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\"score\": 0.909}, {\"word\": \"善\", \"start\": 910.094, \"end\": 910.114, \"score\": 0.0}], \"language\": \"zh\"}","srt":"1\n00:00:16,264 --> 00:00:21,249\n謝謝院長。我請行政院卓院長。麻煩請卓院長再次備詢。\n\n2\n00:00:28,220 --> 00:00:56,880\n總委員好總委員長又見面了我今天第二段的質詢是要跟你談一些那麼雖然比較細微但是其實是更重要的啦所以我們今天就很和緩的來討論那麼我想我們幾十年來我們台灣\n\n3\n00:00:58,072 --> 00:01:21,454\n最大的一個特點也是我們國家的一個優點就是我們國家的醫療品質跟這個服務價格那如果我簡單用四個字形容我們台灣的醫療品質跟價格相比叫做價廉物美\n\n4\n00:01:22,810 --> 00:01:47,584\n那這價廉務美其實是長期以來建立在我們國家醫護人員他們有很多權益的犧牲尤其是跟先進的國家相比那他們不但所得也好他們的工作環境也好大概都遠遠不能相比\n\n5\n00:01:48,527 --> 00:02:11,698\n但是我們醫護人員不管是從醫學中心一直到基層醫療診所大家都還是一樣恪遵職守那兢兢業業的在為全體國人在效命那麼所以就提到我們委員幾乎都會提到這個典職啦\n\n6\n00:02:12,793 --> 00:02:41,228\n那點子當然該是多少我們國家再來細算這當然是沒問題可是這個點子的部分我覺得基層醫療的點子最重要因為基層醫療相較於其他的醫學中心、區域醫院、地區醫院而言他們的平均的成本都比較高\n\n7\n00:02:42,597 --> 00:03:10,070\n甚至成本都遠高於醫學中心我舉例比方說基層醫療診所第一點他們有任何業外收入他不像大型醫院有業外收入地下室可以停車有停車場有那麼多空間為了要造福病患跟病患家屬所以他們可以出租做美食中心做賣醫療器具的場所等等等等\n\n8\n00:03:11,363 --> 00:03:37,857\n那這些業外收入很多那大型醫院尤其醫學中心採購的藥量體那麼大他們的折扣相對也比較大第三個比方說他們一些基本的成本護理人員的成本藥師的成本他們相對平均下來會比較低那基層醫療診所這些負擔都非常非常的重\n\n9\n00:03:38,772 --> 00:04:05,638\n結果我看了一下我們這個基層醫療診所的點子竟然竟然連這幾年連0.9都不到0.9都不到當然所以醫界現在尤其是基層醫療診所他們是頗有怨言當然吐了怨言以後他們事後也都會吞下來可是可是\n\n10\n00:04:07,717 --> 00:04:19,586\n長期以往這是非常不公平的一位醫生從他學生學生的過程他要高於其他各\n\n11\n00:04:21,067 --> 00:04:25,328\n這部分基層醫療診所這個委屈太大了委屈大家尤其這幾年又有一個風氣那這個\n\n12\n00:04:49,124 --> 00:05:01,605\n故然不是在你們手上去放行的可是過去歷屆幾位院長竟然放任這些醫學中心、大型醫院他們到基層去\n\n13\n00:05:02,921 --> 00:05:21,942\n假藉著這個醫學中心的名號那去設置診所去設置大量的基層診所你看到處在臺北市到處看的時候那一棵大樹之下那個符號之下欸它是個診所夠膽他去開設分院我們還沒話講\n\n14\n00:05:23,524 --> 00:05:43,525\n分院他要買土地蓋房舍,要購買檢驗機具等等,成本他也不花,他為什麼設診所?除了成本低以外,對他們而言他們就像把牛肉湯撐水一樣,他要來分食基層醫療的點子。\n\n15\n00:05:47,386 --> 00:06:06,372\n院長我希望在你任內這些通通不要再放行了不要再任由這些大型尤其是財團醫院在各縣市在各地方去廣設基層診所因為這是非常不公平的他們就是要來瓜分基層醫療的點子\n\n16\n00:06:10,765 --> 00:06:35,746\n這個會造成時時在做基層醫療的醫師們那非常非常大的痛苦傷心所以這一點能不能做到因為照說你都會區本來就不該你要設那你應該到偏鄉偏鄉醫療的地方去設不是這樣嗎結果台北市核准的通通是這些大型大型的財團醫院\n\n17\n00:06:38,117 --> 00:06:53,912\n這一點是不是院長你可以承諾這一個部分要做檢討好不好?好謝謝委員用了相當長的時間闡述基層醫療在台灣現在整個醫療體系上它的弱勢我個人認為不只基層醫療連地區醫院進行上都是困難的\n\n18\n00:06:54,960 --> 00:07:23,590\n那過去我在議會在立法院的時代我接觸最多的就是基層醫療協會現在也是如此我深深知道他們的需求他們所面臨的困境那麼台如果是以都會區來講又是一個治療醫療資源比較充沛的地方更不應該更不應該這樣去做來自醫界們你看他那個他們那個心聲多痛苦我就舉罕病就好罕病我們全國有兩萬一千八百位\n\n19\n00:07:25,629 --> 00:07:50,984\n每年需要將近百億,今年預估會超過一百,大概一百零八億需要的耗費。但是這也完全符合我們全體國人共同要救治他們的心願。結果在一屆的聲音你看,他就是要求政府說要不然把罕病這一塊從健保這個拿出來,不要加入點子,單獨來計算。\n\n20\n00:07:52,665 --> 00:07:55,426\n今年我們罕病用藥還給他加了一些經費預算,希望能夠加到20億。\n\n21\n00:08:16,255 --> 00:08:17,076\n韓病有加?\n\n22\n00:08:17,076 --> 00:08:37,977\n有,有加,韓病用藥。包括我們除了健保完全的加進去以外,行政院這一個部份,公衛生多20億。我們洗腎有9萬7千人啦,那現在歐美日國家他們有進步的醫療啦,那可以再加洗腎,這再加洗腎又可以免掉患者他們周遮勞頓。\n\n23\n00:08:39,638 --> 00:09:02,443\n那又可以讓他們洗腎時間長一點減少這個逆滲透的身體不舒服那麼這些非常這個重要結果光這個我們一屆提案來給我們那個健保這邊審專家會議都通過了現在在等所謂共同擬定會議一等\n\n24\n00:09:04,883 --> 00:09:32,352\n要是也不知何年何日才要通過我覺得這個部分院長是不是你交代部長這個部分查查看到底怎麼回事好不好公會那邊跟部裡面應該現在還在保持接觸當中我最近才得到這個訊息接觸了幾年了還在接觸我說就明年的明年這個計算的這個內容還在接觸當中希望說在你的手上在你的任內這個部分就能夠通過\n\n25\n00:09:33,476 --> 00:09:40,427\n我請部長趕快去計算清楚跟他們就業務上來詳細的規劃一下。