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00:01:05,035\n三位首長好那今年初公布了醫院評鑑的結果臺北慈濟雙核醫院還有臺大新竹分院三家醫院升格為醫學中心創下臺灣醫學中心最高的這個紀錄那雖然三位首長當時不在職但我還是要請問卓院長院長您知道這件事的影響嗎我知道三家醫院升格為醫學中心我們的醫學中心總共會增加到22所\n\n3\n00:01:06,961 --> 00:01:11,620\n據您了解這個對分歧醫療是好事還是壞事?\n\n4\n00:01:13,168 --> 00:01:41,277\n也許對整個醫療的服務量能來看是有所升級但是我們一向在推分級的醫療的制度等等來看它或許有它另外一個影響也不一定院長我很高興說我上次在總質詢的時候您主動有提到事實上根據醫療網的這個計畫臺灣應該是兩百萬人口一家醫學中心好那我們考慮到新竹一路的人口從這個新竹臺北深閣這個\n\n5\n00:01:43,118 --> 00:01:44,560\n二、上午9時至10時為國是論壇時間。．陳昭姿二、上午9時至10時為國是論壇時間。．陳昭姿\n\n6\n00:02:06,956 --> 00:02:27,014\n衛福部根本就是帶頭破壞分級醫療制度所以10月27號監察院通過了對衛福部的糾正案監察院指出衛福部無視作業程序規定進行增額評定臺北區醫學中心已經傷害醫院評鑑公信力請問院長你知道這是誰的決策嗎?\n\n7\n00:02:29,939 --> 00:02:52,939\n他是經過評鑑小組共同決定那未來為何不應該已經會成立一個評鑑小組的改革的機制改革的小組甚至將來是不是要演繹提升整個評鑑的基準讓這個評審能夠更精確院長請您看一下投影片你能不能幫我指出薛前部長、陳時中前部長跟王必勝前次長這三個人的共同點\n\n8\n00:02:54,994 --> 00:02:59,916\n院長,太明顯了啦,整個醫界都心知肚明,他們都來自同一所學校。\n\n9\n00:03:10,069 --> 00:03:38,296\n早在醫院評鑑之前醫界就盛傳說萬芳醫院會從醫學中心降為準醫學中心那臺北慈濟會取代它成為醫學中心然後莫名其妙的過去都是年底公布啊但是這件事一直到今年大選後才公布那最後臺北慈濟如外傳的它升為醫學中心那原本要降為準醫學中心的這個萬芳醫院卻維持住了醫學中心\n\n10\n00:03:39,036 --> 00:03:59,418\n然後很意外的雙核醫院竟然成為醫學中心然後增加了臺大新竹為醫學中心這當作一個陪襯跟一個掩護看到這個結果整個醫界都跳腳了醫務管理學會紅里市長他質疑這個做法究竟是誰受益\n\n11\n00:04:00,799 --> 00:04:16,411\n我當時有質詢薛前部長是否專門為某個門系來護航他回答我說這是臆測之詞我現在想問院長薛前部長這樣算不算圖利罪圖利自己的學校算不算圖利罪\n\n12\n00:04:17,729 --> 00:04:39,016\n圖利罪要有更明確的事證那他們這個背景相同背景相同他破壞了這個規範把這個當時改變遊戲規則我今天不在這邊多說時間也改變遊戲規則也改變這個是不是要立刻收押進建啊圖利罪耶既然捐財案都提出糾正案了那衛福部誰該負責院長衛福部誰該負責這個整個\n\n13\n00:04:45,152 --> 00:05:03,210\n總不能說他們兩個都現任嗎?這個不用說明,邱部長當時也不在職,我們都很清楚這件事發生了,發生切實。所以說主計長我想請問你,當一家醫院升格為醫學中心,您認為他這樣子會增加您收益有多少?主計長你有資料嗎?\n\n14\n00:05:04,943 --> 00:05:05,904\n報告委員,這個因為是今年才開始實行\n\n15\n00:05:24,005 --> 00:05:32,991\n所以我想我們會統計他對財務的一個衝擊,以及人……我們會統計民眾的就醫的狀況的變化。這可以了解嘛,對不對?那請問院長下次評鑒的時候可不可以回歸到醫療網計畫?是不是要回歸到200萬,如果台灣應該只有2400萬人口,200萬大概12家左右,大家來競爭嘛,不是這樣無限制一直增加啊?\n\n16\n00:05:48,702 --> 00:06:09,381\n院長這樣可以嗎?不僅跟委員報告,我們也應該趁這個機會向國人跟整個醫界說明,未來衛部在進行回歸醫療網計畫,在進行評鑑的時候,務必要重新調整這一次外界的意見。那麼它已經有改革小組,已經有提高標準等等,要回歸到專業,更有公信力。我聽到你的承諾,謝謝你。因為醫界跟民間對這個決定都憂心忡忡了。\n\n17\n00:06:13,004 --> 00:06:29,237\n社區醫院協會主理市長指出,這樣反而會造成民眾候診時間變長,醫院往返的路程變遠,家屬也需要多陪同等等,反而使民眾就醫的成本增加。醫改會也說,有半數的醫學中心都在雙北地區,區域正義何在?\n\n18\n00:06:34,076 --> 00:06:42,506\n那衛福部考慮過民眾就醫負擔的衝擊嗎?以及醫療資源分布軍的影響嗎?我可不可以請院長回答?衛福部有考慮這些事嗎?這些事重要嗎?\n\n19\n00:06:44,347 --> 00:07:03,490\n剛剛委員所說那幾項都應該是我們在推行醫療服務整個量能讓它均衡化的過程當中重要的幾項我要告訴院長的是當時衛福部說新北區增加兩家醫學中心健保醫療費用推估支出月1億6千萬點對財務健保影響很低\n\n20\n00:07:04,775 --> 00:07:21,323\n我覺得很誇張耶,原來一億六千萬點對外服務是小錢耶外服務如此信口開河一億六千萬點就這樣掃出去然後回頭告訴立法院跟議界朋友說明年我們努力努力讓點值提升到0.95我們能接受嗎?\n\n21\n00:07:23,254 --> 00:07:45,602\n我希望衛福部這種講法他應該要重新的在思考我們考量的不是金額支出的多少而已而是這整個制度改變之後增加之後對民眾是不是有好的醫療服務而且整個醫療水準是不是有提升我剛剛提的數字我想邱部長都有數那我就讓院長也知道院長我在台大醫院服務了10年有一位教授朋友他定期會給我一些這個從\n\n22\n00:07:47,142 --> 00:08:09,033\n急診人數因爆滿而溢出照片,請院長看一下這個圖片。急診病床因為不敷使用,溢滿溢出到醫院的大門正廳。聽說晚上更嚴重,如果院長您如果為福出巡一下,晚上是更嚴重。你看看這個圖,可是醫事室都很清楚,大家都知道是常態。\n\n23\n00:08:11,485 --> 00:08:26,644\n那很奇妙的每次醫院評鑑的時候這些病人跟病床又會消失掉因為我們誰都知道把病床放在大廳不合格不管是隱私、感染、不符合病床的標準這個都是不合格但是它是常態\n\n24\n00:08:28,888 --> 00:08:42,692\n院長我明白齁臺大醫院或一些醫學中心是國人心目中的神醫院啊大家看病都往這裡跑但也不能這樣放任啊你不能把這個理所當然的完全不思改善啊部長怎麼辦\n\n25\n00:08:44,002 --> 00:08:45,383\n部長你這個說法什麼禮拜一禮拜二整個有各個醫學中心發生這種情況的\n\n26\n00:09:17,148 --> 00:09:34,358\n一、四、四都很清楚一、四、四都很清楚好,我們看健保法第六十二在協商的時候卻不得您親手寫下這個主決議嘛就是努力在明年六月達到這個平均點1.0.95元那在委員會協商的時候部長跟健保署署長都說出了這個需要700億欸\n\n27\n00:09:36,991 --> 00:09:38,573\n二、上午9時至10時為國是論壇時間。．陳昭姿二、上午9時至10時為國是論壇時間。．陳昭姿\n\n28\n00:10:05,799 --> 00:10:25,937\n主計長你有嗎?