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\"zh\"}","srt":"1\n00:00:00,089 --> 00:00:03,410\n剛才大家都在講急診,我幫你講屏東的情況是,謝謝屏東,屏東市有很嚴重度,屏東貧瘠\n\n2\n00:00:27,040 --> 00:00:50,428\n他的腦神因為腎中毒後他就要腦神經內科要二十四小時所以大家都在等他去找他的四個神經內科醫生找三個現在只剩下一個一個要來我那裡我說不可以啦你不可以把他修我跟他認定說你不可以把他修那修了他就斑斑\n\n3\n00:00:51,670 --> 00:00:56,912\n很嚴重,有三個醫生,五個早上到早上兩個都早上,早上兩個都早上,每天連續一天,早上兩個有三個醫生,一個八十幾歲,一個六十幾歲,數十,還沒要胖,所以我現在跟他們說,不然就做區域聯防啦,區域聯防,這是一個步啦,所以還是要想辦法啦,\n\n4\n00:01:19,600 --> 00:01:41,009\n那這所以平基任何跑掉的就就給他引導再去府營婦產科啦不然怎麼辦所以我們在地方上我們都很努力的在讓他能夠維持好的運作雖然要有保證知道事情真的可能不是跟他鬥氣而已身高也很嚴重因為現在婦產科醫生平均五六十歲\n\n5\n00:01:46,431 --> 00:01:48,355\n所以現在生小孩在家麻煩,婦醫生麻煩\n\n6\n00:01:51,038 --> 00:02:12,992\n那像兒科,我們那邊現在維持七個兒科醫師,都是刺磚科那是硬要拿的,每個都撩錢,撩到頭就頭所以這個要怎麼去補償?署長你可能要研究看看每一次看到你們我都很疼惜啦還要疼惜我們這個年輕人現在整個社會的觀念都變了現在年輕人,沒有在聽這套啦\n\n7\n00:02:19,685 --> 00:02:36,189\n現在因為科技業者晶片業者他們太好找工作了而且只要你願意值班我們的住院醫師在值班人家在晶片的施工的也在值班但是人家只要值班年薪就250萬起跳\n\n8\n00:02:41,142 --> 00:03:03,701\n我去竹科那邊看八八八三班另外一個班是oncall那oncall就是不能離開新竹縣市call你的時候40分鐘要到那就四班在亂每一個都是250起跳隔年就可以到300萬了我院長的小孩是念志工碩士\n\n9\n00:03:05,182 --> 00:03:16,898\n他現在在日夜光我說你現在年薪多少他就說80幾萬年薪沒有就上白班而已如果說他要值班就260\n\n10\n00:03:19,085 --> 00:03:43,105\n所以現在年輕人你跟他講說喔當公務人員多好當警察多好當醫生多好他不應該信到以前的公務人員社會地位都很高現在公務人員要搞一個什麼退休用你自己提撥的錢加政府提撥的錢這一筆基金發完就沒了現在聽說變成這樣這樣還得了我覺得這以後搞不搞就沒有人要考啦\n\n11\n00:03:47,692 --> 00:03:49,961\n整個都崩盤了嘛所以整個價值觀都變啦\n\n12\n00:03:52,332 --> 00:04:17,698\n這醫生這麼多年都沒薪水、沒什麼提高所以還是要籌多一點錢待遇還是很重要的一位醫生到台北去做醫生、做到老沒有一間房子,要找西人人家在國外是薪水月薪月薪差不多18個月就可以買一個房子\n\n13\n00:04:20,673 --> 00:04:42,978\n四個月也可以買一部車子這是當統計所以部長還有署長你們責任重大好今天講今天的健保的東西這十幾年來就是偶爾就會出現一個官員用CME拿資料出去了然後被判刑了\n\n14\n00:04:44,178 --> 00:04:55,324\n好像都一直來那你現在的那個內部要拿資料的前線現在到底有沒有加強部長我們有要求健保署一定要去查清楚整個機制要加強請署長回答\n\n15\n00:05:04,347 --> 00:05:20,083\n跟委員報告這個案子當然還在檢調偵查中不過我們在這個事件之後已經重新檢討過在內積的部分去強化包含資料使用權限的限縮還有可取得的這個\n\n16\n00:05:21,484 --> 00:05:39,789\n資料的那個欄位就是最少原則那如果需要到大筆資料還要簽核所以都加強了這個內控的機制所有的使用紀錄都會被留下來就是你只要經過就對對對對另外還導入外機的機制包含這個ISO27001的標準CNS27001的標準還有外機所以我們是強化內機之外也導入外機的機制\n\n17\n00:05:49,571 --> 00:06:06,115\n好那出皮肉都是健保署那國健署都沒問題喔國健署的資料也沒救捏我們這三高我們這什麼癌症病人都害得了所以國健署這邊有沒有洩露出去有沒有出事跟蘇昭偉報告一下這兩件事這個是形式問題這是他自己這是職員那個怕我們這個話齁\n\n18\n00:06:11,696 --> 00:06:18,039\n那是我們本來就很嚴格,要在那個本金裡面,去個別化或是識別化,拿出來今天可以再做這兩件事情啦,那這個我們當然需要去檢討\n\n19\n00:06:28,749 --> 00:06:56,109\n但是今天討論的是因為我們本來就已經在做後來是因為宣判所以我們把他弄得就能夠讓大家安心病人隱私的一個保護跟安全啦這有兩個齁這個法案過了會比較清楚規範說要怎麼贏啊背信給人家拿資料去贏我希望疫情開始的20年我的資料可以贏沒有你的資料可以贏你也不知道\n\n20\n00:06:57,550 --> 00:07:19,350\n說什麼去名字都去掉就用了搞不好你已經被用了一百次了我被用了一千次了論文就有六千篇了嘛對不對所以你這個法通過你也不知道你繼續也不知道你到底有沒有用啊說你可以退出還是不同意我不知道發一個發一個問求你說給天保署說我的資料都沒有用\n\n21\n00:07:25,860 --> 00:07:40,488\n有這個我們社權法規委來處理這個而且會更細膩來看他不能釋出哪些資料那基本上如果去識別化的話像我個人的話我覺得只要識別化對公共衛生對國家的一個醫藥發展提升我覺得應該是\n\n22\n00:07:41,553 --> 00:08:06,308\n沒有啦我們的資料被用去世白話名字都遮起來這樣這樣如果能遮到這樣那當然安心啦對社會也有貢獻連捐大體都在捐的大體老師都是這樣捐的嘛所以我們是可以理解但是一般百姓會不會理解我不知道好你這個法通過之後跟另外一件事就是倒賣個資倒賣資料出去這是兩回事\n\n23\n00:08:07,849 --> 00:08:30,487\n所以倒賣這一塊你們有什麼防患的措施剛剛署長講的以外有加強嗎還是現在都不可能發生啊從此以後不會發生的對我們都強化了就是剛剛講的都是在那個事件之後我們重新檢討過強化到目前的話都維持得很好我們一定要強化到絕對不可能再發生\n\n24\n00:08:32,202 --> 00:08:39,428\n今天這個法案拿出來院辦得出來是要迎合這個憲法法庭的判決那跟我們資料會被盜賣這是兩回事所以這個要怎麼加強\n\n25\n00:08:46,704 --> 00:09:14,620\n你要回答?來,你來回答我來,我問李處長資料被...