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00:01:28,460\n我是很希望你可以拿出魄力來是不是可以跟交通部高鐵或者是國籍的航空等等去談如何可以兼顧親子友善兼顧生育率然後又不至於讓現在網路上吵成一團那您也需要出來主持空道啦我舉幾個案例讓您聽聽看\n\n5\n00:01:31,221 --> 00:01:47,766\n比如說現在呢高鐵他們會說如果說有發現這個小朋友可能有發出一些聲音干擾到其他的乘客他們會去協助安撫並且給予乖乖你覺得你贊成這樣子的做法嗎\n\n6\n00:01:50,373 --> 00:02:14,478\n這個不夠專業的做法你說為什麼這個應該要先了解協助了解這個孩子會哭鬧因為他的表達比較小的孩子他的表達不容易所以常常以哭鬧的方式來表達所以應該先去了解這個孩子真正會哭鬧的原因什麼來解決問題不是隨便給一個零食\n\n7\n00:02:15,518 --> 00:02:32,840\n是高鐵的同仁如果是給予一些安撫那再加上給予餅乾等等請問你覺得這一組父母加上小孩會不會有可能被標籤化反而讓這個車廂其他乘客的人發現就是這些人在吵所以監務人員過來了\n\n8\n00:02:35,354 --> 00:02:53,395\n会不会被标签化有这个可能性但是如果有孩子不断的哭闹我们还是应该主动的去关心我想这个那我再举第二个例子这个都是实际发生的案例有一个带大宝跟二宝的妈妈她因为被举牌\n\n9\n00:02:54,156 --> 00:03:20,284\n要求降低音量所以勸導說你可以帶寶寶到車廂跟車廂中間的走道去安撫這件事情我本人也做過我有三個那三個都這樣子做過結果呢他只能把大寶放在座位上帶著二寶到車廂中間去安撫我想問他讓大寶單獨留在車廂被迫單獨留在車廂是不是違反了兒少保護法\n\n10\n00:03:21,124 --> 00:03:47,842\n是不是这样的处理方式并不恰当那您有什么建议吗我还是那个我们整个车厢这个维持这个车厢的安宁对于多数的乘客是有好处这个我们不反对但是对于这个按照我们这个儿少福利法的规定在交通方面还是要对亲子友善好\n\n11\n00:03:48,903 --> 00:04:10,636\n這就是我一再強調的我們跟其他國家差很多其他國家他也許會在一些觀光的網站上去特別註明哪些餐廳親子友善推薦大家去那他們的車廂有些國家是採取部分車廂寧靜但其他車廂他不會特別標註親子友善可是他也不會那麼在意營量\n\n12\n00:04:12,738 --> 00:04:25,593\n請問你大概在什麼時間內可以去找到高鐵或是交通部做這樣子的溝通可以給大家滿多家長在關心這個議題請問你大概多久以內可以去做這個協調\n\n13\n00:04:27,314 --> 00:04:47,099\n我們在9月2號其實已經發函去了解了請這個交通部去督導這個高鐵公司因為高鐵公司的這個主管機關是交通部所以我們也請了交通部去督導那麼我們會進一步去追蹤這個最後結果大概多久以內\n\n14\n00:04:47,939 --> 00:05:01,887\n因為現在每天他們都在網路上炒翻天這個您知道嗎一個月內嗎一個月內我希望你跟交通部可以共擬出一個稍微彈性的做法不要再引起兩方之間的互相仇視好嗎好謝謝\n\n15\n00:05:05,250 --> 00:05:27,484\n好下一個是您接受了採訪我知道你講了很多很多的關於醫療方面的改革但我今天稍微講兩點就好了有一點是您提到在醫療飽和區也就是蛋黃區健保診所太多的地方就不給開了請自行前往醫療資源不足的地方開立診所\n\n16\n00:05:27,964 --> 00:05:51,692\n好現在有許多醫師可能比較多是新出來的醫師他會說所以你是請我們回家吃自己嗎因為在這個蛋黃區都會區為什麼會這樣做我跟你講他們的心聲很多人講啊他說我要選擇在哪邊職業當然除了薪資以外我還要考慮我配偶的工作對吧我還要考慮小孩就學的問題\n\n17\n00:05:52,552 --> 00:06:18,003\n如果他有長輩要就近照顧還有長輩要照顧那這些地方變成蛋黃區是因為很多原因造成的而不是說他特意去把這些地方列為他的首選所以我想要問你可不可以變更你的做法你要不要去針對醫療資源不足的地方給予更多的誘因而讓各種不同世代的醫師都願意去那個地方嘛\n\n18\n00:06:19,572 --> 00:06:34,051\n這個跟委員說明按照我們的醫師法的規定或醫療法的規定醫師當然有他的職業自由他可以在任何一個地方只要他取得了合格的醫師執照他都可以開業\n\n19\n00:06:35,353 --> 00:06:54,552\n但是健保有他的特約規定那麼針對醫療資源應該要納入他健保特約的時候的考量因為健保的資源是有限的所以有一些不是健保特約的診所但是如果是要健保特約的診所健保必須考慮到他所\n\n20\n00:06:55,453 --> 00:07:24,572\n提供服務的可進性跟資源的平衡性就好像我們現在在總額之下在分配各個縣市或者是各個區域的總額也是有他的分配的考量我剛剛已經跟你講得很清楚了他會選擇這個地方他當然也想兼顧你所謂的醫療資源等等的但他還有其他考慮的面向嘛那你現在的意思就是說這一區已經很多人來了你就不要再來了\n\n21\n00:07:25,593 --> 00:07:44,333\n那是先到先贏的概念所以在這個制度之下我們會有折約特優的概念而不是所有的人就是你要特約就一直特約一直特約我們在醫學生的部分是有管制的就是總人數這個不是一個完全自由的市場所以在\n\n22\n00:07:45,234 --> 00:08:06,380\n提供服務的時候也應該要有所邏輯而不是說就完全是放任性的那這樣前面加強管制出口端進口端供應端是管制的結果到後來執行業務的時候卻自由的放任那這樣反而造成另外一種不公\n\n23\n00:08:07,253 --> 00:08:33,576\n我是給你一個建議請部長考量一下是不是願意到醫療資源不足的地方你給予更多的誘因而不是去限制他們不准去已經飽和的地方這個是大家現在很反彈的當然跟委員說明要解決這個醫療資源不足地區還有很多的方式啦這個也不是單單的一個不過這個是希望能夠讓醫療資源的分佈也能夠更平衡\n\n24\n00:08:35,904 --> 00:08:53,464\n讓這個多少人口多少醫師因為我們所有的這個醫學生也是按照這樣在管制所以要按照當地多少人口需要多少醫師來特約這個才是符合我們健保的精神這邊有兩件事情我希望一個月看可不可以給予可行性評估\n\n25\n00:08:54,165 --> 00:09:19,847\n第二件事情也是很多人在意的就是說現在在醫院職業的醫師每一筆錢他都必須要繳稅勞基法是用加班費免稅可是你也知道非常多主治醫師以上層級的並不是用勞基法所以工時比人家長很多可是沒有免稅的比例原則那亞東醫院院長最近就有出來講了很長一段的話大概跟你講\n\n26\n00:09:20,808 --> 