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\"謝\"}, {\"word\": \"謝\"}, {\"word\": \"翁\", \"start\": 685.094, \"end\": 685.214, \"score\": 0.86}, {\"word\": \"委\", \"start\": 685.214, \"end\": 685.354, \"score\": 0.827}, {\"word\": \"員\"}, {\"word\": \"的\", \"start\": 685.354, \"end\": 685.454, \"score\": 0.997}, {\"word\": \"宣\", \"start\": 685.454, \"end\": 685.654, \"score\": 0.901}, {\"word\": \"導\"}, {\"word\": \"也\", \"start\": 685.654, \"end\": 686.415, \"score\": 0.96}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"部\", \"start\": 686.415, \"end\": 686.435, \"score\": 0.017}, {\"word\": \"長\"}], \"language\": \"zh\"}","srt":"1\n00:00:02,825 --> 00:00:07,010\n那我們委員會這邊公告蘇清泉、趙偉宣達結束休息10分鐘謝謝好謝謝趙偉我們是不是有請邱部長來請部長委員長\n\n2\n00:00:18,732 --> 00:00:20,033\n部長好部長我想剛剛很多人都提到了現在我們醫療現場急重症這個人力不足的問題那再加上從昨天到今天陸續有急診科的醫師他去提到說這個\n\n3\n00:00:37,964 --> 00:00:52,846\n急診科醫師想要離開沒有表態的離職人數我看到這個數字有點嚇到上看120人我不曉得這位醫師講的是真實的還是是他有推估比較多如果是這樣一個數據的話\n\n4\n00:00:54,528 --> 00:01:15,290\n那我覺得面對未來還有新冠疫情的升溫這是讓人家會非常擔心的就是可能連急診的第一現場要去救治病患這個人手都嚴重的不足第二個是重症的部分剛剛也這個陳俊輝醫師有提到這個新聞也引發大家的關注就是\n\n5\n00:01:16,151 --> 00:01:20,173\n這位長庚醫院的這位醫師他發出的這個訊息簡訊我覺得是一個求救的訊息就是他在現場他可能已經看到這樣的狀況的惡化如果再不告訴醫院的高層跟政府的高層\n\n6\n00:01:35,678 --> 00:01:51,930\n他認為這樣的一個醫療的崩壞真的是我想他站在現場第一位真的是非常的擔心所以我個人會覺得這樣的簡訊是是一種求救性就覺得現場的狀況真的很糟了那我就要問一下部長你們有沒有實際\n\n7\n00:01:53,451 --> 00:02:16,866\n去了解去關心或者去找這些疾重症的醫師們真的坐下來稍微焦點團體一下他們現在最最需要政府伸出援手的到底是什麼看了讓人家很心疼啊就是感覺他們是願意蹭在第一線的但是感覺快要倒下了然後希望說是不是趕快有人可以來協助他們我看到這樣的訊息是有這樣子的一個感受\n\n8\n00:02:22,910 --> 00:02:30,655\n那我現在要問的就是說作為中央部會主管機關到底衛福部在緊急當然分階段剛剛部長你有說有一些是長期根本的問題但是現況就已經很糟了那現在這麼糟怎麼樣去穩住他們然後讓這個醫療現場不要有更多的這個醫師離開我覺得這個是我們處理事情分階段這個是第一要務可能要做的請問衛福部可以做什麼他們已經發出這樣一個訊息請問衛福部可以做什麼\n\n9\n00:02:52,182 --> 00:03:17,290\n好謝謝委員的詢問我想分幾個來報告第一個急診方面有建議在過年那段期間的游泳賽我們除了對護理方面的盡量來給他照顧鼓勵改善以外當然相對的對醫師也會好因為整個是團隊的事情在這個部分也有提高給付第二個我們也希望能夠分級醫療減少\n\n10\n00:03:19,806 --> 00:03:26,774\n減少那個急診醫師的部分輕重那個急診醫師是這樣子我們一年大概像113年的急診醫師是102個通過那112年在前年是109個大概都100出頭那當然我們我剛剛有報告過\n\n11\n00:03:38,737 --> 00:03:57,865\n有些醫院可能離開的比較嚴重有些醫院像台大我剛剛只有一個退休其他目前是還沒有動那我想問的就是說比較嚴重的你們有沒有特別去觀察我想我們如果以這種訊息出來我們當然想要來瞭解整個很快來瞭解急重症我們這兩天在討論部隊在討論就一直說要去注意到各個科裡面的一個\n\n12\n00:04:06,188 --> 00:04:26,674\n現在的流線我懂但是急診是第一線他講120人我覺得這個數據你覺得有高估嗎現場是不是大概是這樣子因為120人上百位要離職他說沒表才想離職有這麼高這個上百位其實對第一線現場我覺得是一個很大的衝擊因為說實在的啦長這段這些年來的確我們當醫師也很辛苦\n\n13\n00:04:33,324 --> 00:04:50,033\n像我一輩子在醫院打扮我也買不到一間房子台北市還在貸款所以你就知道說年輕的醫師是不是更加的困難所以他們當然會牽涉我這個改變就牽涉到你的各種給付、工作環境這個是長久以來累積的一個很大的當然我們很感佩\n\n14\n00:05:01,039 --> 00:05:15,891\n立法院這一屆的委員真的都很用心在幫忙解決這個問題我們的政府真的也是日夜在解決這個問題醫療方面被立法院全力支持以我當一個醫學院教授這麼多年我總是希望我的學生出來\n\n15\n00:05:16,832 --> 00:05:44,509\n能夠好我做不能給他遭避不然我就死了對啊所以那個環境很重要嘛可能就不是去做他的專科了所以部長因為我還有下一個要問的如果能夠跑到蘇昭偉那邊去服務還可以得到很好的奮鬥環境因為現在現場無論是急診或是重症他們都已經發出這樣的求救訊息那我覺得作為中央主管機關你們有責任要提出方案\n\n16\n00:05:45,109 --> 00:05:59,610\n到底怎麼去解決跟改善那這個部分我覺得你們應該要去回應就是基層的問題我們知道長期來問題我們知道但是眼下是這樣一個問題因為接下來我就要問新冠的高峰\n\n17\n00:06:00,965 --> 00:06:16,391\n還要面對這樣的挑戰如果前面的急診量能都不足了醫師要離開那過去的新冠疫情我們已經看到了急診現場亂成一團全部擁捨到那邊去恐怕是雪上加霜啊\n\n18\n00:06:17,071 --> 