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\"score\": 0.861}, {\"word\": \"果\", \"start\": 884.06, \"end\": 884.26, \"score\": 0.902}, {\"word\": \"全\", \"start\": 884.26, \"end\": 884.6, \"score\": 0.934}, {\"word\": \"國\"}, {\"word\": \"的\", \"start\": 884.6, \"end\": 884.841, \"score\": 0.974}, {\"word\": \"民\", \"start\": 884.841, \"end\": 885.141, \"score\": 0.91}, {\"word\": \"眾\"}, {\"word\": \"能\", \"start\": 885.141, \"end\": 885.421, \"score\": 0.928}, {\"word\": \"夠\"}, {\"word\": \"都\", \"start\": 885.421, \"end\": 885.561, \"score\": 0.859}, {\"word\": \"能\", \"start\": 885.561, \"end\": 885.701, \"score\": 0.999}, {\"word\": \"瞭\", \"start\": 885.701, \"end\": 885.941, \"score\": 0.916}, {\"word\": \"解\", \"start\": 885.941, \"end\": 886.341, \"score\": 0.894}, {\"word\": \"這\"}, {\"word\": \"樣\"}, {\"word\": \"的\", \"start\": 886.341, \"end\": 886.421, \"score\": 0.841}, {\"word\": \"一\", \"start\": 886.421, \"end\": 886.602, \"score\": 0.885}, {\"word\": \"個\"}, {\"word\": \"方\", \"start\": 886.602, \"end\": 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{\"word\": \"努\", \"start\": 913.315, \"end\": 913.515, \"score\": 0.901}, {\"word\": \"力\", \"start\": 913.515, \"end\": 913.715, \"score\": 0.903}, {\"word\": \"討\"}, {\"word\": \"論\"}, {\"word\": \"以\", \"start\": 913.715, \"end\": 913.895, \"score\": 0.889}, {\"word\": \"後\", \"start\": 913.895, \"end\": 914.456, \"score\": 0.882}, {\"word\": \"其\", \"start\": 914.456, \"end\": 914.816, \"score\": 0.896}, {\"word\": \"實\"}, {\"word\": \"也\", \"start\": 914.816, \"end\": 915.016, \"score\": 0.999}, {\"word\": \"希\", \"start\": 915.016, \"end\": 915.176, \"score\": 0.998}, {\"word\": \"望\", \"start\": 915.176, \"end\": 915.316, \"score\": 0.998}, {\"word\": \"能\", \"start\": 915.316, \"end\": 915.596, \"score\": 0.905}, {\"word\": \"夠\"}, {\"word\": \"有\", \"start\": 915.596, \"end\": 915.756, \"score\": 0.999}, {\"word\": \"健\", \"start\": 915.756, \"end\": 915.956, \"score\": 0.915}, {\"word\": \"保\", \"start\": 915.956, \"end\": 916.336, \"score\": 0.945}, {\"word\": \"協\"}, 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00:01:42,975\n主決議的內容就是希望在明年的6月30日以前我們這個醫院服務的點值要到達1.095元這樣的一個成效那這一部分不知道目前包括卓院長還有部長努力的成果做了哪一些的努力那進度可不可以再次跟國人做個報告\n\n4\n00:01:44,312 --> 00:02:03,264\n好謝謝委員大院的主決議對行政院來講都是非常的重視的也是讓我們有一個改革目標的一個衝勁我們希望往這個目標能夠全力的來達成但過程當中經過什麼樣的途徑用什麼樣的時程甚至要用什麼樣的經費預算來達成就要由我們的\n\n5\n00:02:04,365 --> 00:02:23,147\n主管部會來做詳細的規劃那這個怎麼情境我想明年的預算我們已經呈現出一部分往這個目標走的相關的預算那到底他執行的效率如何到明年的6月30號會到達什麼樣的程度我想請衛生部來做一個說明但是很多都是現在的預估\n\n6\n00:02:25,485 --> 00:02:40,155\n謝謝委員歡迎我想委員是專家我們在過去當然就是都有補點子的機制所以也曾經在112年、113年政府撥補到健保基金240億以及去年的200億那這個都是在COVID以後因為\n\n7\n00:02:51,960 --> 00:03:06,636\n因為那個病人增加增加了很多醫療援手的負擔所以就有補點值讓他到一定的程度我想這個部分是過去的努力我想未來我們也會關心\n\n8\n00:03:08,052 --> 00:03:33,644\n那在114年度在健康台灣願景之下其實有分了三個部分來成長第一個就是由我們的一個藝助健保的一個財務的一個協助方案這個大概有336億那當然另外特別是在那個深耕計畫的一個60億這個是就是您\n\n9\n00:03:35,925 --> 00:04:04,246\n就是您王委員現在提的這個部分如何來留下人才留好的人才在醫療體系怎麼優化他們的工作環境還有整個醫療環境最重要是讓人民的醫療品質得到最提升然後健保能夠永續的一個深耕計畫這個也是創醫療界可以說是臺灣的醫療史裡面第一次非常重要的一個計畫那另外就是\n\n10\n00:04:05,166 --> 00:04:32,486\n行政院也非常支持我們的總額這個部分我想這個部分是大家都很清楚總額過去的成長都很少超過都是4點多比較多今年我們的高推估到達5點多所以在低推估就已經多了大概有可能有300多億那高推估又多了100多億所以在這個部分就可能有多500總額大概可以多到500\n\n11\n00:04:34,286 --> 00:04:49,556\n三十一億加上那個剛剛講的三十六億的那個財務健保財務的一個協助方案裡面有大概一百八十億八十一億是有助於健保的其他都是一種\n\n12\n00:04:50,546 --> 00:04:51,387\n當然這個部分如果要談到點子我們當然強調的\n\n13\n00:05:16,909 --> 00:05:42,552\n更重要是它的怎麼去發揮這個健保的價值,這個部分是我們一直過去所堅持的,當然點子我們也要關心,這個部分也要看,另外也要做好管理,在各區裡面我們都有自治性的管理,那像台北區在過去基層真的是比較弱一點,那這個部分都是因為有\n\n14\n00:05:43,615 --> 00:06:12,041\n有過去傳統歷史的因素那這個部分我想全國的醫界也都會很共體時間會做一個處理讓各區能夠平衡我想大家醫療院所很感佩我們行政院在這一次可以說是有史以來給最多的幫忙都很感動所以很多醫界的同仁也跟我們講我們一定也要自我來努力跟他共同來朝向一個更好的一個\n\n15\n00:06:12,601 --> 00:06:17,625\n的確院長早上的報告讓我們知道在明年的總額實質上會增加712億希望能夠達標至少一點可以維持0.95元\n\n16\n00:06:35,758 --> 00:06:59,209\n臺灣的健保制度一直受到全球的推崇,對於民眾的這些不管在疾病或各方面的保障都非常的令我們的民眾可以非常安心,也可以達到一個我們希望讓民眾不要因病而窮這樣的一個目標。