00:09:47,318\n他說最具醫療韌性也就是最具戰時韌性的這群人反而是近年來流失最快的其中包括武大科包括急重症包括急診等等的那這些人才困難的他就是在夜間假日值班最多的那除了提高他的健保點值以外因為提高以後他工作很辛苦但在最後又繳稅了\n\n27\n00:09:48,678 --> 00:09:59,141\n所以他必須要雙重雙軌之下你有辦法留住這些人第一個就是額外津貼第二個就是他的夜間他的假日值班他的這些業務應該要免稅請問以上兩點就是關於\n\n28\n00:10:05,803 --> 00:10:21,193\n責量能特約還有這個免稅跟津貼雙軌制來拯救這些人才流失最多的這顆你有沒有辦法一個月內給予可行性評估因為你今年已經編了過兆的健保預算了\n\n29\n00:10:23,986 --> 00:10:47,721\n這個醫師的這個稅負公平性的問題我之前就已經注意到這個事情那因為目前在醫院工作者裡面只有醫師還沒有納入勞基法那其餘都是已經適用勞基法而適用勞基法人員裡面呢他有一個加班費是適用所得稅法免稅規定那但是因為勞基法有他的加班時數的上限\n\n30\n00:10:48,001 --> 00:11:16,277\n所以在那个额度内其实是已经符合免税目前就已经在执行了倒是因为医师他没有适用这个劳基法的关系再加上医疗的特性跟这个病人的需要所以他的加班时间往往是高于这个劳基法所规定的这个加班的上限所以在这个现实的情形之下我们一直在努力的在沟通希望扩大你要跟谁沟通劳动部财政部你要\n\n31\n00:11:18,539 --> 00:11:31,956\n這個稅負的主管機關是財政部所以你希望往院長講的這個方向前進就是要讓這個叫做稅負公平他一樣是因為延長工作時間那麼所得到的這些收入\n\n32\n00:11:32,797 --> 00:11:48,824\n就是所謂的加班費所以一個月內這兩點我們等一下送個書面可不可以請你給我們可行性的評估這個書面是沒有問題的那只是說在推動的過程當中也需要委員來給我們協助因為這個還有跟財政部之間的溝通\n\n33\n00:11:49,144 --> 00:12:12,006\n好第三個我們要問的問題是最近我們有一個好運3方案當然右邊這邊我就先不多說了右邊大家有知道說原來10萬塊講得很好聽結果不同級別的保險他只是去補差額所以如果是比如說勞保的他幾乎差額只有一點點他並不是這麼的有感但\n\n34\n00:12:12,947 --> 00:12:33,462\n考量問到許多專家他們都覺得每個月的津貼才是真正可以促進生育率的方式而不是這種單次一次性的好那之前陳時中政委他在其他的媒體採訪裡面他自己都講喔他說一個月他覺得要拿到三萬塊才算是有感的補貼才願意\n\n35\n00:12:35,563 --> 00:13:02,536\n這個促進生育啊等等的當我們去試算每一個縣市就算是最好最好的狀況大概都沒有到兩萬那我們看一下這個表看一下這個表現在是零到六歲的嬰幼兒每月主要的開銷包括尿布啊副食品或是你自己在家帶托育等等如果你是自己帶或是準公共比較難抽到的比較偏向兩萬但如果是送到托育可能會偏向四萬塊好\n\n36\n00:13:03,777 --> 00:13:24,250\n但是你現在的育嬰育兒津貼已經非常久沒有調整了第一名子女每個月五千第二名每個月六千第三名每個月七千你有沒有考慮把它調高主席快結束來響應陳時中政委所說的家總至少要折合三萬塊民眾才會有感\n\n37\n00:13:26,076 --> 00:13:45,048\n跟委員說明當然這一個擴大生育補助方案就是讓大家的這個補助讓他拉齊不會因為你的身份不同得到的最後的那個補助不同所以把公保勞保國保等等的保險甚至都沒有保的也都把它拉在一起\n\n38\n00:13:46,289 --> 00:14:14,596\n第一步而已那自己為了減輕年輕這個父母對於這個育兒上的壓力當然有育兒津貼剛剛您提到的這樣但是我們也另外有這個準托育跟這個公托跟準公托的補助那個我記得如果是準公托的話也到一萬三到一萬五就是看你的胎次會逐步的增加我知道但是我剛就有講有些人他是並沒有用到托育的嘛\n\n39\n00:14:16,497 --> 00:14:42,575\n这个十万块我们才发现说原来很多人是没有劳保的这个下去我们才发现为什么我们要去补对对所以他不一定会有用到托育因为托育你就只能选一个嘛你的育儿津贴跟托育他就只能选择一个育儿津贴跟托育补助所以我讲的是这个族群的人你有没有办法协助他您说的是完全没有育儿津贴对\n\n40\n00:14:43,577 --> 00:14:56,007\n完全沒有參加任何保險沒有我講的是他可能沒有用到托育的那就是育兒津貼嘛對一個是托育補助一個是育兒津貼這二則一是您的意思是說\n\n41\n00:14:57,779 --> 00:15:21,828\n沒有托育的就是育兒津貼的部分就是他必須申請育兒津貼的這部分你有沒有考慮再把它往上提育兒津貼的部分再增加的意思我們來研究看看在政府的財政的能力下因為現在因為這個財法法的關係中央的統籌分配款也受到影響所以我們再來評估看看那我們再跟你做報告謝謝好謝謝陳委員謝謝部長\n\n","tsv":"start\tend\ttext\n1570\t3515\t主席 謝謝 我想請石部長來 請部長陳院長\n9639\t37401\t部長好 部長您是親子友善兒少保護法還有促進我們國家生育率的大家長但是您知道從9月22號開始高鐵全面上路 寧靜車廂的措施之後啊現在網路上有帶著家長的帶著小孩 家長帶著小孩還有反對這些小孩發出聲音的人已經在網路上大戰 這件事情您知道嗎\n39097\t66648\t我最近有聽說啦我坐高鐵的時候也有看到他現在都有個牌子等一下我會提供您一些截圖我先舉一些國外的案例國外呢他們是比如說為了促進生育率一家四口一家五口去旅行是坐國籍的航空或者是火車或者是他們一家去遊樂園是給予很多折扣的但是反觀我們台灣\n67808\t88460\t我是很希望你可以拿出魄力來是不是可以跟交通部高鐵或者是國籍的航空等等去談如何可以兼顧親子友善兼顧生育率然後又不至於讓現在網路上吵成一團那您也需要出來主持空道啦我舉幾個案例讓您聽聽看\n91221\t107766\t比如說現在呢高鐵他們會說如果說有發現這個小朋友可能有發出一些聲音干擾到其他的乘客他們會去協助安撫並且給予乖乖你覺得你贊成這樣子的做法嗎\n110373\t134478\t這個不夠專業的做法你說為什麼這個應該要先了解協助了解這個孩子會哭鬧因為他的表達比較小的孩子他的表達不容易所以常常以哭鬧的方式來表達所以應該先去了解這個孩子真正會哭鬧的原因什麼來解決問題不是隨便給一個零食\n135518\t152840\t是 