大量資料被下載所以我們已經從去年開始就進行一個管理每個月每個單位,它只要有哪一個人在不對的時間、不對的地點、不對的量去下載資料,我們全部都有掌握然後都會給各個主管所以這個在USB跟硬碟現在都有這些管理跟委員報告好,OK\n\n26\n00:09:15,595 --> 00:09:37,513\n那我們健保這樣說30年來我們的就醫資料有680幾億筆有這麼多那怎麼用你們現在有人家的apply來申請你們IRB通過之外你們這邊有一個委員會在審查在核准嗎我們有專案小組有專案小組這裡面有24個委員在做審查\n\n27\n00:09:42,798 --> 00:10:07,499\n那現在的設計如果經過審查以後當然沒有爭議就就看看後續怎麼樣我們會再來演繹但是如果有困難矛盾的話我們會有執議會來處理所以這個審查委員會上面還有一個執議會那這個執議會是這個因為他不可能主案審查那可能會受不了啦不可能啦不可能所以這個委員會先\n\n28\n00:10:08,655 --> 00:10:11,780\n先審查小組,過了就過了,沒有過的再送到執意會有爭議的到執意會\n\n29\n00:10:19,622 --> 00:10:32,197\n好那最後一個問題現在疫苗現在有還有三百多萬劑那現在要你不是支持高麗大家要煮有我自己煮六支我這個如果標準的就兩個童弟我就煮但是我煮到現在我會嚇到的阿博爹你有煮嗎\n\n30\n00:10:39,167 --> 00:10:50,513\n我十月請他煮一支,四月請他煮一支我現在有很多老闆或鄉長、鎮長跟我說要煮嗎?煮了怎麼辦?我說你不煮可能會瘋掉煮會瘋掉嗎?我說也不一定煮疫苗出現事情的規矩但是你不煮疫苗應該是更危險\n\n31\n00:11:05,305 --> 00:11:28,922\n錄影,這樣會中症嘛,中症會跳起來因為我在民間看那些玩家,有的年輕人,有的年輕人在過去這個疫情,做疫苗要有心理不整的有肉膜積水,心肝膜積水,咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕\n\n32\n00:11:34,045 --> 00:11:55,664\n我想大家都會說有可能有可能但是他們去秤的那些要害沒有一件過的因為都不會死但是就都有症狀有的真的主要病心力不整真的有所以我在新浪溝這邊碰到一大堆所以我越看越擔心\n\n33\n00:11:56,405 --> 00:11:59,928\n所以你現在叫我打,我還是會去打啦但是我怕會被打掉但是如果有人問我,我真的會保留保證你宣示一下市長可不可以請我們專家跟大家宣導一下打疫苗是不是過去專家的\n\n34\n00:12:15,469 --> 00:12:16,170\n因為我們目前都還是有在針對所有的這個\n\n35\n00:12:31,802 --> 00:12:55,724\n疫苗的接種之後有如果不良反應其實是都可以通報所以我們一直有在蒐集這方面的數據然後在這個食藥署這邊有去做定期的這個統計那另外像委員提到就是說有這種接種之後疑似是因為疫苗造成的其實我們在這個不管在第一層衛生局這邊也都會去做調查然後如果這個真的是可能跟疫苗有關的也都會跟他說有這個救濟的這個管道\n\n36\n00:12:56,184 --> 00:13:18,171\n也就是可以提這個疫苗接種預防接種受害救濟這個部分那我們有一個獨立的這個專家委員會去做審議去判斷這個相關性因為疫苗本身一直在突變突變突變到現在跟原來的以前三年前的完全不太一樣了嘛那所以你現在新的疫苗是最新的這個病毒的突變那應該都有cover到\n\n37\n00:13:19,372 --> 00:13:37,937\n至少自主會後如果中就中不中重鎮嘛重鎮的死亡率高嘛尤其是三高的人所以還是鼓勵要打啦個人覺得也是要鼓勵啦所以你們要宣導要講清楚啦現在老人家最大的疑慮就是剛剛我講的無主會死主人白會死嗎\n\n38\n00:13:43,702 --> 00:14:04,605\n所以現在針對這個疫苗接種的利弊得失的話我們當然還是會最建議的就是在這個高風險的族群像是這65歲以上的長者或者是這個有這個慢性病的患者他們如果得到這個新冠之後病發重症跟死亡的風險都很高所以在這個族群我們是一直大力的推廣要接種好謝謝好謝謝署長謝謝謝謝主席好謝謝謝謝部長謝謝\n\n","tsv":"start\tend\ttext\n89\t3410\t剛才大家都在講急診,我幫你講屏東的情況是,謝謝屏東,屏東市有很嚴重度,屏東貧瘠\n27040\t50428\t他的腦神因為腎中毒後他就要腦神經內科要二十四小時所以大家都在等他去找他的四個神經內科醫生找三個現在只剩下一個一個要來我那裡我說不可以啦你不可以把他修我跟他認定說你不可以把他修那修了他就斑斑\n51670\t56912\t很嚴重,有三個醫生,五個早上到早上兩個都早上,早上兩個都早上,每天連續一天,早上兩個有三個醫生,一個八十幾歲,一個六十幾歲,數十,還沒要胖,所以我現在跟他們說,不然就做區域聯防啦,區域聯防,這是一個步啦,所以還是要想辦法啦,\n79600\t101009\t那這所以平基任何跑掉的就就給他引導 再去府營 婦產科啦不然怎麼辦所以我們在地方上我們都很努力的在讓他能夠維持好的運作雖然要有保證知道事情真的可能不是跟他鬥氣而已身高也很嚴重因為現在婦產科醫生平均五六十歲\n106431\t108355\t所以現在生小孩在家麻煩,婦醫生麻煩\n111038\t132992\t那像兒科,我們那邊現在維持七個兒科醫師,都是刺磚科那是硬要拿的,每個都撩錢,撩到頭就頭所以這個要怎麼去補償?署長你可能要研究看看每一次看到你們我都很疼惜啦還要疼惜我們這個年輕人現在整個社會的觀念都變了現在年輕人,沒有在聽這套啦\n139685\t156189\t現在因為科技業者晶片業者他們太好找工作了而且只要你願意值班我們的住院醫師在值班人家在晶片的施工的也在值班但是人家只要值班年薪就250萬起跳\n161142\t183701\t我去竹科那邊看 八八八三班另外一個班是on call那on call就是不能離開新竹縣市call你的時候40分鐘要到那就四班在亂每一個都是250起跳 隔年就可以到300萬了我院長的小孩是念志工碩士\n185182\t196898\t他現在在日夜光我說你現在年薪多少他就說80幾萬年薪沒有就上白班而已如果說他要值班就260\n199085\t223105\t所以現在年輕人你跟他講說 喔 當公務人員多好當警察多好 當醫生多好他不應該信到以前的公務人員 社會地位都很高現在公務人員要搞一個什麼退休用你自己提撥的錢 加政府提撥的錢這一筆基金 發完就沒了現在聽說變成這樣 這樣還得了我覺得這以後搞不搞就沒有人要考啦\n227692\t229961\t整個都崩盤了嘛所以整個價值觀都變啦\n232332\t257698\t這醫生這麼多年都沒薪水、沒什麼提高所以還是要籌多一點錢待遇還是很重要的一位醫生到台北去做醫生、做到老沒有一間房子,要找西人人家在國外是薪水月薪月薪差不多18個月就可以買一個房子\n260673\t282978\t四個月也可以買一部車子這是當統計所以部長還有署長你們責任重大好 