那麼我們也很樂意來看到就是說這個身心障礙權益保護法\n\n26\n00:09:48,351 --> 00:10:14,702\n說實在話這17年沒修了在你的手上總算這有修了但是這個修啊我整個法把它看過以後我發現我們對於自立生活身障者他們自立生活的部分還是沒有任何的著墨沒有任何的提升啦那麼身心障礙者這個所有的長照大概我們現在平均算在一天給他們大概\n\n27\n00:10:18,189 --> 00:10:41,846\n連長照連智力生活照護每天不得超過6個小時的這一部分的補助啦但是這個部分啦那個剛剛講到這個效應後那個院長這個部分我特別要針對長照師講的話我今天要質詢的部分喔我等了他三個禮拜啦資料都還沒來\n\n28\n00:10:42,915 --> 00:10:57,610\n我問他說這個輔具啊我們對生長者的輔具生長者的輔具有科技輔具一般輔具那真正生長者在使用它必須兩者並用\n\n29\n00:11:00,012 --> 00:11:26,199\n但是長期以來我們對身障者的補助在這一個部分通通做掉身障者說你只能擇醫我一再的問那為什麼要擇醫同樣一個費用你讓他買兩種輔具或者有哪幾種科技輔具哪些一般輔具你有沒有這相關的資料因為\n\n30\n00:11:27,319 --> 00:11:46,341\n身障者真的跟家屬去買啦,到時候來申報,又不過,這個也不能過,那個也不能過,所以我就要常教師說,你答覆我為什麼不能兩者共用,兩者都買。\n\n31\n00:11:47,315 --> 00:12:04,964\n只要在你總額總金額內啊不是嗎然後我要他答覆我說申請那麼困難那你乾脆告訴我們有哪些輔具哪些廠牌可用等了三個禮拜他連甩都不甩啦天啊我們在立法院問\n\n32\n00:12:06,840 --> 00:12:25,372\n他都這種態度啦那他是如何面對現在身障者包括需要長照的老年獨居老人者他們來接洽會是多麼的困難所以也因為這樣我特別要求就是說是不是\n\n33\n00:12:26,431 --> 00:12:52,656\n我們針對需要長照的以及身障者我們應該開政府應該研究一個統一窗口我舉個例齁為什麼他們的需求需要統一窗口來面對比方說我如果是個身障者我今天要去學校就學我接洽的必須跟教育部教育部再跟地方教育局聯絡那來幫助我\n\n34\n00:12:54,209 --> 00:13:17,314\n好了我要去工作我要就業需要勞動部勞動部在支援地方的勞工局所以到底我的需求就這一些啊那我需要長照的部分當然那就來啦就社家署就是我們衛福部社家署我們一個身障者一天\n\n35\n00:13:18,547 --> 00:13:44,484\n要做的就學就業長照那需要跟這麼多不同單位洽詢洽詢通過他們的核准以後再去找機構來派人力天吶我覺得這樣子這樣子的程序過於冗長那麼對於真正需要幫助的比方說獨居老人比方說身障者\n\n36\n00:13:45,051 --> 00:13:48,513\n委員剛剛所說的狀況,我深覺得是不合理,也不應該啦。那,請會護,應該立刻從制度上馬上去\n\n37\n00:14:15,267 --> 00:14:17,877\n定定一套方式一般國人都應該\n\n38\n00:14:19,438 --> 00:14:44,961\n簡正辨明,何況是對身障者,我們更應該有這個方向去走。我們現在的照顧制度很多,但如果落實這個才重要,馬上提出一個方式,馬上去執行。是,是。乾脆我們就訂一個額度,一個金額裡面,那它多少要用在長照,多少它是要用在自立生活,還有自立生活我們至少,院長,至少從最基本的喘息服務,\n\n39\n00:14:45,885 --> 00:14:48,627\n你提的這些都是未來長照3.0非常重要的重點,我們會去推\n\n40\n00:15:09,673 --> 00:15:10,114\n我們會改善\n\n","tsv":"start\tend\ttext\n16264\t21249\t謝謝院長。我請行政院卓院長。麻煩請卓院長再次備詢。\n28220\t56880\t總委員好 總委員長又見面了我今天第二段的質詢是要跟你談一些那麼雖然比較細微但是其實是更重要的啦所以我們今天就很和緩的來討論那麼我想我們幾十年來我們台灣\n58072\t81454\t最大的一個特點也是我們國家的一個優點就是我們國家的醫療品質跟這個服務價格那如果我簡單用四個字形容我們台灣的醫療品質跟價格相比叫做價廉物美\n82810\t107584\t那這價廉務美其實是長期以來建立在我們國家醫護人員他們有很多權益的犧牲尤其是跟先進的國家相比那他們不但所得也好他們的工作環境也好大概都遠遠不能相比\n108527\t131698\t但是我們醫護人員不管是從醫學中心一直到基層醫療診所 大家都還是一樣 恪遵職守那兢兢業業的在為全體國人在效命那麼所以就提到我們委員幾乎都會提到這個典職啦\n132793\t161228\t那點子當然該是多少我們國家再來細算這當然是沒問題可是這個點子的部分我覺得基層醫療的點子最重要因為基層醫療相較於其他的醫學中心、區域醫院、地區醫院而言他們的平均的成本都比較高\n162597\t190070\t甚至成本都遠高於醫學中心我舉例比方說基層醫療診所第一點他們有任何業外收入他不像大型醫院有業外收入地下室可以停車有停車場有那麼多空間為了要造福病患跟病患家屬所以他們可以出租做美食中心做賣醫療器具的場所等等等等\n191363\t217857\t那這些業外收入很多那大型醫院尤其醫學中心採購的藥量體那麼大他們的折扣相對也比較大第三個比方說他們一些基本的成本護理人員的成本藥師的成本他們相對平均下來會比較低那基層醫療診所這些負擔都非常非常的重\n218772\t245638\t結果我看了一下我們這個基層醫療診所的點子竟然竟然連這幾年連0.9都不到0.9都不到當然所以醫界現在尤其是基層醫療診所他們是頗有怨言當然吐了怨言以後他們事後也都會吞下來可是可是\n247717\t259586\t長期以往這是非常不公平的一位醫生從他學生學生的過程他要高於其他各\n261067\t265328\t這部分基層醫療診所這個委屈太大了委屈大家尤其這幾年又有一個風氣那這個\n289124\t301605\t故然不是在你們手上去放行的可是過去歷屆幾位院長竟然放任這些醫學中心、大型醫院他們到基層去\n302921\t321942\t假藉著這個醫學中心的名號那去設置診所去設置大量的基層診所你看到處在臺北市到處看的時候那一棵大樹之下那個符號之下 欸它是個診所夠膽他去開設分院我們還沒話講\n323524\t343525\t分院他要買土地蓋房舍,要購買檢驗機具等等,成本他也不花,他為什麼設診所?除了成本低以外,對他們而言他們就像把牛肉湯撐水一樣,他要來分食基層醫療的點子。\n347386\t366372\t院長我希望在你任內這些通通不要再放行了不要再任由這些大型尤其是財團醫院在各縣市在各地方去廣設基層診所因為這是非常不公平的他們就是要來瓜分基層醫療的點子\n370765\t395746\t這個會造成時時在做基層醫療的醫師們那非常非常大的痛苦傷心所以這一點能不能做到因為照說你都會區本來就不該你要設那你應該到偏鄉偏鄉醫療的地方去設不是這樣嗎結果台北市核准的通通是這些大型大型的財團醫院\n398117\t413912\t這一點是不是院長你可以承諾這一個部分要做檢討好不好?好謝謝委員用了相當長的時間闡述基層醫療在台灣現在整個醫療體系上它的弱勢我個人認為不只基層醫療連地區醫院進行上都是困難的\n414960\t443590\t那過去我在議會在立法院的時代我接觸最多的就是基層醫療協會現在也是如此我深深知道他們的需求他們所面臨的困境那麼台如果是以都會區來講又是一個治療醫療資源比較充沛的地方更不應該更不應該這樣去做來自醫界們你看他那個他們那個心聲多痛苦我就舉罕病就好罕病我們全國有兩萬一千八百位\n445629\t470984\t每年需要將近百億,今年預估會超過一百,大概一百零八億需要的耗費。但是這也完全符合我們全體國人共同要救治他們的心願。