高鐵的同仁如果是給予一些安撫那再加上給予餅乾等等請問你覺得這一組父母加上小孩會不會有可能被標籤化反而讓這個車廂其他乘客的人發現就是這些人在吵所以監務人員過來了\n155354\t173395\t会不会被标签化有这个可能性但是如果有孩子不断的哭闹我们还是应该主动的去关心我想这个那我再举第二个例子这个都是实际发生的案例有一个带大宝跟二宝的妈妈她因为被举牌\n174156\t200284\t要求降低音量所以勸導說你可以帶寶寶到車廂跟車廂中間的走道去安撫這件事情我本人也做過我有三個那三個都這樣子做過結果呢他只能把大寶放在座位上帶著二寶到車廂中間去安撫我想問他讓大寶單獨留在車廂被迫單獨留在車廂是不是違反了兒少保護法\n201124\t227842\t是不是这样的处理方式并不恰当那您有什么建议吗我还是那个我们整个车厢这个维持这个车厢的安宁对于多数的乘客是有好处这个我们不反对但是对于这个按照我们这个儿少福利法的规定在交通方面还是要对亲子友善好\n228903\t250636\t這就是我一再強調的我們跟其他國家差很多其他國家他也許會在一些觀光的網站上去特別註明哪些餐廳親子友善推薦大家去那他們的車廂有些國家是採取部分車廂寧靜但其他車廂他不會特別標註親子友善可是他也不會那麼在意營量\n252738\t265593\t請問你大概在什麼時間內可以去找到高鐵或是交通部做這樣子的溝通可以給大家滿多家長在關心這個議題請問你大概多久以內可以去做這個協調\n267314\t287099\t我們在9月2號其實已經發函去了解了請這個交通部去督導這個高鐵公司因為高鐵公司的這個主管機關是交通部所以我們也請了交通部去督導那麼我們會進一步去追蹤這個最後結果大概多久以內\n287939\t301887\t因為現在每天他們都在網路上炒翻天這個您知道嗎一個月內嗎一個月內我希望你跟交通部可以共擬出一個稍微彈性的做法不要再引起兩方之間的互相仇視好嗎好 謝謝\n305250\t327484\t好下一個是您接受了採訪我知道你講了很多很多的關於醫療方面的改革但我今天稍微講兩點就好了有一點是您提到在醫療飽和區也就是蛋黃區健保診所太多的地方就不給開了請自行前往醫療資源不足的地方開立診所\n327964\t351692\t好現在有許多醫師可能比較多是新出來的醫師他會說所以你是請我們回家吃自己嗎因為在這個蛋黃區都會區為什麼會這樣做我跟你講他們的心聲很多人講啊他說我要選擇在哪邊職業當然除了薪資以外我還要考慮我配偶的工作對吧我還要考慮小孩就學的問題\n352552\t378003\t如果他有長輩要就近照顧還有長輩要照顧那這些地方變成蛋黃區是因為很多原因造成的而不是說他特意去把這些地方列為他的首選所以我想要問你可不可以變更你的做法你要不要去針對醫療資源不足的地方給予更多的誘因而讓各種不同世代的醫師都願意去那個地方嘛\n379572\t394051\t這個跟委員說明按照我們的醫師法的規定或醫療法的規定醫師當然有他的職業自由他可以在任何一個地方只要他取得了合格的醫師執照他都可以開業\n395353\t414552\t但是健保有他的特約規定那麼針對醫療資源應該要納入他健保特約的時候的考量因為健保的資源是有限的所以有一些不是健保特約的診所但是如果是要健保特約的診所健保必須考慮到他所\n415453\t444572\t提供服務的可進性跟資源的平衡性就好像我們現在在總額之下在分配各個縣市或者是各個區域的總額也是有他的分配的考量我剛剛已經跟你講得很清楚了他會選擇這個地方他當然也想兼顧你所謂的醫療資源等等的但他還有其他考慮的面向嘛那你現在的意思就是說這一區已經很多人來了你就不要再來了\n445593\t464333\t那是先到先贏的概念所以在這個制度之下我們會有折約特優的概念而不是所有的人就是你要特約就一直特約一直特約我們在醫學生的部分是有管制的就是總人數這個不是一個完全自由的市場所以在\n465234\t486380\t提供服務的時候也應該要有所邏輯而不是說就完全是放任性的那這樣前面加強管制出口端進口端供應端是管制的結果到後來執行業務的時候卻自由的放任那這樣反而造成另外一種不公\n487253\t513576\t我是給你一個建議請部長考量一下是不是願意到醫療資源不足的地方你給予更多的誘因而不是去限制他們不准去已經飽和的地方這個是大家現在很反彈的當然跟委員說明要解決這個醫療資源不足地區還有很多的方式啦這個也不是單單的一個不過這個是希望能夠讓醫療資源的分佈也能夠更平衡\n515904\t533464\t讓這個多少人口多少醫師因為我們所有的這個醫學生也是按照這樣在管制所以要按照當地多少人口需要多少醫師來特約這個才是符合我們健保的精神這邊有兩件事情我希望一個月看可不可以給予可行性評估\n534165\t559847\t第二件事情也是很多人在意的就是說現在在醫院職業的醫師每一筆錢他都必須要繳稅勞基法是用加班費免稅可是你也知道非常多主治醫師以上層級的並不是用勞基法所以工時比人家長很多可是沒有免稅的比例原則那亞東醫院院長最近就有出來講了很長一段的話大概跟你講\n560808\t587318\t他說最具醫療韌性也就是最具戰時韌性的這群人反而是近年來流失最快的其中包括武大科包括急重症包括急診等等的那這些人才困難的他就是在夜間假日值班最多的那除了提高他的健保點值以外因為提高以後他工作很辛苦但在最後又繳稅了\n588678\t599141\t所以他必須要雙重雙軌之下你有辦法留住這些人第一個就是額外津貼第二個就是他的夜間他的假日值班他的這些業務應該要免稅請問以上兩點就是關於\n605803\t621193\t責量能特約還有這個免稅跟津貼雙軌制來拯救這些人才流失最多的這顆你有沒有辦法一個月內給予可行性評估因為你今年已經編了過兆的健保預算了\n623986\t647721\t這個醫師的這個稅負公平性的問題我之前就已經注意到這個事情那因為目前在醫院工作者裡面只有醫師還沒有納入勞基法那其餘都是已經適用勞基法而適用勞基法人員裡面呢他有一個加班費是適用所得稅法免稅規定那但是因為勞基法有他的加班時數的上限\n648001\t676277\t所以在那个额度内其实是已经符合免税目前就已经在执行了倒是因为医师他没有适用这个劳基法的关系再加上医疗的特性跟这个病人的需要所以他的加班时间往往是高于这个劳基法所规定的这个加班的上限所以在这个现实的情形之下我们一直在努力的在沟通希望扩大你要跟谁沟通劳动部财政部你要\n678539\t691956\t這個稅負的主管機關是財政部所以你希望往院長講的這個方向前進就是要讓這個叫做稅負公平他一樣是因為延長工作時間那麼所得到的這些收入\n692797\t708824\t就是所謂的加班費所以一個月內這兩點我們等一下送個書面可不可以請你給我們可行性的評估這個書面是沒有問題的那只是說在推動的過程當中也需要委員來給我們協助因為這個還有跟財政部之間的溝通\n709144\t732006\t好第三個我們要問的問題是最近我們有一個好運3方案當然右邊這邊我就先不多說了右邊大家有知道說原來10萬塊講得很好聽結果不同級別的保險他只是去補差額所以如果是比如說勞保的他幾乎差額只有一點點他並不是這麼的有感但\n732947\t753462\t考量問到許多專家他們都覺得每個月的津貼才是真正可以促進生育率的方式而不是這種單次一次性的好那之前陳時中政委他在其他的媒體採訪裡面他自己都講喔他說一個月他覺得要拿到三萬塊才算是有感的補貼才願意\n755563\t782536\t這個促進生育啊等等的當我們去試算每一個縣市就算是最好最好的狀況大概都沒有到兩萬那我們看一下這個表看一下這個表現在是零到六歲的嬰幼兒每月主要的開銷包括尿布啊副食品或是你自己在家帶托育等等如果你是自己帶或是準公共比較難抽到的比較偏向兩萬但如果是送到托育可能會偏向四萬塊好\n783777\t804250\t但是你現在的育嬰育兒津貼已經非常久沒有調整了第一名子女每個月五千第二名每個月六千第三名每個月七千你有沒有考慮把它調高主席快結束來響應陳時中政委所說的家總至少要折合三萬塊民眾才會有感\n806076\t825048\t跟委員說明 