辦法我也在這邊示範給其他委員看邱正軍委員看其他官員看沒有接觸醫療很久你們可能有點忘記了這個是500CC的生理食鹽水就這麼一小包我們現在只有這個不管是進口或者是台灣其他廠商做的\n一個外科手術他可能需要平常兩公升或三公升兩三包就夠了所以臨床像我遇到醫生他開比較複雜的手術他就這樣子換了三十包三十幾包所以不知道部長有沒有回憶起來通常我們做手術的時候我們需要一個加壓器你要把身體食鹽水加進去他才會加壓嘛他才會滴注到病人的體內\n所以這個加壓器打開你把它關起來就要好幾秒的時間再來你要把外面的包裝拆開接下來你要接這個外面輸液的頭欸所以你一台手術因為這樣子浪費了多少護理人員時間還有麻醉科醫生的時間還有手術醫生的時間因為光是在換輸液這件事情至少要4個月而且你還不知道10月的時候永豐有沒有辦法恢復2公升3公升1公升這樣子規格喔\n你還不知道喔所以現在有的機構是把需要大規格輸液的手術暫停那有些他就這樣換護理師跟他老闆說老闆如果你要我站在這個加壓器旁邊一路換30包那我的手已經斷掉了我等一下什麼事都不用做了他平常在手術中他要做手術記錄他要聯絡下一台他要記錄生命真相等等他就光是在那邊換輸液就好了\n這也不是最大的重點,最大的重點是這是一個國安危機啊,如果今天我們有很重大的公安意外\n或是天災或是目前大家也很擔心我們的這個戰略位置很危險我們沒有辦法做出自己的生理鹹水請問有30幾家有藥證願意復工的部長您現在知道有哪些了嗎有幾家願意嗎你們有給他誘因你們有去輔導他嗎\n我想這個輔導還有提供誘因是一直在做那我也非常感謝委員提出來的醫療現場的一些非常重要的狀況因為我也是臨床醫師我很清楚有些手術真的會造成這樣的一個問題那我想整個衛福部的團隊在維護我們醫療的品質\n人民的健康之下當然有它一定的規定那在這規定當中有些配套措施需要再加強這個我們一定都去彌補那希望醫療院所能夠先體諒那個這樣的一個情況我知道管理上面像臺大的藥劑部主任一直在跟我反映\n他管理上因為我們要分好幾個廠商等等的這些其實都是有真的大家辛苦拜託大家配合至於1公升的我想我們在7月底就可以來提供那2公升的我相信我們到年底就會來恢復正常也是從永豐嗎?永豐是2公升\n所以這個是我大概上個禮拜一就所知但至今沒有任何的回覆我們也很想知道說您\n陳菁徽\n沒有人要做本來有30幾家的人要做最後只有一個人願意做好結果你們去年11月就發現他違規那個時候你們沒有想到說他有可能最後會做不出來導致現在這樣子的狀況\n其實也非常多人關心不管是輸液、一般的用藥、腸胃藥、胃藥、胃潰瘍藥、止痛藥、退燒藥這些都是我們國家如果發生重大公安事件或是天災或是戰爭有可能一下就全部短缺\n我這邊也很希望跟你們所知你們可不可以統計出來不管是醫材或是輸液或是藥品如果有什麼東西因為你們的健保點值導致本來幾十家在做現在只剩一兩家還佔了七八成如果這一兩家你怎麼知道今年是生理食鹽水\n明年又是什麼後年又是什麼可是你們沒有去做風險管理啊你們也沒有列出一個表我們現在到底有哪些這些很緊急的重大的醫材藥品或是輸液其實只剩一兩家在做了然後一兩家又佔了七八成以上你們也不知道嘛對不對你們知道嗎\n其實有6個月就會公告衛生部就會公告這個重要的藥品或醫材的清單那如果有任何問題就趕快解決那如果這樣都還我非常同意委員所提的雞蛋也不要放在一個\n對,可是你們有知道比例嗎?你們當然知道說你們有提供給國防部或是退府會一些重大的清單我們面臨緊急狀況最需要哪些東西但是你們知道他們現在廠商分布的比例嗎?你說現在的藥品嗎?