因為我找不到請教你這個專家報告委員我們今年在那個投注在健保的部分金額是336億可是本身在因為健保現在是總額制我們在總額在增加百分之五點多的時候那也是增加了\n\n29\n00:10:26,477 --> 00:10:48,117\n主計長我還是請你幫忙搞清楚包括剛剛一個醫院能夠升格為醫學中心到底年收益增加多少我根本看不到前預算在哪裡衛福部講不清楚結果用了下面這張圖來搪塞我們你看下面這張圖院長部長衛福部一直對外說今年以高推估5.5%計算加上行政院預注的主計長講的336億元東湊西湊就有700億\n\n30\n00:10:53,121 --> 00:11:18,574\n東湊西湊我認為這個七百億需要釐清一下我們來看這個圖像的這個健保財務協助方案休會期間我跟陳菊惠文舉辦了一個百億癌藥基金會那我一直都非常熟悉也非常關心癌症必有權益今年2024年健保署放在新藥新特載暫時性的支付的這個全年經費是24億元那明年的癌藥新癌藥基金有50億元\n\n31\n00:11:19,975 --> 00:11:34,605\n那但是總和部長還在你的桌上你還沒批吧那我想請問部長你會不會因為有這50億的癌藥基金到位你就把新藥新熱財總預算金額就減少了或歸零你會不會請部長回答我\n\n32\n00:11:35,646 --> 00:12:02,543\n原有的、原有的戰時性支付原有的癌症如果他、原有的癌症基金那個原有的癌症會用都一定會保留原來在總額裡面的那這個是比較針對新藥戰時性的支付我要部長確定喔因為如果你把他挪移了或歸零你這個50億就不是真的我們一年花在癌症的一千兩百億一千兩百億你對外宣稱撥50億\n\n33\n00:12:04,264 --> 00:12:20,108\n你不要把今年的東西刪掉,挪移!這個是因為我們政府體諒到有一些新要,它可能還在CategoryA,太不方便了部長,你增加50億本來要100億嘛,分3年到位,你增加50億就要說到做到,這是賴總統競選時的承諾喔!你不要從別的地方挪移喔,50億要確確實實地做,而且如果有需要我們會再\n\n34\n00:12:31,435 --> 00:12:31,635\n財政部長\n\n35\n00:13:01,375 --> 00:13:02,576\n二、上午9時至10時為國是論壇時間。二、上午9時至10時為國是論壇時間\n\n36\n00:13:19,868 --> 00:13:48,579\n降低癌症的死亡率除了從藥品之外我們還從提前再做檢測來發現以及改變現在的醫療方式來著手建保總額就像一個大水庫很多都流來流去但是有所謂專款嘛但是專款就是當年度沒用完就留回建保的這個安全準備金喊病藥費常常被這樣詬病雖然預算好像年年增加但是每年沒用完都留回這個基金等於實質增加的不等於帳面增加的\n\n37\n00:13:49,139 --> 00:13:50,621\n二、上午9時至10時為國是論壇時間。二、上午9時至10時為國是論壇時間。\n\n38\n00:14:09,660 --> 00:14:38,197\n基金、準備金,這個是兩命守法耶。院長,我想請教,你知道這筆錢可以救多少人嗎?這個怪黨,曾經這個不分居提名人,前陣子過世的那個陳俊翰律師,他就是罹患這個積水性的肌肉性萎縮症,他不符合使用條例啊。所以當他過世以後,健保就通通全開放啦。所以你知道這個都是留下的這個錢,沒有好好使用,這個就是衛福部最大的責任啊。\n\n39\n00:14:39,177 --> 00:14:40,518\n主計長,我們有什麼法規可以讓罕病預算留在專款內?\n\n40\n00:15:07,225 --> 00:15:32,181\n有嗎?有法規嗎?有或沒有?主計長你再討論一下,我到時候會請你再給我一些報告那為什麼生理食鹽水這次又變成11億進來呢?打算明年繼續進口生理食鹽水嗎?沒有花完再留回這個健保準備金嗎?還有健保連續虧損7年喔?你有沒有具體的檢討收支平衡計畫呢?到底哪一個項目可以挹注這個點數?我都看不出來欸\n\n41\n00:15:33,902 --> 00:15:49,898\n副委員這個健保總和這個部分是協商。好。好,謝謝。謝謝陳委員。好,也謝謝\n\n","tsv":"start\tend\ttext\n12385\t21552\t謝謝主席。有請左院長、主計長及衛福部邱部長。左院長、主計長及衛福部邱部長請備詢。陳委員好。\n36513\t65035\t三位首長好那今年初公布了醫院評鑑的結果臺北慈濟雙核醫院還有臺大新竹分院三家醫院升格為醫學中心創下臺灣醫學中心最高的這個紀錄那雖然三位首長當時不在職但我還是要請問卓院長院長您知道這件事的影響嗎我知道三家醫院升格為醫學中心我們的醫學中心總共會增加到22所\n66961\t71620\t據您了解這個對分歧醫療是好事還是壞事?\n73168\t101277\t也許對整個醫療的服務量能來看是有所升級但是我們一向在推分級的醫療的制度等等來看它或許有它另外一個影響也不一定院長我很高興說我上次在總質詢的時候您主動有提到事實上根據醫療網的這個計畫臺灣應該是兩百萬人口一家醫學中心好那我們考慮到新竹一路的人口從這個新竹臺北深閣這個\n103118\t104560\t二、上午9時至10時為國是論壇時間。．陳昭姿二、上午9時至10時為國是論壇時間。．陳昭姿\n126956\t147014\t衛福部根本就是帶頭破壞分級醫療制度所以10月27號監察院通過了對衛福部的糾正案監察院指出衛福部無視作業程序規定進行增額評定臺北區醫學中心已經傷害醫院評鑑公信力請問院長你知道這是誰的決策嗎?\n149939\t172939\t他是經過評鑑小組共同決定那未來為何不應該已經會成立一個評鑑小組的改革的機制改革的小組甚至將來是不是要演繹提升整個評鑑的基準讓這個評審能夠更精確院長請您看一下投影片你能不能幫我指出薛前部長、陳時中前部長跟王必勝前次長這三個人的共同點\n174994\t179916\t院長,太明顯了啦,整個醫界都心知肚明,他們都來自同一所學校。\n190069\t218296\t早在醫院評鑑之前醫界就盛傳說萬芳醫院會從醫學中心降為準醫學中心那臺北慈濟會取代它成為醫學中心然後莫名其妙的過去都是年底公布啊但是這件事一直到今年大選後才公布那最後臺北慈濟如外傳的它升為醫學中心那原本要降為準醫學中心的這個萬芳醫院卻維持住了醫學中心\n219036\t239418\t然後很意外的雙核醫院竟然成為醫學中心然後增加了臺大新竹為醫學中心這當作一個陪襯跟一個掩護看到這個結果整個醫界都跳腳了醫務管理學會紅里市長他質疑這個做法究竟是誰受益\n240799\t256411\t我當時有質詢薛前部長是否專門為某個門系來護航他回答我說這是臆測之詞我現在想問院長薛前部長這樣算不算圖利罪圖利自己的學校算不算圖利罪\n257729\t279016\t圖利罪要有更明確的事證那他們這個背景相同背景相同他破壞了這個規範把這個當時改變遊戲規則我今天不在這邊多說時間也改變遊戲規則也改變這個是不是要立刻收押進建啊圖利罪耶既然捐財案都提出糾正案了那衛福部誰該負責院長衛福部誰該負責這個整個\n285152\t303210\t總不能說他們兩個都現任嗎?這個不用說明,邱部長當時也不在職,我們都很清楚這件事發生了,發生切實。所以說主計長我想請問你,當一家醫院升格為醫學中心,您認為他這樣子會增加您收益有多少?主計長你有資料嗎?\n304943\t305904\t報告委員,這個因為是今年才開始實行\n324005\t332991\t所以我想我們會統計他對財務的一個衝擊,以及人……我們會統計民眾的就醫的狀況的變化。這可以了解嘛,對不對?那請問院長下次評鑒的時候可不可以回歸到醫療網計畫?是不是要回歸到200萬,如果台灣應該只有2400萬人口,200萬大概12家左右,大家來競爭嘛,不是這樣無限制一直增加啊?\n348702\t369381\t院長這樣可以嗎?不僅跟委員報告,我們也應該趁這個機會向國人跟整個醫界說明,未來衛部在進行回歸醫療網計畫,在進行評鑑的時候,務必要重新調整這一次外界的意見。那麼它已經有改革小組,已經有提高標準等等,要回歸到專業,更有公信力。我聽到你的承諾,謝謝你。因為醫界跟民間對這個決定都憂心忡忡了。\n373004\t389237\t社區醫院協會主理市長指出,這樣反而會造成民眾候診時間變長,醫院往返的路程變遠,家屬也需要多陪同等等,反而使民眾就醫的成本增加。醫改會也說,有半數的醫學中心都在雙北地區,區域正義何在?\n394076\t402506\t那衛福部考慮過民眾就醫負擔的衝擊嗎?以及醫療資源分布軍的影響嗎?我可不可以請院長回答?衛福部有考慮這些事嗎?這些事重要嗎?\n404347\t423490\t剛剛委員所說那幾項都應該是我們在推行醫療服務整個量能讓它均衡化的過程當中重要的幾項我要告訴院長的是當時衛福部說新北區增加兩家醫學中心健保醫療費用推估支出月1億6千萬點對財務健保影響很低\n424775\t441323\t我覺得很誇張耶,原來一億六千萬點對外服務是小錢耶外服務如此信口開河一億六千萬點就這樣掃出去然後回頭告訴立法院跟議界朋友說明年我們努力努力讓點值提升到0.95我們能接受嗎?\n443254\t465602\t我希望衛福部這種講法他應該要重新的在思考我們考量的不是金額支出的多少而已而是這整個制度改變之後增加之後對民眾是不是有好的醫療服務而且整個醫療水準是不是有提升我剛剛提的數字我想邱部長都有數那我就讓院長也知道院長我在台大醫院服務了10年有一位教授朋友他定期會給我一些這個從\n467142\t489033\t急診人數因爆滿而溢出照片,請院長看一下這個圖片。