00:06:39,591\n所以我們應該要看一下這個部分你如果沒有解決未來這一些在增加新的疫情的人進到急診來那這個真的是會很可怕的一件事情所以我這邊希望你們針對之前的就是在新冠疫情高峰的時候所有的這個配套方案你們要超前部署是的我們有超前部署\n\n19\n00:06:40,532 --> 00:06:52,055\n那接下來我要問的是今天這個委員會要審的有關於整個健保資料庫的這個管理怎麼去加強它的監督管理因為之前的外洩事件的確對於個人來講這個是一個個資被倒賣那我想這個是一個很嚴重的這個侵害\n\n20\n00:07:00,857 --> 00:07:16,810\n那在這樣的一個情況底下你們這一次的修法就是你們好像是就用退出權而不是同意權這樣的概念也就是說我的健保資料要不要要不要提供學術研究是我要去申請退出\n\n21\n00:07:18,106 --> 00:07:40,527\n然後它才不會在上面而不是像金融機構說我可不可以應用你的資料它是問你的同意為什麼是這樣的差別因為現在也有民間團體說那為什麼是我要記得去講的時候我的資料才不會被應用就是一下子好像政府就幫我做決定你只要在我資料庫裡面呢我就是通通都可以用那我就問你像這些未成年人的資料\n\n22\n00:07:41,167 --> 00:08:02,679\n他自己可能也沒有敏感這個議題他也不會去退出啊那他的資料就是大批的從0到18歲通通都是政府使用那有一些年紀比較大的這些老人他可能不太知道這件事啊所以他的資料就整個在資料庫裡面就是沒有經過同意情況底下只是因為他沒有退出所以就被大量的使用我不知道你們有沒有思考過這個問題\n\n23\n00:08:03,840 --> 00:08:18,119\n因為當民間團體這樣子質疑的時候這的確是一個我們在如果同時要保護各自的話不是應該是他同意的情況底下使用嗎那你們現在是說你退出我就不用這有沒有有點便宜形式啊\n\n24\n00:08:19,161 --> 00:08:46,869\n好我想同意不同意這件事情等一下再請那個負責健保的主管來報告那我先跟兩件事情報告第一件事情就是資安系統我們被攻擊了以後我們衛福部立即啟動各種防衛的機制現在應該都攻不進去了醫院方面啦不是健保局裡面健保署裡面那健保署裡面的資料早就這些年來可能有十幾年了吧\n\n25\n00:08:47,609 --> 00:09:05,018\n是非常的嚴格一定要到一個房間然後你什麼都不能帶喔那有人幫你輔導你要的資料就跑完跑完之後拿出結果完全都氣勢白話所以這個部分其實在個資方面是絕對沒有問題我想請署長也可以再confirm一下\n\n26\n00:09:05,598 --> 00:09:33,326\n跟委員報告我們採取這個所謂的這個退出權的行使主要是第一個我們這個資料的使用有相當的限縮他是以公益目的使用第二個資料都在特定的空間裡面那麼經過去識別化之後的資料來跑所以理論上他已經這個相當的安全那麼使用的時候已經很安全再者呢也不可以有資料的吸出\n\n27\n00:09:33,786 --> 00:09:43,693\n最後只拿出的是統計的結果所以在安全性還有各自的保護上已經達到最高的程度保護是一回事那我是在問說為什麼不是取得個人的同意權而是用退出權\n\n28\n00:09:49,036 --> 00:10:09,514\n其實所有的資料的使用它也是按照它的程度的不同有所謂的OPINOPOUT就是說事前告知同意或者是事後退出都可以就是假設同意事後退出或事前同意那麼事後退出或事前同意這有三種的不同的方式那我們這個資料因為已經這個\n\n29\n00:10:12,196 --> 00:10:37,525\n基本上都已經是經過去各自的方式去處理過所以我們採用的是用那個假設同意事後退出然後經過專法的管理我想這個問題我們還會回到主條的討論但是我也希望主管機關去思考就是說運用他的這些資料然後如果是他同意就是作為研究使用在這個\n\n30\n00:10:39,005 --> 00:10:55,550\n民眾他有同意的情況底下我想你們使用起來是更放心但是我們現在模式是有點覺得說我既然都已經去識別化了然後我也保護的很安全所以不用經過你的同意這個你沒有反對再出聲這樣子會變成是有點倒過來這個跟現在就是我們有個資法之後的這個潮流坦白講他不是一致性很高的就是說你看連金融機構他們現在都被要求說要勾很多的同意書\n\n31\n00:11:08,763 --> 00:11:26,435\n他才可以這樣子所以我希望這個問題呢你們也好好思考在相關修法的時候我有相關的修正動作大家在討論好我們希望這個條例能夠創造三贏的局面是是好謝謝委員好謝謝翁委員的宣導也謝謝部長\n\n","tsv":"start\tend\ttext\n2825\t7010\t那我們委員會這邊公告蘇清泉、趙偉宣達結束休息10分鐘謝謝好謝謝趙偉我們是不是有請邱部長來請部長委員長\n18732\t20033\t部長好部長我想剛剛很多人都提到了現在我們醫療現場急重症這個人力不足的問題那再加上從昨天到今天陸續有急診科的醫師他去提到說這個\n37964\t52846\t急診科醫師想要離開沒有表態的離職人數 我看到這個數字有點嚇到上看120人 我不曉得這位醫師講的是真實的還是是他有推估比較多 如果是這樣一個數據的話\n54528\t75290\t那我覺得面對未來還有新冠疫情的升溫這是讓人家會非常擔心的就是可能連急診的第一現場要去救治病患這個人手都嚴重的不足第二個是重症的部分剛剛也這個陳俊輝醫師有提到這個新聞也引發大家的關注就是\n76151\t80173\t這位長庚醫院的這位醫師他發出的這個訊息簡訊我覺得是一個求救的訊息就是他在現場他可能已經看到這樣的狀況的惡化如果再不告訴醫院的高層跟政府的高層\n95678\t111930\t他認為這樣的一個醫療的崩壞真的是我想他站在現場第一位真的是非常的擔心所以我個人會覺得這樣的簡訊是是一種求救性就覺得現場的狀況真的很糟了那我就要問一下部長你們有沒有實際\n113451\t136866\t去了解 去關心或者去找這些疾重症的醫師們真的坐下來稍微焦點團體一下他們現在最最需要政府伸出援手的到底是什麼看了讓人家很心疼啊就是感覺他們是願意蹭在第一線的但是感覺快要倒下了然後希望說是不是趕快有人可以來協助他們我看到這樣的訊息是有這樣子的一個感受\n142910\t150655\t那我現在要問的就是說作為中央部會主管機關到底衛福部在緊急當然分階段剛剛部長你有說有一些是長期根本的問題但是現況就已經很糟了那現在這麼糟怎麼樣去穩住他們然後讓這個醫療現場不要有更多的這個醫師離開我覺得這個是我們處理事情分階段這個是第一要務可能要做的請問衛福部可以做什麼他們已經發出這樣一個訊息請問衛福部可以做什麼\n172182\t197290\t好謝謝委員的詢問我想分幾個來報告第一個急診方面有建議在過年那段期間的游泳賽我們除了對護理方面的盡量來給他照顧鼓勵改善以外當然相對的對醫師也會好因為整個是團隊的事情在這個部分也有提高給付第二個我們也希望能夠分級醫療減少\n199806\t206774\t減少那個急診醫師的部分輕重那個急診醫師是這樣子我們一年大概像113年的急診醫師是102個通過那112年在前年是109個大概都100出頭那當然我們我剛剛有報告過\n218737\t237865\t有些醫院可能離開的比較嚴重有些醫院像台大我剛剛只有一個退休其他目前是還沒有動那我想問的就是說比較嚴重的你們有沒有特別去觀察我想我們如果以這種訊息出來我們當然想要來瞭解整個很快來瞭解急重症我們這兩天在討論部隊在討論就一直說要去注意到各個科裡面的一個\n246188\t266674\t現在的流線 