當然我們是在實施這個總額制度之下還是有蠻多\n\n17\n00:07:00,049 --> 00:07:20,531\n大家所擔心不管是從醫界、從民眾或是從政府端會看到一些需要在解決的問題,包括在醫界很擔心如果說我們的點子無法維持好的點子的話,那導致經營的困難,所以很希望透過各方面的努力來保障點子。\n\n18\n00:07:21,212 --> 00:07:22,393\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\n19\n00:07:45,162 --> 00:07:46,243\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\n20\n00:08:12,777 --> 00:08:37,337\n民眾或者是醫療服務端就是醫師相關的這些醫事方面的機構還有政府都必須要共同來針對未來的變化還要再加強這部分我們就麻煩院長跟部長持續來努力當我們期待民眾端就能夠盡量的去讓這個醫療資源的利用可以更為\n\n21\n00:08:38,558 --> 00:08:43,963\n我相信政府當然還是要最重要,包括如何能夠加強數據的管理,增加制定預警機制。這部分期待院長能夠持續領導衛福部來加強這方面的努力。\n\n22\n00:09:02,591 --> 00:09:22,377\n那當然部長其實也提到了另外一個重點因為我們現在全國是分成六區那這個六區的過程裡面就會有一些區域上的一些問題產生就變成說不同的分區點子公平性的問題會衝擊蠻大的我們可以看到一個數據就是今年第一季\n\n23\n00:09:24,144 --> 00:09:51,801\n有關於這個我們的健保分區可以看到臺北分區還有北區還有中區點子就因為可能是COVID以後的一些影響或者是天候的影響造成這個點子非常非常的不理想甚至會低到這個平均點子在0.85以下那這部分不知道院長或部長可以做哪一些的努力或者是來怎麼樣來改變這個\n\n24\n00:09:54,195 --> 00:10:10,650\n因為分區造成了一些影響,院長不曉得有沒有想法?謝謝委員有關於金人度算出來的確是有幾個區,它是比較偏低\n\n25\n00:10:11,689 --> 00:10:32,519\n尤其是三個區那台北區大概是最嚴重一直都是這樣子那我們也依照去年的一個補值的狀況我們也文健保署也簽了一個補點值的方案那因為那個部分可以動用我們現在去年有200億到那個\n\n26\n00:10:35,260 --> 00:10:49,021\n建保安全基金方面我們也簽上去希望能夠讓我們的比較那個低的比較偏低的地區能夠得到按照以前我們大家討論的方式\n\n27\n00:10:50,851 --> 00:10:51,491\n二、上午9時至10時為國是論壇時間。\n\n28\n00:11:07,942 --> 00:11:23,148\n因為總額的制度它有非常大的不可抗因素變化非常大所以我們只有從分級、審查各方面來著手但是兩個原則就是不能讓醫護人員醫療院所應該所得到的這種點子\n\n29\n00:11:25,307 --> 00:11:37,561\n被降低了,降低到不合理,所以我們一定要保證將來在0.9的這個狀況底下一定要往上拉高,沒有達到的我們要靠整個制度的檢討來將它補足。\n\n30\n00:11:39,028 --> 00:12:07,631\n那明年我們如果能到朝0.95這個目標來前進這個是我們共同的努力方向那當然我們也知道說除了維持點子以外其實有一些是要優先來處理包括集中南韓還有偏向跟兒童醫療的部分那這部分應該院長跟部長都會同意吧就是說我們在保障點子的同時這其實都有都已經有保障那我們會特別注意到他實際上他的付出\n\n31\n00:12:08,531 --> 00:12:30,943\n跟他的酬勞是不是有相對的?這個部分我們一定會再一直密切來注意很多的努力、辛苦應該得到更多的保障這是絕對是大家都說得通的理由過去30年國人受健保的保障、健康我想現在是大家回頭來保障健保制度讓他能夠健全的時代我們應該做共同這樣的努力\n\n32\n00:12:31,863 --> 00:12:58,331\n因為專家的意見其實也告訴我們說我們不是在追求保障點子而已其實我們也需要有更多的多元的改革方案來讓我們的健保可以永續那講到這個健保財務多元的微調方案其實包括部分負擔的薪資上入一年來可以看到有非常好的成果那這一部分我們期待未來能夠再根據這個未來有關於部分負擔的差異化的\n\n33\n00:12:59,241 --> 00:12:59,821\n二、上午9時至10時為國是論壇時間。\n\n34\n00:13:16,870 --> 00:13:41,602\n謝謝,我想分歧醫療是世界的潮流臺灣其實從民國75年的醫療網開始就是在建立一個很好的各地方的分歧醫療到現在但是因為後來醫院實在是一直強大起來所以分歧醫療在推的成果的確是需要再加把勁這當中當然要配合財務的\n\n35\n00:13:44,673 --> 00:14:14,217\n一些規劃嘛,包括在健保法的第43條那邊也有一些到各級醫院裡面它的一個部分負擔的一個當然沒有完全去落實到那個法條那我們用這個去年用這樣的一個部分負擔的方式的確是有幫助一點但是我在這邊還是要感謝這個我們的在健康台灣裡面的很多的項目其實我們都希望由基層來做我們也要\n\n36\n00:14:14,875 --> 00:14:39,537\n跟全國的民眾講基層的醫師臺灣的基層醫師都是非常優秀的而且都能夠做你全能的照顧他可以從篩檢從你的疾病的篩檢就可以在你最方便的方式到達甚至你的老人家的一個在家照顧安老善終這整個基層醫師系統下可以做很多的事情而且很有品質\n\n37\n00:14:40,458 --> 00:14:51,624\n然後如果再配合分級醫療這樣的話我如果全國的民眾能夠都能瞭解這樣的一個方式這樣的一個體系大家來配合我相信我們會變成很有效率的一個醫療體系\n\n38\n00:14:52,827 --> 00:15:19,278\n那針對這個健保法的部分的修正包括適度調高補充保費還有提高這個扣稅的上限也希望院長到時候能夠支持是不是來往這邊修法那另外有關於這個商保合作健保的部分我們很期待經過這個國會院經一年的努力討論以後其實也希望能夠有健保協同商保這個第二層政策保險的部分\n\n39\n00:15:20,908 --> 00:15:41,255\n目前下禮拜二就會有一個結案報告這個主持人盧教授很希望有機會再跟院長做一個比較全面的相關的報告不知道院長有沒有機會來接受這樣的報告的這種研議的機會好謝謝我們跟衛福都會很審慎來因應這個修法的相關\n\n40\n00:15:45,604 --> 00:15:46,605\n主席\n\n","tsv":"start\tend\ttext\n25434\t31378\t謝謝主席。