還是對,就是臨床上不可或缺的\n你現在只知道永豐佔了八成啊你怎麼知道其他的不管是其他的書藝或是其他的藥品有沒有是一兩家廠商獨佔的有關你重要的藥品跟醫材怎麼樣我們來管理真的是比較安全另外呢因為我們現在專案所以你們找了七家其中有一家叫做恆山我們來看一下\n臺中國軍總醫院109年公布\n好,謝謝,這個部分是不是請石教授回答,請錢念回答是,跟委員報告\n過去曾經如果有被我們說有嚴重違反GDP的業者我們都會要求他提出矯正措施的改善報告那如果這個業者已經提出改善報告而且經過我們確認沒有問題的話那這等於他的違規已經矯正那就是可以繼續的執行那另外剛剛委員提到有兩家專案輸入業者目前還沒確認的部分\n因為我們目前在公開徵求的時候第一個都會要求他的GMP要符合PIX GMP就跟我國的GMP要求是一樣第二個是在當地的國家要有上市的許可然後要有相關的這些檢驗規格要符合要點的規範這些條件符合之下我們才會允許他專案輸入那至於說剛剛委員提到有兩家那是目前還在洽談之中就是在確認他的生產是不是可以提供1L有多少量500cc多少量這個部分確認之後我們就會核發專案輸入函那他就會繼續跟健保那邊去洽商以上\n但是你們現在有找到比較大容量的願意進口的?你們有找到比較大容量願意製作的嗎?還是要維持只有原封?報告委員1L的部分目前國外有業者是願意可以加強來幫台灣製造那這部分我們就在協調看他一個月可以增加的量但是國內沒有人願意做了?國內的話目前1L的量相當的少因為能夠生產的廠商只有一家那他目前已經除了供應他自己的這個原來的客戶之外他已經有幫忙協助增產\n所以部長你有沒有什麼想法要怎麼樣讓大於一家的廠商願意製作這個手術非常需要的輸益?好,我想我們會往這方面來研議啦,這樣對國安啦,或者是說像這一次我們在找的,我有問過在負責的林靜儀次長我去找這幾間,大家知道比較不方便啦\n部長這可能都不是重點,重點是我們國家還是要有大於一家廠商做不同規格的輸易\n主席主席主席\n是另外這邊我也希望要幫基層醫療請命這個2022年的時候 疾管署曾經編列845億的後疫情防治經費當時您是立委所以您也有被拜訪過但是您應該也知道2023年3月防疫指揮中心在沒有做社會溝通也沒有醫界溝通之下突然公告COVID-19門診相關費用改由健保來給付\n那因為這個的確非常不公平因為2023年的健保總額是在2022年就協商完成所以你2023年3月才說我又要把COVID的東西納入健保這個很不合理那為什麼最近我們一定要解決這件事情是因為你也看到從上個月開始確診達到10萬死亡人數不斷的升高所以呢\n精神醫療算一算再加上攤扣今年的第一劑低於0.8的點值第二劑可能會更低因為現在確診數一直上升還缺藥所以2023年的時候我們有預注241元當然這個金額跟2022年不能比可是你現在並沒有看到疫情有減緩那同時你規劃2024年要預注200億請問這200億什麼時候才會撥補下來\n我想這件事情我應該算很清楚的過去一年來非常努力在去年從第二季開始也就是說26號宣布以後的確點子整個都下降所以我們也做了各方面的努力\n所以大概去年總共補了大概將近100億來達到點值0.9那這個部分說實在的醫院方面大概也佔了應該有七成那其他西醫基層大概也有一部分那我想這個部分今年看起來\n第一劑也是跟去年一樣相當的低所以這個問題我想會再出現上週五我們後生會有舉辦了一個後疫情時代應該要如何因應而且衛福部其實今年10月11月也要開始打新的變種的COVID疫苗表示全世界都知道這件事情沒有終止所以你們的後疫情的這些編列也不應該終止\n你們不能像是好像COVID快結束了所以我們再把它納回到納回到健保因為這些人也有Long COVID也有一些後遺症需要處理所以其實你是很確定的是他們就是會佔我們未來的醫療很大一塊跟你一直提到的這些新藥基金科技一樣啊一樣的意思啊\n是,我想這個部分應該,如果他因為一個嚴重的疫情所產生的一個醫療的負擔,我覺得不能全部由醫療院所來承擔,這樣點子會太低。所以可能要來爭取相關的意想。\n會再追蹤 最後只是跟部長稍微提醒因為那次我總諮詢沒有聲音所以沒有辦法很完整的表達今年2月衛福部承諾白班護理津貼會撥下來但是5月的時候又說可能要到明年我覺得這個對於護理師也是是個打擊啊 士氣的打擊所以如果可以加快的話我們也希望大家可以盡快的加快 謝謝\n好,我們一定用全力來爭取由各個角度、各個項目來爭取護理人員最大的一個薪資的提升以及他的工作環境的改善這是我們每天都在努力的好,謝謝委員指教\n","vtt":"WEBVTT\n\n00:04.588 --> 00:08.434\n主席、各位委員、各位官員早安。