我懂 但是急診是第一線他講120人 我覺得這個數據 你覺得有高估嗎現場是不是大概是這樣子因為120人 上百位要離職他說沒表 才想離職有這麼高 這個上百位其實對第一線現場 我覺得是一個很大的衝擊因為說實在的啦 長這段這些年來的確我們當醫師也很辛苦\n273324\t290033\t像我一輩子在醫院打扮我也買不到一間房子台北市還在貸款所以你就知道說年輕的醫師是不是更加的困難所以他們當然會牽涉我這個改變就牽涉到你的各種給付、工作環境這個是長久以來累積的一個很大的當然我們很感佩\n301039\t315891\t立法院這一屆的委員真的都很用心在幫忙解決這個問題我們的政府真的也是日夜在解決這個問題醫療方面被立法院全力支持以我當一個醫學院教授這麼多年我總是希望我的學生出來\n316832\t344509\t能夠好我做 不能給他遭避 不然我就死了對啊 所以那個環境很重要嘛可能就不是去做他的專科了所以部長 因為我還有下一個要問的如果能夠跑到蘇昭偉那邊去服務還可以得到很好的奮鬥環境因為現在現場無論是急診或是重症他們都已經發出這樣的求救訊息那我覺得作為中央主管機關你們有責任要提出方案\n345109\t359610\t到底怎麼去解決跟改善那這個部分我覺得你們應該要去回應就是基層的問題我們知道長期來問題我們知道但是眼下是這樣一個問題因為接下來我就要問新冠的高峰\n360965\t376391\t還要面對這樣的挑戰如果前面的急診量能都不足了醫師要離開那過去的新冠疫情我們已經看到了急診現場亂成一團全部擁捨到那邊去恐怕是雪上加霜啊\n377071\t399591\t所以我們應該要看一下這個部分你如果沒有解決未來這一些在增加新的疫情的人進到急診來那這個真的是會很可怕的一件事情所以我這邊希望你們針對之前的就是在新冠疫情高峰的時候所有的這個配套方案你們要超前部署是的我們有超前部署\n400532\t412055\t那接下來我要問的是今天這個委員會要審的有關於整個健保資料庫的這個管理怎麼去加強它的監督管理因為之前的外洩事件的確對於個人來講這個是一個個資被倒賣那我想這個是一個很嚴重的這個侵害\n420857\t436810\t那在這樣的一個情況底下你們這一次的修法就是你們好像是就用退出權而不是同意權這樣的概念也就是說我的健保資料要不要要不要提供學術研究是我要去申請退出\n438106\t460527\t然後它才不會在上面而不是像金融機構說我可不可以應用你的資料它是問你的同意為什麼是這樣的差別因為現在也有民間團體說那為什麼是我要記得去講的時候我的資料才不會被應用就是一下子好像政府就幫我做決定你只要在我資料庫裡面呢我就是通通都可以用那我就問你像這些未成年人的資料\n461167\t482679\t他自己可能也沒有敏感這個議題他也不會去退出啊那他的資料就是大批的從0到18歲通通都是政府使用那有一些年紀比較大的這些老人他可能不太知道這件事啊所以他的資料就整個在資料庫裡面就是沒有經過同意情況底下只是因為他沒有退出所以就被大量的使用我不知道你們有沒有思考過這個問題\n483840\t498119\t因為當民間團體這樣子質疑的時候這的確是一個我們在如果同時要保護各自的話不是應該是他同意的情況底下使用嗎那你們現在是說你退出我就不用這有沒有有點便宜形式啊\n499161\t526869\t好 我想同意不同意這件事情 等一下再請那個負責健保的主管來報告那我先跟兩件事情報告 第一件事情就是資安系統我們被攻擊了以後 我們衛福部立即啟動各種防衛的機制 現在應該都攻不進去了醫院方面啦 不是健保局裡面 健保署裡面那健保署裡面的資料早就 這些年來 可能有十幾年了吧\n527609\t545018\t是非常的嚴格一定要到一個房間然後你什麼都不能帶喔那有人幫你輔導你要的資料就跑完跑完之後拿出結果完全都氣勢白話所以這個部分其實在個資方面是絕對沒有問題我想請署長也可以再confirm一下\n545598\t573326\t跟委員報告我們採取這個所謂的這個退出權的行使主要是第一個我們這個資料的使用有相當的限縮他是以公益目的使用第二個資料都在特定的空間裡面那麼經過去識別化之後的資料來跑所以理論上他已經這個相當的安全那麼使用的時候已經很安全再者呢也不可以有資料的吸出\n573786\t583693\t最後只拿出的是統計的結果所以在安全性還有各自的保護上已經達到最高的程度保護是一回事那我是在問說為什麼不是取得個人的同意權而是用退出權\n589036\t609514\t其實所有的資料的使用它也是按照它的程度的不同有所謂的OP IN OP OUT就是說事前告知同意或者是事後退出都可以就是假設同意事後退出或事前同意那麼事後退出或事前同意這有三種的不同的方式那我們這個資料因為已經這個\n612196\t637525\t基本上都已經是經過去各自的方式去處理過所以我們採用的是用那個假設同意事後退出然後經過專法的管理我想這個問題我們還會回到主條的討論但是我也希望主管機關去思考就是說運用他的這些資料然後如果是他同意就是作為研究使用在這個\n639005\t655550\t民眾他有同意的情況底下我想你們使用起來是更放心但是我們現在模式是有點覺得說我既然都已經去識別化了然後我也保護的很安全所以不用經過你的同意這個你沒有反對再出聲這樣子會變成是有點倒過來這個跟現在就是我們有個資法之後的這個潮流坦白講他不是一致性很高的就是說你看連金融機構他們現在都被要求說要勾很多的同意書\n668763\t686435\t他才可以這樣子所以我希望這個問題呢你們也好好思考在相關修法的時候我有相關的修正動作大家在討論好我們希望這個條例能夠創造三贏的局面是是好謝謝委員好謝謝翁委員的宣導也謝謝部長\n","txt":"那我們委員會這邊公告蘇清泉、趙偉宣達結束休息10分鐘謝謝好謝謝趙偉我們是不是有請邱部長來請部長委員長\n部長好部長我想剛剛很多人都提到了現在我們醫療現場急重症這個人力不足的問題那再加上從昨天到今天陸續有急診科的醫師他去提到說這個\n急診科醫師想要離開沒有表態的離職人數 我看到這個數字有點嚇到上看120人 我不曉得這位醫師講的是真實的還是是他有推估比較多 如果是這樣一個數據的話\n那我覺得面對未來還有新冠疫情的升溫這是讓人家會非常擔心的就是可能連急診的第一現場要去救治病患這個人手都嚴重的不足第二個是重症的部分剛剛也這個陳俊輝醫師有提到這個新聞也引發大家的關注就是\n這位長庚醫院的這位醫師他發出的這個訊息簡訊我覺得是一個求救的訊息就是他在現場他可能已經看到這樣的狀況的惡化如果再不告訴醫院的高層跟政府的高層\n他認為這樣的一個醫療的崩壞真的是我想他站在現場第一位真的是非常的擔心所以我個人會覺得這樣的簡訊是是一種求救性就覺得現場的狀況真的很糟了那我就要問一下部長你們有沒有實際\n去了解 