我們有請卓院長及衛福部邱部長。卓院長、邱部長請備選。今天要來請教\n50868\t51709\t法定人數不足\n79850\t102975\t主決議的內容就是希望在明年的6月30日以前我們這個醫院服務的點值要到達1.095元這樣的一個成效那這一部分不知道目前包括卓院長還有部長努力的成果做了哪一些的努力那進度可不可以再次跟國人做個報告\n104312\t123264\t好 謝謝委員大院的主決議對行政院來講都是非常的重視的也是讓我們有一個改革目標的一個衝勁我們希望往這個目標能夠全力的來達成但過程當中經過什麼樣的途徑用什麼樣的時程甚至要用什麼樣的經費預算來達成就要由我們的\n124365\t143147\t主管部會來做詳細的規劃那這個怎麼情境我想明年的預算我們已經呈現出一部分往這個目標走的相關的預算那到底他執行的效率如何到明年的6月30號會到達什麼樣的程度我想請衛生部來做一個說明但是很多都是現在的預估\n145485\t160155\t謝謝委員 歡迎我想委員是專家我們在過去當然就是都有補點子的機制所以也曾經在112年、113年政府撥補到健保基金240億以及去年的200億那這個都是在COVID以後因為\n171960\t186636\t因為那個病人增加增加了很多醫療援手的負擔所以就有補點值讓他到一定的程度我想這個部分是過去的努力我想未來我們也會關心\n188052\t213644\t那在114年度在健康台灣願景之下其實有分了三個部分來成長第一個就是由我們的一個藝助健保的一個財務的一個協助方案這個大概有336億那當然另外特別是在那個深耕計畫的一個60億這個是就是您\n215925\t244246\t就是您王委員現在提的這個部分如何來留下人才留好的人才在醫療體系怎麼優化他們的工作環境還有整個醫療環境最重要是讓人民的醫療品質得到最提升然後健保能夠永續的一個深耕計畫這個也是創醫療界可以說是臺灣的醫療史裡面第一次非常重要的一個計畫那另外就是\n245166\t272486\t行政院也非常支持我們的總額這個部分我想這個部分是大家都很清楚總額過去的成長都很少超過都是4點多比較多今年我們的高推估到達5點多所以在低推估就已經多了大概有可能有300多億那高推估又多了100多億所以在這個部分就可能有多500總額大概可以多到500\n274286\t289556\t三十一億加上那個剛剛講的三十六億的那個財務健保財務的一個協助方案裡面有大概一百八十億八十一億是有助於健保的其他都是一種\n290546\t291387\t當然這個部分如果要談到點子我們當然強調的\n316909\t342552\t更重要是它的怎麼去發揮這個健保的價值,這個部分是我們一直過去所堅持的,當然點子我們也要關心,這個部分也要看,另外也要做好管理,在各區裡面我們都有自治性的管理,那像台北區在過去基層真的是比較弱一點,那這個部分都是因為有\n343615\t372041\t有過去傳統歷史的因素那這個部分我想全國的醫界也都會很共體時間會做一個處理讓各區能夠平衡我想大家醫療院所很感佩我們行政院在這一次可以說是有史以來給最多的幫忙都很感動所以很多醫界的同仁也跟我們講我們一定也要自我來努力跟他共同來朝向一個更好的一個\n372601\t377625\t的確院長早上的報告讓我們知道在明年的總額實質上會增加712億希望能夠達標至少一點可以維持0.95元\n395758\t419209\t臺灣的健保制度一直受到全球的推崇,對於民眾的這些不管在疾病或各方面的保障都非常的令我們的民眾可以非常安心,也可以達到一個我們希望讓民眾不要因病而窮這樣的一個目標。當然我們是在實施這個總額制度之下還是有蠻多\n420049\t440531\t大家所擔心不管是從醫界、從民眾或是從政府端會看到一些需要在解決的問題,包括在醫界很擔心如果說我們的點子無法維持好的點子的話,那導致經營的困難,所以很希望透過各方面的努力來保障點子。\n441212\t442393\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。\n465162\t466243\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。．\n492777\t517337\t民眾或者是醫療服務端就是醫師相關的這些醫事方面的機構還有政府都必須要共同來針對未來的變化還要再加強這部分我們就麻煩院長跟部長持續來努力當我們期待民眾端就能夠盡量的去讓這個醫療資源的利用可以更為\n518558\t523963\t我相信政府當然還是要最重要,包括如何能夠加強數據的管理,增加制定預警機制。這部分期待院長能夠持續領導衛福部來加強這方面的努力。\n542591\t562377\t那當然部長其實也提到了另外一個重點因為我們現在全國是分成六區那這個六區的過程裡面就會有一些區域上的一些問題產生就變成說不同的分區點子公平性的問題會衝擊蠻大的我們可以看到一個數據就是今年第一季\n564144\t591801\t有關於這個我們的健保分區可以看到臺北分區還有北區還有中區點子就因為可能是COVID以後的一些影響或者是天候的影響造成這個點子非常非常的不理想甚至會低到這個平均點子在0.85以下那這部分不知道院長或部長可以做哪一些的努力或者是來怎麼樣來改變這個\n594195\t610650\t因為分區造成了一些影響,院長不曉得有沒有想法?謝謝委員有關於金人度算出來的確是有幾個區,它是比較偏低\n611689\t632519\t尤其是三個區那台北區大概是最嚴重一直都是這樣子那我們也依照去年的一個補值的狀況我們也文健保署也簽了一個補點值的方案那因為那個部分可以動用我們現在去年有200億到那個\n635260\t649021\t建保安全基金方面我們也簽上去希望能夠讓我們的比較那個低的比較偏低的地區能夠得到按照以前我們大家討論的方式\n650851\t651491\t二、上午9時至10時為國是論壇時間。\n667942\t683148\t因為總額的制度它有非常大的不可抗因素變化非常大所以我們只有從分級、審查各方面來著手但是兩個原則就是不能讓醫護人員醫療院所應該所得到的這種點子\n685307\t697561\t被降低了,降低到不合理,所以我們一定要保證將來在0.9的這個狀況底下一定要往上拉高,沒有達到的我們要靠整個制度的檢討來將它補足。\n699028\t727631\t那明年我們如果能到朝0.95這個目標來前進這個是我們共同的努力方向那當然我們也知道說除了維持點子以外其實有一些是要優先來處理包括集中南韓還有偏向跟兒童醫療的部分那這部分應該院長跟部長都會同意吧就是說我們在保障點子的同時這其實都有都已經有保障那我們會特別注意到他實際上他的付出\n728531\t750943\t跟他的酬勞是不是有相對的?這個部分我們一定會再一直密切來注意很多的努力、辛苦應該得到更多的保障這是絕對是大家都說得通的理由過去30年國人受健保的保障、健康我想現在是大家回頭來保障健保制度讓他能夠健全的時代我們應該做共同這樣的努力\n751863\t778331\t因為專家的意見其實也告訴我們說我們不是在追求保障點子而已其實我們也需要有更多的多元的改革方案來讓我們的健保可以永續那講到這個健保財務多元的微調方案其實包括部分負擔的薪資上入一年來可以看到有非常好的成果那這一部分我們期待未來能夠再根據這個未來有關於部分負擔的差異化的\n779241\t779821\t二、上午9時至10時為國是論壇時間。