今天講今天的健保的東西這十幾年來就是偶爾就會出現一個官員用CME拿資料出去了然後被判刑了\n284178\t295324\t好像都一直來那你現在的那個內部要拿資料的前線現在到底有沒有加強部長我們有要求健保署一定要去查清楚整個機制要加強請署長回答\n304347\t320083\t跟委員報告這個案子當然還在檢調偵查中不過我們在這個事件之後已經重新檢討過在內積的部分去強化包含資料使用權限的限縮還有可取得的這個\n321484\t339789\t資料的那個欄位就是最少原則那如果需要到大筆資料還要簽核所以都加強了這個內控的機制所有的使用紀錄都會被留下來就是你只要經過就對對對對另外還導入外機的機制包含這個ISO27001的標準CNS27001的標準還有外機所以我們是強化內機之外也導入外機的機制\n349571\t366115\t好那出皮肉都是健保署那國健署都沒問題喔國健署的資料也沒救捏我們這三高我們這什麼癌症病人都害得了所以國健署這邊有沒有洩露出去有沒有出事跟蘇昭偉報告一下這兩件事這個是形式問題這是他自己這是職員那個怕我們這個話齁\n371696\t378039\t那是我們本來就很嚴格,要在那個本金裡面,去個別化或是識別化,拿出來今天可以再做這兩件事情啦,那這個我們當然需要去檢討\n388749\t416109\t但是今天討論的是因為我們本來就已經在做後來是因為宣判所以我們把他弄得就能夠讓大家安心病人隱私的一個保護跟安全啦這有兩個齁這個法案過了會比較清楚規範說要怎麼贏啊背信給人家拿資料去贏我希望疫情開始的20年我的資料可以贏沒有你的資料可以贏你也不知道\n417550\t439350\t說什麼去名字都去掉就用了搞不好你已經被用了一百次了我被用了一千次了論文就有六千篇了嘛對不對所以你這個法通過你也不知道你繼續也不知道你到底有沒有用啊說你可以退出還是不同意我不知道發一個發一個問求你說給天保署說我的資料都沒有用\n445860\t460488\t有這個我們社權法規委來處理這個而且會更細膩來看他不能釋出哪些資料那基本上如果去識別化的話像我個人的話我覺得只要識別化對公共衛生對國家的一個醫藥發展提升我覺得應該是\n461553\t486308\t沒有啦 我們的資料被用去世白話 名字都遮起來這樣 這樣如果能遮到這樣 那當然安心啦對社會也有貢獻 連捐大體都在捐的大體老師都是這樣捐的嘛所以 我們是可以理解但是一般百姓會不會理解 我不知道好 你這個法通過之後跟另外一件事就是倒賣個資 倒賣資料出去這是兩回事\n487849\t510487\t所以倒賣這一塊你們有什麼防患的措施剛剛署長講的以外有加強嗎 還是現在都不可能發生啊從此以後不會發生的對 我們都強化了就是剛剛講的都是在那個事件之後我們重新檢討過強化到目前的話都維持得很好我們一定要強化到絕對不可能再發生\n512202\t519428\t今天這個法案拿出來 院辦得出來是要迎合這個憲法法庭的判決那跟我們資料會被盜賣這是兩回事所以這個要怎麼加強\n526704\t554620\t你要回答?來,你來回答我來,我問李處長資料被...大量資料被下載所以我們已經從去年開始就進行一個管理每個月每個單位,它只要有哪一個人在不對的時間、不對的地點、不對的量去下載資料,我們全部都有掌握然後都會給各個主管所以這個在USB跟硬碟現在都有這些管理跟委員報告好,OK\n555595\t577513\t那我們健保這樣說30年來我們的就醫資料有680幾億筆有這麼多那怎麼用你們現在有人家的apply來申請你們IRB通過之外你們這邊有一個委員會在審查在核准嗎我們有專案小組有專案小組這裡面有24個委員在做審查\n582798\t607499\t那現在的設計如果經過審查以後當然沒有爭議就就看看後續怎麼樣我們會再來演繹但是如果有困難矛盾的話我們會有執議會來處理所以這個審查委員會上面還有一個執議會那這個執議會是這個因為他不可能主案審查那可能會受不了啦不可能啦不可能所以這個委員會先\n608655\t611780\t先審查小組,過了就過了,沒有過的再送到執意會有爭議的到執意會\n619622\t632197\t好那最後一個問題現在疫苗現在有還有三百多萬劑那現在要你不是支持高麗大家要煮有我自己煮六支我這個如果標準的就兩個童弟我就煮但是我煮到現在我會嚇到的阿博爹你有煮嗎\n639167\t650513\t我十月請他煮一支,四月請他煮一支我現在有很多老闆或鄉長、鎮長跟我說要煮嗎?煮了怎麼辦?我說你不煮可能會瘋掉煮會瘋掉嗎?我說也不一定煮疫苗出現事情的規矩但是你不煮疫苗應該是更危險\n665305\t688922\t錄影,這樣會中症嘛,中症會跳起來因為我在民間看那些玩家,有的年輕人,有的年輕人在過去這個疫情,做疫苗要有心理不整的有肉膜積水,心肝膜積水,咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕\n694045\t715664\t我想大家都會說有可能有可能但是他們去秤的那些要害沒有一件過的因為都不會死 但是就都有症狀有的真的 主要病心力不整 真的有所以我在新浪溝這邊碰到一大堆所以我越看越擔心\n716405\t719928\t所以你現在叫我打,我還是會去打啦但是我怕會被打掉但是如果有人問我,我真的會保留保證你宣示一下市長可不可以請我們專家跟大家宣導一下打疫苗是不是過去專家的\n735469\t736170\t因為我們目前都還是有在針對所有的這個\n751802\t775724\t疫苗的接種之後有如果不良反應其實是都可以通報所以我們一直有在蒐集這方面的數據然後在這個食藥署這邊有去做定期的這個統計那另外像委員提到就是說有這種接種之後疑似是因為疫苗造成的其實我們在這個不管在第一層衛生局這邊也都會去做調查然後如果這個真的是可能跟疫苗有關的也都會跟他說有這個救濟的這個管道\n776184\t798171\t也就是可以提這個疫苗接種預防接種受害救濟這個部分那我們有一個獨立的這個專家委員會去做審議去判斷這個相關性因為疫苗本身一直在突變突變突變到現在跟原來的以前三年前的完全不太一樣了嘛那所以你現在新的疫苗是最新的這個病毒的突變那應該都有cover到\n799372\t817937\t至少自主會後 如果中就中不中重鎮嘛重鎮的死亡率高嘛 尤其是三高的人所以還是鼓勵要打啦個人覺得也是要鼓勵啦所以你們要宣導要講清楚啦現在老人家最大的疑慮就是剛剛我講的無主會死 主人白會死嗎\n823702\t844605\t所以現在針對這個疫苗接種的利弊得失的話我們當然還是會最建議的就是在這個高風險的族群像是這65歲以上的長者或者是這個有這個慢性病的患者他們如果得到這個新冠之後病發重症跟死亡的風險都很高所以在這個族群我們是一直大力的推廣要接種好 謝謝好 謝謝署長 謝謝 謝謝主席好 謝謝 謝謝部長 謝謝\n","txt":"剛才大家都在講急診,我幫你講屏東的情況是,謝謝屏東,屏東市有很嚴重度,屏東貧瘠\n他的腦神因為腎中毒後他就要腦神經內科要二十四小時所以大家都在等他去找他的四個神經內科醫生找三個現在只剩下一個一個要來我那裡我說不可以啦你不可以把他修我跟他認定說你不可以把他修那修了他就斑斑\n很嚴重,有三個醫生,五個早上到早上兩個都早上,早上兩個都早上,每天連續一天,早上兩個有三個醫生,一個八十幾歲,一個六十幾歲,數十,還沒要胖,所以我現在跟他們說,不然就做區域聯防啦,區域聯防,這是一個步啦,所以還是要想辦法啦,\n那這所以平基任何跑掉的就就給他引導 再去府營 婦產科啦不然怎麼辦所以我們在地方上我們都很努力的在讓他能夠維持好的運作雖然要有保證知道事情真的可能不是跟他鬥氣而已身高也很嚴重因為現在婦產科醫生平均五六十歲\n所以現在生小孩在家麻煩,婦醫生麻煩\n那像兒科,我們那邊現在維持七個兒科醫師,都是刺磚科那是硬要拿的,每個都撩錢,撩到頭就頭所以這個要怎麼去補償?