急診病床因為不敷使用,溢滿溢出到醫院的大門正廳。聽說晚上更嚴重,如果院長您如果為福出巡一下,晚上是更嚴重。你看看這個圖,可是醫事室都很清楚,大家都知道是常態。\n491485\t506644\t那很奇妙的每次醫院評鑑的時候這些病人跟病床又會消失掉因為我們誰都知道把病床放在大廳不合格不管是隱私、感染、不符合病床的標準這個都是不合格但是它是常態\n508888\t522692\t院長我明白齁臺大醫院或一些醫學中心是國人心目中的神醫院啊大家看病都往這裡跑但也不能這樣放任啊你不能把這個理所當然的完全不思改善啊部長怎麼辦\n524002\t525383\t部長你這個說法什麼禮拜一禮拜二整個有各個醫學中心發生這種情況的\n557148\t574358\t一、四、四都很清楚一、四、四都很清楚好,我們看健保法第六十二在協商的時候卻不得您親手寫下這個主決議嘛就是努力在明年六月達到這個平均點1.0.95元那在委員會協商的時候部長跟健保署署長都說出了這個需要700億欸\n576991\t578573\t二、上午9時至10時為國是論壇時間。．陳昭姿二、上午9時至10時為國是論壇時間。．陳昭姿\n605799\t625937\t主計長你有嗎?因為我找不到請教你這個專家報告委員我們今年在那個投注在健保的部分金額是336億可是本身在因為健保現在是總額制我們在總額在增加百分之五點多的時候那也是增加了\n626477\t648117\t主計長我還是請你幫忙搞清楚包括剛剛一個醫院能夠升格為醫學中心到底年收益增加多少我根本看不到前預算在哪裡衛福部講不清楚結果用了下面這張圖來搪塞我們你看下面這張圖院長部長衛福部一直對外說今年以高推估5.5%計算加上行政院預注的主計長講的336億元東湊西湊就有700億\n653121\t678574\t東湊西湊我認為這個七百億需要釐清一下我們來看這個圖像的這個健保財務協助方案休會期間我跟陳菊惠文舉辦了一個百億癌藥基金會那我一直都非常熟悉也非常關心癌症必有權益今年2024年健保署放在新藥新特載暫時性的支付的這個全年經費是24億元那明年的癌藥新癌藥基金有50億元\n679975\t694605\t那但是總和部長還在你的桌上你還沒批吧那我想請問部長你會不會因為有這50億的癌藥基金到位你就把新藥新熱財總預算金額就減少了或歸零你會不會請部長回答我\n695646\t722543\t原有的、原有的戰時性支付原有的癌症如果他、原有的癌症基金那個原有的癌症會用都一定會保留原來在總額裡面的那這個是比較針對新藥戰時性的支付我要部長確定喔因為如果你把他挪移了或歸零你這個50億就不是真的我們一年花在癌症的一千兩百億一千兩百億你對外宣稱撥50億\n724264\t740108\t你不要把今年的東西刪掉,挪移!這個是因為我們政府體諒到有一些新要,它可能還在Category A,太不方便了部長,你增加50億本來要100億嘛,分3年到位,你增加50億就要說到做到,這是賴總統競選時的承諾喔!你不要從別的地方挪移喔,50億要確確實實地做,而且如果有需要我們會再\n751435\t751635\t財政部長\n781375\t782576\t二、上午9時至10時為國是論壇時間。二、上午9時至10時為國是論壇時間\n799868\t828579\t降低癌症的死亡率除了從藥品之外我們還從提前再做檢測來發現以及改變現在的醫療方式來著手建保總額就像一個大水庫很多都流來流去但是有所謂專款嘛但是專款就是當年度沒用完就留回建保的這個安全準備金喊病藥費常常被這樣詬病雖然預算好像年年增加但是每年沒用完都留回這個基金等於實質增加的不等於帳面增加的\n829139\t830621\t二、上午9時至10時為國是論壇時間。二、上午9時至10時為國是論壇時間。\n849660\t878197\t基金、準備金,這個是兩命守法耶。院長,我想請教,你知道這筆錢可以救多少人嗎?這個怪黨,曾經這個不分居提名人,前陣子過世的那個陳俊翰律師,他就是罹患這個積水性的肌肉性萎縮症,他不符合使用條例啊。所以當他過世以後,健保就通通全開放啦。所以你知道這個都是留下的這個錢,沒有好好使用,這個就是衛福部最大的責任啊。\n879177\t880518\t主計長,我們有什麼法規可以讓罕病預算留在專款內?\n907225\t932181\t有嗎?有法規嗎?有或沒有?主計長你再討論一下,我到時候會請你再給我一些報告那為什麼生理食鹽水這次又變成11億進來呢?打算明年繼續進口生理食鹽水嗎?沒有花完再留回這個健保準備金嗎?還有健保連續虧損7年喔?你有沒有具體的檢討收支平衡計畫呢?到底哪一個項目可以挹注這個點數?我都看不出來欸\n933902\t949898\t副委員這個健保總和這個部分是協商。好。好,謝謝。謝謝陳委員。好,也謝謝\n","txt":"謝謝主席。有請左院長、主計長及衛福部邱部長。左院長、主計長及衛福部邱部長請備詢。陳委員好。\n三位首長好那今年初公布了醫院評鑑的結果臺北慈濟雙核醫院還有臺大新竹分院三家醫院升格為醫學中心創下臺灣醫學中心最高的這個紀錄那雖然三位首長當時不在職但我還是要請問卓院長院長您知道這件事的影響嗎我知道三家醫院升格為醫學中心我們的醫學中心總共會增加到22所\n據您了解這個對分歧醫療是好事還是壞事?\n也許對整個醫療的服務量能來看是有所升級但是我們一向在推分級的醫療的制度等等來看它或許有它另外一個影響也不一定院長我很高興說我上次在總質詢的時候您主動有提到事實上根據醫療網的這個計畫臺灣應該是兩百萬人口一家醫學中心好那我們考慮到新竹一路的人口從這個新竹臺北深閣這個\n二、上午9時至10時為國是論壇時間。．陳昭姿二、上午9時至10時為國是論壇時間。．陳昭姿\n衛福部根本就是帶頭破壞分級醫療制度所以10月27號監察院通過了對衛福部的糾正案監察院指出衛福部無視作業程序規定進行增額評定臺北區醫學中心已經傷害醫院評鑑公信力請問院長你知道這是誰的決策嗎?\n他是經過評鑑小組共同決定那未來為何不應該已經會成立一個評鑑小組的改革的機制改革的小組甚至將來是不是要演繹提升整個評鑑的基準讓這個評審能夠更精確院長請您看一下投影片你能不能幫我指出薛前部長、陳時中前部長跟王必勝前次長這三個人的共同點\n院長,太明顯了啦,整個醫界都心知肚明,他們都來自同一所學校。\n早在醫院評鑑之前醫界就盛傳說萬芳醫院會從醫學中心降為準醫學中心那臺北慈濟會取代它成為醫學中心然後莫名其妙的過去都是年底公布啊但是這件事一直到今年大選後才公布那最後臺北慈濟如外傳的它升為醫學中心那原本要降為準醫學中心的這個萬芳醫院卻維持住了醫學中心\n然後很意外的雙核醫院竟然成為醫學中心然後增加了臺大新竹為醫學中心這當作一個陪襯跟一個掩護看到這個結果整個醫界都跳腳了醫務管理學會紅里市長他質疑這個做法究竟是誰受益\n我當時有質詢薛前部長是否專門為某個門系來護航他回答我說這是臆測之詞我現在想問院長薛前部長這樣算不算圖利罪圖利自己的學校算不算圖利罪\n圖利罪要有更明確的事證那他們這個背景相同背景相同他破壞了這個規範把這個當時改變遊戲規則我今天不在這邊多說時間也改變遊戲規則也改變這個是不是要立刻收押進建啊圖利罪耶既然捐財案都提出糾正案了那衛福部誰該負責院長衛福部誰該負責這個整個\n總不能說他們兩個都現任嗎?這個不用說明,邱部長當時也不在職,我們都很清楚這件事發生了,發生切實。所以說主計長我想請問你,當一家醫院升格為醫學中心,您認為他這樣子會增加您收益有多少?主計長你有資料嗎?\n報告委員,這個因為是今年才開始實行\n所以我想我們會統計他對財務的一個衝擊,以及人……我們會統計民眾的就醫的狀況的變化。這可以了解嘛,對不對?那請問院長下次評鑒的時候可不可以回歸到醫療網計畫?是不是要回歸到200萬,如果台灣應該只有2400萬人口,200萬大概12家左右,大家來競爭嘛,不是這樣無限制一直增加啊?\n院長這樣可以嗎?不僅跟委員報告,我們也應該趁這個機會向國人跟整個醫界說明,未來衛部在進行回歸醫療網計畫,在進行評鑑的時候,務必要重新調整這一次外界的意見。那麼它已經有改革小組,已經有提高標準等等,要回歸到專業,更有公信力。我聽到你的承諾,謝謝你。因為醫界跟民間對這個決定都憂心忡忡了。\n社區醫院協會主理市長指出,這樣反而會造成民眾候診時間變長,醫院往返的路程變遠,家屬也需要多陪同等等,反而使民眾就醫的成本增加。醫改會也說,有半數的醫學中心都在雙北地區,區域正義何在?\n那衛福部考慮過民眾就醫負擔的衝擊嗎?以及醫療資源分布軍的影響嗎?我可不可以請院長回答?衛福部有考慮這些事嗎?這些事重要嗎?