當然這一個擴大生育補助方案就是讓大家的這個補助讓他拉齊不會因為你的身份不同得到的最後的那個補助不同所以把公保 勞保 國保等等的保險甚至都沒有保的也都把它拉在一起\n826289\t854596\t第一步而已那自己為了減輕年輕這個父母對於這個育兒上的壓力當然有育兒津貼剛剛您提到的這樣但是我們也另外有這個準托育跟這個公托跟準公托的補助那個我記得如果是準公托的話也到一萬三到一萬五就是看你的胎次會逐步的增加我知道但是我剛就有講有些人他是並沒有用到托育的嘛\n856497\t882575\t这个十万块我们才发现说原来很多人是没有劳保的这个下去我们才发现为什么我们要去补对对所以他不一定会有用到托育因为托育你就只能选一个嘛你的育儿津贴跟托育他就只能选择一个育儿津贴跟托育补助所以我讲的是这个族群的人你有没有办法协助他您说的是完全没有育儿津贴对\n883577\t896007\t完全沒有參加任何保險沒有我講的是他可能沒有用到托育的那就是育兒津貼嘛對一個是托育補助一個是育兒津貼這二則一是您的意思是說\n897779\t921828\t沒有托育的就是育兒津貼的部分就是他必須申請育兒津貼的這部分你有沒有考慮再把它往上提育兒津貼的部分再增加的意思我們來研究看看在政府的財政的能力下因為現在因為這個財法法的關係中央的統籌分配款也受到影響所以我們再來評估看看那我們再跟你做報告 謝謝好 謝謝陳委員 謝謝部長\n","txt":"主席 謝謝 我想請石部長來 請部長陳院長\n部長好 部長您是親子友善兒少保護法還有促進我們國家生育率的大家長但是您知道從9月22號開始高鐵全面上路 寧靜車廂的措施之後啊現在網路上有帶著家長的帶著小孩 家長帶著小孩還有反對這些小孩發出聲音的人已經在網路上大戰 這件事情您知道嗎\n我最近有聽說啦我坐高鐵的時候也有看到他現在都有個牌子等一下我會提供您一些截圖我先舉一些國外的案例國外呢他們是比如說為了促進生育率一家四口一家五口去旅行是坐國籍的航空或者是火車或者是他們一家去遊樂園是給予很多折扣的但是反觀我們台灣\n我是很希望你可以拿出魄力來是不是可以跟交通部高鐵或者是國籍的航空等等去談如何可以兼顧親子友善兼顧生育率然後又不至於讓現在網路上吵成一團那您也需要出來主持空道啦我舉幾個案例讓您聽聽看\n比如說現在呢高鐵他們會說如果說有發現這個小朋友可能有發出一些聲音干擾到其他的乘客他們會去協助安撫並且給予乖乖你覺得你贊成這樣子的做法嗎\n這個不夠專業的做法你說為什麼這個應該要先了解協助了解這個孩子會哭鬧因為他的表達比較小的孩子他的表達不容易所以常常以哭鬧的方式來表達所以應該先去了解這個孩子真正會哭鬧的原因什麼來解決問題不是隨便給一個零食\n是 高鐵的同仁如果是給予一些安撫那再加上給予餅乾等等請問你覺得這一組父母加上小孩會不會有可能被標籤化反而讓這個車廂其他乘客的人發現就是這些人在吵所以監務人員過來了\n会不会被标签化有这个可能性但是如果有孩子不断的哭闹我们还是应该主动的去关心我想这个那我再举第二个例子这个都是实际发生的案例有一个带大宝跟二宝的妈妈她因为被举牌\n要求降低音量所以勸導說你可以帶寶寶到車廂跟車廂中間的走道去安撫這件事情我本人也做過我有三個那三個都這樣子做過結果呢他只能把大寶放在座位上帶著二寶到車廂中間去安撫我想問他讓大寶單獨留在車廂被迫單獨留在車廂是不是違反了兒少保護法\n是不是这样的处理方式并不恰当那您有什么建议吗我还是那个我们整个车厢这个维持这个车厢的安宁对于多数的乘客是有好处这个我们不反对但是对于这个按照我们这个儿少福利法的规定在交通方面还是要对亲子友善好\n這就是我一再強調的我們跟其他國家差很多其他國家他也許會在一些觀光的網站上去特別註明哪些餐廳親子友善推薦大家去那他們的車廂有些國家是採取部分車廂寧靜但其他車廂他不會特別標註親子友善可是他也不會那麼在意營量\n請問你大概在什麼時間內可以去找到高鐵或是交通部做這樣子的溝通可以給大家滿多家長在關心這個議題請問你大概多久以內可以去做這個協調\n我們在9月2號其實已經發函去了解了請這個交通部去督導這個高鐵公司因為高鐵公司的這個主管機關是交通部所以我們也請了交通部去督導那麼我們會進一步去追蹤這個最後結果大概多久以內\n因為現在每天他們都在網路上炒翻天這個您知道嗎一個月內嗎一個月內我希望你跟交通部可以共擬出一個稍微彈性的做法不要再引起兩方之間的互相仇視好嗎好 謝謝\n好下一個是您接受了採訪我知道你講了很多很多的關於醫療方面的改革但我今天稍微講兩點就好了有一點是您提到在醫療飽和區也就是蛋黃區健保診所太多的地方就不給開了請自行前往醫療資源不足的地方開立診所\n好現在有許多醫師可能比較多是新出來的醫師他會說所以你是請我們回家吃自己嗎因為在這個蛋黃區都會區為什麼會這樣做我跟你講他們的心聲很多人講啊他說我要選擇在哪邊職業當然除了薪資以外我還要考慮我配偶的工作對吧我還要考慮小孩就學的問題\n如果他有長輩要就近照顧還有長輩要照顧那這些地方變成蛋黃區是因為很多原因造成的而不是說他特意去把這些地方列為他的首選所以我想要問你可不可以變更你的做法你要不要去針對醫療資源不足的地方給予更多的誘因而讓各種不同世代的醫師都願意去那個地方嘛\n這個跟委員說明按照我們的醫師法的規定或醫療法的規定醫師當然有他的職業自由他可以在任何一個地方只要他取得了合格的醫師執照他都可以開業\n但是健保有他的特約規定那麼針對醫療資源應該要納入他健保特約的時候的考量因為健保的資源是有限的所以有一些不是健保特約的診所但是如果是要健保特約的診所健保必須考慮到他所\n提供服務的可進性跟資源的平衡性就好像我們現在在總額之下在分配各個縣市或者是各個區域的總額也是有他的分配的考量我剛剛已經跟你講得很清楚了他會選擇這個地方他當然也想兼顧你所謂的醫療資源等等的但他還有其他考慮的面向嘛那你現在的意思就是說這一區已經很多人來了你就不要再來了\n那是先到先贏的概念所以在這個制度之下我們會有折約特優的概念而不是所有的人就是你要特約就一直特約一直特約我們在醫學生的部分是有管制的就是總人數這個不是一個完全自由的市場所以在\n提供服務的時候也應該要有所邏輯而不是說就完全是放任性的那這樣前面加強管制出口端進口端供應端是管制的結果到後來執行業務的時候卻自由的放任那這樣反而造成另外一種不公\n我是給你一個建議請部長考量一下是不是願意到醫療資源不足的地方你給予更多的誘因而不是去限制他們不准去已經飽和的地方這個是大家現在很反彈的當然跟委員說明要解決這個醫療資源不足地區還有很多的方式啦這個也不是單單的一個不過這個是希望能夠讓醫療資源的分佈也能夠更平衡\n讓這個多少人口多少醫師因為我們所有的這個醫學生也是按照這樣在管制所以要按照當地多少人口需要多少醫師來特約這個才是符合我們健保的精神這邊有兩件事情我希望一個月看可不可以給予可行性評估\n第二件事情也是很多人在意的就是說現在在醫院職業的醫師每一筆