署長你可能要研究看看每一次看到你們我都很疼惜啦還要疼惜我們這個年輕人現在整個社會的觀念都變了現在年輕人,沒有在聽這套啦\n現在因為科技業者晶片業者他們太好找工作了而且只要你願意值班我們的住院醫師在值班人家在晶片的施工的也在值班但是人家只要值班年薪就250萬起跳\n我去竹科那邊看 八八八三班另外一個班是on call那on call就是不能離開新竹縣市call你的時候40分鐘要到那就四班在亂每一個都是250起跳 隔年就可以到300萬了我院長的小孩是念志工碩士\n他現在在日夜光我說你現在年薪多少他就說80幾萬年薪沒有就上白班而已如果說他要值班就260\n所以現在年輕人你跟他講說 喔 當公務人員多好當警察多好 當醫生多好他不應該信到以前的公務人員 社會地位都很高現在公務人員要搞一個什麼退休用你自己提撥的錢 加政府提撥的錢這一筆基金 發完就沒了現在聽說變成這樣 這樣還得了我覺得這以後搞不搞就沒有人要考啦\n整個都崩盤了嘛所以整個價值觀都變啦\n這醫生這麼多年都沒薪水、沒什麼提高所以還是要籌多一點錢待遇還是很重要的一位醫生到台北去做醫生、做到老沒有一間房子,要找西人人家在國外是薪水月薪月薪差不多18個月就可以買一個房子\n四個月也可以買一部車子這是當統計所以部長還有署長你們責任重大好 今天講今天的健保的東西這十幾年來就是偶爾就會出現一個官員用CME拿資料出去了然後被判刑了\n好像都一直來那你現在的那個內部要拿資料的前線現在到底有沒有加強部長我們有要求健保署一定要去查清楚整個機制要加強請署長回答\n跟委員報告這個案子當然還在檢調偵查中不過我們在這個事件之後已經重新檢討過在內積的部分去強化包含資料使用權限的限縮還有可取得的這個\n資料的那個欄位就是最少原則那如果需要到大筆資料還要簽核所以都加強了這個內控的機制所有的使用紀錄都會被留下來就是你只要經過就對對對對另外還導入外機的機制包含這個ISO27001的標準CNS27001的標準還有外機所以我們是強化內機之外也導入外機的機制\n好那出皮肉都是健保署那國健署都沒問題喔國健署的資料也沒救捏我們這三高我們這什麼癌症病人都害得了所以國健署這邊有沒有洩露出去有沒有出事跟蘇昭偉報告一下這兩件事這個是形式問題這是他自己這是職員那個怕我們這個話齁\n那是我們本來就很嚴格,要在那個本金裡面,去個別化或是識別化,拿出來今天可以再做這兩件事情啦,那這個我們當然需要去檢討\n但是今天討論的是因為我們本來就已經在做後來是因為宣判所以我們把他弄得就能夠讓大家安心病人隱私的一個保護跟安全啦這有兩個齁這個法案過了會比較清楚規範說要怎麼贏啊背信給人家拿資料去贏我希望疫情開始的20年我的資料可以贏沒有你的資料可以贏你也不知道\n說什麼去名字都去掉就用了搞不好你已經被用了一百次了我被用了一千次了論文就有六千篇了嘛對不對所以你這個法通過你也不知道你繼續也不知道你到底有沒有用啊說你可以退出還是不同意我不知道發一個發一個問求你說給天保署說我的資料都沒有用\n有這個我們社權法規委來處理這個而且會更細膩來看他不能釋出哪些資料那基本上如果去識別化的話像我個人的話我覺得只要識別化對公共衛生對國家的一個醫藥發展提升我覺得應該是\n沒有啦 我們的資料被用去世白話 名字都遮起來這樣 這樣如果能遮到這樣 那當然安心啦對社會也有貢獻 連捐大體都在捐的大體老師都是這樣捐的嘛所以 我們是可以理解但是一般百姓會不會理解 我不知道好 你這個法通過之後跟另外一件事就是倒賣個資 倒賣資料出去這是兩回事\n所以倒賣這一塊你們有什麼防患的措施剛剛署長講的以外有加強嗎 還是現在都不可能發生啊從此以後不會發生的對 我們都強化了就是剛剛講的都是在那個事件之後我們重新檢討過強化到目前的話都維持得很好我們一定要強化到絕對不可能再發生\n今天這個法案拿出來 院辦得出來是要迎合這個憲法法庭的判決那跟我們資料會被盜賣這是兩回事所以這個要怎麼加強\n你要回答?來,你來回答我來,我問李處長資料被...大量資料被下載所以我們已經從去年開始就進行一個管理每個月每個單位,它只要有哪一個人在不對的時間、不對的地點、不對的量去下載資料,我們全部都有掌握然後都會給各個主管所以這個在USB跟硬碟現在都有這些管理跟委員報告好,OK\n那我們健保這樣說30年來我們的就醫資料有680幾億筆有這麼多那怎麼用你們現在有人家的apply來申請你們IRB通過之外你們這邊有一個委員會在審查在核准嗎我們有專案小組有專案小組這裡面有24個委員在做審查\n那現在的設計如果經過審查以後當然沒有爭議就就看看後續怎麼樣我們會再來演繹但是如果有困難矛盾的話我們會有執議會來處理所以這個審查委員會上面還有一個執議會那這個執議會是這個因為他不可能主案審查那可能會受不了啦不可能啦不可能所以這個委員會先\n先審查小組,過了就過了,沒有過的再送到執意會有爭議的到執意會\n好那最後一個問題現在疫苗現在有還有三百多萬劑那現在要你不是支持高麗大家要煮有我自己煮六支我這個如果標準的就兩個童弟我就煮但是我煮到現在我會嚇到的阿博爹你有煮嗎\n我十月請他煮一支,四月請他煮一支我現在有很多老闆或鄉長、鎮長跟我說要煮嗎?煮了怎麼辦?我說你不煮可能會瘋掉煮會瘋掉嗎?我說也不一定煮疫苗出現事情的規矩但是你不煮疫苗應該是更危險\n錄影,這樣會中症嘛,中症會跳起來因為我在民間看那些玩家,有的年輕人,有的年輕人在過去這個疫情,做疫苗要有心理不整的有肉膜積水,心肝膜積水,咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕\n我想大家都會說有可能有可能但是他們去秤的那些要害沒有一件過的因為都不會死 但是就都有症狀有的真的 主要病心力不整 真的有所以我在新浪溝這邊碰到一大堆所以我越看越擔心\n所以你現在叫我打,我還是會去打啦但是我怕會被打掉但是如果有人問我,我真的會保留保證你宣示一下市長可不可以請我們專家跟大家宣導一下打疫苗是不是過去專家的\n因為我們目前都還是有在針對所有的這個\n疫苗的接種之後有如果不良反應其實是都可以通報所以我們一直有在蒐集這方面的數據然後在這個食藥署這邊有去做定期的這個統計那另外像委員提到就是說有這種接種之後疑似是因為疫苗造成的其實我們在這個不管在第一層衛生局這邊也都會去做調查然後如果這個真的是可能跟疫苗有關的也都會跟他說有這個救濟的這個管道\n也就是可以提這個疫苗接種預防接種受害救濟這個部分那我們有一個獨立的這個專家委員會去做審議去判斷這個相關性因為疫苗本身一直在突變突變突變到現在跟原來的以前三年前的完全不太一樣了嘛那所以你現在新的疫苗是最新的這個病毒的突變那應該都有cover到\n至少自主會後 如果中就中不中重鎮嘛重鎮的死亡率高嘛 尤其是三高的人所以還是鼓勵要打啦個人覺得也是要鼓勵啦所以你們要宣導要講清楚啦現在老人家最大的疑慮就是剛剛我講的無主會死 主人白會死嗎\n所以現在針對這個疫苗接種的利弊得失的話我們當然還是會最建議的就是在這個高風險的族群像是這65歲以上的長者或者是這個有這個慢性病的患者他們如果得到這個新冠之後病發重症跟死亡的風險都很高所以在這個族群我們是一直大力的推廣要接種好 謝謝好 謝謝署長 謝謝 謝謝主席好 謝謝 謝謝部長 謝謝\n","vtt":"WEBVTT\n\n00:00.089 --> 00:03.410\n剛才大家都在講急診,我幫你講屏東的情況是,謝謝屏東,屏東市有很嚴重度,屏東貧瘠\n\n00:27.040 --> 00:50.428\n他的腦神因為腎中毒後他就要腦神經內科要二十四小時所以大家都在等他去找他的四個神經內科醫生找三個現在只剩下一個一個要來我那裡我說不可以啦你不可以把他修我跟他認定說你不可以把他修那修了他就斑斑\n\n00:51.670 --> 00:56.912\n很嚴重,有三個醫生,五個早上到早上兩個都早上,早上兩個都早上,每天連續一天,早上兩個有三個醫生,一個八十幾歲,一個六十幾歲,數十,還沒要胖,所以我現在跟他們說,不然就做區域聯防啦,區域聯防,這是一個步啦,所以還是要想辦法啦,\n\n01:19.600 --> 01:41.009\n那這所以平基任何跑掉的就就給他引導再去府營婦產科啦不然怎麼辦所以我們在地方上我們都很努力的在讓他能夠維持好的運作雖然要有保證知道事情真的可能不是跟他鬥氣而已身高也很嚴重因為現在婦產科醫生平均五六十歲\n\n01:46.431 --> 01:48.355\n所以現在生小孩在家麻煩,婦醫生麻煩\n\n01:51.038 --> 02:12.992\n那像兒科,我們那邊現在維持七個兒科醫師,都是刺磚科那是硬要拿的,每個都撩錢,撩到頭就頭所以這個要怎麼去補償?