我也想請邱部長,謝謝。我們先到第一張。\n\n00:21.803 --> 00:46.060\n部長早安這個是非常多因為你知道醫生週末就是參加醫學會所以許許多多的外科醫師跟我反映這件事情我們才剛去WHO跟大家說臺灣canhelp結果才不到一個月我們就發生了輸疫事件而且這個輸疫看起來短期內是無法結束我也很遺憾有跟食藥署討論過\n\n00:47.761 --> 01:16.667\n7月、8月、9月、10月現在至少4個月而且10月我們還沒有辦法確認這個廠家有沒有辦法改善他的流程因為他總共有63項的違規現在很確定的是7、8、9、14個月我們要靠跟國外進口兩到三倍的價格500CC另外一個很確定的事情是大規格的2公升、3公升的生理食品水沒有\n\n01:18.568 --> 01:44.178\n這個週末呢我遇到我的同業他現在如果要排子宮鏡手術他先取消了沒辦法我也在這邊示範給其他委員看邱正軍委員看其他官員看沒有接觸醫療很久你們可能有點忘記了這個是500CC的生理食鹽水就這麼一小包我們現在只有這個不管是進口或者是台灣其他廠商做的\n\n01:44.958 --> 02:10.114\n一個外科手術他可能需要平常兩公升或三公升兩三包就夠了所以臨床像我遇到醫生他開比較複雜的手術他就這樣子換了三十包三十幾包所以不知道部長有沒有回憶起來通常我們做手術的時候我們需要一個加壓器你要把身體食鹽水加進去他才會加壓嘛他才會滴注到病人的體內\n\n02:11.856 --> 02:40.735\n所以這個加壓器打開你把它關起來就要好幾秒的時間再來你要把外面的包裝拆開接下來你要接這個外面輸液的頭欸所以你一台手術因為這樣子浪費了多少護理人員時間還有麻醉科醫生的時間還有手術醫生的時間因為光是在換輸液這件事情至少要4個月而且你還不知道10月的時候永豐有沒有辦法恢復2公升3公升1公升這樣子規格喔\n\n02:41.295 --> 03:10.455\n你還不知道喔所以現在有的機構是把需要大規格輸液的手術暫停那有些他就這樣換護理師跟他老闆說老闆如果你要我站在這個加壓器旁邊一路換30包那我的手已經斷掉了我等一下什麼事都不用做了他平常在手術中他要做手術記錄他要聯絡下一台他要記錄生命真相等等他就光是在那邊換輸液就好了\n\n03:11.556 --> 03:19.888\n這也不是最大的重點,最大的重點是這是一個國安危機啊,如果今天我們有很重大的公安意外\n\n03:21.308 --> 03:41.454\n或是天災或是目前大家也很擔心我們的這個戰略位置很危險我們沒有辦法做出自己的生理鹹水請問有30幾家有藥證願意復工的部長您現在知道有哪些了嗎有幾家願意嗎你們有給他誘因你們有去輔導他嗎\n\n03:43.513 --> 04:04.324\n我想這個輔導還有提供誘因是一直在做那我也非常感謝委員提出來的醫療現場的一些非常重要的狀況因為我也是臨床醫師我很清楚有些手術真的會造成這樣的一個問題那我想整個衛福部的團隊在維護我們醫療的品質\n\n04:09.227 --> 04:31.141\n人民的健康之下當然有它一定的規定那在這規定當中有些配套措施需要再加強這個我們一定都去彌補那希望醫療院所能夠先體諒那個這樣的一個情況我知道管理上面像臺大的藥劑部主任一直在跟我反映\n\n04:32.202 --> 04:52.651\n他管理上因為我們要分好幾個廠商等等的這些其實都是有真的大家辛苦拜託大家配合至於1公升的我想我們在7月底就可以來提供那2公升的我相信我們到年底就會來恢復正常也是從永豐嗎?