結果在一屆的聲音你看,他就是要求政府說要不然把罕病這一塊從健保這個拿出來,不要加入點子,單獨來計算。\n472665\t475426\t今年我們罕病用藥還給他加了一些經費預算,希望能夠加到20億。\n496255\t497076\t韓病有加?\n497076\t517977\t有,有加,韓病用藥。包括我們除了健保完全的加進去以外,行政院這一個部份,公衛生多20億。我們洗腎有9萬7千人啦,那現在歐美日國家他們有進步的醫療啦,那可以再加洗腎,這再加洗腎又可以免掉患者他們周遮勞頓。\n519638\t542443\t那又可以讓他們洗腎時間長一點減少這個逆滲透的身體不舒服那麼這些非常這個重要結果光這個我們一屆提案來給我們那個健保這邊審專家會議都通過了現在在等所謂共同擬定會議一等\n544883\t572352\t要是也不知何年何日才要通過 我覺得這個部分 院長是不是你交代部長這個部分查查看到底怎麼回事好不好公會那邊跟部裡面應該現在還在保持接觸當中我最近才得到這個訊息接觸了幾年了還在接觸我說就明年的明年這個計算的這個內容還在接觸當中希望說在你的手上在你的任內這個部分就能夠通過\n573476\t580427\t我請部長趕快去計算清楚跟他們就業務上來詳細的規劃一下。 那麼我們也很樂意來看到就是說這個身心障礙權益保護法\n588351\t614702\t說實在話這17年沒修了在你的手上總算這有修了但是這個修啊我整個法把它看過以後我發現我們對於自立生活身障者他們自立生活的部分還是沒有任何的著墨沒有任何的提升啦那麼身心障礙者這個所有的長照大概我們現在平均算在一天給他們大概\n618189\t641846\t連長照連智力生活照護每天不得超過6個小時的這一部分的補助啦但是這個部分啦那個剛剛講到這個效應後那個院長這個部分我特別要針對長照師講的話我今天要質詢的部分喔我等了他三個禮拜啦資料都還沒來\n642915\t657610\t我問他說 這個輔具啊 我們對生長者的輔具生長者的輔具 有科技輔具 一般輔具那真正生長者在使用 它必須兩者並用\n660012\t686199\t但是長期以來我們對身障者的補助在這一個部分通通做掉身障者說你只能擇醫我一再的問那為什麼要擇醫同樣一個費用你讓他買兩種輔具或者有哪幾種科技輔具哪些一般輔具你有沒有這相關的資料因為\n687319\t706341\t身障者真的跟家屬去買啦,到時候來申報,又不過,這個也不能過,那個也不能過,所以我就要常教師說,你答覆我為什麼不能兩者共用,兩者都買。\n707315\t724964\t只要在你總額總金額內啊不是嗎然後我要他答覆我說申請那麼困難那你乾脆告訴我們有哪些輔具哪些廠牌可用等了三個禮拜他連甩都不甩啦天啊我們在立法院問\n726840\t745372\t他都這種態度啦那他是如何面對現在身障者包括需要長照的老年獨居老人者他們來接洽會是多麼的困難所以也因為這樣我特別要求就是說是不是\n746431\t772656\t我們針對需要長照的以及身障者我們應該開政府應該研究一個統一窗口我舉個例齁為什麼他們的需求需要統一窗口來面對比方說我如果是個身障者我今天要去學校就學我接洽的必須跟教育部教育部再跟地方教育局聯絡那來幫助我\n774209\t797314\t好了 我要去工作 我要就業 需要勞動部 勞動部在支援地方的勞工局所以到底我的需求就這一些啊 那我需要長照的部分 當然那就來啦就社家署 就是我們衛福部社家署 我們一個身障者一天\n798547\t824484\t要做的就學就業長照那需要跟這麼多不同單位洽詢洽詢通過他們的核准以後再去找機構來派人力天吶我覺得這樣子這樣子的程序過於冗長那麼對於真正需要幫助的比方說獨居老人比方說身障者\n825051\t828513\t委員剛剛所說的狀況,我深覺得是不合理,也不應該啦。那,請會護,應該立刻從制度上馬上去\n855267\t857877\t定定一套方式一般國人都應該\n859438\t884961\t簡正辨明,何況是對身障者,我們更應該有這個方向去走。我們現在的照顧制度很多,但如果落實這個才重要,馬上提出一個方式,馬上去執行。是,是。乾脆我們就訂一個額度,一個金額裡面,那它多少要用在長照,多少它是要用在自立生活,還有自立生活我們至少,院長,至少從最基本的喘息服務,\n885885\t888627\t你提的這些都是未來長照3.0非常重要的重點,我們會去推\n909673\t910114\t我們會改善\n","txt":"謝謝院長。我請行政院卓院長。麻煩請卓院長再次備詢。\n總委員好 總委員長又見面了我今天第二段的質詢是要跟你談一些那麼雖然比較細微但是其實是更重要的啦所以我們今天就很和緩的來討論那麼我想我們幾十年來我們台灣\n最大的一個特點也是我們國家的一個優點就是我們國家的醫療品質跟這個服務價格那如果我簡單用四個字形容我們台灣的醫療品質跟價格相比叫做價廉物美\n那這價廉務美其實是長期以來建立在我們國家醫護人員他們有很多權益的犧牲尤其是跟先進的國家相比那他們不但所得也好他們的工作環境也好大概都遠遠不能相比\n但是我們醫護人員不管是從醫學中心一直到基層醫療診所 大家都還是一樣 恪遵職守那兢兢業業的在為全體國人在效命那麼所以就提到我們委員幾乎都會提到這個典職啦\n那點子當然該是多少我們國家再來細算這當然是沒問題可是這個點子的部分我覺得基層醫療的點子最重要因為基層醫療相較於其他的醫學中心、區域醫院、地區醫院而言他們的平均的成本都比較高\n甚至成本都遠高於醫學中心我舉例比方說基層醫療診所第一點他們有任何業外收入他不像大型醫院有業外收入地下室可以停車有停車場有那麼多空間為了要造福病患跟病患家屬所以他們可以出租做美食中心做賣醫療器具的場所等等等等\n那這些業外收入很多那大型醫院尤其醫學中心採購的藥量體那麼大他們的折扣相對也比較大第三個比方說他們一些基本的成本護理人員的成本藥師的成本他們相對平均下來會比較低那基層醫療診所這些負擔都非常非常的重\n結果我看了一下我們這個基層醫療診所的點子竟然竟然連這幾年連0.9都不到0.9都不到當然所以醫界現在尤其是基層醫療診所他們是頗有怨言當然吐了怨言以後他們事後也都會吞下來可是可是\n長期以往這是非常不公平的一位醫生從他學生學生的過程他要高於其他各\n這部分基層醫療診所這個委屈太大了委屈大家尤其這幾年又有一個風氣那這個\n故然不是在你們手上去放行的可是過去歷屆幾位院長竟然放任這些醫學中心、大型醫院他們到基層去\n假藉著這個醫學中心的名號那去設置診所去設置大量的基層診所你看到處在臺北市到處看的時候那一棵大樹之下那個符號之下 欸它是個診所夠膽他去開設分院我們還沒話講\n分院他要買土地蓋房舍,要購買檢驗機具等等,成本他也不花,他為什麼設診所?除了成本低以外,對他們而言他們就像把牛肉湯撐水一樣,他要來分食基層醫療的點子。\n院長我希望在你任內這些通通不要再放行了不要再任由這些大型尤其是財團醫院在各縣市在各地方去廣設基層診所因為這是非常不公平的他們就是要來瓜分基層醫療的點子\n這個會造成時時在做基層醫療的醫師們那非常非常大的痛苦傷心所以這一點能不能做到因為照說你都會區本來就不該你要設那你應該到偏鄉偏鄉醫療的地方去設不是這樣嗎結果台北市核准的通通是這些大型大型的財團醫院\n這一點是不是院長你可以承諾這一個部分要做檢討好不好?好謝謝委員用了相當長的時間闡述基層醫療在台灣現在整個醫療體系上它的弱勢我個人認為不只基層醫療連地區醫院進行上都是困難的\n那過去我在議會在立法院的時代我接觸最多的就是基層醫療協會現在也是如此我深深知道他們的需求他們所面臨的困境那麼台如果是以都會區來講又是一個治療醫療資源比較充沛的地方更不應該更不應該這樣去做來自醫界們你看他那個他們那個心聲多痛苦我就舉罕病就好罕病我們全國有兩萬一千八百位\n每年需要將近百億,今年預估會超過一百,大概一百零八億需要的耗費。