\n796870\t821602\t謝謝,我想分歧醫療是世界的潮流臺灣其實從民國75年的醫療網開始就是在建立一個很好的各地方的分歧醫療到現在但是因為後來醫院實在是一直強大起來所以分歧醫療在推的成果的確是需要再加把勁這當中當然要配合財務的\n824673\t854217\t一些規劃嘛,包括在健保法的第43條那邊也有一些到各級醫院裡面它的一個部分負擔的一個當然沒有完全去落實到那個法條那我們用這個去年用這樣的一個部分負擔的方式的確是有幫助一點但是我在這邊還是要感謝這個我們的在健康台灣裡面的很多的項目其實我們都希望由基層來做我們也要\n854875\t879537\t跟全國的民眾講基層的醫師臺灣的基層醫師都是非常優秀的而且都能夠做你全能的照顧他可以從篩檢從你的疾病的篩檢就可以在你最方便的方式到達甚至你的老人家的一個在家照顧安老善終這整個基層醫師系統下可以做很多的事情而且很有品質\n880458\t891624\t然後如果再配合分級醫療這樣的話我如果全國的民眾能夠都能瞭解這樣的一個方式這樣的一個體系大家來配合我相信我們會變成很有效率的一個醫療體系\n892827\t919278\t那針對這個健保法的部分的修正包括適度調高補充保費還有提高這個扣稅的上限也希望院長到時候能夠支持是不是來往這邊修法那另外有關於這個商保合作健保的部分我們很期待經過這個國會院經一年的努力討論以後其實也希望能夠有健保協同商保這個第二層政策保險的部分\n920908\t941255\t目前下禮拜二就會有一個結案報告這個主持人盧教授很希望有機會再跟院長做一個比較全面的相關的報告不知道院長有沒有機會來接受這樣的報告的這種研議的機會好謝謝我們跟衛福都會很審慎來因應這個修法的相關\n945604\t946605\t主席\n","txt":"謝謝主席。我們有請卓院長及衛福部邱部長。卓院長、邱部長請備選。今天要來請教\n法定人數不足\n主決議的內容就是希望在明年的6月30日以前我們這個醫院服務的點值要到達1.095元這樣的一個成效那這一部分不知道目前包括卓院長還有部長努力的成果做了哪一些的努力那進度可不可以再次跟國人做個報告\n好 謝謝委員大院的主決議對行政院來講都是非常的重視的也是讓我們有一個改革目標的一個衝勁我們希望往這個目標能夠全力的來達成但過程當中經過什麼樣的途徑用什麼樣的時程甚至要用什麼樣的經費預算來達成就要由我們的\n主管部會來做詳細的規劃那這個怎麼情境我想明年的預算我們已經呈現出一部分往這個目標走的相關的預算那到底他執行的效率如何到明年的6月30號會到達什麼樣的程度我想請衛生部來做一個說明但是很多都是現在的預估\n謝謝委員 歡迎我想委員是專家我們在過去當然就是都有補點子的機制所以也曾經在112年、113年政府撥補到健保基金240億以及去年的200億那這個都是在COVID以後因為\n因為那個病人增加增加了很多醫療援手的負擔所以就有補點值讓他到一定的程度我想這個部分是過去的努力我想未來我們也會關心\n那在114年度在健康台灣願景之下其實有分了三個部分來成長第一個就是由我們的一個藝助健保的一個財務的一個協助方案這個大概有336億那當然另外特別是在那個深耕計畫的一個60億這個是就是您\n就是您王委員現在提的這個部分如何來留下人才留好的人才在醫療體系怎麼優化他們的工作環境還有整個醫療環境最重要是讓人民的醫療品質得到最提升然後健保能夠永續的一個深耕計畫這個也是創醫療界可以說是臺灣的醫療史裡面第一次非常重要的一個計畫那另外就是\n行政院也非常支持我們的總額這個部分我想這個部分是大家都很清楚總額過去的成長都很少超過都是4點多比較多今年我們的高推估到達5點多所以在低推估就已經多了大概有可能有300多億那高推估又多了100多億所以在這個部分就可能有多500總額大概可以多到500\n三十一億加上那個剛剛講的三十六億的那個財務健保財務的一個協助方案裡面有大概一百八十億八十一億是有助於健保的其他都是一種\n當然這個部分如果要談到點子我們當然強調的\n更重要是它的怎麼去發揮這個健保的價值,這個部分是我們一直過去所堅持的,當然點子我們也要關心,這個部分也要看,另外也要做好管理,在各區裡面我們都有自治性的管理,那像台北區在過去基層真的是比較弱一點,那這個部分都是因為有\n有過去傳統歷史的因素那這個部分我想全國的醫界也都會很共體時間會做一個處理讓各區能夠平衡我想大家醫療院所很感佩我們行政院在這一次可以說是有史以來給最多的幫忙都很感動所以很多醫界的同仁也跟我們講我們一定也要自我來努力跟他共同來朝向一個更好的一個\n的確院長早上的報告讓我們知道在明年的總額實質上會增加712億希望能夠達標至少一點可以維持0.95元\n臺灣的健保制度一直受到全球的推崇,對於民眾的這些不管在疾病或各方面的保障都非常的令我們的民眾可以非常安心,也可以達到一個我們希望讓民眾不要因病而窮這樣的一個目標。當然我們是在實施這個總額制度之下還是有蠻多\n大家所擔心不管是從醫界、從民眾或是從政府端會看到一些需要在解決的問題,包括在醫界很擔心如果說我們的點子無法維持好的點子的話,那導致經營的困難,所以很希望透過各方面的努力來保障點子。\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民眾或者是醫療服務端就是醫師相關的這些醫事方面的機構還有政府都必須要共同來針對未來的變化還要再加強這部分我們就麻煩院長跟部長持續來努力當我們期待民眾端就能夠盡量的去讓這個醫療資源的利用可以更為\n我相信政府當然還是要最重要,包括如何能夠加強數據的管理,增加制定預警機制。這部分期待院長能夠持續領導衛福部來加強這方面的努力。\n那當然部長其實也提到了另外一個重點因為我們現在全國是分成六區那這個六區的過程裡面就會有一些區域上的一些問題產生就變成說不同的分區點子公平性的問題會衝擊蠻大的我們可以看到一個數據就是今年第一季\n有關於這個我們的健保分區可以看到臺北分區還有北區還有中區點子就因為可能是COVID以後的一些影響或者是天候的影響造成這個點子非常非常的不理想甚至會低到這個平均點子在0.85以下那這部分不知道院長或部長可以做哪一些的努力或者是來怎麼樣來改變這個\n因為分區造成了一些影響,院長不曉得有沒有想法?謝謝委員有關於金人度算出來的確是有幾個區,它是比較偏低\n尤其是三個區那台北區大概是最嚴重一直都是這樣子那我們也依照去年的一個補值的狀況我們也文健保署也簽了一個補點值的方案那因為那個部分可以動用我們現在去年有200億到那個\n建保安全基金方面我們也簽上去希望能夠讓我們的比較那個低的比較偏低的地區能夠得到按照以前我們大家討論的方式\n二、上午9時至10時為國是論壇時間。\n因為總額的制度它有非常大的不可抗因素變化非常大所以我們只有從分級、審查各方面來著手但是兩個原則就是不能讓醫護人員醫療院所應該所得到的這種點子\n被降低了,降低到不合理,所以我們一定要保證將來在0.9的這個狀況底下一定要往上拉高,沒有達到的我們要靠整個制度的檢討來將它補足。\n那明年我們如果能到朝0.95這個目標來前進這個是我們共同的努力方向那當然我們也知道說除了維持點子以外其實有一些是要優先來處理包括集中南韓還有偏向跟兒童醫療的部分那這部分應該院長跟部長都會同意吧就是說我們在保障點子的同時這其實都有都已經有保障那我們會特別注意到他實際上他的付出\n跟他的酬勞是不是有相對的?這個部分我們一定會再一直密切來注意很多的努力、辛苦應該得到更多的保障這是絕對是大家都說得通的理由過去30年國人受健保的保障、健康我想現在是大家回頭來保障健保制度讓他能夠健全的時代我們應該做共同這樣的努力\n因為專家的意見其實也告訴我們說我們不是在追求保障點子而已其實我們也需要有更多的多元的改革方案來讓我們的健保可以永續那講到這個健保財務多元的微調方案其實包括部分負擔的薪資上入一年來可以看到有非常好的成果那這一部分我們期待未來能夠再根據這個未來有關於部分負擔的差異化的\n二、上午9時至10時為國是論壇時間。