永豐是2公升\n\n05:04.449 --> 05:14.074\n所以這個是我大概上個禮拜一就所知但至今沒有任何的回覆我們也很想知道說您\n\n05:14.894 --> 05:15.074\n陳菁徽\n\n05:33.260 --> 05:47.410\n沒有人要做本來有30幾家的人要做最後只有一個人願意做好結果你們去年11月就發現他違規那個時候你們沒有想到說他有可能最後會做不出來導致現在這樣子的狀況\n\n05:49.522 --> 06:07.140\n其實也非常多人關心不管是輸液、一般的用藥、腸胃藥、胃藥、胃潰瘍藥、止痛藥、退燒藥這些都是我們國家如果發生重大公安事件或是天災或是戰爭有可能一下就全部短缺\n\n06:07.941 --> 06:26.657\n我這邊也很希望跟你們所知你們可不可以統計出來不管是醫材或是輸液或是藥品如果有什麼東西因為你們的健保點值導致本來幾十家在做現在只剩一兩家還佔了七八成如果這一兩家你怎麼知道今年是生理食鹽水\n\n06:27.398 --> 06:45.277\n明年又是什麼後年又是什麼可是你們沒有去做風險管理啊你們也沒有列出一個表我們現在到底有哪些這些很緊急的重大的醫材藥品或是輸液其實只剩一兩家在做了然後一兩家又佔了七八成以上你們也不知道嘛對不對你們知道嗎\n\n06:46.863 --> 07:02.637\n其實有6個月就會公告衛生部就會公告這個重要的藥品或醫材的清單那如果有任何問題就趕快解決那如果這樣都還我非常同意委員所提的雞蛋也不要放在一個\n\n07:03.437 --> 07:16.568\n對,可是你們有知道比例嗎?你們當然知道說你們有提供給國防部或是退府會一些重大的清單我們面臨緊急狀況最需要哪些東西但是你們知道他們現在廠商分布的比例嗎?你說現在的藥品嗎?還是對,就是臨床上不可或缺的\n\n07:27.147 --> 07:49.774\n你現在只知道永豐佔了八成啊你怎麼知道其他的不管是其他的書藝或是其他的藥品有沒有是一兩家廠商獨佔的有關你重要的藥品跟醫材怎麼樣我們來管理真的是比較安全另外呢因為我們現在專案所以你們找了七家其中有一家叫做恆山我們來看一下\n\n07:50.894 --> 07:51.515\n臺中國軍總醫院109年公布\n\n08:11.173 --> 08:13.535\n好,謝謝,這個部分是不是請石教授回答,請錢念回答是,跟委員報告\n\n08:35.271 --> 08:52.649\n過去曾經如果有被我們說有嚴重違反GDP的業者我們都會要求他提出矯正措施的改善報告那如果這個業者已經提出改善報告而且經過我們確認沒有問題的話那這等於他的違規已經矯正那就是可以繼續的執行那另外剛剛委員提到有兩家專案輸入業者目前還沒確認的部分\n\n08:53.109 --> 09:21.427\n因為我們目前在公開徵求的時候第一個都會要求他的GMP要符合PIXGMP就跟我國的GMP要求是一樣第二個是在當地的國家要有上市的許可然後要有相關的這些檢驗規格要符合要點的規範這些條件符合之下我們才會允許他專案輸入那至於說剛剛委員提到有兩家那是目前還在洽談之中就是在確認他的生產是不是可以提供1L有多少量500cc多少量這個部分確認之後我們就會核發專案輸入函那他就會繼續跟健保那邊去洽商以上\n\n09:21.547 --> 09:49.787\n但是你們現在有找到比較大容量的願意進口的?你們有找到比較大容量願意製作的嗎?還是要維持只有原封?報告委員1L的部分目前國外有業者是願意可以加強來幫台灣製造那這部分我們就在協調看他一個月可以增加的量但是國內沒有人願意做了?國內的話目前1L的量相當的少因為能夠生產的廠商只有一家那他目前已經除了供應他自己的這個原來的客戶之外他已經有幫忙協助增產\n\n09:50.680 --> 10:15.235\n所以部長你有沒有什麼想法要怎麼樣讓大於一家的廠商願意製作這個手術非常需要的輸益?