去關心或者去找這些疾重症的醫師們真的坐下來稍微焦點團體一下他們現在最最需要政府伸出援手的到底是什麼看了讓人家很心疼啊就是感覺他們是願意蹭在第一線的但是感覺快要倒下了然後希望說是不是趕快有人可以來協助他們我看到這樣的訊息是有這樣子的一個感受\n那我現在要問的就是說作為中央部會主管機關到底衛福部在緊急當然分階段剛剛部長你有說有一些是長期根本的問題但是現況就已經很糟了那現在這麼糟怎麼樣去穩住他們然後讓這個醫療現場不要有更多的這個醫師離開我覺得這個是我們處理事情分階段這個是第一要務可能要做的請問衛福部可以做什麼他們已經發出這樣一個訊息請問衛福部可以做什麼\n好謝謝委員的詢問我想分幾個來報告第一個急診方面有建議在過年那段期間的游泳賽我們除了對護理方面的盡量來給他照顧鼓勵改善以外當然相對的對醫師也會好因為整個是團隊的事情在這個部分也有提高給付第二個我們也希望能夠分級醫療減少\n減少那個急診醫師的部分輕重那個急診醫師是這樣子我們一年大概像113年的急診醫師是102個通過那112年在前年是109個大概都100出頭那當然我們我剛剛有報告過\n有些醫院可能離開的比較嚴重有些醫院像台大我剛剛只有一個退休其他目前是還沒有動那我想問的就是說比較嚴重的你們有沒有特別去觀察我想我們如果以這種訊息出來我們當然想要來瞭解整個很快來瞭解急重症我們這兩天在討論部隊在討論就一直說要去注意到各個科裡面的一個\n現在的流線 我懂 但是急診是第一線他講120人 我覺得這個數據 你覺得有高估嗎現場是不是大概是這樣子因為120人 上百位要離職他說沒表 才想離職有這麼高 這個上百位其實對第一線現場 我覺得是一個很大的衝擊因為說實在的啦 長這段這些年來的確我們當醫師也很辛苦\n像我一輩子在醫院打扮我也買不到一間房子台北市還在貸款所以你就知道說年輕的醫師是不是更加的困難所以他們當然會牽涉我這個改變就牽涉到你的各種給付、工作環境這個是長久以來累積的一個很大的當然我們很感佩\n立法院這一屆的委員真的都很用心在幫忙解決這個問題我們的政府真的也是日夜在解決這個問題醫療方面被立法院全力支持以我當一個醫學院教授這麼多年我總是希望我的學生出來\n能夠好我做 不能給他遭避 不然我就死了對啊 所以那個環境很重要嘛可能就不是去做他的專科了所以部長 因為我還有下一個要問的如果能夠跑到蘇昭偉那邊去服務還可以得到很好的奮鬥環境因為現在現場無論是急診或是重症他們都已經發出這樣的求救訊息那我覺得作為中央主管機關你們有責任要提出方案\n到底怎麼去解決跟改善那這個部分我覺得你們應該要去回應就是基層的問題我們知道長期來問題我們知道但是眼下是這樣一個問題因為接下來我就要問新冠的高峰\n還要面對這樣的挑戰如果前面的急診量能都不足了醫師要離開那過去的新冠疫情我們已經看到了急診現場亂成一團全部擁捨到那邊去恐怕是雪上加霜啊\n所以我們應該要看一下這個部分你如果沒有解決未來這一些在增加新的疫情的人進到急診來那這個真的是會很可怕的一件事情所以我這邊希望你們針對之前的就是在新冠疫情高峰的時候所有的這個配套方案你們要超前部署是的我們有超前部署\n那接下來我要問的是今天這個委員會要審的有關於整個健保資料庫的這個管理怎麼去加強它的監督管理因為之前的外洩事件的確對於個人來講這個是一個個資被倒賣那我想這個是一個很嚴重的這個侵害\n那在這樣的一個情況底下你們這一次的修法就是你們好像是就用退出權而不是同意權這樣的概念也就是說我的健保資料要不要要不要提供學術研究是我要去申請退出\n然後它才不會在上面而不是像金融機構說我可不可以應用你的資料它是問你的同意為什麼是這樣的差別因為現在也有民間團體說那為什麼是我要記得去講的時候我的資料才不會被應用就是一下子好像政府就幫我做決定你只要在我資料庫裡面呢我就是通通都可以用那我就問你像這些未成年人的資料\n他自己可能也沒有敏感這個議題他也不會去退出啊那他的資料就是大批的從0到18歲通通都是政府使用那有一些年紀比較大的這些老人他可能不太知道這件事啊所以他的資料就整個在資料庫裡面就是沒有經過同意情況底下只是因為他沒有退出所以就被大量的使用我不知道你們有沒有思考過這個問題\n因為當民間團體這樣子質疑的時候這的確是一個我們在如果同時要保護各自的話不是應該是他同意的情況底下使用嗎那你們現在是說你退出我就不用這有沒有有點便宜形式啊\n好 我想同意不同意這件事情 等一下再請那個負責健保的主管來報告那我先跟兩件事情報告 第一件事情就是資安系統我們被攻擊了以後 我們衛福部立即啟動各種防衛的機制 現在應該都攻不進去了醫院方面啦 不是健保局裡面 健保署裡面那健保署裡面的資料早就 這些年來 可能有十幾年了吧\n是非常的嚴格一定要到一個房間然後你什麼都不能帶喔那有人幫你輔導你要的資料就跑完跑完之後拿出結果完全都氣勢白話所以這個部分其實在個資方面是絕對沒有問題我想請署長也可以再confirm一下\n跟委員報告我們採取這個所謂的這個退出權的行使主要是第一個我們這個資料的使用有相當的限縮他是以公益目的使用第二個資料都在特定的空間裡面那麼經過去識別化之後的資料來跑所以理論上他已經這個相當的安全那麼使用的時候已經很安全再者呢也不可以有資料的吸出\n最後只拿出的是統計的結果所以在安全性還有各自的保護上已經達到最高的程度保護是一回事那我是在問說為什麼不是取得個人的同意權而是用退出權\n其實所有的資料的使用它也是按照它的程度的不同有所謂的OP IN OP OUT就是說事前告知同意或者是事後退出都可以就是假設同意事後退出或事前同意那麼事後退出或事前同意這有三種的不同的方式那我們這個資料因為已經這個\n基本上都已經是經過去各自的方式去處理過所以我們採用的是用那個假設同意事後退出然後經過專法的管理我想這個問題我們還會回到主條的討論但是我也希望主管機關去思考就是說運用他的這些資料然後如果是他同意就是作為研究使用在這個\n民眾他有同意的情況底下我想你們使用起來是更放心但是我們現在模式是有點覺得說我既然都已經去識別化了然後我也保護的很安全所以不用經過你的同意這個你沒有反對再出聲這樣子會變成是有點倒過來這個跟現在就是我們有個資法之後的這個潮流坦白講他不是一致性很高的就是說你看連金融機構他們現在都被要求說要勾很多的同意書\n他才可以這樣子所以我希望這個問題呢你們也好好思考在相關修法的時候我有相關的修正動作大家在討論好我們希望這個條例能夠創造三贏的局面是是好謝謝委員好謝謝翁委員的宣導也謝謝部長\n","vtt":"WEBVTT\n\n00:02.825 --> 00:07.010\n那我們委員會這邊公告蘇清泉、趙偉宣達結束休息10分鐘謝謝好謝謝趙偉我們是不是有請邱部長來請部長委員長\n\n00:18.732 --> 00:20.033\n部長好部長我想剛剛很多人都提到了現在我們醫療現場急重症這個人力不足的問題那再加上從昨天到今天陸續有急診科的醫師他去提到說這個\n\n00:37.964 --> 00:52.846\n急診科醫師想要離開沒有表態的離職人數我看到這個數字有點嚇到上看120人我不曉得這位醫師講的是真實的還是是他有推估比較多如果是這樣一個數據的話\n\n00:54.528 --> 01:15.290\n那我覺得面對未來還有新冠疫情的升溫這是讓人家會非常擔心的就是可能連急診的第一現場要去救治病患這個人手都嚴重的不足第二個是重症的部分剛剛也這個陳俊輝醫師有提到這個新聞也引發大家的關注就是\n\n01:16.151 --> 01:20.173\n這位長庚醫院的這位醫師他發出的這個訊息簡訊我覺得是一個求救的訊息就是他在現場他可能已經看到這樣的狀況的惡化如果再不告訴醫院的高層跟政府的高層\n\n01:35.678 --> 01:51.930\n他認為這樣的一個醫療的崩壞真的是我想他站在現場第一位真的是非常的擔心所以我個人會覺得這樣的簡訊是是一種求救性就覺得現場的狀況真的很糟了那我就要問一下部長你們有沒有實際\n\n01:53.451 --> 02:16.866\n去了解去關心或者去找這些疾重症的醫師們真的坐下來稍微焦點團體一下他們現在最最需要政府伸出援手的到底是什麼看了讓人家很心疼啊就是感覺他們是願意蹭在第一線的但是感覺快要倒下了然後希望說是不是趕快有人可以來協助他們我看到這樣的訊息是有這樣子的一個感受\n\n02:22.910 --> 02:30.655\n那我現在要問的就是說作為中央部會主管機關到底衛福部在緊急當然分階段剛剛部長你有說有一些是長期根本的問題但是現況就已經很糟了那現在這麼糟怎麼樣去穩住他們然後讓這個醫療現場不要有更多的這個醫師離開我覺得這個是我們處理事情分階段這個是第一要務可能要做的請問衛福部可以做什麼他們已經發出這樣一個訊息請問衛福部可以做什麼\n\n02:52.182 --> 03:17.290\n好謝謝委員的詢問我想分幾個來報告第一個急診方面有建議在過年那段期間的游泳賽我們除了對護理方面的盡量來給他照顧鼓勵改善以外當然相對的對醫師也會好因為整個是團隊的事情在這個部分也有提高給付第二個我們也希望能夠分級醫療減少\n\n03:19.806 --> 03:26.774\n減少那個急診醫師的部分輕重那個急診醫師是這樣子我們一年大概像113年的急診醫師是102個通過那112年在前年是109個大概都100出頭那當然我們我剛剛有報告過\n\n03:38.737 --> 03:57.865\n有些醫院可能離開的比較嚴重有些醫院像台大我剛剛只有一個退休其他目前是還沒有動那我想問的就是說比較嚴重的你們有沒有特別去觀察我想我們如果以這種訊息出來我們當然想要來瞭解整個很快來瞭解急重症我們這兩天在討論部隊在討論就一直說要去注意到各個科裡面的一個\n\n04:06.188 --> 04:26.674\n現在的流線我懂但是急診是第一線他講120人我覺得這個數據你覺得有高估嗎現場是不是大概是這樣子因為120人上百位要離職他說沒表才想離職有這麼高這個上百位其實對第一線現場我覺得是一個很大的衝擊因為說實在的啦長這段這些年來的確我們當醫師也很辛苦\n\n04:33.324 --> 04:50.033\n像我一輩子在醫院打扮我也買不到一間房子台北市還在貸款所以你就知道說年輕的醫師是不是更加的困難所以他們當然會牽涉我這個改變就牽涉到你的各種給付、工作環境這個是長久以來累積的一個很大的當然我們很感佩\n\n05:01.039 --> 05:15.891\n立法院這一屆的委員真的都很用心在幫忙解決這個問題我們的政府真的也是日夜在解決這個問題醫療方面被立法院全力支持以我當一個醫學院教授這麼多年我總是希望我的學生出來\n\n05:16.832 --> 05:44.509\n能夠好我做不能給他遭避不然我就死了對啊所以那個環境很重要嘛可能就不是去做他的專科了所以部長因為我還有下一個要問的如果能夠跑到蘇昭偉那邊去服務還可以得到很好的奮鬥環境因為現在現場無論是急診或是重症他們都已經發出這樣的求救訊息那我覺得作為中央主管機關你們有責任要提出方案\n\n05:45.109 --> 05:59.610\n到底怎麼去解決跟改善那這個部分我覺得你們應該要去回應就是基層的問題我們知道長期來問題我們知道但是眼下是這樣一個問題因為接下來我就要問新冠的高峰\n\n06:00.965 --> 06:16.391\n還要面對這樣的挑戰如果前面的急診量能都不足了醫師要離開那過去的新冠疫情我們已經看到了急診現場亂成一團全部擁捨到那邊去恐怕是雪上加霜啊\n\n06:17.071 --> 06:39.591\n所以我們應該要看一下這個部分你如果沒有解決未來這一些在增加新的疫情的人進到急診來那這個真的是會很可怕的一件事情所以我這邊希望你們針對之前的就是在新冠疫情高峰的時候所有的這個配套方案你們要超前部署是的我們有超前部署\n\n06:40.532 --> 06:52.055\n那接下來我要問的是今天這個委員會要審的有關於整個健保資料庫的這個管理怎麼去加強它的監督管理因為之前的外洩事件的確對於個人來講這個是一個個資被倒賣那我想這個是一個很嚴重的這個侵害\n\n07:00.857 --> 07:16.810\n那在這樣的一個情況底下你們這一次的修法就是你們好像是就用退出權而不是同意權這樣的概念也就是說我的健保資料要不要要不要提供學術研究是我要去申請退出\n\n07:18.106 --> 07:40.527\n然後它才不會在上面而不是像金融機構說我可不可以應用你的資料它是問你的同意為什麼是這樣的差別因為現在也有民間團體說那為什麼是我要記得去講的時候我的資料才不會被應用就是一下子好像政府就幫我做決定你只要在我資料庫裡面呢我就是通通都可以用那我就問你像這些未成年人的資料\n\n07:41.167 --> 08:02.679\n他自己可能也沒有敏感這個議題他也不會去退出啊那他的資料就是大批的從0到18歲通通都是政府使用那有一些年紀比較大的這些老人他可能不太知道這件事啊所以他的資料就整個在資料庫裡面就是沒有經過同意情況底下只是因為他沒有退出所以就被大量的使用我不知道你們有沒有思考過這個問題\n\n08:03.840 --> 08:18.119\n因為當民間團體這樣子質疑的時候這的確是一個我們在如果同時要保護各自的話不是應該是他同意的情況底下使用嗎那你們現在是說你退出我就不用這有沒有有點便宜形式啊\n\n08:19.161 --> 08:46.869\n好我想同意不同意這件事情等一下再請那個負責健保的主管來報告那我先跟兩件事情報告第一件事情就是資安系統我們被攻擊了以後我們衛福部立即啟動各種防衛的機制現在應該都攻不進去了醫院方面啦不是健保局裡面健保署裡面那健保署裡面的資料早就這些年來可能有十幾年了吧\n\n08:47.609 --> 09:05.018\n是非常的嚴格一定要到一個房間然後你什麼都不能帶喔那有人幫你輔導你要的資料就跑完跑完之後拿出結果完全都氣勢白話所以這個部分其實在個資方面是絕對沒有問題我想請署長也可以再confirm一下\n\n09:05.598 --> 09:33.326\n跟委員報告我們採取這個所謂的這個退出權的行使主要是第一個我們這個資料的使用有相當的限縮他是以公益目的使用第二個資料都在特定的空間裡面那麼經過去識別化之後的資料來跑所以理論上他已經這個相當的安全那麼使用的時候已經很安全再者呢也不可以有資料的吸出\n\n09:33.786 --> 09:43.693\n最後只拿出的是統計的結果所以在安全性還有各自的保護上已經達到最高的程度保護是一回事那我是在問說為什麼不是取得個人的同意權而是用退出權\n\n09:49.036 --> 10:09.514\n其實所有的資料的使用它也是按照它的程度的不同有所謂的OPINOPOUT就是說事前告知同意或者是事後退出都可以就是假設同意事後退出或事前同意那麼事後退出或事前同意這有三種的不同的方式那我們這個資料因為已經這個\n\n10:12.196 --> 10:37.525\n基本上都已經是經過去各自的方式去處理過所以我們採用的是用那個假設同意事後退出然後經過專法的管理我想這個問題我們還會回到主條的討論但是我也希望主管機關去思考就是說運用他的這些資料然後如果是他同意就是作為研究使用在這個\n\n10:39.005 --> 10:55.550\n民眾他有同意的情況底下我想你們使用起來是更放心但是我們現在模式是有點覺得說我既然都已經去識別化了然後我也保護的很安全所以不用經過你的同意這個你沒有反對再出聲這樣子會變成是有點倒過來這個跟現在就是我們有個資法之後的這個潮流坦白講他不是一致性很高的就是說你看連金融機構他們現在都被要求說要勾很多的同意書\n\n11:08.763 --> 11:26.435\n他才可以這樣子所以我希望這個問題呢你們也好好思考在相關修法的時候我有相關的修正動作大家在討論好我們希望這個條例能夠創造三贏的局面是是好謝謝委員好謝謝翁委員的宣導也謝謝部長\n\n","segments":[{"start":2.825,"end":7.01,"text":"那我們委員會這邊公告蘇清泉、趙偉宣達結束休息10分鐘謝謝好謝謝趙偉我們是不是有請邱部長來請部長委員長"},{"start":18.732,"end":20.033,"text":"部長好部長我想剛剛很多人都提到了現在我們醫療現場急重症這個人力不足的問題那再加上從昨天到今天陸續有急診科的醫師他去提到說這個"},{"start":37.964,"end":52.846,"text":"急診科醫師想要離開沒有表態的離職人數 我看到這個數字有點嚇到上看120人 我不曉得這位醫師講的是真實的還是是他有推估比較多 如果是這樣一個數據的話"},{"start":54.528,"end":75.29,"text":"那我覺得面對未來還有新冠疫情的升溫這是讓人家會非常擔心的就是可能連急診的第一現場要去救治病患這個人手都嚴重的不足第二個是重症的部分剛剛也這個陳俊輝醫師有提到這個新聞也引發大家的關注就是"},{"start":76.151,"end":80.173,"text":"這位長庚醫院的這位醫師他發出的這個訊息簡訊我覺得是一個求救的訊息就是他在現場他可能已經看到這樣的狀況的惡化如果再不告訴醫院的高層跟政府的高層"},{"start":95.678,"end":111.93,"text":"他認為這樣的一個醫療的崩壞真的是我想他站在現場第一位真的是非常的擔心所以我個人會覺得這樣的簡訊是是一種求救性就覺得現場的狀況真的很糟了那我就要問一下部長你們有沒有實際"},{"start":113.451,"end":136.866,"text":"去了解 去關心或者去找這些疾重症的醫師們真的坐下來稍微焦點團體一下他們現在最最需要政府伸出援手的到底是什麼看了讓人家很心疼啊就是感覺他們是願意蹭在第一線的但是感覺快要倒下了然後希望說是不是趕快有人可以來協助他們我看到這樣的訊息是有這樣子的一個感受"},{"start":142.91,"end":150.655,"text":"那我現在要問的就是說作為中央部會主管機關到底衛福部在緊急當然分階段剛剛部長你有說有一些是長期根本的問題但是現況就已經很糟了那現在這麼糟怎麼樣去穩住他們然後讓這個醫療現場不要有更多的這個醫師離開我覺得這個是我們處理事情分階段這個是第一要務可能要做的請問衛福部可以做什麼他們已經發出這樣一個訊息請問衛福部可以做什麼"},{"start":172.182,"end":197.29,"text":"好謝謝委員的詢問我想分幾個來報告第一個急診方面有建議在過年那段期間的游泳賽我們除了對護理方面的盡量來給他照顧鼓勵改善以外當然相對的對醫師也會好因為整個是團隊的事情在這個部分也有提高給付第二個我們也希望能夠分級醫療減少"},{"start":199.806,"end":206.774,"text":"減少那個急診醫師的部分輕重那個急診醫師是這樣子我們一年大概像113年的急診醫師是102個通過那112年在前年是109個大概都100出頭那當然我們我剛剛有報告過"},{"start":218.737,"end":237.865,"text":"有些醫院可能離開的比較嚴重有些醫院像台大我剛剛只有一個退休其他目前是還沒有動那我想問的就是說比較嚴重的你們有沒有特別去觀察我想我們如果以這種訊息出來我們當然想要來瞭解整個很快來瞭解急重症我們這兩天在討論部隊在討論就一直說要去注意到各個科裡面的一個"},{"start":246.188,"end":266.674,"text":"現在的流線 我懂 但是急診是第一線他講120人 我覺得這個數據 你覺得有高估嗎現場是不是大概是這樣子因為120人 上百位要離職他說沒表 才想離職有這麼高 這個上百位其實對第一線現場 我覺得是一個很大的衝擊因為說實在的啦 長這段這些年來的確我們當醫師也很辛苦"},{"start":273.324,"end":290.033,"text":"像我一輩子在醫院打扮我也買不到一間房子台北市還在貸款所以你就知道說年輕的醫師是不是更加的困難所以他們當然會牽涉我這個改變就牽涉到你的各種給付、工作環境這個是長久以來累積的一個很大的當然我們很感佩"},{"start":301.039,"end":315.891,"text":"立法院這一屆的委員真的都很用心在幫忙解決這個問題我們的政府真的也是日夜在解決這個問題醫療方面被立法院全力支持以我當一個醫學院教授這麼多年我總是希望我的學生出來"},{"start":316.832,"end":344.509,"text":"能夠好我做 不能給他遭避 不然我就死了對啊 所以那個環境很重要嘛可能就不是去做他的專科了所以部長 