\n剛剛委員所說那幾項都應該是我們在推行醫療服務整個量能讓它均衡化的過程當中重要的幾項我要告訴院長的是當時衛福部說新北區增加兩家醫學中心健保醫療費用推估支出月1億6千萬點對財務健保影響很低\n我覺得很誇張耶,原來一億六千萬點對外服務是小錢耶外服務如此信口開河一億六千萬點就這樣掃出去然後回頭告訴立法院跟議界朋友說明年我們努力努力讓點值提升到0.95我們能接受嗎?\n我希望衛福部這種講法他應該要重新的在思考我們考量的不是金額支出的多少而已而是這整個制度改變之後增加之後對民眾是不是有好的醫療服務而且整個醫療水準是不是有提升我剛剛提的數字我想邱部長都有數那我就讓院長也知道院長我在台大醫院服務了10年有一位教授朋友他定期會給我一些這個從\n急診人數因爆滿而溢出照片,請院長看一下這個圖片。急診病床因為不敷使用,溢滿溢出到醫院的大門正廳。聽說晚上更嚴重,如果院長您如果為福出巡一下,晚上是更嚴重。你看看這個圖,可是醫事室都很清楚,大家都知道是常態。\n那很奇妙的每次醫院評鑑的時候這些病人跟病床又會消失掉因為我們誰都知道把病床放在大廳不合格不管是隱私、感染、不符合病床的標準這個都是不合格但是它是常態\n院長我明白齁臺大醫院或一些醫學中心是國人心目中的神醫院啊大家看病都往這裡跑但也不能這樣放任啊你不能把這個理所當然的完全不思改善啊部長怎麼辦\n部長你這個說法什麼禮拜一禮拜二整個有各個醫學中心發生這種情況的\n一、四、四都很清楚一、四、四都很清楚好,我們看健保法第六十二在協商的時候卻不得您親手寫下這個主決議嘛就是努力在明年六月達到這個平均點1.0.95元那在委員會協商的時候部長跟健保署署長都說出了這個需要700億欸\n二、上午9時至10時為國是論壇時間。．陳昭姿二、上午9時至10時為國是論壇時間。．陳昭姿\n主計長你有嗎?因為我找不到請教你這個專家報告委員我們今年在那個投注在健保的部分金額是336億可是本身在因為健保現在是總額制我們在總額在增加百分之五點多的時候那也是增加了\n主計長我還是請你幫忙搞清楚包括剛剛一個醫院能夠升格為醫學中心到底年收益增加多少我根本看不到前預算在哪裡衛福部講不清楚結果用了下面這張圖來搪塞我們你看下面這張圖院長部長衛福部一直對外說今年以高推估5.5%計算加上行政院預注的主計長講的336億元東湊西湊就有700億\n東湊西湊我認為這個七百億需要釐清一下我們來看這個圖像的這個健保財務協助方案休會期間我跟陳菊惠文舉辦了一個百億癌藥基金會那我一直都非常熟悉也非常關心癌症必有權益今年2024年健保署放在新藥新特載暫時性的支付的這個全年經費是24億元那明年的癌藥新癌藥基金有50億元\n那但是總和部長還在你的桌上你還沒批吧那我想請問部長你會不會因為有這50億的癌藥基金到位你就把新藥新熱財總預算金額就減少了或歸零你會不會請部長回答我\n原有的、原有的戰時性支付原有的癌症如果他、原有的癌症基金那個原有的癌症會用都一定會保留原來在總額裡面的那這個是比較針對新藥戰時性的支付我要部長確定喔因為如果你把他挪移了或歸零你這個50億就不是真的我們一年花在癌症的一千兩百億一千兩百億你對外宣稱撥50億\n你不要把今年的東西刪掉,挪移!這個是因為我們政府體諒到有一些新要,它可能還在Category A,太不方便了部長,你增加50億本來要100億嘛,分3年到位,你增加50億就要說到做到,這是賴總統競選時的承諾喔!你不要從別的地方挪移喔,50億要確確實實地做,而且如果有需要我們會再\n財政部長\n二、上午9時至10時為國是論壇時間。二、上午9時至10時為國是論壇時間\n降低癌症的死亡率除了從藥品之外我們還從提前再做檢測來發現以及改變現在的醫療方式來著手建保總額就像一個大水庫很多都流來流去但是有所謂專款嘛但是專款就是當年度沒用完就留回建保的這個安全準備金喊病藥費常常被這樣詬病雖然預算好像年年增加但是每年沒用完都留回這個基金等於實質增加的不等於帳面增加的\n二、上午9時至10時為國是論壇時間。二、上午9時至10時為國是論壇時間。\n基金、準備金,這個是兩命守法耶。院長,我想請教,你知道這筆錢可以救多少人嗎?這個怪黨,曾經這個不分居提名人,前陣子過世的那個陳俊翰律師,他就是罹患這個積水性的肌肉性萎縮症,他不符合使用條例啊。所以當他過世以後,健保就通通全開放啦。所以你知道這個都是留下的這個錢,沒有好好使用,這個就是衛福部最大的責任啊。\n主計長,我們有什麼法規可以讓罕病預算留在專款內?\n有嗎?有法規嗎?有或沒有?主計長你再討論一下,我到時候會請你再給我一些報告那為什麼生理食鹽水這次又變成11億進來呢?打算明年繼續進口生理食鹽水嗎?沒有花完再留回這個健保準備金嗎?還有健保連續虧損7年喔?你有沒有具體的檢討收支平衡計畫呢?到底哪一個項目可以挹注這個點數?我都看不出來欸\n副委員這個健保總和這個部分是協商。好。好,謝謝。謝謝陳委員。好,也謝謝\n","vtt":"WEBVTT\n\n00:12.385 --> 00:21.552\n謝謝主席。有請左院長、主計長及衛福部邱部長。左院長、主計長及衛福部邱部長請備詢。陳委員好。\n\n00:36.513 --> 01:05.035\n三位首長好那今年初公布了醫院評鑑的結果臺北慈濟雙核醫院還有臺大新竹分院三家醫院升格為醫學中心創下臺灣醫學中心最高的這個紀錄那雖然三位首長當時不在職但我還是要請問卓院長院長您知道這件事的影響嗎我知道三家醫院升格為醫學中心我們的醫學中心總共會增加到22所\n\n01:06.961 --> 01:11.620\n據您了解這個對分歧醫療是好事還是壞事?\n\n01:13.168 --> 01:41.277\n也許對整個醫療的服務量能來看是有所升級但是我們一向在推分級的醫療的制度等等來看它或許有它另外一個影響也不一定院長我很高興說我上次在總質詢的時候您主動有提到事實上根據醫療網的這個計畫臺灣應該是兩百萬人口一家醫學中心好那我們考慮到新竹一路的人口從這個新竹臺北深閣這個\n\n01:43.118 --> 01:44.560\n二、上午9時至10時為國是論壇時間。．陳昭姿二、上午9時至10時為國是論壇時間。．陳昭姿\n\n02:06.956 --> 02:27.014\n衛福部根本就是帶頭破壞分級醫療制度所以10月27號監察院通過了對衛福部的糾正案監察院指出衛福部無視作業程序規定進行增額評定臺北區醫學中心已經傷害醫院評鑑公信力請問院長你知道這是誰的決策嗎?\n\n02:29.939 --> 02:52.939\n他是經過評鑑小組共同決定那未來為何不應該已經會成立一個評鑑小組的改革的機制改革的小組甚至將來是不是要演繹提升整個評鑑的基準讓這個評審能夠更精確院長請您看一下投影片你能不能幫我指出薛前部長、陳時中前部長跟王必勝前次長這三個人的共同點\n\n02:54.994 --> 02:59.916\n院長,太明顯了啦,整個醫界都心知肚明,他們都來自同一所學校。\n\n03:10.069 --> 03:38.296\n早在醫院評鑑之前醫界就盛傳說萬芳醫院會從醫學中心降為準醫學中心那臺北慈濟會取代它成為醫學中心然後莫名其妙的過去都是年底公布啊但是這件事一直到今年大選後才公布那最後臺北慈濟如外傳的它升為醫學中心那原本要降為準醫學中心的這個萬芳醫院卻維持住了醫學中心\n\n03:39.036 --> 03:59.418\n然後很意外的雙核醫院竟然成為醫學中心然後增加了臺大新竹為醫學中心這當作一個陪襯跟一個掩護看到這個結果整個醫界都跳腳了醫務管理學會紅里市長他質疑這個做法究竟是誰受益\n\n04:00.799 --> 04:16.411\n我當時有質詢薛前部長是否專門為某個門系來護航他回答我說這是臆測之詞我現在想問院長薛前部長這樣算不算圖利罪圖利自己的學校算不算圖利罪\n\n04:17.729 --> 04:39.016\n圖利罪要有更明確的事證那他們這個背景相同背景相同他破壞了這個規範把這個當時改變遊戲規則我今天不在這邊多說時間也改變遊戲規則也改變這個是不是要立刻收押進建啊圖利罪耶既然捐財案都提出糾正案了那衛福部誰該負責院長衛福部誰該負責這個整個\n\n04:45.152 --> 05:03.210\n總不能說他們兩個都現任嗎?這個不用說明,邱部長當時也不在職,我們都很清楚這件事發生了,發生切實。所以說主計長我想請問你,當一家醫院升格為醫學中心,您認為他這樣子會增加您收益有多少?主計長你有資料嗎?\n\n05:04.943 --> 05:05.904\n報告委員,這個因為是今年才開始實行\n\n05:24.005 --> 05:32.991\n所以我想我們會統計他對財務的一個衝擊,以及人……我們會統計民眾的就醫的狀況的變化。這可以了解嘛,對不對?那請問院長下次評鑒的時候可不可以回歸到醫療網計畫?