好,我想我們會往這方面來研議啦,這樣對國安啦,或者是說像這一次我們在找的,我有問過在負責的林靜儀次長我去找這幾間,大家知道比較不方便啦\n\n10:15.695 --> 10:17.477\n部長這可能都不是重點,重點是我們國家還是要有大於一家廠商做不同規格的輸易\n\n10:35.999 --> 10:36.379\n主席主席主席\n\n10:54.324 --> 11:21.144\n是另外這邊我也希望要幫基層醫療請命這個2022年的時候疾管署曾經編列845億的後疫情防治經費當時您是立委所以您也有被拜訪過但是您應該也知道2023年3月防疫指揮中心在沒有做社會溝通也沒有醫界溝通之下突然公告COVID-19門診相關費用改由健保來給付\n\n11:22.725 --> 11:46.452\n那因為這個的確非常不公平因為2023年的健保總額是在2022年就協商完成所以你2023年3月才說我又要把COVID的東西納入健保這個很不合理那為什麼最近我們一定要解決這件事情是因為你也看到從上個月開始確診達到10萬死亡人數不斷的升高所以呢\n\n11:47.432 --> 12:11.621\n精神醫療算一算再加上攤扣今年的第一劑低於0.8的點值第二劑可能會更低因為現在確診數一直上升還缺藥所以2023年的時候我們有預注241元當然這個金額跟2022年不能比可是你現在並沒有看到疫情有減緩那同時你規劃2024年要預注200億請問這200億什麼時候才會撥補下來\n\n12:21.574 --> 12:47.040\n我想這件事情我應該算很清楚的過去一年來非常努力在去年從第二季開始也就是說26號宣布以後的確點子整個都下降所以我們也做了各方面的努力\n\n12:48.920 --> 13:10.959\n所以大概去年總共補了大概將近100億來達到點值0.9那這個部分說實在的醫院方面大概也佔了應該有七成那其他西醫基層大概也有一部分那我想這個部分今年看起來\n\n13:12.968 --> 13:39.557\n第一劑也是跟去年一樣相當的低所以這個問題我想會再出現上週五我們後生會有舉辦了一個後疫情時代應該要如何因應而且衛福部其實今年10月11月也要開始打新的變種的COVID疫苗表示全世界都知道這件事情沒有終止所以你們的後疫情的這些編列也不應該終止\n\n13:41.345 --> 14:02.893\n你們不能像是好像COVID快結束了所以我們再把它納回到納回到健保因為這些人也有LongCOVID也有一些後遺症需要處理所以其實你是很確定的是他們就是會佔我們未來的醫療很大一塊跟你一直提到的這些新藥基金科技一樣啊一樣的意思啊\n\n14:04.068 --> 14:18.292\n是,我想這個部分應該,如果他因為一個嚴重的疫情所產生的一個醫療的負擔,我覺得不能全部由醫療院所來承擔,這樣點子會太低。所以可能要來爭取相關的意想。\n\n14:21.693 --> 14:44.202\n會再追蹤最後只是跟部長稍微提醒因為那次我總諮詢沒有聲音所以沒有辦法很完整的表達今年2月衛福部承諾白班護理津貼會撥下來但是5月的時候又說可能要到明年我覺得這個對於護理師也是是個打擊啊士氣的打擊所以如果可以加快的話我們也希望大家可以盡快的加快謝謝\n\n14:45.333 --> 15:02.351\n好,我們一定用全力來爭取由各個角度、各個項目來爭取護理人員最大的一個薪資的提升以及他的工作環境的改善這是我們每天都在努力的好,謝謝委員指教\n\n","segments":[{"start":4.588,"end":8.434,"text":"主席、各位委員、各位官員早安。我也想請邱部長,謝謝。我們先到第一張。"