\n謝謝,我想分歧醫療是世界的潮流臺灣其實從民國75年的醫療網開始就是在建立一個很好的各地方的分歧醫療到現在但是因為後來醫院實在是一直強大起來所以分歧醫療在推的成果的確是需要再加把勁這當中當然要配合財務的\n一些規劃嘛,包括在健保法的第43條那邊也有一些到各級醫院裡面它的一個部分負擔的一個當然沒有完全去落實到那個法條那我們用這個去年用這樣的一個部分負擔的方式的確是有幫助一點但是我在這邊還是要感謝這個我們的在健康台灣裡面的很多的項目其實我們都希望由基層來做我們也要\n跟全國的民眾講基層的醫師臺灣的基層醫師都是非常優秀的而且都能夠做你全能的照顧他可以從篩檢從你的疾病的篩檢就可以在你最方便的方式到達甚至你的老人家的一個在家照顧安老善終這整個基層醫師系統下可以做很多的事情而且很有品質\n然後如果再配合分級醫療這樣的話我如果全國的民眾能夠都能瞭解這樣的一個方式這樣的一個體系大家來配合我相信我們會變成很有效率的一個醫療體系\n那針對這個健保法的部分的修正包括適度調高補充保費還有提高這個扣稅的上限也希望院長到時候能夠支持是不是來往這邊修法那另外有關於這個商保合作健保的部分我們很期待經過這個國會院經一年的努力討論以後其實也希望能夠有健保協同商保這個第二層政策保險的部分\n目前下禮拜二就會有一個結案報告這個主持人盧教授很希望有機會再跟院長做一個比較全面的相關的報告不知道院長有沒有機會來接受這樣的報告的這種研議的機會好謝謝我們跟衛福都會很審慎來因應這個修法的相關\n主席\n","vtt":"WEBVTT\n\n00:25.434 --> 00:31.378\n謝謝主席。我們有請卓院長及衛福部邱部長。卓院長、邱部長請備選。今天要來請教\n\n00:50.868 --> 00:51.709\n法定人數不足\n\n01:19.850 --> 01:42.975\n主決議的內容就是希望在明年的6月30日以前我們這個醫院服務的點值要到達1.095元這樣的一個成效那這一部分不知道目前包括卓院長還有部長努力的成果做了哪一些的努力那進度可不可以再次跟國人做個報告\n\n01:44.312 --> 02:03.264\n好謝謝委員大院的主決議對行政院來講都是非常的重視的也是讓我們有一個改革目標的一個衝勁我們希望往這個目標能夠全力的來達成但過程當中經過什麼樣的途徑用什麼樣的時程甚至要用什麼樣的經費預算來達成就要由我們的\n\n02:04.365 --> 02:23.147\n主管部會來做詳細的規劃那這個怎麼情境我想明年的預算我們已經呈現出一部分往這個目標走的相關的預算那到底他執行的效率如何到明年的6月30號會到達什麼樣的程度我想請衛生部來做一個說明但是很多都是現在的預估\n\n02:25.485 --> 02:40.155\n謝謝委員歡迎我想委員是專家我們在過去當然就是都有補點子的機制所以也曾經在112年、113年政府撥補到健保基金240億以及去年的200億那這個都是在COVID以後因為\n\n02:51.960 --> 03:06.636\n因為那個病人增加增加了很多醫療援手的負擔所以就有補點值讓他到一定的程度我想這個部分是過去的努力我想未來我們也會關心\n\n03:08.052 --> 03:33.644\n那在114年度在健康台灣願景之下其實有分了三個部分來成長第一個就是由我們的一個藝助健保的一個財務的一個協助方案這個大概有336億那當然另外特別是在那個深耕計畫的一個60億這個是就是您\n\n03:35.925 --> 04:04.246\n就是您王委員現在提的這個部分如何來留下人才留好的人才在醫療體系怎麼優化他們的工作環境還有整個醫療環境最重要是讓人民的醫療品質得到最提升然後健保能夠永續的一個深耕計畫這個也是創醫療界可以說是臺灣的醫療史裡面第一次非常重要的一個計畫那另外就是\n\n04:05.166 --> 04:32.486\n行政院也非常支持我們的總額這個部分我想這個部分是大家都很清楚總額過去的成長都很少超過都是4點多比較多今年我們的高推估到達5點多所以在低推估就已經多了大概有可能有300多億那高推估又多了100多億所以在這個部分就可能有多500總額大概可以多到500\n\n04:34.286 --> 04:49.556\n三十一億加上那個剛剛講的三十六億的那個財務健保財務的一個協助方案裡面有大概一百八十億八十一億是有助於健保的其他都是一種\n\n04:50.546 --> 04:51.387\n當然這個部分如果要談到點子我們當然強調的\n\n05:16.909 --> 05:42.552\n更重要是它的怎麼去發揮這個健保的價值,這個部分是我們一直過去所堅持的,當然點子我們也要關心,這個部分也要看,另外也要做好管理,在各區裡面我們都有自治性的管理,那像台北區在過去基層真的是比較弱一點,那這個部分都是因為有\n\n05:43.615 --> 06:12.041\n有過去傳統歷史的因素那這個部分我想全國的醫界也都會很共體時間會做一個處理讓各區能夠平衡我想大家醫療院所很感佩我們行政院在這一次可以說是有史以來給最多的幫忙都很感動所以很多醫界的同仁也跟我們講我們一定也要自我來努力跟他共同來朝向一個更好的一個\n\n06:12.601 --> 06:17.625\n的確院長早上的報告讓我們知道在明年的總額實質上會增加712億希望能夠達標至少一點可以維持0.95元\n\n06:35.758 --> 06:59.209\n臺灣的健保制度一直受到全球的推崇,對於民眾的這些不管在疾病或各方面的保障都非常的令我們的民眾可以非常安心,也可以達到一個我們希望讓民眾不要因病而窮這樣的一個目標。當然我們是在實施這個總額制度之下還是有蠻多\n\n07:00.049 --> 07:20.531\n大家所擔心不管是從醫界、從民眾或是從政府端會看到一些需要在解決的問題,包括在醫界很擔心如果說我們的點子無法維持好的點子的話,那導致經營的困難,所以很希望透過各方面的努力來保障點子。\n\n07:21.212 --> 07:22.393\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\n07:45.162 --> 07:46.243\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\n08:12.777 --> 08:37.337\n民眾或者是醫療服務端就是醫師相關的這些醫事方面的機構還有政府都必須要共同來針對未來的變化還要再加強這部分我們就麻煩院長跟部長持續來努力當我們期待民眾端就能夠盡量的去讓這個醫療資源的利用可以更為\n\n08:38.558 --> 08:43.963\n我相信政府當然還是要最重要,包括如何能夠加強數據的管理,增加制定預警機制。這部分期待院長能夠持續領導衛福部來加強這方面的努力。\n\n09:02.591 --> 09:22.377\n那當然部長其實也提到了另外一個重點因為我們現在全國是分成六區那這個六區的過程裡面就會有一些區域上的一些問題產生就變成說不同的分區點子公平性的問題會衝擊蠻大的我們可以看到一個數據就是今年第一季\n\n09:24.144 --> 09:51.801\n有關於這個我們的健保分區可以看到臺北分區還有北區還有中區點子就因為可能是COVID以後的一些影響或者是天候的影響造成這個點子非常非常的不理想甚至會低到這個平均點子在0.85以下那這部分不知道院長或部長可以做哪一些的努力或者是來怎麼樣來改變這個\n\n09:54.195 --> 10:10.650\n因為分區造成了一些影響,院長不曉得有沒有想法?謝謝委員有關於金人度算出來的確是有幾個區,它是比較偏低\n\n10:11.689 --> 10:32.519\n尤其是三個區那台北區大概是最嚴重一直都是這樣子那我們也依照去年的一個補值的狀況我們也文健保署也簽了一個補點值的方案那因為那個部分可以動用我們現在去年有200億到那個\n\n10:35.260 --> 10:49.021\n建保安全基金方面我們也簽上去希望能夠讓我們的比較那個低的比較偏低的地區能夠得到按照以前我們大家討論的方式\n\n10:50.851 --> 10:51.491\n二、上午9時至10時為國是論壇時間。\n\n11:07.942 --> 11:23.148\n因為總額的制度它有非常大的不可抗因素變化非常大所以我們只有從分級、審查各方面來著手但是兩個原則就是不能讓醫護人員醫療院所應該所得到的這種點子\n\n11:25.307 --> 11:37.561\n被降低了,降低到不合理,所以我們一定要保證將來在0.9的這個狀況底下一定要往上拉高,沒有達到的我們要靠整個制度的檢討來將它補足。