是不是要回歸到200萬,如果台灣應該只有2400萬人口,200萬大概12家左右,大家來競爭嘛,不是這樣無限制一直增加啊?\n\n05:48.702 --> 06:09.381\n院長這樣可以嗎?不僅跟委員報告,我們也應該趁這個機會向國人跟整個醫界說明,未來衛部在進行回歸醫療網計畫,在進行評鑑的時候,務必要重新調整這一次外界的意見。那麼它已經有改革小組,已經有提高標準等等,要回歸到專業,更有公信力。我聽到你的承諾,謝謝你。因為醫界跟民間對這個決定都憂心忡忡了。\n\n06:13.004 --> 06:29.237\n社區醫院協會主理市長指出,這樣反而會造成民眾候診時間變長,醫院往返的路程變遠,家屬也需要多陪同等等,反而使民眾就醫的成本增加。醫改會也說,有半數的醫學中心都在雙北地區,區域正義何在?\n\n06:34.076 --> 06:42.506\n那衛福部考慮過民眾就醫負擔的衝擊嗎?以及醫療資源分布軍的影響嗎?我可不可以請院長回答?衛福部有考慮這些事嗎?這些事重要嗎?\n\n06:44.347 --> 07:03.490\n剛剛委員所說那幾項都應該是我們在推行醫療服務整個量能讓它均衡化的過程當中重要的幾項我要告訴院長的是當時衛福部說新北區增加兩家醫學中心健保醫療費用推估支出月1億6千萬點對財務健保影響很低\n\n07:04.775 --> 07:21.323\n我覺得很誇張耶,原來一億六千萬點對外服務是小錢耶外服務如此信口開河一億六千萬點就這樣掃出去然後回頭告訴立法院跟議界朋友說明年我們努力努力讓點值提升到0.95我們能接受嗎?\n\n07:23.254 --> 07:45.602\n我希望衛福部這種講法他應該要重新的在思考我們考量的不是金額支出的多少而已而是這整個制度改變之後增加之後對民眾是不是有好的醫療服務而且整個醫療水準是不是有提升我剛剛提的數字我想邱部長都有數那我就讓院長也知道院長我在台大醫院服務了10年有一位教授朋友他定期會給我一些這個從\n\n07:47.142 --> 08:09.033\n急診人數因爆滿而溢出照片,請院長看一下這個圖片。急診病床因為不敷使用,溢滿溢出到醫院的大門正廳。聽說晚上更嚴重,如果院長您如果為福出巡一下,晚上是更嚴重。你看看這個圖,可是醫事室都很清楚,大家都知道是常態。\n\n08:11.485 --> 08:26.644\n那很奇妙的每次醫院評鑑的時候這些病人跟病床又會消失掉因為我們誰都知道把病床放在大廳不合格不管是隱私、感染、不符合病床的標準這個都是不合格但是它是常態\n\n08:28.888 --> 08:42.692\n院長我明白齁臺大醫院或一些醫學中心是國人心目中的神醫院啊大家看病都往這裡跑但也不能這樣放任啊你不能把這個理所當然的完全不思改善啊部長怎麼辦\n\n08:44.002 --> 08:45.383\n部長你這個說法什麼禮拜一禮拜二整個有各個醫學中心發生這種情況的\n\n09:17.148 --> 09:34.358\n一、四、四都很清楚一、四、四都很清楚好,我們看健保法第六十二在協商的時候卻不得您親手寫下這個主決議嘛就是努力在明年六月達到這個平均點1.0.95元那在委員會協商的時候部長跟健保署署長都說出了這個需要700億欸\n\n09:36.991 --> 09:38.573\n二、上午9時至10時為國是論壇時間。．陳昭姿二、上午9時至10時為國是論壇時間。．陳昭姿\n\n10:05.799 --> 10:25.937\n主計長你有嗎?因為我找不到請教你這個專家報告委員我們今年在那個投注在健保的部分金額是336億可是本身在因為健保現在是總額制我們在總額在增加百分之五點多的時候那也是增加了\n\n10:26.477 --> 10:48.117\n主計長我還是請你幫忙搞清楚包括剛剛一個醫院能夠升格為醫學中心到底年收益增加多少我根本看不到前預算在哪裡衛福部講不清楚結果用了下面這張圖來搪塞我們你看下面這張圖院長部長衛福部一直對外說今年以高推估5.5%計算加上行政院預注的主計長講的336億元東湊西湊就有700億\n\n10:53.121 --> 11:18.574\n東湊西湊我認為這個七百億需要釐清一下我們來看這個圖像的這個健保財務協助方案休會期間我跟陳菊惠文舉辦了一個百億癌藥基金會那我一直都非常熟悉也非常關心癌症必有權益今年2024年健保署放在新藥新特載暫時性的支付的這個全年經費是24億元那明年的癌藥新癌藥基金有50億元\n\n11:19.975 --> 11:34.605\n那但是總和部長還在你的桌上你還沒批吧那我想請問部長你會不會因為有這50億的癌藥基金到位你就把新藥新熱財總預算金額就減少了或歸零你會不會請部長回答我\n\n11:35.646 --> 12:02.543\n原有的、原有的戰時性支付原有的癌症如果他、原有的癌症基金那個原有的癌症會用都一定會保留原來在總額裡面的那這個是比較針對新藥戰時性的支付我要部長確定喔因為如果你把他挪移了或歸零你這個50億就不是真的我們一年花在癌症的一千兩百億一千兩百億你對外宣稱撥50億\n\n12:04.264 --> 12:20.108\n你不要把今年的東西刪掉,挪移!這個是因為我們政府體諒到有一些新要,它可能還在CategoryA,太不方便了部長,你增加50億本來要100億嘛,分3年到位,你增加50億就要說到做到,這是賴總統競選時的承諾喔!你不要從別的地方挪移喔,50億要確確實實地做,而且如果有需要我們會再\n\n12:31.435 --> 12:31.635\n財政部長\n\n13:01.375 --> 13:02.576\n二、上午9時至10時為國是論壇時間。二、上午9時至10時為國是論壇時間\n\n13:19.868 --> 13:48.579\n降低癌症的死亡率除了從藥品之外我們還從提前再做檢測來發現以及改變現在的醫療方式來著手建保總額就像一個大水庫很多都流來流去但是有所謂專款嘛但是專款就是當年度沒用完就留回建保的這個安全準備金喊病藥費常常被這樣詬病雖然預算好像年年增加但是每年沒用完都留回這個基金等於實質增加的不等於帳面增加的\n\n13:49.139 --> 13:50.621\n二、上午9時至10時為國是論壇時間。二、上午9時至10時為國是論壇時間。\n\n14:09.660 --> 14:38.197\n基金、準備金,這個是兩命守法耶。院長,我想請教,你知道這筆錢可以救多少人嗎?這個怪黨,曾經這個不分居提名人,前陣子過世的那個陳俊翰律師,他就是罹患這個積水性的肌肉性萎縮症,他不符合使用條例啊。所以當他過世以後,健保就通通全開放啦。所以你知道這個都是留下的這個錢,沒有好好使用,這個就是衛福部最大的責任啊。\n\n14:39.177 --> 14:40.518\n主計長,我們有什麼法規可以讓罕病預算留在專款內?\n\n15:07.225 --> 15:32.181\n有嗎?有法規嗎?有或沒有?主計長你再討論一下,我到時候會請你再給我一些報告那為什麼生理食鹽水這次又變成11億進來呢?打算明年繼續進口生理食鹽水嗎?沒有花完再留回這個健保準備金嗎?還有健保連續虧損7年喔?你有沒有具體的檢討收支平衡計畫呢?到底哪一個項目可以挹注這個點數?我都看不出來欸\n\n15:33.902 --> 15:49.898\n副委員這個健保總和這個部分是協商。好。好,謝謝。謝謝陳委員。好,也謝謝\n\n","segments":[{"start":12.385,"end":21.552,"text":"謝謝主席。有請左院長、主計長及衛福部邱部長。左院長、主計長及衛福部邱部長請備詢。陳委員好。"},{"start":36.513,"end":65.035,"text":"三位首長好那今年初公布了醫院評鑑的結果臺北慈濟雙核醫院還有臺大新竹分院三家醫院升格為醫學中心創下臺灣醫學中心最高的這個紀錄那雖然三位首長當時不在職但我還是要請問卓院長院長您知道這件事的影響嗎我知道三家醫院升格為醫學中心我們的醫學中心總共會增加到22所"},{"start":66.961,"end":71.62,"text":"據您了解這個對分歧醫療是好事還是壞事?"},{"start":73.168,"end":101.277,"text":"也許對整個醫療的服務量能來看是有所升級但是我們一向在推分級的醫療的制度等等來看它或許有它另外一個影響也不一定院長我很高興說我上次在總質詢的時候您主動有提到事實上根據醫療網的這個計畫臺灣應該是兩百萬人口一家醫學中心好那我們考慮到新竹一路的人口從這個新竹臺北深閣這個"},{"start":103.118,"end":104.56,"text":"二、上午9時至10時為國是論壇時間。．陳昭姿二、上午9時至10時為國是論壇時間。．