},{"start":21.803,"end":46.06,"text":"部長早安這個是非常多因為你知道醫生週末就是參加醫學會所以許許多多的外科醫師跟我反映這件事情我們才剛去WHO跟大家說臺灣can help結果才不到一個月我們就發生了輸疫事件而且這個輸疫看起來短期內是無法結束我也很遺憾有跟食藥署討論過"},{"start":47.761,"end":76.667,"text":"7月、8月、9月、10月現在至少4個月而且10月我們還沒有辦法確認這個廠家有沒有辦法改善他的流程因為他總共有63項的違規現在很確定的是7、8、9、14個月我們要靠跟國外進口兩到三倍的價格500CC另外一個很確定的事情是大規格的2公升、3公升的生理食品水沒有"},{"start":78.568,"end":104.178,"text":"這個週末呢我遇到我的同業他現在如果要排子宮鏡手術他先取消了沒辦法我也在這邊示範給其他委員看邱正軍委員看其他官員看沒有接觸醫療很久你們可能有點忘記了這個是500CC的生理食鹽水就這麼一小包我們現在只有這個不管是進口或者是台灣其他廠商做的"},{"start":104.958,"end":130.114,"text":"一個外科手術他可能需要平常兩公升或三公升兩三包就夠了所以臨床像我遇到醫生他開比較複雜的手術他就這樣子換了三十包三十幾包所以不知道部長有沒有回憶起來通常我們做手術的時候我們需要一個加壓器你要把身體食鹽水加進去他才會加壓嘛他才會滴注到病人的體內"},{"start":131.856,"end":160.735,"text":"所以這個加壓器打開你把它關起來就要好幾秒的時間再來你要把外面的包裝拆開接下來你要接這個外面輸液的頭欸所以你一台手術因為這樣子浪費了多少護理人員時間還有麻醉科醫生的時間還有手術醫生的時間因為光是在換輸液這件事情至少要4個月而且你還不知道10月的時候永豐有沒有辦法恢復2公升3公升1公升這樣子規格喔"},{"start":161.295,"end":190.455,"text":"你還不知道喔所以現在有的機構是把需要大規格輸液的手術暫停那有些他就這樣換護理師跟他老闆說老闆如果你要我站在這個加壓器旁邊一路換30包那我的手已經斷掉了我等一下什麼事都不用做了他平常在手術中他要做手術記錄他要聯絡下一台他要記錄生命真相等等他就光是在那邊換輸液就好了"},{"start":191.556,"end":199.888,"text":"這也不是最大的重點,最大的重點是這是一個國安危機啊,如果今天我們有很重大的公安意外"},{"start":201.308,"end":221.454,"text":"或是天災或是目前大家也很擔心我們的這個戰略位置很危險我們沒有辦法做出自己的生理鹹水請問有30幾家有藥證願意復工的部長您現在知道有哪些了嗎有幾家願意嗎你們有給他誘因你們有去輔導他嗎"},{"start":223.513,"end":244.324,"text":"我想這個輔導還有提供誘因是一直在做那我也非常感謝委員提出來的醫療現場的一些非常重要的狀況因為我也是臨床醫師我很清楚有些手術真的會造成這樣的一個問題那我想整個衛福部的團隊在維護我們醫療的品質"},{"start":249.227,"end":271.141,"text":"人民的健康之下當然有它一定的規定那在這規定當中有些配套措施需要再加強這個我們一定都去彌補那希望醫療院所能夠先體諒那個這樣的一個情況我知道管理上面像臺大的藥劑部主任一直在跟我反映"},{"start":272.202,"end":292.651,"text":"他管理上因為我們要分好幾個廠商等等的這些其實都是有真的大家辛苦拜託大家配合至於1公升的我想我們在7月底就可以來提供那2公升的我相信我們到年底就會來恢復正常也是從永豐嗎?