錢他都必須要繳稅勞基法是用加班費免稅可是你也知道非常多主治醫師以上層級的並不是用勞基法所以工時比人家長很多可是沒有免稅的比例原則那亞東醫院院長最近就有出來講了很長一段的話大概跟你講\n他說最具醫療韌性也就是最具戰時韌性的這群人反而是近年來流失最快的其中包括武大科包括急重症包括急診等等的那這些人才困難的他就是在夜間假日值班最多的那除了提高他的健保點值以外因為提高以後他工作很辛苦但在最後又繳稅了\n所以他必須要雙重雙軌之下你有辦法留住這些人第一個就是額外津貼第二個就是他的夜間他的假日值班他的這些業務應該要免稅請問以上兩點就是關於\n責量能特約還有這個免稅跟津貼雙軌制來拯救這些人才流失最多的這顆你有沒有辦法一個月內給予可行性評估因為你今年已經編了過兆的健保預算了\n這個醫師的這個稅負公平性的問題我之前就已經注意到這個事情那因為目前在醫院工作者裡面只有醫師還沒有納入勞基法那其餘都是已經適用勞基法而適用勞基法人員裡面呢他有一個加班費是適用所得稅法免稅規定那但是因為勞基法有他的加班時數的上限\n所以在那个额度内其实是已经符合免税目前就已经在执行了倒是因为医师他没有适用这个劳基法的关系再加上医疗的特性跟这个病人的需要所以他的加班时间往往是高于这个劳基法所规定的这个加班的上限所以在这个现实的情形之下我们一直在努力的在沟通希望扩大你要跟谁沟通劳动部财政部你要\n這個稅負的主管機關是財政部所以你希望往院長講的這個方向前進就是要讓這個叫做稅負公平他一樣是因為延長工作時間那麼所得到的這些收入\n就是所謂的加班費所以一個月內這兩點我們等一下送個書面可不可以請你給我們可行性的評估這個書面是沒有問題的那只是說在推動的過程當中也需要委員來給我們協助因為這個還有跟財政部之間的溝通\n好第三個我們要問的問題是最近我們有一個好運3方案當然右邊這邊我就先不多說了右邊大家有知道說原來10萬塊講得很好聽結果不同級別的保險他只是去補差額所以如果是比如說勞保的他幾乎差額只有一點點他並不是這麼的有感但\n考量問到許多專家他們都覺得每個月的津貼才是真正可以促進生育率的方式而不是這種單次一次性的好那之前陳時中政委他在其他的媒體採訪裡面他自己都講喔他說一個月他覺得要拿到三萬塊才算是有感的補貼才願意\n這個促進生育啊等等的當我們去試算每一個縣市就算是最好最好的狀況大概都沒有到兩萬那我們看一下這個表看一下這個表現在是零到六歲的嬰幼兒每月主要的開銷包括尿布啊副食品或是你自己在家帶托育等等如果你是自己帶或是準公共比較難抽到的比較偏向兩萬但如果是送到托育可能會偏向四萬塊好\n但是你現在的育嬰育兒津貼已經非常久沒有調整了第一名子女每個月五千第二名每個月六千第三名每個月七千你有沒有考慮把它調高主席快結束來響應陳時中政委所說的家總至少要折合三萬塊民眾才會有感\n跟委員說明 當然這一個擴大生育補助方案就是讓大家的這個補助讓他拉齊不會因為你的身份不同得到的最後的那個補助不同所以把公保 勞保 國保等等的保險甚至都沒有保的也都把它拉在一起\n第一步而已那自己為了減輕年輕這個父母對於這個育兒上的壓力當然有育兒津貼剛剛您提到的這樣但是我們也另外有這個準托育跟這個公托跟準公托的補助那個我記得如果是準公托的話也到一萬三到一萬五就是看你的胎次會逐步的增加我知道但是我剛就有講有些人他是並沒有用到托育的嘛\n这个十万块我们才发现说原来很多人是没有劳保的这个下去我们才发现为什么我们要去补对对所以他不一定会有用到托育因为托育你就只能选一个嘛你的育儿津贴跟托育他就只能选择一个育儿津贴跟托育补助所以我讲的是这个族群的人你有没有办法协助他您说的是完全没有育儿津贴对\n完全沒有參加任何保險沒有我講的是他可能沒有用到托育的那就是育兒津貼嘛對一個是托育補助一個是育兒津貼這二則一是您的意思是說\n沒有托育的就是育兒津貼的部分就是他必須申請育兒津貼的這部分你有沒有考慮再把它往上提育兒津貼的部分再增加的意思我們來研究看看在政府的財政的能力下因為現在因為這個財法法的關係中央的統籌分配款也受到影響所以我們再來評估看看那我們再跟你做報告 謝謝好 謝謝陳委員 謝謝部長\n","vtt":"WEBVTT\n\n00:01.570 --> 00:03.515\n主席謝謝我想請石部長來請部長陳院長\n\n00:09.639 --> 00:37.401\n部長好部長您是親子友善兒少保護法還有促進我們國家生育率的大家長但是您知道從9月22號開始高鐵全面上路寧靜車廂的措施之後啊現在網路上有帶著家長的帶著小孩家長帶著小孩還有反對這些小孩發出聲音的人已經在網路上大戰這件事情您知道嗎\n\n00:39.097 --> 01:06.648\n我最近有聽說啦我坐高鐵的時候也有看到他現在都有個牌子等一下我會提供您一些截圖我先舉一些國外的案例國外呢他們是比如說為了促進生育率一家四口一家五口去旅行是坐國籍的航空或者是火車或者是他們一家去遊樂園是給予很多折扣的但是反觀我們台灣\n\n01:07.808 --> 01:28.460\n我是很希望你可以拿出魄力來是不是可以跟交通部高鐵或者是國籍的航空等等去談如何可以兼顧親子友善兼顧生育率然後又不至於讓現在網路上吵成一團那您也需要出來主持空道啦我舉幾個案例讓您聽聽看\n\n01:31.221 --> 01:47.766\n比如說現在呢高鐵他們會說如果說有發現這個小朋友可能有發出一些聲音干擾到其他的乘客他們會去協助安撫並且給予乖乖你覺得你贊成這樣子的做法嗎\n\n01:50.373 --> 02:14.478\n這個不夠專業的做法你說為什麼這個應該要先了解協助了解這個孩子會哭鬧因為他的表達比較小的孩子他的表達不容易所以常常以哭鬧的方式來表達所以應該先去了解這個孩子真正會哭鬧的原因什麼來解決問題不是隨便給一個零食\n\n02:15.518 --> 02:32.840\n是高鐵的同仁如果是給予一些安撫那再加上給予餅乾等等請問你覺得這一組父母加上小孩會不會有可能被標籤化反而讓這個車廂其他乘客的人發現就是這些人在吵所以監務人員過來了\n\n02:35.354 --> 02:53.395\n会不会被标签化有这个可能性但是如果有孩子不断的哭闹我们还是应该主动的去关心我想这个那我再举第二个例子这个都是实际发生的案例有一个带大宝跟二宝的妈妈她因为被举牌\n\n02:54.156 --> 03:20.284\n要求降低音量所以勸導說你可以帶寶寶到車廂跟車廂中間的走道去安撫這件事情我本人也做過我有三個那三個都這樣子做過結果呢他只能把大寶放在座位上帶著二寶到車廂中間去安撫我想問他讓大寶單獨留在車廂被迫單獨留在車廂是不是違反了兒少保護法\n\n03:21.124 --> 03:47.842\n是不是这样的处理方式并不恰当那您有什么建议吗我还是那个我们整个车厢这个维持这个车厢的安宁对于多数的乘客是有好处这个我们不反对但是对于这个按照我们这个儿少福利法的规定在交通方面还是要对亲子友善好\n\n03:48.903 --> 04:10.636\n這就是我一再強調的我們跟其他國家差很多其他國家他也許會在一些觀光的網站上去特別註明哪些餐廳親子友善推薦大家去那他們的車廂有些國家是採取部分車廂寧靜但其他車廂他不會特別標註親子友善可是他也不會那麼在意營量\n\n04:12.738 --> 04:25.593\n請問你大概在什麼時間內可以去找到高鐵或是交通部做這樣子的溝通可以給大家滿多家長在關心這個議題請問你大概多久以內可以去做這個協調\n\n04:27.314 --> 04:47.099\n我們在9月2號其實已經發函去了解了請這個交通部去督導這個高鐵公司因為高鐵公司的這個主管機關是交通部所以我們也請了交通部去督導那麼我們會進一步去追蹤這個最後結果大概多久以內\n\n04:47.939 --> 05:01.887\n因為現在每天他們都在網路上炒翻天這個您知道嗎一個月內嗎一個月內我希望你跟交通部可以共擬出一個稍微彈性的做法不要再引起兩方之間的互相仇視好嗎好謝謝\n\n05:05.250 --> 05:27.484\n好下一個是您接受了採訪我知道你講了很多很多的關於醫療方面的改革但我今天稍微講兩點就好了有一點是您提到在醫療飽和區也就是蛋黃區健保診所太多的地方就不給開了請自行前往醫療資源不足的地方開立診所\n\n05:27.964 --> 05:51.692\n好現在有許多醫師可能比較多是新出來的醫師他會說所以你是請我們回家吃自己嗎因為在這個蛋黃區都會區為什麼會這樣做我跟你講他們的心聲很多人講啊他說我要選擇在哪邊職業當然除了薪資以外我還要考慮我配偶的工作對吧我還要考慮小孩就學的問題\n\n05:52.552 --> 06:18.003\n如果他有長輩要就近照顧還有長輩要照顧那這些地方變成蛋黃區是因為很多原因造成的而不是說他特意去把這些地方列為他的首選所以我想要問你可不可以變更你的做法你要不要去針對醫療資源不足的地方給予更多的誘因而讓各種不同世代的醫師都願意去那個地方嘛\n\n06:19.572 --> 06:34.051\n這個跟委員說明按照我們的醫師法的規定或醫療法的規定醫師當然有他的職業自由他可以在任何一個地方只要他取得了合格的醫師執照他都可以開業\n\n06:35.353 --> 06:54.552\n但是健保有他的特約規定那麼針對醫療資源應該要納入他健保特約的時候的考量因為健保的資源是有限的所以有一些不是健保特約的診所但是如果是要健保特約的診所健保必須考慮到他所\n\n06:55.453 --> 07:24.572\n提供服務的可進性跟資源的平衡性就好像我們現在在總額之下在分配各個縣市或者是各個區域的總額也是有他的分配的考量我剛剛已經跟你講得很清楚了他會選擇這個地方他當然也想兼顧你所謂的醫療資源等等的但他還有其他考慮的面向嘛那你現在的意思就是說這一區已經很多人來了你就不要再來了\n\n07:25.593 --> 07:44.333\n那是先到先贏的概念所以在這個制度之下我們會有折約特優的概念而不是所有的人就是你要特約就一直特約一直特約我們在醫學生的部分是有管制的就是總人數這個不是一個完全自由的市場所以在\n\n07:45.234 --> 08:06.380\n提供服務的時候也應該要有所邏輯而不是說就完全是放任性的那這樣前面加強管制出口端進口端供應端是管制的結果到後來執行業務的時候卻自由的放任那這樣反而造成另外一種不公\n\n08:07.253 --> 08:33.576\n我是給你一個建議請部長考量一下是不是願意到醫療資源不足的地方你給予更多的誘因而不是去限制他們不准去已經飽和的地方這個是大家現在很反彈的當然跟委員說明要解決這個醫療資源不足地區還有很多的方式啦這個也不是單單的一個不過這個是希望能夠讓醫療資源的分佈也能夠更平衡\n\n08:35.904 --> 08:53.464\n讓這個多少人口多少醫師因為我們所有的這個醫學生也是按照這樣在管制所以要按照當地多少人口需要多少醫師來特約這個才是符合我們健保的精神這邊有兩件事情我希望一個月看可不可以給予可行性評估\n\n08:54.165 --> 09:19.847\n第二件事情也是很多人在意的就是說現在在醫院職業的醫師每一筆錢他都必須要繳稅勞基法是用加班費免稅可是你也知道非常多主治醫師以上層級的並不是用勞基法所以工時比人家長很多可是沒有免稅的比例原則那亞東醫院院長最近就有出來講了很長一段的話大概跟你講\n\n09:20.808 --> 09:47.318\n他說最具醫療韌性也就是最具戰時韌性的這群人反而是近年來流失最快的其中包括武大科包括急重症包括急診等等的那這些人才困難的他就是在夜間假日值班最多的那除了提高他的健保點值以外因為提高以後他工作很辛苦但在最後又繳稅了\n\n09:48.678 --> 09:59.141\n所以他必須要雙重雙軌之下你有辦法留住這些人第一個就是額外津貼第二個就是他的夜間他的假日值班他的這些業務應該要免稅請問以上兩點就是關於\n\n10:05.803 --> 10:21.193\n責量能特約還有這個免稅跟津貼雙軌制來拯救這些人才流失最多的這顆你有沒有辦法一個月內給予可行性評估因為你今年已經編了過兆的健保預算了\n\n10:23.986 --> 10:47.721\n這個醫師的這個稅負公平性的問題我之前就已經注意到這個事情那因為目前在醫院工作者裡面只有醫師還沒有納入勞基法那其餘都是已經適用勞基法而適用勞基法人員裡面呢他有一個加班費是適用所得稅法免稅規定那但是因為勞基法有他的加班時數的上限\n\n10:48.001 --> 11:16.277\n所以在那个额度内其实是已经符合免税目前就已经在执行了倒是因为医师他没有适用这个劳基法的关系再加上医疗的特性跟这个病人的需要所以他的加班时间往往是高于这个劳基法所规定的这个加班的上限所以在这个现实的情形之下我们一直在努力的在沟通希望扩大你要跟谁沟通劳动部财政部你要\n\n11:18.539 --> 11:31.956\n這個稅負的主管機關是財政部所以你希望往院長講的這個方向前進就是要讓這個叫做稅負公平他一樣是因為延長工作時間那麼所得到的這些收入\n\n11:32.797 --> 11:48.824\n就是所謂的加班費所以一個月內這兩點我們等一下送個書面可不可以請你給我們可行性的評估這個書面是沒有問題的那只是說在推動的過程當中也需要委員來給我們協助因為這個還有跟財政部之間的溝通\n\n11:49.144 --> 12:12.006\n好第三個我們要問的問題是最近我們有一個好運3方案當然右邊這邊我就先不多說了右邊大家有知道說原來10萬塊講得很好聽結果不同級別的保險他只是去補差額所以如果是比如說勞保的他幾乎差額只有一點點他並不是這麼的有感但\n\n12:12.947 --> 12:33.462\n考量問到許多專家他們都覺得每個月的津貼才是真正可以促進生育率的方式而不是這種單次一次性的好那之前陳時中政委他在其他的媒體採訪裡面他自己都講喔他說一個月他覺得要拿到三萬塊才算是有感的補貼才願意\n\n12:35.563 --> 13:02.536\n這個促進生育啊等等的當我們去試算每一個縣市就算是最好最好的狀況大概都沒有到兩萬那我們看一下這個表看一下這個表現在是零到六歲的嬰幼兒每月主要的開銷包括尿布啊副食品或是你自己在家帶托育等等如果你是自己帶或是準公共比較難抽到的比較偏向兩萬但如果是送到托育可能會偏向四萬塊好\n\n13:03.777 --> 