署長你可能要研究看看每一次看到你們我都很疼惜啦還要疼惜我們這個年輕人現在整個社會的觀念都變了現在年輕人,沒有在聽這套啦\n\n02:19.685 --> 02:36.189\n現在因為科技業者晶片業者他們太好找工作了而且只要你願意值班我們的住院醫師在值班人家在晶片的施工的也在值班但是人家只要值班年薪就250萬起跳\n\n02:41.142 --> 03:03.701\n我去竹科那邊看八八八三班另外一個班是oncall那oncall就是不能離開新竹縣市call你的時候40分鐘要到那就四班在亂每一個都是250起跳隔年就可以到300萬了我院長的小孩是念志工碩士\n\n03:05.182 --> 03:16.898\n他現在在日夜光我說你現在年薪多少他就說80幾萬年薪沒有就上白班而已如果說他要值班就260\n\n03:19.085 --> 03:43.105\n所以現在年輕人你跟他講說喔當公務人員多好當警察多好當醫生多好他不應該信到以前的公務人員社會地位都很高現在公務人員要搞一個什麼退休用你自己提撥的錢加政府提撥的錢這一筆基金發完就沒了現在聽說變成這樣這樣還得了我覺得這以後搞不搞就沒有人要考啦\n\n03:47.692 --> 03:49.961\n整個都崩盤了嘛所以整個價值觀都變啦\n\n03:52.332 --> 04:17.698\n這醫生這麼多年都沒薪水、沒什麼提高所以還是要籌多一點錢待遇還是很重要的一位醫生到台北去做醫生、做到老沒有一間房子,要找西人人家在國外是薪水月薪月薪差不多18個月就可以買一個房子\n\n04:20.673 --> 04:42.978\n四個月也可以買一部車子這是當統計所以部長還有署長你們責任重大好今天講今天的健保的東西這十幾年來就是偶爾就會出現一個官員用CME拿資料出去了然後被判刑了\n\n04:44.178 --> 04:55.324\n好像都一直來那你現在的那個內部要拿資料的前線現在到底有沒有加強部長我們有要求健保署一定要去查清楚整個機制要加強請署長回答\n\n05:04.347 --> 05:20.083\n跟委員報告這個案子當然還在檢調偵查中不過我們在這個事件之後已經重新檢討過在內積的部分去強化包含資料使用權限的限縮還有可取得的這個\n\n05:21.484 --> 05:39.789\n資料的那個欄位就是最少原則那如果需要到大筆資料還要簽核所以都加強了這個內控的機制所有的使用紀錄都會被留下來就是你只要經過就對對對對另外還導入外機的機制包含這個ISO27001的標準CNS27001的標準還有外機所以我們是強化內機之外也導入外機的機制\n\n05:49.571 --> 06:06.115\n好那出皮肉都是健保署那國健署都沒問題喔國健署的資料也沒救捏我們這三高我們這什麼癌症病人都害得了所以國健署這邊有沒有洩露出去有沒有出事跟蘇昭偉報告一下這兩件事這個是形式問題這是他自己這是職員那個怕我們這個話齁\n\n06:11.696 --> 06:18.039\n那是我們本來就很嚴格,要在那個本金裡面,去個別化或是識別化,拿出來今天可以再做這兩件事情啦,那這個我們當然需要去檢討\n\n06:28.749 --> 06:56.109\n但是今天討論的是因為我們本來就已經在做後來是因為宣判所以我們把他弄得就能夠讓大家安心病人隱私的一個保護跟安全啦這有兩個齁這個法案過了會比較清楚規範說要怎麼贏啊背信給人家拿資料去贏我希望疫情開始的20年我的資料可以贏沒有你的資料可以贏你也不知道\n\n06:57.550 --> 07:19.350\n說什麼去名字都去掉就用了搞不好你已經被用了一百次了我被用了一千次了論文就有六千篇了嘛對不對所以你這個法通過你也不知道你繼續也不知道你到底有沒有用啊說你可以退出還是不同意我不知道發一個發一個問求你說給天保署說我的資料都沒有用\n\n07:25.860 --> 07:40.488\n有這個我們社權法規委來處理這個而且會更細膩來看他不能釋出哪些資料那基本上如果去識別化的話像我個人的話我覺得只要識別化對公共衛生對國家的一個醫藥發展提升我覺得應該是\n\n07:41.553 --> 08:06.308\n沒有啦我們的資料被用去世白話名字都遮起來這樣這樣如果能遮到這樣那當然安心啦對社會也有貢獻連捐大體都在捐的大體老師都是這樣捐的嘛所以我們是可以理解但是一般百姓會不會理解我不知道好你這個法通過之後跟另外一件事就是倒賣個資倒賣資料出去這是兩回事\n\n08:07.849 --> 08:30.487\n所以倒賣這一塊你們有什麼防患的措施剛剛署長講的以外有加強嗎還是現在都不可能發生啊從此以後不會發生的對我們都強化了就是剛剛講的都是在那個事件之後我們重新檢討過強化到目前的話都維持得很好我們一定要強化到絕對不可能再發生\n\n08:32.202 --> 08:39.428\n今天這個法案拿出來院辦得出來是要迎合這個憲法法庭的判決那跟我們資料會被盜賣這是兩回事所以這個要怎麼加強\n\n08:46.704 --> 09:14.620\n你要回答?來,你來回答我來,我問李處長資料被...大量資料被下載所以我們已經從去年開始就進行一個管理每個月每個單位,它只要有哪一個人在不對的時間、不對的地點、不對的量去下載資料,我們全部都有掌握然後都會給各個主管所以這個在USB跟硬碟現在都有這些管理跟委員報告好,OK\n\n09:15.595 --> 09:37.513\n那我們健保這樣說30年來我們的就醫資料有680幾億筆有這麼多那怎麼用你們現在有人家的apply來申請你們IRB通過之外你們這邊有一個委員會在審查在核准嗎我們有專案小組有專案小組這裡面有24個委員在做審查\n\n09:42.798 --> 10:07.499\n那現在的設計如果經過審查以後當然沒有爭議就就看看後續怎麼樣我們會再來演繹但是如果有困難矛盾的話我們會有執議會來處理所以這個審查委員會上面還有一個執議會那這個執議會是這個因為他不可能主案審查那可能會受不了啦不可能啦不可能所以這個委員會先\n\n10:08.655 --> 10:11.780\n先審查小組,過了就過了,沒有過的再送到執意會有爭議的到執意會\n\n10:19.622 --> 10:32.197\n好那最後一個問題現在疫苗現在有還有三百多萬劑那現在要你不是支持高麗大家要煮有我自己煮六支我這個如果標準的就兩個童弟我就煮但是我煮到現在我會嚇到的阿博爹你有煮嗎\n\n10:39.167 --> 10:50.513\n我十月請他煮一支,四月請他煮一支我現在有很多老闆或鄉長、鎮長跟我說要煮嗎?煮了怎麼辦?我說你不煮可能會瘋掉煮會瘋掉嗎?