但是這也完全符合我們全體國人共同要救治他們的心願。結果在一屆的聲音你看,他就是要求政府說要不然把罕病這一塊從健保這個拿出來,不要加入點子,單獨來計算。\n今年我們罕病用藥還給他加了一些經費預算,希望能夠加到20億。\n韓病有加?\n有,有加,韓病用藥。包括我們除了健保完全的加進去以外,行政院這一個部份,公衛生多20億。我們洗腎有9萬7千人啦,那現在歐美日國家他們有進步的醫療啦,那可以再加洗腎,這再加洗腎又可以免掉患者他們周遮勞頓。\n那又可以讓他們洗腎時間長一點減少這個逆滲透的身體不舒服那麼這些非常這個重要結果光這個我們一屆提案來給我們那個健保這邊審專家會議都通過了現在在等所謂共同擬定會議一等\n要是也不知何年何日才要通過 我覺得這個部分 院長是不是你交代部長這個部分查查看到底怎麼回事好不好公會那邊跟部裡面應該現在還在保持接觸當中我最近才得到這個訊息接觸了幾年了還在接觸我說就明年的明年這個計算的這個內容還在接觸當中希望說在你的手上在你的任內這個部分就能夠通過\n我請部長趕快去計算清楚跟他們就業務上來詳細的規劃一下。 那麼我們也很樂意來看到就是說這個身心障礙權益保護法\n說實在話這17年沒修了在你的手上總算這有修了但是這個修啊我整個法把它看過以後我發現我們對於自立生活身障者他們自立生活的部分還是沒有任何的著墨沒有任何的提升啦那麼身心障礙者這個所有的長照大概我們現在平均算在一天給他們大概\n連長照連智力生活照護每天不得超過6個小時的這一部分的補助啦但是這個部分啦那個剛剛講到這個效應後那個院長這個部分我特別要針對長照師講的話我今天要質詢的部分喔我等了他三個禮拜啦資料都還沒來\n我問他說 這個輔具啊 我們對生長者的輔具生長者的輔具 有科技輔具 一般輔具那真正生長者在使用 它必須兩者並用\n但是長期以來我們對身障者的補助在這一個部分通通做掉身障者說你只能擇醫我一再的問那為什麼要擇醫同樣一個費用你讓他買兩種輔具或者有哪幾種科技輔具哪些一般輔具你有沒有這相關的資料因為\n身障者真的跟家屬去買啦,到時候來申報,又不過,這個也不能過,那個也不能過,所以我就要常教師說,你答覆我為什麼不能兩者共用,兩者都買。\n只要在你總額總金額內啊不是嗎然後我要他答覆我說申請那麼困難那你乾脆告訴我們有哪些輔具哪些廠牌可用等了三個禮拜他連甩都不甩啦天啊我們在立法院問\n他都這種態度啦那他是如何面對現在身障者包括需要長照的老年獨居老人者他們來接洽會是多麼的困難所以也因為這樣我特別要求就是說是不是\n我們針對需要長照的以及身障者我們應該開政府應該研究一個統一窗口我舉個例齁為什麼他們的需求需要統一窗口來面對比方說我如果是個身障者我今天要去學校就學我接洽的必須跟教育部教育部再跟地方教育局聯絡那來幫助我\n好了 我要去工作 我要就業 需要勞動部 勞動部在支援地方的勞工局所以到底我的需求就這一些啊 那我需要長照的部分 當然那就來啦就社家署 就是我們衛福部社家署 我們一個身障者一天\n要做的就學就業長照那需要跟這麼多不同單位洽詢洽詢通過他們的核准以後再去找機構來派人力天吶我覺得這樣子這樣子的程序過於冗長那麼對於真正需要幫助的比方說獨居老人比方說身障者\n委員剛剛所說的狀況,我深覺得是不合理,也不應該啦。那,請會護,應該立刻從制度上馬上去\n定定一套方式一般國人都應該\n簡正辨明,何況是對身障者,我們更應該有這個方向去走。我們現在的照顧制度很多,但如果落實這個才重要,馬上提出一個方式,馬上去執行。是,是。乾脆我們就訂一個額度,一個金額裡面,那它多少要用在長照,多少它是要用在自立生活,還有自立生活我們至少,院長,至少從最基本的喘息服務,\n你提的這些都是未來長照3.0非常重要的重點,我們會去推\n我們會改善\n","vtt":"WEBVTT\n\n00:16.264 --> 00:21.249\n謝謝院長。我請行政院卓院長。麻煩請卓院長再次備詢。\n\n00:28.220 --> 00:56.880\n總委員好總委員長又見面了我今天第二段的質詢是要跟你談一些那麼雖然比較細微但是其實是更重要的啦所以我們今天就很和緩的來討論那麼我想我們幾十年來我們台灣\n\n00:58.072 --> 01:21.454\n最大的一個特點也是我們國家的一個優點就是我們國家的醫療品質跟這個服務價格那如果我簡單用四個字形容我們台灣的醫療品質跟價格相比叫做價廉物美\n\n01:22.810 --> 01:47.584\n那這價廉務美其實是長期以來建立在我們國家醫護人員他們有很多權益的犧牲尤其是跟先進的國家相比那他們不但所得也好他們的工作環境也好大概都遠遠不能相比\n\n01:48.527 --> 02:11.698\n但是我們醫護人員不管是從醫學中心一直到基層醫療診所大家都還是一樣恪遵職守那兢兢業業的在為全體國人在效命那麼所以就提到我們委員幾乎都會提到這個典職啦\n\n02:12.793 --> 02:41.228\n那點子當然該是多少我們國家再來細算這當然是沒問題可是這個點子的部分我覺得基層醫療的點子最重要因為基層醫療相較於其他的醫學中心、區域醫院、地區醫院而言他們的平均的成本都比較高\n\n02:42.597 --> 03:10.070\n甚至成本都遠高於醫學中心我舉例比方說基層醫療診所第一點他們有任何業外收入他不像大型醫院有業外收入地下室可以停車有停車場有那麼多空間為了要造福病患跟病患家屬所以他們可以出租做美食中心做賣醫療器具的場所等等等等\n\n03:11.363 --> 03:37.857\n那這些業外收入很多那大型醫院尤其醫學中心採購的藥量體那麼大他們的折扣相對也比較大第三個比方說他們一些基本的成本護理人員的成本藥師的成本他們相對平均下來會比較低那基層醫療診所這些負擔都非常非常的重\n\n03:38.772 --> 04:05.638\n結果我看了一下我們這個基層醫療診所的點子竟然竟然連這幾年連0.9都不到0.9都不到當然所以醫界現在尤其是基層醫療診所他們是頗有怨言當然吐了怨言以後他們事後也都會吞下來可是可是\n\n04:07.717 --> 04:19.586\n長期以往這是非常不公平的一位醫生從他學生學生的過程他要高於其他各\n\n04:21.067 --> 04:25.328\n這部分基層醫療診所這個委屈太大了委屈大家尤其這幾年又有一個風氣那這個\n\n04:49.124 --> 05:01.605\n故然不是在你們手上去放行的可是過去歷屆幾位院長竟然放任這些醫學中心、大型醫院他們到基層去\n\n05:02.921 --> 05:21.942\n假藉著這個醫學中心的名號那去設置診所去設置大量的基層診所你看到處在臺北市到處看的時候那一棵大樹之下那個符號之下欸它是個診所夠膽他去開設分院我們還沒話講\n\n05:23.524 --> 05:43.525\n分院他要買土地蓋房舍,要購買檢驗機具等等,成本他也不花,他為什麼設診所?除了成本低以外,對他們而言他們就像把牛肉湯撐水一樣,他要來分食基層醫療的點子。