永豐是2公升"},{"start":304.449,"end":314.074,"text":"所以這個是我大概上個禮拜一就所知但至今沒有任何的回覆我們也很想知道說您"},{"start":314.894,"end":315.074,"text":"陳菁徽"},{"start":333.26,"end":347.41,"text":"沒有人要做本來有30幾家的人要做最後只有一個人願意做好結果你們去年11月就發現他違規那個時候你們沒有想到說他有可能最後會做不出來導致現在這樣子的狀況"},{"start":349.522,"end":367.14,"text":"其實也非常多人關心不管是輸液、一般的用藥、腸胃藥、胃藥、胃潰瘍藥、止痛藥、退燒藥這些都是我們國家如果發生重大公安事件或是天災或是戰爭有可能一下就全部短缺"},{"start":367.941,"end":386.657,"text":"我這邊也很希望跟你們所知你們可不可以統計出來不管是醫材或是輸液或是藥品如果有什麼東西因為你們的健保點值導致本來幾十家在做現在只剩一兩家還佔了七八成如果這一兩家你怎麼知道今年是生理食鹽水"},{"start":387.398,"end":405.277,"text":"明年又是什麼後年又是什麼可是你們沒有去做風險管理啊你們也沒有列出一個表我們現在到底有哪些這些很緊急的重大的醫材藥品或是輸液其實只剩一兩家在做了然後一兩家又佔了七八成以上你們也不知道嘛對不對你們知道嗎"},{"start":406.863,"end":422.637,"text":"其實有6個月就會公告衛生部就會公告這個重要的藥品或醫材的清單那如果有任何問題就趕快解決那如果這樣都還我非常同意委員所提的雞蛋也不要放在一個"},{"start":423.437,"end":436.568,"text":"對,可是你們有知道比例嗎?你們當然知道說你們有提供給國防部或是退府會一些重大的清單我們面臨緊急狀況最需要哪些東西但是你們知道他們現在廠商分布的比例嗎?你說現在的藥品嗎?還是對,就是臨床上不可或缺的"},{"start":447.147,"end":469.774,"text":"你現在只知道永豐佔了八成啊你怎麼知道其他的不管是其他的書藝或是其他的藥品有沒有是一兩家廠商獨佔的有關你重要的藥品跟醫材怎麼樣我們來管理真的是比較安全另外呢因為我們現在專案所以你們找了七家其中有一家叫做恆山我們來看一下"},{"start":470.894,"end":471.515,"text":"臺中國軍總醫院109年公布"},{"start":491.173,"end":493.535,"text":"好,謝謝,這個部分是不是請石教授回答,請錢念回答是,跟委員報告"},{"start":515.271,"end":532.649,"text":"過去曾經如果有被我們說有嚴重違反GDP的業者我們都會要求他提出矯正措施的改善報告那如果這個業者已經提出改善報告而且經過我們確認沒有問題的話那這等於他的違規已經矯正那就是可以繼續的執行那另外剛剛委員提到有兩家專案輸入業者目前還沒確認的部分"},{"start":533.109,"end":561.427,"text":"因為我們目前在公開徵求的時候第一個都會要求他的GMP要符合PIX GMP就跟我國的GMP要求是一樣第二個是在當地的國家要有上市的許可然後要有相關的這些檢驗規格要符合要點的規範這些條件符合之下我們才會允許他專案輸入那至於說剛剛委員提到有兩家那是目前還在洽談之中就是在確認他的生產是不是可以提供1L有多少量500cc多少量這個部分確認之後我們就會核發專案輸入函那他就會繼續跟健保那邊去洽商以上"},{"start":561.547,"end":589.787,"text":"但是你們現在有找到比較大容量的願意進口的?你們有找到比較大容量願意製作的嗎?還是要維持只有原封?報告委員1L的部分目前國外有業者是願意可以加強來幫台灣製造那這部分我們就在協調看他一個月可以增加的量但是國內沒有人願意做了?國內的話目前1L的量相當的少因為能夠生產的廠商只有一家那他目前已經除了供應他自己的這個原來的客戶之外他已經有幫忙協助增產"},{"start":590.68,"end":615.235,"text":"所以部長你有沒有什麼想法要怎麼樣讓大於一家的廠商願意製作這個手術非常需要的輸益?