因為我還有下一個要問的如果能夠跑到蘇昭偉那邊去服務還可以得到很好的奮鬥環境因為現在現場無論是急診或是重症他們都已經發出這樣的求救訊息那我覺得作為中央主管機關你們有責任要提出方案"},{"start":345.109,"end":359.61,"text":"到底怎麼去解決跟改善那這個部分我覺得你們應該要去回應就是基層的問題我們知道長期來問題我們知道但是眼下是這樣一個問題因為接下來我就要問新冠的高峰"},{"start":360.965,"end":376.391,"text":"還要面對這樣的挑戰如果前面的急診量能都不足了醫師要離開那過去的新冠疫情我們已經看到了急診現場亂成一團全部擁捨到那邊去恐怕是雪上加霜啊"},{"start":377.071,"end":399.591,"text":"所以我們應該要看一下這個部分你如果沒有解決未來這一些在增加新的疫情的人進到急診來那這個真的是會很可怕的一件事情所以我這邊希望你們針對之前的就是在新冠疫情高峰的時候所有的這個配套方案你們要超前部署是的我們有超前部署"},{"start":400.532,"end":412.055,"text":"那接下來我要問的是今天這個委員會要審的有關於整個健保資料庫的這個管理怎麼去加強它的監督管理因為之前的外洩事件的確對於個人來講這個是一個個資被倒賣那我想這個是一個很嚴重的這個侵害"},{"start":420.857,"end":436.81,"text":"那在這樣的一個情況底下你們這一次的修法就是你們好像是就用退出權而不是同意權這樣的概念也就是說我的健保資料要不要要不要提供學術研究是我要去申請退出"},{"start":438.106,"end":460.527,"text":"然後它才不會在上面而不是像金融機構說我可不可以應用你的資料它是問你的同意為什麼是這樣的差別因為現在也有民間團體說那為什麼是我要記得去講的時候我的資料才不會被應用就是一下子好像政府就幫我做決定你只要在我資料庫裡面呢我就是通通都可以用那我就問你像這些未成年人的資料"},{"start":461.167,"end":482.679,"text":"他自己可能也沒有敏感這個議題他也不會去退出啊那他的資料就是大批的從0到18歲通通都是政府使用那有一些年紀比較大的這些老人他可能不太知道這件事啊所以他的資料就整個在資料庫裡面就是沒有經過同意情況底下只是因為他沒有退出所以就被大量的使用我不知道你們有沒有思考過這個問題"},{"start":483.84,"end":498.119,"text":"因為當民間團體這樣子質疑的時候這的確是一個我們在如果同時要保護各自的話不是應該是他同意的情況底下使用嗎那你們現在是說你退出我就不用這有沒有有點便宜形式啊"},{"start":499.161,"end":526.869,"text":"好 我想同意不同意這件事情 等一下再請那個負責健保的主管來報告那我先跟兩件事情報告 第一件事情就是資安系統我們被攻擊了以後 我們衛福部立即啟動各種防衛的機制 現在應該都攻不進去了醫院方面啦 不是健保局裡面 健保署裡面那健保署裡面的資料早就 這些年來 可能有十幾年了吧"},{"start":527.609,"end":545.018,"text":"是非常的嚴格一定要到一個房間然後你什麼都不能帶喔那有人幫你輔導你要的資料就跑完跑完之後拿出結果完全都氣勢白話所以這個部分其實在個資方面是絕對沒有問題我想請署長也可以再confirm一下"},{"start":545.598,"end":573.326,"text":"跟委員報告我們採取這個所謂的這個退出權的行使主要是第一個我們這個資料的使用有相當的限縮他是以公益目的使用第二個資料都在特定的空間裡面那麼經過去識別化之後的資料來跑所以理論上他已經這個相當的安全那麼使用的時候已經很安全再者呢也不可以有資料的吸出"},{"start":573.786,"end":583.693,"text":"最後只拿出的是統計的結果所以在安全性還有各自的保護上已經達到最高的程度保護是一回事那我是在問說為什麼不是取得個人的同意權而是用退出權"},{"start":589.036,"end":609.514,"text":"其實所有的資料的使用它也是按照它的程度的不同有所謂的OP IN OP OUT就是說事前告知同意或者是事後退出都可以就是假設同意事後退出或事前同意那麼事後退出或事前同意這有三種的不同的方式那我們這個資料因為已經這個"},{"start":612.196,"end":637.525,"text":"基本上都已經是經過去各自的方式去處理過所以我們採用的是用那個假設同意事後退出然後經過專法的管理我想這個問題我們還會回到主條的討論但是我也希望主管機關去思考就是說運用他的這些資料然後如果是他同意就是作為研究使用在這個"},{"start":639.005,"end":655.55,"text":"民眾他有同意的情況底下我想你們使用起來是更放心但是我們現在模式是有點覺得說我既然都已經去識別化了然後我也保護的很安全所以不用經過你的同意這個你沒有反對再出聲這樣子會變成是有點倒過來這個跟現在就是我們有個資法之後的這個潮流坦白講他不是一致性很高的就是說你看連金融機構他們現在都被要求說要勾很多的同意書"},{"start":668.763,"end":686.435,"text":"他才可以這樣子所以我希望這個問題呢你們也好好思考在相關修法的時候我有相關的修正動作大家在討論好我們希望這個條例能夠創造三贏的局面是是好謝謝委員好謝謝翁委員的宣導也謝謝部長"}]}}},"gazette":{"lineno":384,"blocks":[["王委員育敏：（10時9分）謝謝召委，有請邱部長。"],["主席：請部長。"],["邱部長泰源：委員早。"],["王委員育敏：部長好。部長，剛剛很多委員都提到了現在醫療現場急重症人力不足的問題，再加上從昨天到今天，陸續有急診科醫師提到急診科醫師想要離開而沒有表態的人數上看120人，我看到這個數字有點嚇到，我不曉得這位醫師講的是真實的，還是他有推估比較多？如果是這樣的數據，我覺得面對未來還有新冠疫情的升溫，讓人家非常擔心，就是可能連急診要去救治病患的第一現場，人手都嚴重不足。","第二個是重症的部分，剛剛陳菁徽醫師也有提到，這個新聞引發大家的關注，這一位長庚醫院的醫師發出的簡訊，我覺得是一個求救的訊息，他在現場可能已經看到狀況的惡化，如果再不告訴醫院高層跟政府高層，他認為這樣的醫療崩壞，站在第一線的現場，真的是非常擔心，所以我個人會覺得這樣的簡訊是一種求救信，覺得現場的狀況真的很糟了。我就要問一下部長，你們有沒有實際去了解、關心，或者去找這一些急重症的醫師們，真的坐下來，稍微聚焦一下，他們現在最需要政府伸出援手的到底是什麼？看得讓人家很心疼，他們是願意撐在第一線的，但是感覺快要倒下了，希望趕快有人可以協助他們，我看到訊息是有這樣的感受。我現在要問的就是，作為中央部會主管機關，到底衛福部在緊急……當然分階段，剛剛部長有說有一些是長期根本的問題，但是現況就已經很糟了，現在這麼糟，怎樣去穩住他們，讓醫療現場不要有更多的醫師離開？我們處理事情要分階段，而這是第一要務要做的，他們已經發出這樣的訊息，請問衛福部可以做什麼？"],["邱部長泰源：謝謝委員的詢問，我想分幾點來報告，第一個，急診方面，有鑑於過年那段期間的壅塞，我們除了對護理方面儘量照顧、鼓勵、改善以外，當然相對的，對醫師也會好，因為整個是團隊的事情，在這個部分也有提高給付。