\n\n05:47.386 --> 06:06.372\n院長我希望在你任內這些通通不要再放行了不要再任由這些大型尤其是財團醫院在各縣市在各地方去廣設基層診所因為這是非常不公平的他們就是要來瓜分基層醫療的點子\n\n06:10.765 --> 06:35.746\n這個會造成時時在做基層醫療的醫師們那非常非常大的痛苦傷心所以這一點能不能做到因為照說你都會區本來就不該你要設那你應該到偏鄉偏鄉醫療的地方去設不是這樣嗎結果台北市核准的通通是這些大型大型的財團醫院\n\n06:38.117 --> 06:53.912\n這一點是不是院長你可以承諾這一個部分要做檢討好不好?好謝謝委員用了相當長的時間闡述基層醫療在台灣現在整個醫療體系上它的弱勢我個人認為不只基層醫療連地區醫院進行上都是困難的\n\n06:54.960 --> 07:23.590\n那過去我在議會在立法院的時代我接觸最多的就是基層醫療協會現在也是如此我深深知道他們的需求他們所面臨的困境那麼台如果是以都會區來講又是一個治療醫療資源比較充沛的地方更不應該更不應該這樣去做來自醫界們你看他那個他們那個心聲多痛苦我就舉罕病就好罕病我們全國有兩萬一千八百位\n\n07:25.629 --> 07:50.984\n每年需要將近百億,今年預估會超過一百,大概一百零八億需要的耗費。但是這也完全符合我們全體國人共同要救治他們的心願。結果在一屆的聲音你看,他就是要求政府說要不然把罕病這一塊從健保這個拿出來,不要加入點子,單獨來計算。\n\n07:52.665 --> 07:55.426\n今年我們罕病用藥還給他加了一些經費預算,希望能夠加到20億。\n\n08:16.255 --> 08:17.076\n韓病有加?\n\n08:17.076 --> 08:37.977\n有,有加,韓病用藥。包括我們除了健保完全的加進去以外,行政院這一個部份,公衛生多20億。我們洗腎有9萬7千人啦,那現在歐美日國家他們有進步的醫療啦,那可以再加洗腎,這再加洗腎又可以免掉患者他們周遮勞頓。\n\n08:39.638 --> 09:02.443\n那又可以讓他們洗腎時間長一點減少這個逆滲透的身體不舒服那麼這些非常這個重要結果光這個我們一屆提案來給我們那個健保這邊審專家會議都通過了現在在等所謂共同擬定會議一等\n\n09:04.883 --> 09:32.352\n要是也不知何年何日才要通過我覺得這個部分院長是不是你交代部長這個部分查查看到底怎麼回事好不好公會那邊跟部裡面應該現在還在保持接觸當中我最近才得到這個訊息接觸了幾年了還在接觸我說就明年的明年這個計算的這個內容還在接觸當中希望說在你的手上在你的任內這個部分就能夠通過\n\n09:33.476 --> 09:40.427\n我請部長趕快去計算清楚跟他們就業務上來詳細的規劃一下。那麼我們也很樂意來看到就是說這個身心障礙權益保護法\n\n09:48.351 --> 10:14.702\n說實在話這17年沒修了在你的手上總算這有修了但是這個修啊我整個法把它看過以後我發現我們對於自立生活身障者他們自立生活的部分還是沒有任何的著墨沒有任何的提升啦那麼身心障礙者這個所有的長照大概我們現在平均算在一天給他們大概\n\n10:18.189 --> 10:41.846\n連長照連智力生活照護每天不得超過6個小時的這一部分的補助啦但是這個部分啦那個剛剛講到這個效應後那個院長這個部分我特別要針對長照師講的話我今天要質詢的部分喔我等了他三個禮拜啦資料都還沒來\n\n10:42.915 --> 10:57.610\n我問他說這個輔具啊我們對生長者的輔具生長者的輔具有科技輔具一般輔具那真正生長者在使用它必須兩者並用\n\n11:00.012 --> 11:26.199\n但是長期以來我們對身障者的補助在這一個部分通通做掉身障者說你只能擇醫我一再的問那為什麼要擇醫同樣一個費用你讓他買兩種輔具或者有哪幾種科技輔具哪些一般輔具你有沒有這相關的資料因為\n\n11:27.319 --> 11:46.341\n身障者真的跟家屬去買啦,到時候來申報,又不過,這個也不能過,那個也不能過,所以我就要常教師說,你答覆我為什麼不能兩者共用,兩者都買。\n\n11:47.315 --> 12:04.964\n只要在你總額總金額內啊不是嗎然後我要他答覆我說申請那麼困難那你乾脆告訴我們有哪些輔具哪些廠牌可用等了三個禮拜他連甩都不甩啦天啊我們在立法院問\n\n12:06.840 --> 12:25.372\n他都這種態度啦那他是如何面對現在身障者包括需要長照的老年獨居老人者他們來接洽會是多麼的困難所以也因為這樣我特別要求就是說是不是\n\n12:26.431 --> 12:52.656\n我們針對需要長照的以及身障者我們應該開政府應該研究一個統一窗口我舉個例齁為什麼他們的需求需要統一窗口來面對比方說我如果是個身障者我今天要去學校就學我接洽的必須跟教育部教育部再跟地方教育局聯絡那來幫助我\n\n12:54.209 --> 13:17.314\n好了我要去工作我要就業需要勞動部勞動部在支援地方的勞工局所以到底我的需求就這一些啊那我需要長照的部分當然那就來啦就社家署就是我們衛福部社家署我們一個身障者一天\n\n13:18.547 --> 13:44.484\n要做的就學就業長照那需要跟這麼多不同單位洽詢洽詢通過他們的核准以後再去找機構來派人力天吶我覺得這樣子這樣子的程序過於冗長那麼對於真正需要幫助的比方說獨居老人比方說身障者\n\n13:45.051 --> 13:48.513\n委員剛剛所說的狀況,我深覺得是不合理,也不應該啦。那,請會護,應該立刻從制度上馬上去\n\n14:15.267 --> 14:17.877\n定定一套方式一般國人都應該\n\n14:19.438 --> 14:44.961\n簡正辨明,何況是對身障者,我們更應該有這個方向去走。我們現在的照顧制度很多,但如果落實這個才重要,馬上提出一個方式,馬上去執行。是,是。乾脆我們就訂一個額度,一個金額裡面,那它多少要用在長照,多少它是要用在自立生活,還有自立生活我們至少,院長,至少從最基本的喘息服務,\n\n14:45.885 --> 14:48.627\n你提的這些都是未來長照3.0非常重要的重點,我們會去推\n\n15:09.673 --> 15:10.114\n我們會改善\n\n","segments":[{"start":16.264,"end":21.249,"text":"謝謝院長。我請行政院卓院長。麻煩請卓院長再次備詢。"},{"start":28.22,"end":56.88,"text":"總委員好 總委員長又見面了我今天第二段的質詢是要跟你談一些那麼雖然比較細微但是其實是更重要的啦所以我們今天就很和緩的來討論那麼我想我們幾十年來我們台灣"},{"start":58.072,"end":81.454,"text":"最大的一個特點也是我們國家的一個優點就是我們國家的醫療品質跟這個服務價格那如果我簡單用四個字形容我們台灣的醫療品質跟價格相比叫做價廉物美"},{"start":82.81,"end":107.584,"text":"那這價廉務美其實是長期以來建立在我們國家醫護人員他們有很多權益的犧牲尤其是跟先進的國家相比那他們不但所得也好他們的工作環境也好大概都遠遠不能相比"},{"start":108.527,"end":131.698,"text":"但是我們醫護人員不管是從醫學中心一直到基層醫療診所 大家都還是一樣 