\n\n11:39.028 --> 12:07.631\n那明年我們如果能到朝0.95這個目標來前進這個是我們共同的努力方向那當然我們也知道說除了維持點子以外其實有一些是要優先來處理包括集中南韓還有偏向跟兒童醫療的部分那這部分應該院長跟部長都會同意吧就是說我們在保障點子的同時這其實都有都已經有保障那我們會特別注意到他實際上他的付出\n\n12:08.531 --> 12:30.943\n跟他的酬勞是不是有相對的?這個部分我們一定會再一直密切來注意很多的努力、辛苦應該得到更多的保障這是絕對是大家都說得通的理由過去30年國人受健保的保障、健康我想現在是大家回頭來保障健保制度讓他能夠健全的時代我們應該做共同這樣的努力\n\n12:31.863 --> 12:58.331\n因為專家的意見其實也告訴我們說我們不是在追求保障點子而已其實我們也需要有更多的多元的改革方案來讓我們的健保可以永續那講到這個健保財務多元的微調方案其實包括部分負擔的薪資上入一年來可以看到有非常好的成果那這一部分我們期待未來能夠再根據這個未來有關於部分負擔的差異化的\n\n12:59.241 --> 12:59.821\n二、上午9時至10時為國是論壇時間。\n\n13:16.870 --> 13:41.602\n謝謝,我想分歧醫療是世界的潮流臺灣其實從民國75年的醫療網開始就是在建立一個很好的各地方的分歧醫療到現在但是因為後來醫院實在是一直強大起來所以分歧醫療在推的成果的確是需要再加把勁這當中當然要配合財務的\n\n13:44.673 --> 14:14.217\n一些規劃嘛,包括在健保法的第43條那邊也有一些到各級醫院裡面它的一個部分負擔的一個當然沒有完全去落實到那個法條那我們用這個去年用這樣的一個部分負擔的方式的確是有幫助一點但是我在這邊還是要感謝這個我們的在健康台灣裡面的很多的項目其實我們都希望由基層來做我們也要\n\n14:14.875 --> 14:39.537\n跟全國的民眾講基層的醫師臺灣的基層醫師都是非常優秀的而且都能夠做你全能的照顧他可以從篩檢從你的疾病的篩檢就可以在你最方便的方式到達甚至你的老人家的一個在家照顧安老善終這整個基層醫師系統下可以做很多的事情而且很有品質\n\n14:40.458 --> 14:51.624\n然後如果再配合分級醫療這樣的話我如果全國的民眾能夠都能瞭解這樣的一個方式這樣的一個體系大家來配合我相信我們會變成很有效率的一個醫療體系\n\n14:52.827 --> 15:19.278\n那針對這個健保法的部分的修正包括適度調高補充保費還有提高這個扣稅的上限也希望院長到時候能夠支持是不是來往這邊修法那另外有關於這個商保合作健保的部分我們很期待經過這個國會院經一年的努力討論以後其實也希望能夠有健保協同商保這個第二層政策保險的部分\n\n15:20.908 --> 15:41.255\n目前下禮拜二就會有一個結案報告這個主持人盧教授很希望有機會再跟院長做一個比較全面的相關的報告不知道院長有沒有機會來接受這樣的報告的這種研議的機會好謝謝我們跟衛福都會很審慎來因應這個修法的相關\n\n15:45.604 --> 15:46.605\n主席\n\n","segments":[{"start":25.434,"end":31.378,"text":"謝謝主席。我們有請卓院長及衛福部邱部長。卓院長、邱部長請備選。今天要來請教"},{"start":50.868,"end":51.709,"text":"法定人數不足"},{"start":79.85,"end":102.975,"text":"主決議的內容就是希望在明年的6月30日以前我們這個醫院服務的點值要到達1.095元這樣的一個成效那這一部分不知道目前包括卓院長還有部長努力的成果做了哪一些的努力那進度可不可以再次跟國人做個報告"},{"start":104.312,"end":123.264,"text":"好 謝謝委員大院的主決議對行政院來講都是非常的重視的也是讓我們有一個改革目標的一個衝勁我們希望往這個目標能夠全力的來達成但過程當中經過什麼樣的途徑用什麼樣的時程甚至要用什麼樣的經費預算來達成就要由我們的"},{"start":124.365,"end":143.147,"text":"主管部會來做詳細的規劃那這個怎麼情境我想明年的預算我們已經呈現出一部分往這個目標走的相關的預算那到底他執行的效率如何到明年的6月30號會到達什麼樣的程度我想請衛生部來做一個說明但是很多都是現在的預估"},{"start":145.485,"end":160.155,"text":"謝謝委員 歡迎我想委員是專家我們在過去當然就是都有補點子的機制所以也曾經在112年、113年政府撥補到健保基金240億以及去年的200億那這個都是在COVID以後因為"},{"start":171.96,"end":186.636,"text":"因為那個病人增加增加了很多醫療援手的負擔所以就有補點值讓他到一定的程度我想這個部分是過去的努力我想未來我們也會關心"},{"start":188.052,"end":213.644,"text":"那在114年度在健康台灣願景之下其實有分了三個部分來成長第一個就是由我們的一個藝助健保的一個財務的一個協助方案這個大概有336億那當然另外特別是在那個深耕計畫的一個60億這個是就是您"},{"start":215.925,"end":244.246,"text":"就是您王委員現在提的這個部分如何來留下人才留好的人才在醫療體系怎麼優化他們的工作環境還有整個醫療環境最重要是讓人民的醫療品質得到最提升然後健保能夠永續的一個深耕計畫這個也是創醫療界可以說是臺灣的醫療史裡面第一次非常重要的一個計畫那另外就是"},{"start":245.166,"end":272.486,"text":"行政院也非常支持我們的總額這個部分我想這個部分是大家都很清楚總額過去的成長都很少超過都是4點多比較多今年我們的高推估到達5點多所以在低推估就已經多了大概有可能有300多億那高推估又多了100多億所以在這個部分就可能有多500總額大概可以多到500"},{"start":274.286,"end":289.556,"text":"三十一億加上那個剛剛講的三十六億的那個財務健保財務的一個協助方案裡面有大概一百八十億八十一億是有助於健保的其他都是一種"},{"start":290.546,"end":291.387,"text":"當然這個部分如果要談到點子我們當然強調的"},{"start":316.909,"end":342.552,"text":"更重要是它的怎麼去發揮這個健保的價值,這個部分是我們一直過去所堅持的,當然點子我們也要關心,這個部分也要看,另外也要做好管理,在各區裡面我們都有自治性的管理,那像台北區在過去基層真的是比較弱一點,那這個部分都是因為有"},{"start":343.615,"end":372.041,"text":"有過去傳統歷史的因素那這個部分我想全國的醫界也都會很共體時間會做一個處理讓各區能夠平衡我想大家醫療院所很感佩我們行政院在這一次可以說是有史以來給最多的幫忙都很感動所以很多醫界的同仁也跟我們講我們一定也要自我來努力跟他共同來朝向一個更好的一個"},{"start":372.601,"end":377.625,"text":"的確院長早上的報告讓我們知道在明年的總額實質上會增加712億希望能夠達標至少一點可以維持0.95元"},{"start":395.758,"end":419.209,"text":"臺灣的健保制度一直受到全球的推崇,對於民眾的這些不管在疾病或各方面的保障都非常的令我們的民眾可以非常安心,也可以達到一個我們希望讓民眾不要因病而窮這樣的一個目標。當然我們是在實施這個總額制度之下還是有蠻多"},{"start":420.049,"end":440.531,"text":"大家所擔心不管是從醫界、從民眾或是從政府端會看到一些需要在解決的問題,包括在醫界很擔心如果說我們的點子無法維持好的點子的話,那導致經營的困難,所以很希望透過各方面的努力來保障點子。"