陳昭姿"},{"start":126.956,"end":147.014,"text":"衛福部根本就是帶頭破壞分級醫療制度所以10月27號監察院通過了對衛福部的糾正案監察院指出衛福部無視作業程序規定進行增額評定臺北區醫學中心已經傷害醫院評鑑公信力請問院長你知道這是誰的決策嗎?"},{"start":149.939,"end":172.939,"text":"他是經過評鑑小組共同決定那未來為何不應該已經會成立一個評鑑小組的改革的機制改革的小組甚至將來是不是要演繹提升整個評鑑的基準讓這個評審能夠更精確院長請您看一下投影片你能不能幫我指出薛前部長、陳時中前部長跟王必勝前次長這三個人的共同點"},{"start":174.994,"end":179.916,"text":"院長,太明顯了啦,整個醫界都心知肚明,他們都來自同一所學校。"},{"start":190.069,"end":218.296,"text":"早在醫院評鑑之前醫界就盛傳說萬芳醫院會從醫學中心降為準醫學中心那臺北慈濟會取代它成為醫學中心然後莫名其妙的過去都是年底公布啊但是這件事一直到今年大選後才公布那最後臺北慈濟如外傳的它升為醫學中心那原本要降為準醫學中心的這個萬芳醫院卻維持住了醫學中心"},{"start":219.036,"end":239.418,"text":"然後很意外的雙核醫院竟然成為醫學中心然後增加了臺大新竹為醫學中心這當作一個陪襯跟一個掩護看到這個結果整個醫界都跳腳了醫務管理學會紅里市長他質疑這個做法究竟是誰受益"},{"start":240.799,"end":256.411,"text":"我當時有質詢薛前部長是否專門為某個門系來護航他回答我說這是臆測之詞我現在想問院長薛前部長這樣算不算圖利罪圖利自己的學校算不算圖利罪"},{"start":257.729,"end":279.016,"text":"圖利罪要有更明確的事證那他們這個背景相同背景相同他破壞了這個規範把這個當時改變遊戲規則我今天不在這邊多說時間也改變遊戲規則也改變這個是不是要立刻收押進建啊圖利罪耶既然捐財案都提出糾正案了那衛福部誰該負責院長衛福部誰該負責這個整個"},{"start":285.152,"end":303.21,"text":"總不能說他們兩個都現任嗎?這個不用說明,邱部長當時也不在職,我們都很清楚這件事發生了,發生切實。所以說主計長我想請問你,當一家醫院升格為醫學中心,您認為他這樣子會增加您收益有多少?主計長你有資料嗎?"},{"start":304.943,"end":305.904,"text":"報告委員,這個因為是今年才開始實行"},{"start":324.005,"end":332.991,"text":"所以我想我們會統計他對財務的一個衝擊,以及人……我們會統計民眾的就醫的狀況的變化。這可以了解嘛,對不對?那請問院長下次評鑒的時候可不可以回歸到醫療網計畫?是不是要回歸到200萬,如果台灣應該只有2400萬人口,200萬大概12家左右,大家來競爭嘛,不是這樣無限制一直增加啊?"},{"start":348.702,"end":369.381,"text":"院長這樣可以嗎?不僅跟委員報告,我們也應該趁這個機會向國人跟整個醫界說明,未來衛部在進行回歸醫療網計畫,在進行評鑑的時候,務必要重新調整這一次外界的意見。那麼它已經有改革小組,已經有提高標準等等,要回歸到專業,更有公信力。我聽到你的承諾,謝謝你。因為醫界跟民間對這個決定都憂心忡忡了。"},{"start":373.004,"end":389.237,"text":"社區醫院協會主理市長指出,這樣反而會造成民眾候診時間變長,醫院往返的路程變遠,家屬也需要多陪同等等,反而使民眾就醫的成本增加。醫改會也說,有半數的醫學中心都在雙北地區,區域正義何在?"},{"start":394.076,"end":402.506,"text":"那衛福部考慮過民眾就醫負擔的衝擊嗎?以及醫療資源分布軍的影響嗎?我可不可以請院長回答?衛福部有考慮這些事嗎?這些事重要嗎?"},{"start":404.347,"end":423.49,"text":"剛剛委員所說那幾項都應該是我們在推行醫療服務整個量能讓它均衡化的過程當中重要的幾項我要告訴院長的是當時衛福部說新北區增加兩家醫學中心健保醫療費用推估支出月1億6千萬點對財務健保影響很低"},{"start":424.775,"end":441.323,"text":"我覺得很誇張耶,原來一億六千萬點對外服務是小錢耶外服務如此信口開河一億六千萬點就這樣掃出去然後回頭告訴立法院跟議界朋友說明年我們努力努力讓點值提升到0.95我們能接受嗎?"},{"start":443.254,"end":465.602,"text":"我希望衛福部這種講法他應該要重新的在思考我們考量的不是金額支出的多少而已而是這整個制度改變之後增加之後對民眾是不是有好的醫療服務而且整個醫療水準是不是有提升我剛剛提的數字我想邱部長都有數那我就讓院長也知道院長我在台大醫院服務了10年有一位教授朋友他定期會給我一些這個從"},{"start":467.142,"end":489.033,"text":"急診人數因爆滿而溢出照片,請院長看一下這個圖片。急診病床因為不敷使用,溢滿溢出到醫院的大門正廳。聽說晚上更嚴重,如果院長您如果為福出巡一下,晚上是更嚴重。你看看這個圖,可是醫事室都很清楚,大家都知道是常態。"},{"start":491.485,"end":506.644,"text":"那很奇妙的每次醫院評鑑的時候這些病人跟病床又會消失掉因為我們誰都知道把病床放在大廳不合格不管是隱私、感染、不符合病床的標準這個都是不合格但是它是常態"},{"start":508.888,"end":522.692,"text":"院長我明白齁臺大醫院或一些醫學中心是國人心目中的神醫院啊大家看病都往這裡跑但也不能這樣放任啊你不能把這個理所當然的完全不思改善啊部長怎麼辦"},{"start":524.002,"end":525.383,"text":"部長你這個說法什麼禮拜一禮拜二整個有各個醫學中心發生這種情況的"},{"start":557.148,"end":574.358,"text":"一、四、四都很清楚一、四、四都很清楚好,我們看健保法第六十二在協商的時候卻不得您親手寫下這個主決議嘛就是努力在明年六月達到這個平均點1.0.95元那在委員會協商的時候部長跟健保署署長都說出了這個需要700億欸"},{"start":576.991,"end":578.573,"text":"二、上午9時至10時為國是論壇時間。．陳昭姿二、上午9時至10時為國是論壇時間。．陳昭姿"},{"start":605.799,"end":625.937,"text":"主計長你有嗎?因為我找不到請教你這個專家報告委員我們今年在那個投注在健保的部分金額是336億可是本身在因為健保現在是總額制我們在總額在增加百分之五點多的時候那也是增加了"},{"start":626.477,"end":648.117,"text":"主計長我還是請你幫忙搞清楚包括剛剛一個醫院能夠升格為醫學中心到底年收益增加多少我根本看不到前預算在哪裡衛福部講不清楚結果用了下面這張圖來搪塞我們你看下面這張圖院長部長衛福部一直對外說今年以高推估5.5%計算加上行政院預注的主計長講的336億元東湊西湊就有700億"},{"start":653.121,"end":678.574,"text":"東湊西湊我認為這個七百億需要釐清一下我們來看這個圖像的這個健保財務協助方案休會期間我跟陳菊惠文舉辦了一個百億癌藥基金會那我一直都非常熟悉也非常關心癌症必有權益今年2024年健保署放在新藥新特載暫時性的支付的這個全年經費是24億元那明年的癌藥新癌藥基金有50億元"},{"start":679.975,"end":694.605,"text":"那但是總和部長還在你的桌上你還沒批吧那我想請問部長你會不會因為有這50億的癌藥基金到位你就把新藥新熱財總預算金額就減少了或歸零你會不會請部長回答我"},{"start":695.646,"end":722.543,"text":"原有的、原有的戰時性支付原有的癌症如果他、原有的癌症基金那個原有的癌症會用都一定會保留原來在總額裡面的那這個是比較針對新藥戰時性的支付我要部長確定喔因為如果你把他挪移了或歸零你這個50億就不是真的我們一年花在癌症的一千兩百億一千兩百億你對外宣稱撥50億"},{"start":724.264,"end":740.108,"text":"你不要把今年的東西刪掉,挪移!