恪遵職守那兢兢業業的在為全體國人在效命那麼所以就提到我們委員幾乎都會提到這個典職啦"},{"start":132.793,"end":161.228,"text":"那點子當然該是多少我們國家再來細算這當然是沒問題可是這個點子的部分我覺得基層醫療的點子最重要因為基層醫療相較於其他的醫學中心、區域醫院、地區醫院而言他們的平均的成本都比較高"},{"start":162.597,"end":190.07,"text":"甚至成本都遠高於醫學中心我舉例比方說基層醫療診所第一點他們有任何業外收入他不像大型醫院有業外收入地下室可以停車有停車場有那麼多空間為了要造福病患跟病患家屬所以他們可以出租做美食中心做賣醫療器具的場所等等等等"},{"start":191.363,"end":217.857,"text":"那這些業外收入很多那大型醫院尤其醫學中心採購的藥量體那麼大他們的折扣相對也比較大第三個比方說他們一些基本的成本護理人員的成本藥師的成本他們相對平均下來會比較低那基層醫療診所這些負擔都非常非常的重"},{"start":218.772,"end":245.638,"text":"結果我看了一下我們這個基層醫療診所的點子竟然竟然連這幾年連0.9都不到0.9都不到當然所以醫界現在尤其是基層醫療診所他們是頗有怨言當然吐了怨言以後他們事後也都會吞下來可是可是"},{"start":247.717,"end":259.586,"text":"長期以往這是非常不公平的一位醫生從他學生學生的過程他要高於其他各"},{"start":261.067,"end":265.328,"text":"這部分基層醫療診所這個委屈太大了委屈大家尤其這幾年又有一個風氣那這個"},{"start":289.124,"end":301.605,"text":"故然不是在你們手上去放行的可是過去歷屆幾位院長竟然放任這些醫學中心、大型醫院他們到基層去"},{"start":302.921,"end":321.942,"text":"假藉著這個醫學中心的名號那去設置診所去設置大量的基層診所你看到處在臺北市到處看的時候那一棵大樹之下那個符號之下 欸它是個診所夠膽他去開設分院我們還沒話講"},{"start":323.524,"end":343.525,"text":"分院他要買土地蓋房舍,要購買檢驗機具等等,成本他也不花,他為什麼設診所?除了成本低以外,對他們而言他們就像把牛肉湯撐水一樣,他要來分食基層醫療的點子。"},{"start":347.386,"end":366.372,"text":"院長我希望在你任內這些通通不要再放行了不要再任由這些大型尤其是財團醫院在各縣市在各地方去廣設基層診所因為這是非常不公平的他們就是要來瓜分基層醫療的點子"},{"start":370.765,"end":395.746,"text":"這個會造成時時在做基層醫療的醫師們那非常非常大的痛苦傷心所以這一點能不能做到因為照說你都會區本來就不該你要設那你應該到偏鄉偏鄉醫療的地方去設不是這樣嗎結果台北市核准的通通是這些大型大型的財團醫院"},{"start":398.117,"end":413.912,"text":"這一點是不是院長你可以承諾這一個部分要做檢討好不好?好謝謝委員用了相當長的時間闡述基層醫療在台灣現在整個醫療體系上它的弱勢我個人認為不只基層醫療連地區醫院進行上都是困難的"},{"start":414.96,"end":443.59,"text":"那過去我在議會在立法院的時代我接觸最多的就是基層醫療協會現在也是如此我深深知道他們的需求他們所面臨的困境那麼台如果是以都會區來講又是一個治療醫療資源比較充沛的地方更不應該更不應該這樣去做來自醫界們你看他那個他們那個心聲多痛苦我就舉罕病就好罕病我們全國有兩萬一千八百位"},{"start":445.629,"end":470.984,"text":"每年需要將近百億,今年預估會超過一百,大概一百零八億需要的耗費。但是這也完全符合我們全體國人共同要救治他們的心願。結果在一屆的聲音你看,他就是要求政府說要不然把罕病這一塊從健保這個拿出來,不要加入點子,單獨來計算。"},{"start":472.665,"end":475.426,"text":"今年我們罕病用藥還給他加了一些經費預算,希望能夠加到20億。"},{"start":496.255,"end":497.076,"text":"韓病有加?"},{"start":497.076,"end":517.977,"text":"有,有加,韓病用藥。包括我們除了健保完全的加進去以外,行政院這一個部份,公衛生多20億。我們洗腎有9萬7千人啦,那現在歐美日國家他們有進步的醫療啦,那可以再加洗腎,這再加洗腎又可以免掉患者他們周遮勞頓。"},{"start":519.638,"end":542.443,"text":"那又可以讓他們洗腎時間長一點減少這個逆滲透的身體不舒服那麼這些非常這個重要結果光這個我們一屆提案來給我們那個健保這邊審專家會議都通過了現在在等所謂共同擬定會議一等"},{"start":544.883,"end":572.352,"text":"要是也不知何年何日才要通過 我覺得這個部分 院長是不是你交代部長這個部分查查看到底怎麼回事好不好公會那邊跟部裡面應該現在還在保持接觸當中我最近才得到這個訊息接觸了幾年了還在接觸我說就明年的明年這個計算的這個內容還在接觸當中希望說在你的手上在你的任內這個部分就能夠通過"},{"start":573.476,"end":580.427,"text":"我請部長趕快去計算清楚跟他們就業務上來詳細的規劃一下。 那麼我們也很樂意來看到就是說這個身心障礙權益保護法"},{"start":588.351,"end":614.702,"text":"說實在話這17年沒修了在你的手上總算這有修了但是這個修啊我整個法把它看過以後我發現我們對於自立生活身障者他們自立生活的部分還是沒有任何的著墨沒有任何的提升啦那麼身心障礙者這個所有的長照大概我們現在平均算在一天給他們大概"},{"start":618.189,"end":641.846,"text":"連長照連智力生活照護每天不得超過6個小時的這一部分的補助啦但是這個部分啦那個剛剛講到這個效應後那個院長這個部分我特別要針對長照師講的話我今天要質詢的部分喔我等了他三個禮拜啦資料都還沒來"},{"start":642.915,"end":657.61,"text":"我問他說 這個輔具啊 我們對生長者的輔具生長者的輔具 有科技輔具 一般輔具那真正生長者在使用 它必須兩者並用"},{"start":660.012,"end":686.199,"text":"但是長期以來我們對身障者的補助在這一個部分通通做掉身障者說你只能擇醫我一再的問那為什麼要擇醫同樣一個費用你讓他買兩種輔具或者有哪幾種科技輔具哪些一般輔具你有沒有這相關的資料因為"},{"start":687.319,"end":706.341,"text":"身障者真的跟家屬去買啦,到時候來申報,又不過,這個也不能過,那個也不能過,所以我就要常教師說,你答覆我為什麼不能兩者共用,兩者都買。"