},{"start":441.212,"end":442.393,"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":465.162,"end":466.243,"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":492.777,"end":517.337,"text":"民眾或者是醫療服務端就是醫師相關的這些醫事方面的機構還有政府都必須要共同來針對未來的變化還要再加強這部分我們就麻煩院長跟部長持續來努力當我們期待民眾端就能夠盡量的去讓這個醫療資源的利用可以更為"},{"start":518.558,"end":523.963,"text":"我相信政府當然還是要最重要,包括如何能夠加強數據的管理,增加制定預警機制。這部分期待院長能夠持續領導衛福部來加強這方面的努力。"},{"start":542.591,"end":562.377,"text":"那當然部長其實也提到了另外一個重點因為我們現在全國是分成六區那這個六區的過程裡面就會有一些區域上的一些問題產生就變成說不同的分區點子公平性的問題會衝擊蠻大的我們可以看到一個數據就是今年第一季"},{"start":564.144,"end":591.801,"text":"有關於這個我們的健保分區可以看到臺北分區還有北區還有中區點子就因為可能是COVID以後的一些影響或者是天候的影響造成這個點子非常非常的不理想甚至會低到這個平均點子在0.85以下那這部分不知道院長或部長可以做哪一些的努力或者是來怎麼樣來改變這個"},{"start":594.195,"end":610.65,"text":"因為分區造成了一些影響,院長不曉得有沒有想法?謝謝委員有關於金人度算出來的確是有幾個區,它是比較偏低"},{"start":611.689,"end":632.519,"text":"尤其是三個區那台北區大概是最嚴重一直都是這樣子那我們也依照去年的一個補值的狀況我們也文健保署也簽了一個補點值的方案那因為那個部分可以動用我們現在去年有200億到那個"},{"start":635.26,"end":649.021,"text":"建保安全基金方面我們也簽上去希望能夠讓我們的比較那個低的比較偏低的地區能夠得到按照以前我們大家討論的方式"},{"start":650.851,"end":651.491,"text":"二、上午9時至10時為國是論壇時間。"},{"start":667.942,"end":683.148,"text":"因為總額的制度它有非常大的不可抗因素變化非常大所以我們只有從分級、審查各方面來著手但是兩個原則就是不能讓醫護人員醫療院所應該所得到的這種點子"},{"start":685.307,"end":697.561,"text":"被降低了,降低到不合理,所以我們一定要保證將來在0.9的這個狀況底下一定要往上拉高,沒有達到的我們要靠整個制度的檢討來將它補足。"},{"start":699.028,"end":727.631,"text":"那明年我們如果能到朝0.95這個目標來前進這個是我們共同的努力方向那當然我們也知道說除了維持點子以外其實有一些是要優先來處理包括集中南韓還有偏向跟兒童醫療的部分那這部分應該院長跟部長都會同意吧就是說我們在保障點子的同時這其實都有都已經有保障那我們會特別注意到他實際上他的付出"},{"start":728.531,"end":750.943,"text":"跟他的酬勞是不是有相對的?這個部分我們一定會再一直密切來注意很多的努力、辛苦應該得到更多的保障這是絕對是大家都說得通的理由過去30年國人受健保的保障、健康我想現在是大家回頭來保障健保制度讓他能夠健全的時代我們應該做共同這樣的努力"},{"start":751.863,"end":778.331,"text":"因為專家的意見其實也告訴我們說我們不是在追求保障點子而已其實我們也需要有更多的多元的改革方案來讓我們的健保可以永續那講到這個健保財務多元的微調方案其實包括部分負擔的薪資上入一年來可以看到有非常好的成果那這一部分我們期待未來能夠再根據這個未來有關於部分負擔的差異化的"},{"start":779.241,"end":779.821,"text":"二、上午9時至10時為國是論壇時間。"},{"start":796.87,"end":821.602,"text":"謝謝,我想分歧醫療是世界的潮流臺灣其實從民國75年的醫療網開始就是在建立一個很好的各地方的分歧醫療到現在但是因為後來醫院實在是一直強大起來所以分歧醫療在推的成果的確是需要再加把勁這當中當然要配合財務的"},{"start":824.673,"end":854.217,"text":"一些規劃嘛,包括在健保法的第43條那邊也有一些到各級醫院裡面它的一個部分負擔的一個當然沒有完全去落實到那個法條那我們用這個去年用這樣的一個部分負擔的方式的確是有幫助一點但是我在這邊還是要感謝這個我們的在健康台灣裡面的很多的項目其實我們都希望由基層來做我們也要"},{"start":854.875,"end":879.537,"text":"跟全國的民眾講基層的醫師臺灣的基層醫師都是非常優秀的而且都能夠做你全能的照顧他可以從篩檢從你的疾病的篩檢就可以在你最方便的方式到達甚至你的老人家的一個在家照顧安老善終這整個基層醫師系統下可以做很多的事情而且很有品質"},{"start":880.458,"end":891.624,"text":"然後如果再配合分級醫療這樣的話我如果全國的民眾能夠都能瞭解這樣的一個方式這樣的一個體系大家來配合我相信我們會變成很有效率的一個醫療體系"},{"start":892.827,"end":919.278,"text":"那針對這個健保法的部分的修正包括適度調高補充保費還有提高這個扣稅的上限也希望院長到時候能夠支持是不是來往這邊修法那另外有關於這個商保合作健保的部分我們很期待經過這個國會院經一年的努力討論以後其實也希望能夠有健保協同商保這個第二層政策保險的部分"},{"start":920.908,"end":941.255,"text":"目前下禮拜二就會有一個結案報告這個主持人盧教授很希望有機會再跟院長做一個比較全面的相關的報告不知道院長有沒有機會來接受這樣的報告的這種研議的機會好謝謝我們跟衛福都會很審慎來因應這個修法的相關"},{"start":945.604,"end":946.605,"text":"主席"}]}}},"gazette":{"lineno":803,"blocks":[["王委員正旭：（17時25分）謝謝主席，我們有請卓院長，還有衛福部邱部長。"],["主席：卓院長、邱部長請備詢。"],["卓院長榮泰：王委員好。"],["王委員正旭：院長好。"],["邱部長泰源：委員好。"],["王委員正旭：邱部長好。今天要來請教院長跟部長有關於健保點值的問題，因為大家都非常關心，尤其醫界特別關心點值的問題。事實上，在今年的7月16號，立法院通過了一個主決議，這個主決議的內容就是希望在明年的6月30號以前，我們醫院服務的點值要到達一點0.95元這樣的一個成效。目前這一部分，不知道卓院長還有部長努力的成果，有做了哪一些的努力？進度可不可以再次跟國人做個報告？"],["卓院長榮泰：好，謝謝委員。大院的主決議，對行政院來講都是非常重視的，也是讓我們有改革目標的一個衝勁，我們希望往這個目標，能夠全力的來達成，但過程經過什麼樣的途徑、用什麼樣的時程，甚至要用什麼樣的經費預算來達成，就要由我們相關主管部會來做詳細的規劃。這個是怎麼樣的情境？我想明年的預算，我們已經呈現出一部分往這個目標走的相關的預算，至於到底執行效率如何，到明年的6月30號會到達什麼樣的程度，我想請衛福部來做一個說明，但是很多都是現在的預估啦！"],["邱部長泰源：好，謝謝院長，謝謝委員關心。