好,我想我們會往這方面來研議啦,這樣對國安啦,或者是說像這一次我們在找的,我有問過在負責的林靜儀次長我去找這幾間,大家知道比較不方便啦"},{"start":615.695,"end":617.477,"text":"部長這可能都不是重點,重點是我們國家還是要有大於一家廠商做不同規格的輸易"},{"start":635.999,"end":636.379,"text":"主席主席主席"},{"start":654.324,"end":681.144,"text":"是另外這邊我也希望要幫基層醫療請命這個2022年的時候 疾管署曾經編列845億的後疫情防治經費當時您是立委所以您也有被拜訪過但是您應該也知道2023年3月防疫指揮中心在沒有做社會溝通也沒有醫界溝通之下突然公告COVID-19門診相關費用改由健保來給付"},{"start":682.725,"end":706.452,"text":"那因為這個的確非常不公平因為2023年的健保總額是在2022年就協商完成所以你2023年3月才說我又要把COVID的東西納入健保這個很不合理那為什麼最近我們一定要解決這件事情是因為你也看到從上個月開始確診達到10萬死亡人數不斷的升高所以呢"},{"start":707.432,"end":731.621,"text":"精神醫療算一算再加上攤扣今年的第一劑低於0.8的點值第二劑可能會更低因為現在確診數一直上升還缺藥所以2023年的時候我們有預注241元當然這個金額跟2022年不能比可是你現在並沒有看到疫情有減緩那同時你規劃2024年要預注200億請問這200億什麼時候才會撥補下來"},{"start":741.574,"end":767.04,"text":"我想這件事情我應該算很清楚的過去一年來非常努力在去年從第二季開始也就是說26號宣布以後的確點子整個都下降所以我們也做了各方面的努力"},{"start":768.92,"end":790.959,"text":"所以大概去年總共補了大概將近100億來達到點值0.9那這個部分說實在的醫院方面大概也佔了應該有七成那其他西醫基層大概也有一部分那我想這個部分今年看起來"},{"start":792.968,"end":819.557,"text":"第一劑也是跟去年一樣相當的低所以這個問題我想會再出現上週五我們後生會有舉辦了一個後疫情時代應該要如何因應而且衛福部其實今年10月11月也要開始打新的變種的COVID疫苗表示全世界都知道這件事情沒有終止所以你們的後疫情的這些編列也不應該終止"},{"start":821.345,"end":842.893,"text":"你們不能像是好像COVID快結束了所以我們再把它納回到納回到健保因為這些人也有Long COVID也有一些後遺症需要處理所以其實你是很確定的是他們就是會佔我們未來的醫療很大一塊跟你一直提到的這些新藥基金科技一樣啊一樣的意思啊"},{"start":844.068,"end":858.292,"text":"是,我想這個部分應該,如果他因為一個嚴重的疫情所產生的一個醫療的負擔,我覺得不能全部由醫療院所來承擔,這樣點子會太低。所以可能要來爭取相關的意想。"},{"start":861.693,"end":884.202,"text":"會再追蹤 最後只是跟部長稍微提醒因為那次我總諮詢沒有聲音所以沒有辦法很完整的表達今年2月衛福部承諾白班護理津貼會撥下來但是5月的時候又說可能要到明年我覺得這個對於護理師也是是個打擊啊 士氣的打擊所以如果可以加快的話我們也希望大家可以盡快的加快 謝謝"},{"start":885.333,"end":902.351,"text":"好,我們一定用全力來爭取由各個角度、各個項目來爭取護理人員最大的一個薪資的提升以及他的工作環境的改善這是我們每天都在努力的好,謝謝委員指教"}]}}}}