我說也不一定煮疫苗出現事情的規矩但是你不煮疫苗應該是更危險\n\n11:05.305 --> 11:28.922\n錄影,這樣會中症嘛,中症會跳起來因為我在民間看那些玩家,有的年輕人,有的年輕人在過去這個疫情,做疫苗要有心理不整的有肉膜積水,心肝膜積水,咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕\n\n11:34.045 --> 11:55.664\n我想大家都會說有可能有可能但是他們去秤的那些要害沒有一件過的因為都不會死但是就都有症狀有的真的主要病心力不整真的有所以我在新浪溝這邊碰到一大堆所以我越看越擔心\n\n11:56.405 --> 11:59.928\n所以你現在叫我打,我還是會去打啦但是我怕會被打掉但是如果有人問我,我真的會保留保證你宣示一下市長可不可以請我們專家跟大家宣導一下打疫苗是不是過去專家的\n\n12:15.469 --> 12:16.170\n因為我們目前都還是有在針對所有的這個\n\n12:31.802 --> 12:55.724\n疫苗的接種之後有如果不良反應其實是都可以通報所以我們一直有在蒐集這方面的數據然後在這個食藥署這邊有去做定期的這個統計那另外像委員提到就是說有這種接種之後疑似是因為疫苗造成的其實我們在這個不管在第一層衛生局這邊也都會去做調查然後如果這個真的是可能跟疫苗有關的也都會跟他說有這個救濟的這個管道\n\n12:56.184 --> 13:18.171\n也就是可以提這個疫苗接種預防接種受害救濟這個部分那我們有一個獨立的這個專家委員會去做審議去判斷這個相關性因為疫苗本身一直在突變突變突變到現在跟原來的以前三年前的完全不太一樣了嘛那所以你現在新的疫苗是最新的這個病毒的突變那應該都有cover到\n\n13:19.372 --> 13:37.937\n至少自主會後如果中就中不中重鎮嘛重鎮的死亡率高嘛尤其是三高的人所以還是鼓勵要打啦個人覺得也是要鼓勵啦所以你們要宣導要講清楚啦現在老人家最大的疑慮就是剛剛我講的無主會死主人白會死嗎\n\n13:43.702 --> 14:04.605\n所以現在針對這個疫苗接種的利弊得失的話我們當然還是會最建議的就是在這個高風險的族群像是這65歲以上的長者或者是這個有這個慢性病的患者他們如果得到這個新冠之後病發重症跟死亡的風險都很高所以在這個族群我們是一直大力的推廣要接種好謝謝好謝謝署長謝謝謝謝主席好謝謝謝謝部長謝謝\n\n","segments":[{"start":0.089,"end":3.41,"text":"剛才大家都在講急診,我幫你講屏東的情況是,謝謝屏東,屏東市有很嚴重度,屏東貧瘠"},{"start":27.04,"end":50.428,"text":"他的腦神因為腎中毒後他就要腦神經內科要二十四小時所以大家都在等他去找他的四個神經內科醫生找三個現在只剩下一個一個要來我那裡我說不可以啦你不可以把他修我跟他認定說你不可以把他修那修了他就斑斑"},{"start":51.67,"end":56.912,"text":"很嚴重,有三個醫生,五個早上到早上兩個都早上,早上兩個都早上,每天連續一天,早上兩個有三個醫生,一個八十幾歲,一個六十幾歲,數十,還沒要胖,所以我現在跟他們說,不然就做區域聯防啦,區域聯防,這是一個步啦,所以還是要想辦法啦,"},{"start":79.6,"end":101.009,"text":"那這所以平基任何跑掉的就就給他引導 再去府營 婦產科啦不然怎麼辦所以我們在地方上我們都很努力的在讓他能夠維持好的運作雖然要有保證知道事情真的可能不是跟他鬥氣而已身高也很嚴重因為現在婦產科醫生平均五六十歲"},{"start":106.431,"end":108.355,"text":"所以現在生小孩在家麻煩,婦醫生麻煩"},{"start":111.038,"end":132.992,"text":"那像兒科,我們那邊現在維持七個兒科醫師,都是刺磚科那是硬要拿的,每個都撩錢,撩到頭就頭所以這個要怎麼去補償?署長你可能要研究看看每一次看到你們我都很疼惜啦還要疼惜我們這個年輕人現在整個社會的觀念都變了現在年輕人,沒有在聽這套啦"},{"start":139.685,"end":156.189,"text":"現在因為科技業者晶片業者他們太好找工作了而且只要你願意值班我們的住院醫師在值班人家在晶片的施工的也在值班但是人家只要值班年薪就250萬起跳"},{"start":161.142,"end":183.701,"text":"我去竹科那邊看 八八八三班另外一個班是on call那on call就是不能離開新竹縣市call你的時候40分鐘要到那就四班在亂每一個都是250起跳 隔年就可以到300萬了我院長的小孩是念志工碩士"},{"start":185.182,"end":196.898,"text":"他現在在日夜光我說你現在年薪多少他就說80幾萬年薪沒有就上白班而已如果說他要值班就260"},{"start":199.085,"end":223.105,"text":"所以現在年輕人你跟他講說 喔 當公務人員多好當警察多好 當醫生多好他不應該信到以前的公務人員 社會地位都很高現在公務人員要搞一個什麼退休用你自己提撥的錢 加政府提撥的錢這一筆基金 發完就沒了現在聽說變成這樣 這樣還得了我覺得這以後搞不搞就沒有人要考啦"},{"start":227.692,"end":229.961,"text":"整個都崩盤了嘛所以整個價值觀都變啦"},{"start":232.332,"end":257.698,"text":"這醫生這麼多年都沒薪水、沒什麼提高所以還是要籌多一點錢待遇還是很重要的一位醫生到台北去做醫生、做到老沒有一間房子,要找西人人家在國外是薪水月薪月薪差不多18個月就可以買一個房子"},{"start":260.673,"end":282.978,"text":"四個月也可以買一部車子這是當統計所以部長還有署長你們責任重大好 今天講今天的健保的東西這十幾年來就是偶爾就會出現一個官員用CME拿資料出去了然後被判刑了"},{"start":284.178,"end":295.324,"text":"好像都一直來那你現在的那個內部要拿資料的前線現在到底有沒有加強部長我們有要求健保署一定要去查清楚整個機制要加強請署長回答"},{"start":304.347,"end":320.083,"text":"跟委員報告這個案子當然還在檢調偵查中不過我們在這個事件之後已經重新檢討過在內積的部分去強化包含資料使用權限的限縮還有可取得的這個"},{"start":321.484,"end":339.789,"text":"資料的那個欄位就是最少原則那如果需要到大筆資料還要簽核所以都加強了這個內控的機制所有的使用紀錄都會被留下來就是你只要經過就對對對對另外還導入外機的機制包含這個ISO27001的標準CNS27001的標準還有外機所以我們是強化內機之外也導入外機的機制"},{"start":349.571,"end":366.115,"text":"好那出皮肉都是健保署那國健署都沒問題喔國健署的資料也沒救捏我們這三高我們這什麼癌症病人都害得了所以國健署這邊有沒有洩露出去有沒有出事跟蘇昭偉報告一下這兩件事這個是形式問題這是他自己這是職員那個怕我們這個話齁"},{"start":371.696,"end":378.039,"text":"那是我們本來就很嚴格,要在那個本金裡面,去個別化或是識別化,拿出來今天可以再做這兩件事情啦,那這個我們當然需要去檢討"},{"start":388.749,"end":416.109,"text":"但是今天討論的是因為我們本來就已經在做後來是因為宣判所以我們把他弄得就能夠讓大家安心病人隱私的一個保護跟安全啦這有兩個齁這個法案過了會比較清楚規範說要怎麼贏啊背信給人家拿資料去贏我希望疫情開始的20年我的資料可以贏沒有你的資料可以贏你也不知道"},{"start":417.55,"end":439.35,"text":"說什麼去名字都去掉就用了搞不好你已經被用了一百次了我被用了一千次了論文就有六千篇了嘛對不對所以你這個法通過你也不知道你繼續也不知道你到底有沒有用啊說你可以退出還是不同意我不知道發一個發一個問求你說給天保署說我的資料都沒有用"},{"start":445.86,"end":460.488,"text":"有這個我們社權法規委來處理這個而且會更細膩來看他不能釋出哪些資料那基本上如果去識別化的話像我個人的話我覺得只要識別化對公共衛生對國家的一個醫藥發展提升我覺得應該是"},{"start":461.553,"end":486.308,"text":"沒有啦 我們的資料被用去世白話 名字都遮起來這樣 這樣如果能遮到這樣 那當然安心啦對社會也有貢獻 連捐大體都在捐的大體老師都是這樣捐的嘛所以 我們是可以理解但是一般百姓會不會理解 我不知道好 你這個法通過之後跟另外一件事就是倒賣個資 倒賣資料出去這是兩回事"},{"start":487.849,"end":510.487,"text":"所以倒賣這一塊你們有什麼防患的措施剛剛署長講的以外有加強嗎 還是現在都不可能發生啊從此以後不會發生的對 我們都強化了就是剛剛講的都是在那個事件之後我們重新檢討過強化到目前的話都維持得很好我們一定要強化到絕對不可能再發生"},{"start":512.202,"end":519.428,"text":"今天這個法案拿出來 院辦得出來是要迎合這個憲法法庭的判決那跟我們資料會被盜賣這是兩回事所以這個要怎麼加強"},{"start":526.704,"end":554.62,"text":"你要回答?