這個是因為我們政府體諒到有一些新要,它可能還在Category A,太不方便了部長,你增加50億本來要100億嘛,分3年到位,你增加50億就要說到做到,這是賴總統競選時的承諾喔!你不要從別的地方挪移喔,50億要確確實實地做,而且如果有需要我們會再"},{"start":751.435,"end":751.635,"text":"財政部長"},{"start":781.375,"end":782.576,"text":"二、上午9時至10時為國是論壇時間。二、上午9時至10時為國是論壇時間"},{"start":799.868,"end":828.579,"text":"降低癌症的死亡率除了從藥品之外我們還從提前再做檢測來發現以及改變現在的醫療方式來著手建保總額就像一個大水庫很多都流來流去但是有所謂專款嘛但是專款就是當年度沒用完就留回建保的這個安全準備金喊病藥費常常被這樣詬病雖然預算好像年年增加但是每年沒用完都留回這個基金等於實質增加的不等於帳面增加的"},{"start":829.139,"end":830.621,"text":"二、上午9時至10時為國是論壇時間。二、上午9時至10時為國是論壇時間。"},{"start":849.66,"end":878.197,"text":"基金、準備金,這個是兩命守法耶。院長,我想請教,你知道這筆錢可以救多少人嗎?這個怪黨,曾經這個不分居提名人,前陣子過世的那個陳俊翰律師,他就是罹患這個積水性的肌肉性萎縮症,他不符合使用條例啊。所以當他過世以後,健保就通通全開放啦。所以你知道這個都是留下的這個錢,沒有好好使用,這個就是衛福部最大的責任啊。"},{"start":879.177,"end":880.518,"text":"主計長,我們有什麼法規可以讓罕病預算留在專款內?"},{"start":907.225,"end":932.181,"text":"有嗎?有法規嗎?有或沒有?主計長你再討論一下,我到時候會請你再給我一些報告那為什麼生理食鹽水這次又變成11億進來呢?打算明年繼續進口生理食鹽水嗎?沒有花完再留回這個健保準備金嗎?還有健保連續虧損7年喔?你有沒有具體的檢討收支平衡計畫呢?到底哪一個項目可以挹注這個點數?我都看不出來欸"},{"start":933.902,"end":949.898,"text":"副委員這個健保總和這個部分是協商。好。好,謝謝。謝謝陳委員。好,也謝謝"}]}}},"gazette":{"lineno":2,"blocks":[["陳委員昭姿：（14時32分）謝謝主席，有請卓院長、主計長跟衛福部邱部長。"],["主席：卓院長、主計長還有衛福部邱部長，請備詢。"],["卓院長榮泰：陳委員好。"],["陳委員昭姿：3位首長好。今年初公布了醫院評鑑的結果，台北慈濟、雙和醫院還有臺大新竹分院等3家醫院升格為醫學中心，創下臺灣醫學中心最高的紀錄！雖然3位首長當時不在職，但我還是請問卓院長，院長，您知道這件事的影響嗎？"],["卓院長榮泰：我知道，3家醫院升格為醫學中心，我們的醫學中心總共會增加到22所。"],["陳委員昭姿：據您了解，這個對分級醫療是好事還是壞事？"],["卓院長榮泰：也許以整個醫療服務量能來看是有所升級，但是以我們一向在推的分級醫療制度等等來看，或許有其另外一個影響也不一定。"],["陳委員昭姿：院長，我很高興我上次總質詢的時候您有主動提到，根據醫療網的計畫，臺灣應該是200萬人口1家醫學中心。"],["卓院長榮泰：200萬。"],["陳委員昭姿：我們考慮到新竹的移入人口，臺大新竹分院升格為醫學中心是合情合理的，但是臺北區──就是北、北、基隆市跟宜蘭縣的總人口數在2023年已經降到750萬，那這個區增加2家醫學中心就變成10家醫學中心！根據這個標準明顯超過規範，規範是4家，現在有10家，衛福部根本就是帶頭破壞分級醫療制度！所以10月27號監察院通過了對衛福部的糾正案，監察院指出，衛福部無視作業程序規定，逕行增額評定臺北區醫學中心，已經傷害醫院評鑑之公信力。請問院長，你知道這是誰的決策嗎？"],["卓院長榮泰：這是經過評鑑小組共同決定，未來衛福部應該會成立一個評鑑的改革小組，甚至將來要研議提升整個評鑑的基準，讓這個評鑑能夠更精確。"],["陳委員昭姿：謝謝院長。院長，請您看一下投影片，你能不能幫我指出薛前部長、陳時中前部長跟王必勝前次長這3個人的共同點？"],["卓院長榮泰：共同點，除了都有醫師的背景，而且都是我們衛福部前後期重要的………"],["陳委員昭姿：院長，太明顯了啦！整個醫界都心知肚明，他們都來自同一所學校。早在醫院評鑑之前，醫界就盛傳萬芳醫院會從醫學中心降為準醫學中心，臺北慈濟會取代它成為醫學中心，然後莫名其妙的，過去都是年底公布，但是這件事一直到今年大選後才公布，最後臺北慈濟如外傳的它升為醫學中心，原本要降為準醫學中心的萬芳醫院卻維持住了醫學中心，然後很意外的，雙和醫院竟然成為醫學中心，增加了臺大新竹為醫學中心，當作一個陪襯跟掩護，看到這個結果整個醫界都跳腳了，醫務管理學會洪理事長質疑這個作法究竟是誰授意。我當時有質詢薛前部長是否專門為某個門系來護航，他回答我說這是臆測之詞，我現在想問院長，薛前部長這樣算不算圖利罪？圖利自己的學校算不算圖利罪？"],["卓院長榮泰：圖利罪要有更明確的事證，他們的背景相同……"],["陳委員昭姿：這事證明確啊！他破壞了這個規範，當時還改變遊戲規則，我今天不在這邊多說，時間也改變，遊戲規則也改變，這個是不是要立刻收押禁見？圖利罪耶！既然監察院都提出糾正案了，那衛福部誰該負責？院長，衛福部誰該負責？"],["卓院長榮泰：關於流程、時程的問題……"],["陳委員昭姿：總不能說他們兩個都卸任吧？"],["卓院長榮泰：要不要請邱部長再說明一下？"],["陳委員昭姿：沒有，這個不用說明，邱部長當時也不在，我們都很清楚這件事發生了，確實發生了。所以我想請問主計長，當一家醫院升格為醫學中心，您認為它這樣子會增加您多少收益？主計長有資料嗎？你有資料嗎？當一家醫院升格為醫學中心的時候，它不管來自健保收入、來自自費收入、來自它議價等等能力，它會增加多少收益？你知道這個利益有多大嗎？主計長有資料嗎？"],["陳主計長淑姿：沒有，這一個部分應該是由衛福部來說明。"],["邱部長泰源：報告委員，因為這個是今年才開始實行，所以我想我們會……"],["陳委員昭姿：不是今年才開始大破壞，之前就有了……"],["邱部長泰源：對財務的衝擊以及……"],["陳委員昭姿：我知道主計長一時也回答不出來，但是我請主計長幫我查一下、了解一下……"],["邱部長泰源：我們會去統計民眾就醫狀況的變化……"],["陳委員昭姿：這可以了解嘛，對不對？請問院長下次評鑑的時候可不可以回歸到醫療網計畫？是不是要回歸到200萬？臺灣應該只有2,400萬人口，200萬大概12家左右，大家來競爭嘛，不是這樣無限制一直增加啊！院長，這樣可以嗎？"],["卓院長榮泰：不僅跟委員報告，我們也應該趁這個機會向國人跟整個醫界說明……"],["陳委員昭姿：可以嗎？下次評鑑的時候，回歸醫療網計畫……"],["卓院長榮泰：對，未來衛福部在進行評鑑的時候，務必要重新調整這一次外界的意見，它已經有改革小組，已經有提高標準等等，要回歸到專業，才能更有公信力。"],["陳委員昭姿：謝謝院長，我聽到你的承諾，謝謝你，因為醫界跟民間對這個決定都憂心忡忡。社區醫院協會朱理事長指出這樣反而會造成民眾候診時間變長，往返醫院的路程變遠，家屬也需要多陪同等等，反而使民眾就醫的成本增加。醫改會也說有半數的醫學中心都在雙北地區，區域正義何在？衛福部考慮過民眾就醫負擔的衝擊以及醫療資源分布不均的影響嗎？我可不可以請院長回答，衛福部有考慮這些事嗎？這些事重要嗎？"],["卓院長榮泰：剛剛委員所說那幾項，都應該是我們在推行醫療服務整個量能讓它均衡化的過程當中重要的幾項。"],["陳委員昭姿：我要告訴院長的是，當時衛福部說新北區增加兩家醫學中心，健保醫療費用推估支出約1億6,000萬點，對財務健保影響很低，我覺得很誇張，原來1億6,000萬點對衛福部是小錢耶！衛福部如此信口開河，1億6,000點就這樣撒出去，然後回頭告訴立法院跟醫界朋友說，明年我們努力，努力讓點值提升到0.95，我們能接受嗎？"],["卓院長榮泰：我希望衛福部這種講法應該要重新再思考，我們考量的不是金額支出多少而已，而是這整個制度改變之後、增加之後，對民眾是不是有好的醫療服務，而且整個醫療水準是不是有提升……"],["陳委員昭姿：謝謝院長，我剛剛提的數字我想邱部長都有數，我就讓院長也知道。院長，我在臺大醫院服務了10年，有位臺大醫院的教授朋友定期會給我一些從急診人數因爆滿而溢出的照片，請院長看一下這個圖片，急診病床因為不敷使用，溢滿、溢出到醫院的大門正廳，聽說晚上更嚴重，院長如果微服出巡一下，晚上是更嚴重。