13:24.250\n但是你現在的育嬰育兒津貼已經非常久沒有調整了第一名子女每個月五千第二名每個月六千第三名每個月七千你有沒有考慮把它調高主席快結束來響應陳時中政委所說的家總至少要折合三萬塊民眾才會有感\n\n13:26.076 --> 13:45.048\n跟委員說明當然這一個擴大生育補助方案就是讓大家的這個補助讓他拉齊不會因為你的身份不同得到的最後的那個補助不同所以把公保勞保國保等等的保險甚至都沒有保的也都把它拉在一起\n\n13:46.289 --> 14:14.596\n第一步而已那自己為了減輕年輕這個父母對於這個育兒上的壓力當然有育兒津貼剛剛您提到的這樣但是我們也另外有這個準托育跟這個公托跟準公托的補助那個我記得如果是準公托的話也到一萬三到一萬五就是看你的胎次會逐步的增加我知道但是我剛就有講有些人他是並沒有用到托育的嘛\n\n14:16.497 --> 14:42.575\n这个十万块我们才发现说原来很多人是没有劳保的这个下去我们才发现为什么我们要去补对对所以他不一定会有用到托育因为托育你就只能选一个嘛你的育儿津贴跟托育他就只能选择一个育儿津贴跟托育补助所以我讲的是这个族群的人你有没有办法协助他您说的是完全没有育儿津贴对\n\n14:43.577 --> 14:56.007\n完全沒有參加任何保險沒有我講的是他可能沒有用到托育的那就是育兒津貼嘛對一個是托育補助一個是育兒津貼這二則一是您的意思是說\n\n14:57.779 --> 15:21.828\n沒有托育的就是育兒津貼的部分就是他必須申請育兒津貼的這部分你有沒有考慮再把它往上提育兒津貼的部分再增加的意思我們來研究看看在政府的財政的能力下因為現在因為這個財法法的關係中央的統籌分配款也受到影響所以我們再來評估看看那我們再跟你做報告謝謝好謝謝陳委員謝謝部長\n\n","segments":[{"start":1.57,"end":3.515,"text":"主席 謝謝 我想請石部長來 請部長陳院長"},{"start":9.639,"end":37.401,"text":"部長好 部長您是親子友善兒少保護法還有促進我們國家生育率的大家長但是您知道從9月22號開始高鐵全面上路 寧靜車廂的措施之後啊現在網路上有帶著家長的帶著小孩 家長帶著小孩還有反對這些小孩發出聲音的人已經在網路上大戰 這件事情您知道嗎"},{"start":39.097,"end":66.648,"text":"我最近有聽說啦我坐高鐵的時候也有看到他現在都有個牌子等一下我會提供您一些截圖我先舉一些國外的案例國外呢他們是比如說為了促進生育率一家四口一家五口去旅行是坐國籍的航空或者是火車或者是他們一家去遊樂園是給予很多折扣的但是反觀我們台灣"},{"start":67.808,"end":88.46,"text":"我是很希望你可以拿出魄力來是不是可以跟交通部高鐵或者是國籍的航空等等去談如何可以兼顧親子友善兼顧生育率然後又不至於讓現在網路上吵成一團那您也需要出來主持空道啦我舉幾個案例讓您聽聽看"},{"start":91.221,"end":107.766,"text":"比如說現在呢高鐵他們會說如果說有發現這個小朋友可能有發出一些聲音干擾到其他的乘客他們會去協助安撫並且給予乖乖你覺得你贊成這樣子的做法嗎"},{"start":110.373,"end":134.478,"text":"這個不夠專業的做法你說為什麼這個應該要先了解協助了解這個孩子會哭鬧因為他的表達比較小的孩子他的表達不容易所以常常以哭鬧的方式來表達所以應該先去了解這個孩子真正會哭鬧的原因什麼來解決問題不是隨便給一個零食"},{"start":135.518,"end":152.84,"text":"是 高鐵的同仁如果是給予一些安撫那再加上給予餅乾等等請問你覺得這一組父母加上小孩會不會有可能被標籤化反而讓這個車廂其他乘客的人發現就是這些人在吵所以監務人員過來了"},{"start":155.354,"end":173.395,"text":"会不会被标签化有这个可能性但是如果有孩子不断的哭闹我们还是应该主动的去关心我想这个那我再举第二个例子这个都是实际发生的案例有一个带大宝跟二宝的妈妈她因为被举牌"},{"start":174.156,"end":200.284,"text":"要求降低音量所以勸導說你可以帶寶寶到車廂跟車廂中間的走道去安撫這件事情我本人也做過我有三個那三個都這樣子做過結果呢他只能把大寶放在座位上帶著二寶到車廂中間去安撫我想問他讓大寶單獨留在車廂被迫單獨留在車廂是不是違反了兒少保護法"},{"start":201.124,"end":227.842,"text":"是不是这样的处理方式并不恰当那您有什么建议吗我还是那个我们整个车厢这个维持这个车厢的安宁对于多数的乘客是有好处这个我们不反对但是对于这个按照我们这个儿少福利法的规定在交通方面还是要对亲子友善好"},{"start":228.903,"end":250.636,"text":"這就是我一再強調的我們跟其他國家差很多其他國家他也許會在一些觀光的網站上去特別註明哪些餐廳親子友善推薦大家去那他們的車廂有些國家是採取部分車廂寧靜但其他車廂他不會特別標註親子友善可是他也不會那麼在意營量"},{"start":252.738,"end":265.593,"text":"請問你大概在什麼時間內可以去找到高鐵或是交通部做這樣子的溝通可以給大家滿多家長在關心這個議題請問你大概多久以內可以去做這個協調"},{"start":267.314,"end":287.099,"text":"我們在9月2號其實已經發函去了解了請這個交通部去督導這個高鐵公司因為高鐵公司的這個主管機關是交通部所以我們也請了交通部去督導那麼我們會進一步去追蹤這個最後結果大概多久以內"},{"start":287.939,"end":301.887,"text":"因為現在每天他們都在網路上炒翻天這個您知道嗎一個月內嗎一個月內我希望你跟交通部可以共擬出一個稍微彈性的做法不要再引起兩方之間的互相仇視好嗎好 謝謝"},{"start":305.25,"end":327.484,"text":"好下一個是您接受了採訪我知道你講了很多很多的關於醫療方面的改革但我今天稍微講兩點就好了有一點是您提到在醫療飽和區也就是蛋黃區健保診所太多的地方就不給開了請自行前往醫療資源不足的地方開立診所"},{"start":327.964,"end":351.692,"text":"好現在有許多醫師可能比較多是新出來的醫師他會說所以你是請我們回家吃自己嗎因為在這個蛋黃區都會區為什麼會這樣做我跟你講他們的心聲很多人講啊他說我要選擇在哪邊職業當然除了薪資以外我還要考慮我配偶的工作對吧我還要考慮小孩就學的問題"},{"start":352.552,"end":378.003,"text":"如果他有長輩要就近照顧還有長輩要照顧那這些地方變成蛋黃區是因為很多原因造成的而不是說他特意去把這些地方列為他的首選所以我想要問你可不可以變更你的做法你要不要去針對醫療資源不足的地方給予更多的誘因而讓各種不同世代的醫師都願意去那個地方嘛"},{"start":379.572,