委員是專家，我們在過去當然都有補點值的機制，所以也曾經在112年由政府撥補到健保基金240億，以及（去）113年撥補200億，這個都是在COVID-19以後因為病人增加，增加了很多醫療院所的負擔，所以就有補點值讓它到一定的程度，這個部分是過去的努力，未來我們也會關心。114年度在健康臺灣願景之下，其實有分為三個部分在成長，第一個我們有挹注健保財務的一個協助方案，這個大概有336億，另外，特別是在深耕計畫的有一個60億，這一個就是王委員現在提的這個部分，如何留下人才，留好的人才在醫療體系，怎麼優化他們的工作環境，還有整個醫療環境，最重要是讓人民的醫療品質得到提升，然後健保能夠永續的一個深耕計畫，這個也是創醫療界，可以說是臺灣醫療史裡面第一次非常重要的一個計畫。","另外，行政院也非常支持我們總額這個部分，我想大家都很清楚，總額過去的成長都很少超過……都是四點多比較多，今年我們的高推估到達五點多，所以在低推估就已經多了大概可能有三百多億，而高推估又多了一百多億，所以在這個部分，總額就大概可以多到531億。加上剛剛講的336億健保財務的協助方案裡面，大概181億是有助於健保的，其他很多都是健康臺灣的努力，讓我們醫療院所的同仁更能夠為人民來做更多的事情，這部分我們不把它加入在這個健保裡面。所以181億加530億，明年單單健保的總額，大概就可以增加712億，當然這部分如果要談到點值，更重要是強調它怎麼去發揮健保的價值，這是我們醫界過去所堅持的，點值我們也要關心，這部分也要做好管理，在各區都有自主性的管理。在過去，臺北區的基層真的是比較弱一點，這都是因為過去傳統歷史的因素，我想全國的醫界也都會很共體時艱，會做相關的處理，讓各區能夠平衡。醫療院所也很感佩，行政院在這一次可以說是有史以來給最多的幫忙，都很感動，所以很多醫界的同仁跟我們講，我們一定也要自我努力，共同朝向一個更好的健保點值目標，能夠真的優化醫療環境，讓健保永續，我們會來努力。"],["王委員正旭：是，的確院長早上的報告讓我們知道，明年總額實質上會增加712億，希望能夠達標，至少1點可以維持0.95元，我們也知道臺灣的健保制度一直受到全球的推崇，對於民眾的疾病和各方面的保障都非常令民眾安心，也可以達到我們希望民眾不要因病而窮這樣的目標。當然，在實施總額制度之下還是有滿多大家所擔心的事，不管是從醫界、從民眾或是從政府端會看到一些需要解決的問題，包括醫界很擔心的，如果無法維持好的點值，可能導致經營困難，所以很希望透過各方面的努力來保障點值，希望有更好的營運，包括照顧民眾健康可以有更好的量能，不管是研究或者是服務，還是教育，都能夠達到好的量能。","可是民眾也會擔心，會不會因為點值變化導致保費會因為這樣的變化而需要增加，當然這個重責大任就需要由政府來承擔，我相信依照剛剛院長跟部長所陳述的，我們對於明年的點值應該有一定的信心，不知道這樣的狀況……如果明年有這樣的信心，總額制度還有沒有什麼其他的變革，這可能是大家要共同來努力的。","我們也知道，其實不管是民眾或者是醫療服務端，也就是相關的醫事機構還有政府都必須共同針對未來的變化再做加強，這部分我們就麻煩院長跟部長持續努力。當然，我們期待民眾端能夠儘量讓醫療資源的利用更為依照民眾的需求處理；對於醫療服務提供者，我們也期待能夠有一些好的同儕管理，避免造成太多的影響。我相信政府端還是最重要，包括如何加強數據的管理、增加制定預警機制，這部分期待院長能夠持續領導衛福部來加強這方面的努力。","剛剛部長其實也提到另外一個重點，因為我們現在全國是分成6區，這6區裡面就會有一些區域上的問題產生，變成不同分區的點值公平性問題會衝擊滿大的，我們可以看到今年第一季的數據，我們的健保分區可以看到臺北分區，還有北區、中區的點值，可能因為COVID以後的影響，或者是天候的影響，造成點值非常非常的不理想，甚至低到平均點值在0.85以下，這部分不知道院長或部長可以做哪一些努力？或者怎麼樣來改變因為分區所造成的影響？這部分院長不曉得有沒有想法？"],["邱部長泰源：好，謝謝委員，有關於今年度算出來的資料，的確有幾個區是比較偏低，尤其是三個區，臺北區大概是最嚴重的，一直都是這樣子，我們也依照去年補付的狀況，健保署也簽了一個補點值的方案，因為那個部分去年可以動用200億，就是到健保安全基金，我們也簽上去了，希望能夠讓我們比較偏低的地區，按照以前我們大家討論的一個方式，希望行政院能來裁示……"],["卓院長榮泰：還是要找出像臺北區、北區或是東區的偏低是什麼原因造成的，我想衛福部要去注意，甚至做有效的輔導、管理，從各方面的條件來著手，因為總額的制度下，它有非常大的不可抗因素，變化非常大，所以我們只有從分級、實質審查各方面來著手，但是兩個原則，就是不能讓醫護人員、醫療院所應該得到的點值被降低了，甚至降低到不合理，所以我們一定要保證，將來在1點0.9元的狀況底下，一定要往上拉高，若沒有達到，我們要靠整個制度的檢討來將它補足，明年我們朝0.95元這個目標前進，這是我們共同的努力方向。"],["王委員正旭：好。當然我們也知道，除了維持點值以外，其實有一些是要優先來處理的，包括急、重、難、罕，還有偏鄉跟兒童醫療的部分，這部分院長跟部長應該都會同意吧？就是我們在保障點值的同時……"],["邱部長泰源：其實都已經有保障了，我們會再特別注意到實際上他的付出跟他的酬勞是不是有相對的，這個部分我們一定會一直密切來注意。"],["卓院長榮泰：更多的努力、辛苦應該得到更多的保障，這絕對是大家都說得通的理由。過去30年國人的健康受健保的保障，我想現在是大家回頭來保障健保制度，讓它能夠健全的時代了，我們應該共同做這樣的努力。"],["王委員正旭：好，因為專家的意見其實也告訴我們，我們不是在追求保障點值而已，其實我們也需要有更多元的改革方案，來讓我們的健保可以永續。","談到健保財務多元的微調方案，其實包括部分負擔新制上路一年以來，可以看到非常好的成果，這部分我們期待未來能夠再根據有關於部分負擔差異化的地方，可不可以有更好的研議，因為依照國外的經驗，是可以透過不管是診療，或者是所得設計的差異化等部分來做一些研議的可能性，不知道院長或部長對於這方面是不是也有一些相關的想法？"],["邱部長泰源：謝謝。我想分級醫療是世界的潮流，臺灣其實從民國75年的醫療網開始，就是在建立一個很好的、各地方的分級醫療，然後一直到現在，但是因為後來醫院實在是一直強大起來，所以分級醫療在推動的成果，的確是需要再加把勁。這當中當然要配合一些財務的規劃，包括在健保法第四十三條，也有各級醫院裡面有一些在部分負擔的部分沒有完全落實到那個法條……"],["王委員正旭：我們就繼續往那個方向努力。"],["邱部長泰源：去年用這樣一個部分負擔的方式，的確是有幫助一點，但是我在這邊還是要感謝在健康臺灣裡面很多的項目，其實我們都希望由基層來做，我們也要跟全國的民眾講，臺灣的基層醫師都是非常優秀的，而且都能夠做全人的照顧，他可以從你的疾病篩檢，就會以你最方便的方式來處理，甚至是老人家的在家照顧、安老善終，這整個來說，其實基層醫師就可以做很多事情，而且很有品質，如果再配合分級醫療，這樣的話，如果全國民眾都能夠了解這樣的一個方式、這樣的一個體系，然後大家都來配合，我相信我們會變成一個很有效率的醫療體系。"],["王委員正旭：針對健保法部分的修正，包括適度調高補充保費，還有提高扣稅的上限，也希望院長到時候能夠支持，是不是能夠往這邊來修法。另外，有關於商保合作健保的部分，我們也很期待，經過國衛院近一年的努力討論以後，其實也希望能有健保協同商保的第二層政策保險，目前預計下禮拜二就會有結案報告。主持人盧教授很希望有機會再跟院長做一個比較全面且相關的報告，不知道院長有沒有機會來接受這樣的報告與研議？"],["卓院長榮泰：好，謝謝委員，我們跟衛福部都會很審慎來因應與修法相關的討論，如果有很好的意見，也請委員引薦，謝謝。"],["王委員正旭：跨部會議題包括其他三個部分，另外再找時間跟院長請教。"],["卓院長榮泰：謝謝委員。"],["主席：謝謝王委員，謝謝卓院長。","下一位請鄭天財委員質詢。"]],"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"}}}