第二個，我們也希望能夠分級醫療，減少輕、重症的……"],["王委員育敏：急診醫師的部分？"],["邱部長泰源：像113年的急診醫師是102個通過，112年是109個通過，一年大概都一百出頭個醫師通過，我剛才有報告過，有些醫院可能離開的比較嚴重，有些醫院像臺大，我剛也報告過就只有1個退休，其他目前是還沒有動。"],["王委員育敏：對，那我想問的就是比較嚴重的，你們有沒有特別去關心？"],["邱部長泰源：如果這種訊息出來，我們當然想要了解整個急重症現在的狀況，我們這兩天部內討論就一直說要去注意到各個科裡面現在的流向。"],["王委員育敏：我懂，但是急診是第一線，他講120人，這數據你覺得有高估嗎？現場是不是大概是這樣？因為上百位要離職，他說沒表態想離職的數據有這麼高，上百位想離職，其實對第一線現場是一個很大的衝擊，你們掌握到情況是如何？"],["邱部長泰源：說實在的，這些年來，的確我們當醫師也很辛苦，像我一輩子在醫院努力，我也買不到一間房子，臺北市的房子也還在貸款，你就知道年輕的醫師是不是更加的困難，所以他們當然會尋求……"],["王委員育敏：對，但部長你現在有權力，你可以去改變。"],["邱部長泰源：這個改變就牽涉到各種給付、工作環境，這個是長久以來累積很大的問題。當然我們很感佩立法院這一屆的委員，真的很用心在幫忙解決這個問題，我們政府真的也是日夜在解決這個問題。"],["王委員育敏：我們都願意支持，醫療方面的經費，立法院全力支持。"],["邱部長泰源：以我當一個醫學院教授這麼多年，我總是希望我的學生出來能夠好好做，不要跑掉，不然我就多教的啊！"],["王委員育敏：對啊，所以環境很重要。"],["邱部長泰源：他們走了可能就不是去做他的專科了。"],["王委員育敏：部長，因為我還有下一個要問……"],["邱部長泰源：如果能夠跑到我們蘇召委那邊去服務，還可以得到很好的奮鬥環境。"],["王委員育敏：因為現在現場，不論是急診或是重症，他們都已經發出這樣的求救訊息，我覺得作為中央主管機關，你們有責任要提出方案，到底怎麼去解決跟改善，這部分我覺得你們應該要去回應，就是我們知道基層的問題，我們也知道長期以來的問題，但是眼下是這樣的問題，因為接下來我就要問，還要面對新冠疫情高峰這樣的挑戰，如果前面的急診量能都不足了，醫師要離開，過去的新冠疫情我們已經看到了，就是急診現場亂成一團，全部壅塞到那邊去，恐怕是雪上加霜啊！我們應該要看一下，倘若這個部分你們沒有解決，未來再增加新疫情的病人進到急診來，真的會是很可怕的一件事情。所以我這邊希望你們針對之前新冠疫情高峰的時候，所有的配套方案，你們要超前部署。"],["邱部長泰源：是的，我們有超前部署。"],["王委員育敏：好。接下來要請教的是，針對今天委員會要審查有關於整個健保資料庫的管理，如何加強它的監督管理？因為之前的個資外洩事件，的確對於個人來講，個資被盜賣是一個很嚴重的侵害，在這樣的情況下，你們這一次的修法好像是用退出權，而不是同意權這樣的概念，也就是我的健保資料要不要提供學術研究，是我要去申請退出，然後個資才不會在上面，而不是像金融機構問可不可以運用你的資料，他們是要經過你的同意，為什麼有這樣的差別？因為現在也有民間團體說：為什麼是我要自己去講，我的資料才不會被運用？就是政府好像一下子就幫我做決定，只要在政府的資料庫裡面，就是通通都可以使用。","我就問你，像一些未成年人的資料，他們自己可能也沒有敏感到這個議題，他們也不會自己去退出，那他們的資料就是大批的從0到18歲通通都是政府使用，有一些年紀比較大的老年人，他們可能也不太知道這件事，所以他們的資料就整個在資料庫裡面，在沒有經過同意的情況下，只因為他們沒有退出，所以就被大量的使用。我不知道你們有沒有思考過這個問題？因為當民間團體這樣質疑的時候，如果我們同時要保護個資，不是應該要在他同意的情況下使用嗎？你們現在是說：你退出我就不用。這有沒有有點便宜行事？"],["邱部長泰源：好，我想同意不同意這件事，等一下再請負責健保業務的主責單位報告。我先報告兩件事情：第一件事情，當我們資安系統被攻擊了之後，衛福部會立即啟動各種防衛的機制，現在應該都攻不進去了，這是針對醫院方面，不是健保署裡面，而在健保署裡面的資料，這些年來，可能有十幾年了，早就控管得非常嚴格，若要索取資料一定要到一個特定的房間裡，什麼都不能帶，進入之後有專人會協助，資料跑完的結果完全都是去識別化，所以這個部分在個資方面是絕對沒有問題。我請署長可以再confirm一下。"],["石署長崇良：跟委員報告，我們採取所謂退出權的行使，主要是：第一個，我們這個資料的使用有相當的限縮，它是以公益目的使用；第二個，資料都在特定的空間裡面，經過去識別化之後的資料提供，所以理論上它已經相當的安全，使用的時候一定很安全，再者也不可以將這些資料攜出，最後拿到的只是統計的結果，所以在安全性及個資的保護上已經達到最高的程度，但是……"],["王委員育敏：保護是一回事啦！我是在問，為什麼不是取得個人的同意權，而是用退出權？"],["石署長崇良：其實所有資料的使用也是按照程度的不同，有所謂的opt-in和opt-out，就是事前告知同意，或者是事後退出都可以，假設同意事後退出、事前同意事後退出或事前同意，有這三種不同的方式，我們這個資料基本上都已經是經過去個資的方式處理過，所以我們採用的是假設同意事後退出，再經過專法的管理。"],["王委員育敏：我想這個問題，我們還會回到逐條討論，但是我也希望主管機關思考，就是運用他們的這些資料作為研究使用，在民眾同意的情況下，我想你們使用起來是更放心，但是我們現在模式有點像是：既然都已經去識別化了，也保護得很安全，所以不用經過你的同意，你有反對再出聲。這會變成是有點倒過來，這個跟我們現在有個資法之後的潮流，坦白講，它不是一致性很高的，你看連金融機構他們現在都被要求要勾很多的同意書，他們才可以使用，所以我希望這個問題你們也好好去思考，在修法的時候，我有相關的修正動議，大家再來討論。"],["邱部長泰源：我們希望這個條例能夠創造三贏的局面。"],["王委員育敏：是。好，謝謝。"],["邱部長泰源：謝謝委員。"],["主席：好，謝謝王委員的詢答及謝謝部長。","接下來請蘇清泉召委做詢答。"]],"agenda":{"page_end":188,"meet_id":"委員會-11-3-26-16","speakers":["劉建國","陳昭姿","王正旭","林月琴","陳菁徽","王育敏","蘇清泉","邱鎮軍","林淑芬","黃秀芳","盧縣一","鍾佳濱","廖偉翔","楊曜","翁曉玲","涂權吉","徐欣瑩","陳瑩"],"page_start":1,"meetingDate":["2025-06-09"],"gazette_id":"1145902","agenda_lcidc_ids":["1145902_00002"],"meet_name":"立法院第11屆第3會期社會福利及衛生環境委員會第16次全體委員會議紀錄","content":"審查一、行政院函請審議「全民健康保險資料管理條例草案」案；二、委員林月琴等 21 人擬具\n「全民健康保險資料管理條例草案」案","agenda_id":"1145902_00001"}}}