},{"start":707.315,"end":724.964,"text":"只要在你總額總金額內啊不是嗎然後我要他答覆我說申請那麼困難那你乾脆告訴我們有哪些輔具哪些廠牌可用等了三個禮拜他連甩都不甩啦天啊我們在立法院問"},{"start":726.84,"end":745.372,"text":"他都這種態度啦那他是如何面對現在身障者包括需要長照的老年獨居老人者他們來接洽會是多麼的困難所以也因為這樣我特別要求就是說是不是"},{"start":746.431,"end":772.656,"text":"我們針對需要長照的以及身障者我們應該開政府應該研究一個統一窗口我舉個例齁為什麼他們的需求需要統一窗口來面對比方說我如果是個身障者我今天要去學校就學我接洽的必須跟教育部教育部再跟地方教育局聯絡那來幫助我"},{"start":774.209,"end":797.314,"text":"好了 我要去工作 我要就業 需要勞動部 勞動部在支援地方的勞工局所以到底我的需求就這一些啊 那我需要長照的部分 當然那就來啦就社家署 就是我們衛福部社家署 我們一個身障者一天"},{"start":798.547,"end":824.484,"text":"要做的就學就業長照那需要跟這麼多不同單位洽詢洽詢通過他們的核准以後再去找機構來派人力天吶我覺得這樣子這樣子的程序過於冗長那麼對於真正需要幫助的比方說獨居老人比方說身障者"},{"start":825.051,"end":828.513,"text":"委員剛剛所說的狀況,我深覺得是不合理,也不應該啦。那,請會護,應該立刻從制度上馬上去"},{"start":855.267,"end":857.877,"text":"定定一套方式一般國人都應該"},{"start":859.438,"end":884.961,"text":"簡正辨明,何況是對身障者,我們更應該有這個方向去走。我們現在的照顧制度很多,但如果落實這個才重要,馬上提出一個方式,馬上去執行。是,是。乾脆我們就訂一個額度,一個金額裡面,那它多少要用在長照,多少它是要用在自立生活,還有自立生活我們至少,院長,至少從最基本的喘息服務,"},{"start":885.885,"end":888.627,"text":"你提的這些都是未來長照3.0非常重要的重點,我們會去推"},{"start":909.673,"end":910.114,"text":"我們會改善"}]}}},"gazette":{"lineno":253,"blocks":[["王委員世堅：（15時19分）謝謝院長，我請行政院卓院長。"],["主席：麻煩請卓院長再次備詢。"],["卓院長榮泰：王委員好。"],["王委員世堅：卓院長，我們又見面了。我今天第二段的質詢是要跟你談一些雖然比較細微但是其實更重要的問題，所以我們今天就很和緩的來討論。","我想幾十年來我們臺灣最大的一個特點，也是我們國家的一個優點，就是我們國家的醫療品質跟服務價格，如果我簡單用四個字形容，我們臺灣的醫療品質跟價格相比就叫做價廉物美。那這個價廉物美其實是長期以來建立在我們國家醫護人員他們有很多權益的犧牲，尤其是跟先進的國家相比，不但所得也好、工作環境也好，我們大概都遠遠不能相比。但是我們醫護人員，不管是從醫學中心一直到基層醫療診所，大家都還是一樣恪遵職守，兢兢業業的在為全體國人效命。","我們每位委員幾乎都會提到點值，那點值該是多少，我們國家再來細算，這當然是沒問題。可是這個點值的部分，我覺得基層醫療的點值最重要，因為基層醫療相較於其他的醫學中心、區域醫院、地區醫院而言，他們的平均成本都比較高，甚至都遠高於醫學中心。我可以舉例，比方說基層醫療診所第一點是沒有任何業外收入，它不像大型醫院有業外收入，地下室有停車場可以供人停車，有那麼多的空間，為了要造福病患跟病患的家屬，所以他們可以出租做美食中心、做販賣醫療器具的場所等等，這些業外收入很多。大型醫院尤其是醫學中心採購藥品的量體那麼大，他們的折扣相對也比較大。"],["卓院長榮泰：沒錯。"],["王委員世堅：第三個，比方說他們一些基本的成本、護理人員的成本、藥師的成本相對平均下來會比較低，然而基層醫療診所的這些負擔都非常非常的重。結果我看了一下，我們這些基層醫療診所的點值竟然接連這幾年連0.9都不到，連0.9都不到！所以現在醫界尤其是基層醫療診所，他們是頗有怨言啦！當然，在吐了怨言以後，他們事後也都會吞下來，可是長此以往，這是非常不公平的。一位醫生學成的過程高於其他各系所，他們的求學時間必須7年，他們不但要實習，還要通過醫師考試，所以事實上他們實質花費的，包括精神資源，都遠比其他工作還要高。所以這個部分基層醫療診所的委屈太大了。","尤其在這幾年又有一個風氣，這個固然不是在你們手上去放行的，可是過去歷屆幾位院長竟然放任這些醫學中心、大型醫院他們到基層去假借著醫學中心的名號去設置診所，去設置大量的基層診所，你看在臺北市到處看得到在那棵大樹的那個符號之下，它是個診所。如果夠膽，他去開設分院，我們還沒話講，分院他要買土地、蓋房舍、要購買檢驗機具等等，成本他也要付啊，他為什麼設診所？除了成本低以外，對他們而言，他們就像把牛肉湯摻水一樣，然後他要來分食基層醫療的點值。院長，我希望在你任內，這些統統不要再放行了，不要再任由這些大型尤其是財團醫院，在各縣市、在各地方去廣設基層診所，因為這是非常不公平的，他們就是要來瓜分基層醫療的點值，這個會造成實質在做基層醫療的醫師們非常非常大的痛苦、傷心，所以這一點能不能做到？因為照理說都會區本來就不該，若你要設，那你應該到偏鄉、偏鄉醫療的地方去設，不是這樣嗎？結果臺北市核准的統統是這些大型的財團醫院，對於這一點，院長你是不是可以承諾這個部分要做檢討，好不好？"],["卓院長榮泰：好，謝謝委員用了相當長的時間來闡述基層醫療在臺灣現在整個醫療體系上的弱勢，我個人認為不只基層醫療，連地區醫院經營上都是困難的。過去我在議會、在立法院的時代，我接觸最多的就是基層醫療協會，現在也是如此，我深深知道他們的需求、他們所面臨的困境。如果是以都會區來講，又是一個醫療資源比較充沛的地方，更不應該這樣去做。"],["王委員世堅：你看來自醫界們，你看他們那個心聲多痛苦。"],["卓院長榮泰：是。"],["王委員世堅：我就舉罕病就好，罕病的部分我們全國有2萬1,800位病人，每年需要將近百億，今年預估會超過100，大概需要耗費108億，但是這也完全符合我們全體國人共同要救治他們的心願。結果在醫界的聲音，你看，他就是要求政府說，要不然把罕病這一塊從健保拿出來，不要加入點值，單獨來計算，大家很沉痛的心情才會這麼講，我是認為千萬不要碰罕病這個部分，這個部分本來我們全體國人都願意也很樂意，這個部分應該無條件的就是要救治他們。"],["卓院長榮泰：今年我們罕病用藥還給它加了一些經費、預算，希望能夠……"],["王委員世堅：罕病有加嗎？罕病有加？"],["卓院長榮泰：有、有加，罕病用藥有加20億。"],["邱部長泰源：報告委員，我們除了健保完全的加進去以外，行政院這個部分公務預算多20億……"],["王委員世堅：因為我們洗腎有9萬7,000人，現在歐美日國家他們有進步的醫療，可以在家洗腎，在家洗腎可以免掉患者舟車勞頓，又可以讓他們洗腎時間長一點，減少逆滲透的身體不舒服，這些也非常重要，結果光這一個，醫界提案來給我們健保這邊審，專家會議都通過了，現在在等所謂共同擬訂會議，一等又是不知何年何日才要通過，我覺得這個部分，院長你是不是交代部長查查看這個部分到底怎麼回事，好不好？"],["卓院長榮泰：報告委員，就我所知，公會那邊跟部裡面應該現在還在保持接觸當中，我最近才得到這個訊息。"],["王委員世堅：接觸幾年了還在接觸？"],["卓院長榮泰：我是說就明年計算的內容還在接觸當中。"],["王委員世堅：我希望在你的手上、在你的任內，這個部分就能夠通過。"],["卓院長榮泰：我請部長趕快去計算清楚，跟他們就業務上來詳細的規劃一下。"],["王委員世堅：因為在醫界已經有相當的研究。","另外，那麼我們也很樂意看到，身心障礙者權益保障法，說實在話，這已經17年沒修了，在你的手上總算有修了。但是這個修法，我把整個法看過以後，我發現我們對於自立生活、身障者他們自立生活的部分還是沒有任何的著墨、沒有任何的提升。