來,你來回答我來,我問李處長資料被...大量資料被下載所以我們已經從去年開始就進行一個管理每個月每個單位,它只要有哪一個人在不對的時間、不對的地點、不對的量去下載資料,我們全部都有掌握然後都會給各個主管所以這個在USB跟硬碟現在都有這些管理跟委員報告好,OK"},{"start":555.595,"end":577.513,"text":"那我們健保這樣說30年來我們的就醫資料有680幾億筆有這麼多那怎麼用你們現在有人家的apply來申請你們IRB通過之外你們這邊有一個委員會在審查在核准嗎我們有專案小組有專案小組這裡面有24個委員在做審查"},{"start":582.798,"end":607.499,"text":"那現在的設計如果經過審查以後當然沒有爭議就就看看後續怎麼樣我們會再來演繹但是如果有困難矛盾的話我們會有執議會來處理所以這個審查委員會上面還有一個執議會那這個執議會是這個因為他不可能主案審查那可能會受不了啦不可能啦不可能所以這個委員會先"},{"start":608.655,"end":611.78,"text":"先審查小組,過了就過了,沒有過的再送到執意會有爭議的到執意會"},{"start":619.622,"end":632.197,"text":"好那最後一個問題現在疫苗現在有還有三百多萬劑那現在要你不是支持高麗大家要煮有我自己煮六支我這個如果標準的就兩個童弟我就煮但是我煮到現在我會嚇到的阿博爹你有煮嗎"},{"start":639.167,"end":650.513,"text":"我十月請他煮一支,四月請他煮一支我現在有很多老闆或鄉長、鎮長跟我說要煮嗎?煮了怎麼辦?我說你不煮可能會瘋掉煮會瘋掉嗎?我說也不一定煮疫苗出現事情的規矩但是你不煮疫苗應該是更危險"},{"start":665.305,"end":688.922,"text":"錄影,這樣會中症嘛,中症會跳起來因為我在民間看那些玩家,有的年輕人,有的年輕人在過去這個疫情,做疫苗要有心理不整的有肉膜積水,心肝膜積水,咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕咕嚕"},{"start":694.045,"end":715.664,"text":"我想大家都會說有可能有可能但是他們去秤的那些要害沒有一件過的因為都不會死 但是就都有症狀有的真的 主要病心力不整 真的有所以我在新浪溝這邊碰到一大堆所以我越看越擔心"},{"start":716.405,"end":719.928,"text":"所以你現在叫我打,我還是會去打啦但是我怕會被打掉但是如果有人問我,我真的會保留保證你宣示一下市長可不可以請我們專家跟大家宣導一下打疫苗是不是過去專家的"},{"start":735.469,"end":736.17,"text":"因為我們目前都還是有在針對所有的這個"},{"start":751.802,"end":775.724,"text":"疫苗的接種之後有如果不良反應其實是都可以通報所以我們一直有在蒐集這方面的數據然後在這個食藥署這邊有去做定期的這個統計那另外像委員提到就是說有這種接種之後疑似是因為疫苗造成的其實我們在這個不管在第一層衛生局這邊也都會去做調查然後如果這個真的是可能跟疫苗有關的也都會跟他說有這個救濟的這個管道"},{"start":776.184,"end":798.171,"text":"也就是可以提這個疫苗接種預防接種受害救濟這個部分那我們有一個獨立的這個專家委員會去做審議去判斷這個相關性因為疫苗本身一直在突變突變突變到現在跟原來的以前三年前的完全不太一樣了嘛那所以你現在新的疫苗是最新的這個病毒的突變那應該都有cover到"},{"start":799.372,"end":817.937,"text":"至少自主會後 如果中就中不中重鎮嘛重鎮的死亡率高嘛 尤其是三高的人所以還是鼓勵要打啦個人覺得也是要鼓勵啦所以你們要宣導要講清楚啦現在老人家最大的疑慮就是剛剛我講的無主會死 主人白會死嗎"},{"start":823.702,"end":844.605,"text":"所以現在針對這個疫苗接種的利弊得失的話我們當然還是會最建議的就是在這個高風險的族群像是這65歲以上的長者或者是這個有這個慢性病的患者他們如果得到這個新冠之後病發重症跟死亡的風險都很高所以在這個族群我們是一直大力的推廣要接種好 謝謝好 謝謝署長 謝謝 謝謝主席好 謝謝 謝謝部長 謝謝"}]}}},"gazette":{"lineno":419,"blocks":[["蘇委員清泉：（10時20分）謝謝召委，請部長及石署長。"],["主席：請部長及石署長。"],["邱部長泰源：蘇召委好。"],["蘇委員清泉：剛才大家都在討論急診，我跟你說屏東的情況。"],["邱部長泰源：是，謝謝。"],["蘇委員清泉：屏東市有一間重度級醫院，也就是屏基，它升重度級之後，腦神經內科要提供24小時服務，所以大家都在那邊「釘」啦！結果4個神經內科醫生跑了3個，現在剩1個，這1位說要來我那邊，我說：不行啦！我跟院長說：你不能收，收了屏基就崩盤了。就是這麼嚴重啦！婦產科醫生原本有5個，跑掉只剩2個，這2個都女孩子，東港另外一間醫院剩2個婦產科醫生，一個八十幾歲、一個六十幾歲，署長，要怎麼辦？我現在跟他們說不然就做區域聯防啦！區域聯防是一個方式，所以還是要想辦法。屏基那個跑掉的就引導他到復興醫院的婦產科啦！不然要怎麼辦？","所以我們在地方上都很努力的讓醫院能夠維持好的運作，也要讓部長知道，這個問題真的不只發生在都市而已，鄉下也很嚴重。因為現在婦產科醫生平均都五、六十歲了，所以現在生孩子，這是很麻煩、非常麻煩。譬如像兒科，我們那邊現在維持7個兒科醫師，都是次專科，都在硬撐著，每個月都賠錢，而且賠得很嚴重，所以這個要怎麼補強，署長可能要研究看看要怎麼辦？","每一次看到你們，我都很疼惜啦！還要疼惜我們這些年輕醫生，但現在整個社會的觀念都變了，現在年輕人沒有在跟你聽這套，因為科技業者及晶片業者人員的需求量大，他們太好找工作了，而且只要你願意值班……我們的住院醫師在值班，人家產製晶片的資工人員也在值班，但是人家只要值班，年薪就250萬元起跳，像我看竹科的部分，就是8、8、8共計3班次，另外一個班是on call，就是不能離開新竹縣市，call你的時候40分鐘要到，就4班在run，每一個都是250萬元起跳，隔年就可以到300萬。我們院長的小孩是資工碩士，他現在在日月光，我問他現在月薪多少？他說：報告，八十幾萬年薪。