你看看這個圖，連醫事司都很清楚，大家都知道是常態，很奇妙的，每次醫院評鑑的時候，這些病人跟病床又會消失掉，因為誰都知道把病床放在大廳是不合格的，不管是隱私、感染、不符合病床的標準，這個都是不合格的，但是它是常態耶！院長，我明白臺大醫院或一些醫學中心是國人心目中的神醫院，大家看病都往這裡跑，但也不能這樣放任，不能擺到理所當然，完全不思改善啊！部長，怎麼辦？"],["邱部長泰源：報告委員，我們非常重視這個問題，像這個是臺大醫院……"],["陳委員昭姿：這長期的耶！"],["邱部長泰源：其實……"],["陳委員昭姿：這是白天，晚上更嚴重喔！"],["邱部長泰源：臺大醫院院長跟我澄清，常常都是在禮拜一的時候，特別因為又要等開刀，你也不能讓……"],["陳委員昭姿：部長，都沒有藉口啦！這是長期的。"],["邱部長泰源：對，但是禮拜二就會疏散了，所以有時候不是每一天都這樣子。"],["陳委員昭姿：部長，你這個說法，什麼禮拜一、禮拜二……"],["邱部長泰源：但是各個醫學中心發生這種情況……"],["陳委員昭姿：好，我跟你加LINE，我定期把照片傳給你看。"],["邱部長泰源：我們都有去了解，去解決困難。"],["陳委員昭姿：醫事司都很清楚。我們看健保法第六十二條在協商的時候，邱部長親手寫下這個主決議，就是努力在明年6月達到平均點值一點0.95元，在委員會協商的時候，部長跟健保署署長都說這個需要700億耶！而且還說如果點值是1的話，需要1,000億喔！後來林靜儀次長也是這樣說，0.95需要700億。700億這個數字，當時在場的人都記憶猶新，我相信當天緊盯國會頻道的所有醫界朋友也都聽到了。我想請問主計長，就你所知，衛福部有把保障點值0.95的700億編到預算書裡嗎？有嗎？主計長，有嗎？因為我找不到啊！我請教你這位專家，你有找到嗎？"],["陳主計長淑姿：報告委員，我們今年投注在健保部分的金額是336億，可是因為健保現在是總額制，我們在總額再增加百分之五點多的時候，那也是增加了五百多億，所以……"],["陳委員昭姿：主計長，這樣子啦！我還是請你幫忙搞清楚，包括剛剛一個醫院能夠升格為醫學中心，到底年收益增加多少？我根本看不到前預算在哪裡，衛福部講不清楚，結果用了下面這張圖來搪塞我們。你看下面這張圖，院長、部長，衛福部一直對外說今年已高推估5.5%計算，加上行政院挹注的、主計長講的336億元，東湊西湊就有700億，東湊西湊，我認為這個700億需要釐清一下。我們來看圖上的健保財務協助方案，休會期間我跟陳菁徽委員舉辦了百億癌症新藥基金公聽會，我一直都非常熟悉，也非常關心癌症病友的權益，今年（2024年）健保署放在新藥新特材暫時性支付的全年經費是24億元，明年的新癌藥基金有50億元，但是總額，部長，還在你的桌上耶！你還沒批吧，是不是？我想請問部長，你會不會因為有這50億的癌藥基金到位，你就把新藥新特材的總預算金額減少了或歸零，你會不會？請部長回答我，原有的暫時性支付……"],["邱部長泰源：原有的癌症基金……"],["陳委員昭姿：新藥新特材的暫時性支付。"],["邱部長泰源：原有的癌症費用都一定會保留，原來在總額裡面的，而這個是比較針對新藥暫時性的支付。"],["陳委員昭姿：我要部長確定喔！因為如果你把它挪移了或歸零……"],["卓院長榮泰：不會。"],["陳委員昭姿：你這個50億就不是真的！"],["邱部長泰源：我們一年花在癌症有1,200億……"],["陳委員昭姿：先不要談這個，你對外宣稱撥50億……"],["邱部長泰源：這個都是總額出的。"],["陳委員昭姿：你不要把今年的東西刪掉、挪移。"],["邱部長泰源：是這樣子的，這個是因為政府體諒到有一些新藥可能還在Category A……"],["陳委員昭姿：部長，這個我很熟，謝謝。部長，你增加50億，本來要100億、分3年到位，你增加50億就要說到做到，這是賴總統競選時的承諾喔！"],["邱部長泰源：這個50億一定……"],["陳委員昭姿：你不要從別的地方挪移喔！"],["邱部長泰源：一定會確實去做……"],["陳委員昭姿：50億要確確實實的，院長……"],["邱部長泰源：而且如果有需要，我們會再增加。"],["陳委員昭姿：百億癌藥基金……"],["卓院長榮泰：跟委員報告，我們本來這個年度的癌症新藥暫時性支付大概24億……"],["陳委員昭姿：院長、部長……"],["卓院長榮泰：未來的50億是把它含在裡面，一共增加到50億。"],["陳委員昭姿：免疫療法跟標靶療法，治療新藥應該儘速完整，我為什麼說完整？因為臺灣是獨創的，很不人道，也不符合國際使用指引，做出了所有的新藥都限制對象，一直限縮，同樣病也不能用，然後限制使用的時間，甚至說終身只能選擇一種來使用。也有研究報告發現可近性……就是我有這個病，但是大概頂多只有30%的人能用到這個藥。所以賴總統說2030年要降低癌症死亡率三分之一，這樣做不到啊！因為我請專家估算，根據專家的估算，這個費用至少要編300到500億，所以臺灣這些藥品錢……"],["卓院長榮泰：要降低癌症的死亡率，除了從藥品之外，我們還提前在做檢測，來發現……"],["陳委員昭姿：我們等著看！謝謝院長。"],["卓院長榮泰：已經透過改變現在的醫療方式來著手。"],["陳委員昭姿：謝謝院長。部長，健保總額就像一個大水庫，很多都流來流去，但是也有所謂的專款，而專款就是當年度沒用完就流回健保的安全準備金，罕病藥費常常被這樣詬病，雖然預算好像年年增加，但是每年沒用完都流回這個基金，等於實質增加的不等於帳面增加的。我要講的是，根據報導者的專題，2018到2022罕藥預算總餘額是26億元，衛福部一手編列罕藥的預算，說會增加，也跟社會宣傳，另一手又嚴格審查，然後剩下的餘額又流回基金、準備金，但這個是兩面手法耶！院長，我想請教，你知道這筆錢可以救多少人嗎？","貴黨曾經的不分區提名人──前陣子過世的陳俊翰律師，他就是罹患脊髓性肌肉萎縮症，但他卻不符合使用條例，當他過世以後，健保給付才統統全開放，所以這個都是留下的錢沒有好好使用，這個就是衛福部最大的責任。所以我要請教幾件事：第一個，公務預算挹注的罕藥費用可不可以多照顧罕藥病人？儘量讓它用完嘛！怎麼還會有留下來的呢？"],["邱部長泰源：報告委員，我們罕病所有的健保應該編的預算統統有編。"],["陳委員昭姿：儘量使用，執行率要高！"],["邱部長泰源：而且我們為了照顧罕病的病人，還多編了20億。"],["陳委員昭姿：你可不可以留在罕病專款？可不可以留在罕病專款？"],["邱部長泰源：這是有史以來破紀錄的。"],["陳委員昭姿：主計長，我們有什麼法規可以讓罕病預算留在專款內？有嗎？有法規嗎？有或沒有？好，主計長，你再討論一下，我到時候會請你再給我一些報告。","為什麼生理食鹽水這次又編了11億進來呢？打算明年繼續進口生理食鹽水嗎？沒有花完再流回健保準備金嗎？還有，健保連續虧損7年喔！你有沒有具體的檢討收支平衡計畫呢？到底哪一個項目可以挹注這個點數，我都看不出來耶！"],["邱部長泰源：報告委員，健保總額這個部分是協商，所以也不是我們要搬在哪裡就搬在哪裡，預算那麼多，會有很多代表……"],["陳委員昭姿：協商不表示不能夠兌現。"],["邱部長泰源：只要對人民有幫助的，我們衛福部一定是去說服、去溝通來爭取經費。"],["主席：謝謝陳委員，也謝謝卓院長。"],["卓院長榮泰：我們會繼續來增加。"],["陳委員昭姿：好，謝謝三位首長、謝謝主席。"],["主席：謝謝陳委員，也謝謝卓院長。","下一位請李坤城委員質詢。"]],"agenda":{"page_end":124,"meet_id":"院會-11-2-7","speakers":["韓國瑜","江啟臣","吳思瑤","傅崐萁","陳昭姿","李坤城","林思銘","林國成","陳冠廷","洪孟楷","張雅琳","張嘉郡","陳培瑜","林德福","王正旭","鄭天財Sra Kacaw"],"page_start":22,"meetingDate":["2024-11-01"],"gazette_id":"1138801","agenda_lcidc_ids":["1138801_00002","1138801_00003"],"meet_name":"立法院第11屆第2會期第7次會議紀錄","content":"行政院院長、主計長、財政部部長、國家發展委員會主任委員及相關部會首長列席報告「114年\n度中央政府總預算案」及「中央政府前瞻基礎建設計畫第5期特別預算案」編製經過並備質詢─\n進行質詢 ─","agenda_id":"1138801_00003"}}}