身心障礙者所有的長照，我們現在平均計算一天給他們大概……連長照、連自立生活照護，每天不得超過六個小時的這一部分的補助，但是這個部分，剛剛講到效益，院長，這個部分我特別要針對長照司講個話，我今天要質詢的部分，我等了他三個禮拜，資料都還沒來。我問他，由於身障者的輔具有科技輔具、一般輔具，真正身障者在使用必須是兩者並用，但是長期以來，我們對身障者的補助，在這一個部分都要身障者只能擇一。我一再地問為什麼要擇一？同樣一個費用，你讓他買兩種輔具，或者有哪幾種科技輔具、哪些一般輔具，你有沒有這些相關的資料？因為身障者跟家屬真的去買了，到時候申報又不過，這個也不能過、那個也不能過，所以我就要長照司答復我為什麼不能兩者共用、兩者都買？一樣在總金額內啊！不是嗎？然後我要他答復我，既然申請那麼困難，那就乾脆告訴我們有哪些輔具、哪些廠牌可用。等了三個禮拜，他連甩都不甩啦！天啊！我們在立法院問，他都這種態度，那他是如何面對現在身障者，包括需要長照的獨居老人？他們來接洽會是多麼的困難！","所以也因為這樣，院長，我特別要求，是不是針對需要長照的以及身障者，政府應該研究一個統一窗口？我舉個例，為什麼他們的需求需要統一窗口來面對？比方說，我如果是個身障者，我今天要去學校就學，我接洽的必須是教育部，教育部再跟地方教育局聯絡來幫助我；或者我要去工作、我要就業，需要勞動部，勞動部再知會地方的勞工局。我的需求就這一些啊！至於我需要長照的部分，當然就來了，就是社家署，就是衛福部社家署。一個身障者一天要做的就學、就業、長照，需要跟這麼多不同單位洽詢，然後通過他們的核准以後再去找機構派人力。天啊！我覺得這樣子的程序過於冗長，對於真正需要幫助的，比方說獨居老人、比方說身障者，毫無便利可言！所以院長是不是應該下命令下去研究？我們是不是應該統籌單一窗口，跟需要的身障者還有老人朋友們做一個接洽才對？"],["卓院長榮泰：委員剛剛所說的狀況，我深深覺得不合理，也不應該，請衛福部應該立刻從制度上馬上去訂定一套方式，對一般國人都應該簡政便民，何況是對身障者，我們更應該有這個方向去走。我們現在的照顧制度很多，但如何落實這個才重要！衛福部馬上提出一個方式馬上去執行。"],["邱部長泰源：是。"],["王委員世堅：乾脆我們就訂一個額度，就在一定金額裡面，看他多少要用在長照、多少是要用在自立生活？還有，院長，自立生活至少要從最基本的喘息服務，喘息服務一個月久久才碰到一次嘛！"],["卓院長榮泰：是。"],["王委員世堅：我們現在的喘息服務一定就是只能照顧他在家裡用個餐，連出去買個東西、出去買個書、聽個音樂通通都不行，至少喘息服務這個時間這麼短，我們可以馬上就做。"],["邱部長泰源：報告委員，您提的這些是未來長照3.0非常重要的重點，我們會去推。"],["王委員世堅：部長，剛好你提了，你手下的健保署、長照司、社家署，社家署服務態度、精神最好，健保署是還OK啦，最糟糕的就是這個長照司！我希望你回去丟根粉筆叫他在那裡面罰站，好不好？"],["邱部長泰源：我們會改善。"],["卓院長榮泰：我們來檢討，謝謝。"],["主席：謝謝王世堅委員的質詢，令人感動。謝謝卓院長及各部會首長的備詢，謝謝。","接下來登記第10號、第11號的盧縣一委員、邱若華委員之質詢均以書面提出，請行政院書面答復，並列入紀錄，刊登公報。"],["委員盧縣一書面質詢：","請問：","一、立法院113年7月16日做成主決議：在不修改《全民健康保險法》前提之下，於114年6月30日前行政院須達成健保平均點值1點0.95元目標，以維護醫事人員權益，估算需要額外增加700億元預算，但行政院提報之明年度總預案，卻無規劃。請問未來行政院、衛福部如何編足該項預算？","二、政府目標2030年降低癌症死亡率三分之一，因此行政院預計成立一百億「癌症基金」，明年先挹注50億元跨出第一步，具傳目前正在研擬專款作業要點，以訂出草案，其中是否有部分預算將研議用於提升原住民族健康醫療？","三、行政院、衛福部是有否已推動提升原鄉衛生所設置急診室計畫？例如：先前發生之台東縣金峰鄉農藥托福松中毒案，如果基層衛生所具備急診設備及人力，就不會因距離而延宕就醫。","四、《原住民族健康法》雖已三讀立法通過，但因為衛福部之專責單位「護理及健康照護司」層級過低，是否能研議成立「原住民健康署」，專責原住民族健康照護？"],["委員邱若華書面質詢：","一、衛福部所核定之八德次醫療園區，看似給予北桃園人近年來所缺乏之醫療資源，惟八德人口近年成長直逼基隆、且桃竹苗科技廊道逐漸形成中，未來將有更多居民移入。此醫療園區目前中央僅核予「地區醫院」層級，只具備少數專科，未能有全部次專科及更精進之醫療器材、技術解決嚴重的病症，例如：心肌梗塞等重大疾病之收案，也只能尋求其他區域之醫療資源，未來勢必持續與鄰近縣市之醫療資源競爭，請院長協助北桃園成立區域級醫院，且中央在區域級醫院成立所需之資源與溝通之角色肩負更大之責任。","二、我國即將邁入超高齡社會，以113年算至3月符合申請長照資格尚不到領取身障手冊的老人數有19萬9,693人，部分老年人因退化，而經常發生跌倒或車禍意外。請行政院長招集相關部會，研擬有「必要陪伴者需求」之老人判斷標準、與必要陪伴者享有敬老卡相同優惠政策，並於老人福利法第25條修法，給予有實質陪伴需求之老年人其必要陪伴者相同優惠，藉此降低照護成本、保障老人福利。","三、衛生福利部於111年6月份核定的國民口腔健康促進計畫第二期（111～115年）調查指出，台灣成人牙周病盛行率高達8成，本席詢問衛福部牙周病數據，發現國人牙周病盛行率隨年齡增加，最高者為65歲以上族群。雖衛福部113年新增「113年度全民健康保險牙醫門診總額高風險疾病口腔照護計畫」，提供65歲以上每3個月洗牙及口腔檢查之服務，惟目前國人牙周病盛行率仍嚴重，且牙齒保健政策多半著重於國人在學期間，中老年人牙齒保健政策仍有進步空間，請行政院長招集相關部會，研擬中老年人口腔健康推廣及執行精進政策。","四、全國大客車司機缺工問題嚴重，本年度將擬開放僑外生投入大客車司機行列，惟我國各行業缺工嚴重，明年度擬修法開放使更多僑外生投入我國更多元行業，可能大客車司機復陷入缺工潮。開放僑外生引入我國缺工支援立意甚美，惟相關政策走向及僑外生後續選擇工作之自由亦其權利所在，本席表示尊重。為完全從根本解決我國大客車司機缺工問題，請行政院長招集相關部會，研擬從根本解決大客車司機缺工需求政策。"],["主席：再接下來請登記第12號葉元之委員質詢。"]],"agenda":{"page_end":195,"meet_id":"院會-11-2-5","speakers":["韓國瑜","江啟臣","賴瑞隆","陳亭妃","陳俊宇","黃捷","李坤城","邱志偉","魯明哲","林沛祥","黃珊珊","陳昭姿","林憶君","羅廷瑋","范雲","李彥秀","王世堅","盧縣一","邱若華","葉元之","何欣純","徐欣瑩","羅美玲","劉建國"],"page_start":109,"meetingDate":["2024-10-22"],"gazette_id":"1138101","agenda_lcidc_ids":["1138101_00004","1138101_00005"],"meet_name":"立法院第11屆第2會期第5次會議紀錄","content":"施政質詢\n對行政院院長施政報告繼續質詢─ 詢答完畢─","agenda_id":"1138101_00009"}}}