只有上白班而已，如果他要值班就是260萬。","現在你跟年輕人講當公務人員多好、當警察多好、當醫生多好，他們根本不會理會你，以前公務人員的社會地位很高，現在公務人員搞一個什麼退休金是要用自己提撥的錢加政府提撥的錢，這一筆基金花完就沒了，現在聽說變成這樣，這樣還得了。我覺得以後高普考根本沒有人要考，整個都崩盤了嘛！整個價值觀都改變了，醫生的薪資這麼多年也沒有什麼提高，所以還是要籌多一點錢，待遇還是很重要啦！我聽說一個醫生住臺北市，當醫生當到老，買不到一間房子，笑死人！對不對？人家在國外是差不多18個月的月薪就可以買一個房子，4個月可以買一部車子，這是統計的啊！所以部長還有署長你們責任重大。關於健保，這十幾年來就是偶爾會出現某一個官員又洩密、拿資料出去，然後被判刑，好像一直出現這種案例。部長，現在內部要拿資料的權限到底有沒有加強？"],["邱部長泰源：我們有要求健保署一定要去查清楚，整個機制要加強，請署長回應。"],["石署長崇良：跟委員報告，這個案子還在檢調偵查中，不過在這個事件之後，我們已經重新檢討在內稽部分去強化，包含資料使用權限的限縮，還有可取得資料的欄位最少原則，如果需要大筆資料還要簽核，已經都加強了內控的機制，所有的使用紀錄也會留下來。"],["蘇委員清泉：就是你只要經過就會有痕跡。"],["石署長崇良：對，另外還導入外稽的機制，包含ISO 27001的標準、CNS 27001的標準，所以我們是強化內稽之外，也導入外稽的機制。"],["蘇委員清泉：好，出紕漏都是健保署，那國健署都沒事？國健署的資料也不少，關於三高、癌症病人的部分還得了！國健署有沒有洩漏出去？有沒有出事？"],["邱部長泰源：跟蘇召委報告這兩件事情，這個是刑事問題，我們這個法本來就很嚴格……他們進去那個房間裡面以去識別化拿出來只能……這是兩件事情。這部分當然會去檢討，但是今天討論的是我們本來就已經在做，後來因為憲判，所以把關於病人隱私部分做得更具保護跟安全，以讓大家安心。"],["蘇委員清泉：部長，這有兩點，這個法案通過以後，就有比較清楚的規範要怎麼用，民眾的資料被拿去用，我跟你說，從現在開始的二十年，我的資料被人家使用了嗎？你的資料被人家使用了嗎？你也不知道。名字被去掉就用了，搞不好你已經被用了100次，我被用了1,000次，因為論文就有6,000篇，對不對？所以這個法通過，你也不知道到底有沒有繼續被人家使用？除非是退出還是不同意，那不就要發個文給健保署說我的資料都不讓人用，這樣有可能嗎？"],["邱部長泰源：有啦！我們授權法規有來處理這個部分，而且會更細膩來看不能釋出哪些資料，基本上以我個人看來，如果去識別化對公共衛生及國家的醫藥發展提升有利，我覺得應該是沒有關係。"],["蘇委員清泉：沒有啦！我們的資料去識別化被利用，名字都遮起來，如果都做到這樣當然安心，對社會也有貢獻，人家捐大體都在捐了，大體老師都是這樣捐的，所以我們是可以理解，但是一般百姓會不會理解？我不知道。好，這個法通過之後，跟另外有關盜賣個資、盜賣資料是兩回事，所以盜賣這一塊，你們有什麼防範的措施？除了剛剛署長講的之外，有再加強的部分嗎？還是現在都不可能發生，從此以後不會再發生了？"],["石署長崇良：對，我們都強化了，就是剛剛講的在那個事件之後，我們重新檢討過並強化，到目前都維持得很好。"],["邱部長泰源：我們一定要強化到絕對不可能再發生。"],["蘇委員清泉：今天這個院版的法案提出來，是要迎合憲法法庭的判決，跟我們的資料會被盜賣是兩回事。這個要怎麼加強？你要回答嗎？"],["邱部長泰源：李處長。"],["李處長建璋：跟委員報告，關於資料被大量下載一事，我們已經從去年開始進行管理，只要每個月、每個單位有哪一個人在不對的時間、不對的地點、不對的量去下載資料，我們全部都有掌握，並且會提供給各個主管，所以在USB跟硬碟現在都有這些管理。"],["蘇委員清泉：OK。健保三十年來的就醫資料有六百八十幾億筆，有這麼多？怎麼用？現在有apply來申請，IRB通過之外，你們有一個委員會在審查？在核准嗎？"],["邱部長泰源：我們有專案小組，裡面有24個委員在審查。"],["蘇委員清泉：就是每一筆都審查？"],["邱部長泰源：現在的設計是如果經過審查以後沒有爭議，當然就看看後續怎麼樣我們會再來研議，但是如果有困難、矛盾的，會由諮議會來處理。"],["蘇委員清泉：這個審查委員會上面還有一個諮議會？"],["邱部長泰源：對。"],["蘇委員清泉：這個諮議會是比較……"],["邱部長泰源：它不可能逐案審查，可能委員也會受不了。"],["蘇委員清泉：不可能啦！所以這個委員會先……"],["邱部長泰源：審查小組。"],["蘇委員清泉：scan一次審查，過了就過了，沒有過的就再送到諮議委員會？"],["邱部長泰源：有爭議的送到諮議會。"],["蘇委員清泉：好，最後一個問題，疫苗現在還有三百多萬劑，目前只是鼓勵大家要施打。我自己已經施打了6支，我這個是標準的，如果有通知我就施打，但是施打到現在我會怕，部長你有施打嗎？"],["邱部長泰源：我10月1日施打一支，4月1日又施打一支。"],["蘇委員清泉：現在很多老人家問我，鄉長、鎮長問他們要不要施打，施打後會怎麼樣？我都跟他們說，沒施打有可能會死掉。他問那施打後會死掉嗎？我說這也不一定。施打疫苗後發生事情的一大堆啊！"],["邱部長泰源：但是如果不施打疫苗，應該會更危險。"],["蘇委員清泉：更危險，比較會導致重症，重症會造成死亡。因為我在門診看診時，患者有年輕女孩等等的人，在過去施打COVID-19疫苗後，有心律不整的、有肋膜積水的、有心包膜積水的雜七雜八一大堆，關節問題都跑出來，一些自體免疫的data都變得不正常，每個人都問我這跟打疫苗有關係嗎？我對每個人都說有可能，但是他們去申請藥害救濟沒有一件通過，因為都不會死，但是卻有症狀，有的真的變成心律不整，我在心臟科這邊碰到一大堆，所以我越看越擔心。現在你要我施打，我還是會去施打，就是怕會死掉，對不對？但是人家如果問我，我真的都保留，部長，你宣示一下。"],["邱部長泰源：蘇召委，我請我們專家跟大家宣導，施打疫苗部分過去專家的意見及利弊得失？"],["蘇委員清泉：你要說喔！這是全國都在聽，我把這做成FB的影片po出去。"],["邱部長泰源：林詠青醫師是非常優秀的防疫醫師。"],["林簡任技正詠青：報告委員，因為我們目前還是有針對所有COVID-19疫苗接種之後通報的不良反應，一直在蒐集這方面的數據，食藥署也有做定期的統計。另外像委員提到有接種之後疑似因為疫苗造成的狀況，第一層的衛生局都會去調查，如果真的可能是跟疫苗有關，也會告知救濟的管道，也就是可以提疫苗預防接種受害救濟，我們有一個獨立的專家委員會審議，去判斷相關性。"],["蘇委員清泉：因為病毒本身一直在突變，突變到現在跟原來的、三年前的完全不太一樣，所以現在新的疫苗是最新的病毒突變，應該都有cover到至少注射之後，如果得到比較不會得重症。重症的死亡率高，尤其是有三高的人，個人覺得還是要鼓勵施打，所以你們要宣導，要講清楚。現在老人家最大的疑慮就是剛剛我講的，沒打會死，打了不知道會不會死？不知道。"],["林簡任技正詠青：現在針對疫苗接種的利弊得失，我們當然還是最建議在高風險族群，像是65歲以上的長者或者是有慢性病的患者，他們得到新冠之後，併發重症跟死亡的風險都很高，所以我們一直在這個族群大力推廣要接種。"],["蘇委員清泉：好，謝謝。"],["邱部長泰源：好，謝謝蘇召委，謝謝主席。"],["主席：好，謝謝部長。現在休息10分鐘。","休息（10時34分）","繼續開會（10時46分）"],["主席（林委員月琴代）：現在我們請邱鎮軍委員發言。"]],"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"}}}