"end":394.051,"text":"這個跟委員說明按照我們的醫師法的規定或醫療法的規定醫師當然有他的職業自由他可以在任何一個地方只要他取得了合格的醫師執照他都可以開業"},{"start":395.353,"end":414.552,"text":"但是健保有他的特約規定那麼針對醫療資源應該要納入他健保特約的時候的考量因為健保的資源是有限的所以有一些不是健保特約的診所但是如果是要健保特約的診所健保必須考慮到他所"},{"start":415.453,"end":444.572,"text":"提供服務的可進性跟資源的平衡性就好像我們現在在總額之下在分配各個縣市或者是各個區域的總額也是有他的分配的考量我剛剛已經跟你講得很清楚了他會選擇這個地方他當然也想兼顧你所謂的醫療資源等等的但他還有其他考慮的面向嘛那你現在的意思就是說這一區已經很多人來了你就不要再來了"},{"start":445.593,"end":464.333,"text":"那是先到先贏的概念所以在這個制度之下我們會有折約特優的概念而不是所有的人就是你要特約就一直特約一直特約我們在醫學生的部分是有管制的就是總人數這個不是一個完全自由的市場所以在"},{"start":465.234,"end":486.38,"text":"提供服務的時候也應該要有所邏輯而不是說就完全是放任性的那這樣前面加強管制出口端進口端供應端是管制的結果到後來執行業務的時候卻自由的放任那這樣反而造成另外一種不公"},{"start":487.253,"end":513.576,"text":"我是給你一個建議請部長考量一下是不是願意到醫療資源不足的地方你給予更多的誘因而不是去限制他們不准去已經飽和的地方這個是大家現在很反彈的當然跟委員說明要解決這個醫療資源不足地區還有很多的方式啦這個也不是單單的一個不過這個是希望能夠讓醫療資源的分佈也能夠更平衡"},{"start":515.904,"end":533.464,"text":"讓這個多少人口多少醫師因為我們所有的這個醫學生也是按照這樣在管制所以要按照當地多少人口需要多少醫師來特約這個才是符合我們健保的精神這邊有兩件事情我希望一個月看可不可以給予可行性評估"},{"start":534.165,"end":559.847,"text":"第二件事情也是很多人在意的就是說現在在醫院職業的醫師每一筆錢他都必須要繳稅勞基法是用加班費免稅可是你也知道非常多主治醫師以上層級的並不是用勞基法所以工時比人家長很多可是沒有免稅的比例原則那亞東醫院院長最近就有出來講了很長一段的話大概跟你講"},{"start":560.808,"end":587.318,"text":"他說最具醫療韌性也就是最具戰時韌性的這群人反而是近年來流失最快的其中包括武大科包括急重症包括急診等等的那這些人才困難的他就是在夜間假日值班最多的那除了提高他的健保點值以外因為提高以後他工作很辛苦但在最後又繳稅了"},{"start":588.678,"end":599.141,"text":"所以他必須要雙重雙軌之下你有辦法留住這些人第一個就是額外津貼第二個就是他的夜間他的假日值班他的這些業務應該要免稅請問以上兩點就是關於"},{"start":605.803,"end":621.193,"text":"責量能特約還有這個免稅跟津貼雙軌制來拯救這些人才流失最多的這顆你有沒有辦法一個月內給予可行性評估因為你今年已經編了過兆的健保預算了"},{"start":623.986,"end":647.721,"text":"這個醫師的這個稅負公平性的問題我之前就已經注意到這個事情那因為目前在醫院工作者裡面只有醫師還沒有納入勞基法那其餘都是已經適用勞基法而適用勞基法人員裡面呢他有一個加班費是適用所得稅法免稅規定那但是因為勞基法有他的加班時數的上限"},{"start":648.001,"end":676.277,"text":"所以在那个额度内其实是已经符合免税目前就已经在执行了倒是因为医师他没有适用这个劳基法的关系再加上医疗的特性跟这个病人的需要所以他的加班时间往往是高于这个劳基法所规定的这个加班的上限所以在这个现实的情形之下我们一直在努力的在沟通希望扩大你要跟谁沟通劳动部财政部你要"},{"start":678.539,"end":691.956,"text":"這個稅負的主管機關是財政部所以你希望往院長講的這個方向前進就是要讓這個叫做稅負公平他一樣是因為延長工作時間那麼所得到的這些收入"},{"start":692.797,"end":708.824,"text":"就是所謂的加班費所以一個月內這兩點我們等一下送個書面可不可以請你給我們可行性的評估這個書面是沒有問題的那只是說在推動的過程當中也需要委員來給我們協助因為這個還有跟財政部之間的溝通"},{"start":709.144,"end":732.006,"text":"好第三個我們要問的問題是最近我們有一個好運3方案當然右邊這邊我就先不多說了右邊大家有知道說原來10萬塊講得很好聽結果不同級別的保險他只是去補差額所以如果是比如說勞保的他幾乎差額只有一點點他並不是這麼的有感但"},{"start":732.947,"end":753.462,"text":"考量問到許多專家他們都覺得每個月的津貼才是真正可以促進生育率的方式而不是這種單次一次性的好那之前陳時中政委他在其他的媒體採訪裡面他自己都講喔他說一個月他覺得要拿到三萬塊才算是有感的補貼才願意"},{"start":755.563,"end":782.536,"text":"這個促進生育啊等等的當我們去試算每一個縣市就算是最好最好的狀況大概都沒有到兩萬那我們看一下這個表看一下這個表現在是零到六歲的嬰幼兒每月主要的開銷包括尿布啊副食品或是你自己在家帶托育等等如果你是自己帶或是準公共比較難抽到的比較偏向兩萬但如果是送到托育可能會偏向四萬塊好"},{"start":783.777,"end":804.25,"text":"但是你現在的育嬰育兒津貼已經非常久沒有調整了第一名子女每個月五千第二名每個月六千第三名每個月七千你有沒有考慮把它調高主席快結束來響應陳時中政委所說的家總至少要折合三萬塊民眾才會有感"},{"start":806.076,"end":825.048,"text":"跟委員說明 當然這一個擴大生育補助方案就是讓大家的這個補助讓他拉齊不會因為你的身份不同得到的最後的那個補助不同所以把公保 勞保 國保等等的保險甚至都沒有保的也都把它拉在一起"},{"start":826.289,"end":854.596,"text":"第一步而已那自己為了減輕年輕這個父母對於這個育兒上的壓力當然有育兒津貼剛剛您提到的這樣但是我們也另外有這個準托育跟這個公托跟準公托的補助那個我記得如果是準公托的話也到一萬三到一萬五就是看你的胎次會逐步的增加我知道但是我剛就有講有些人他是並沒有用到托育的嘛"},{"start":856.497,"end":882.575,"text":"这个十万块我们才发现说原来很多人是没有劳保的这个下去我们才发现为什么我们要去补对对所以他不一定会有用到托育因为托育你就只能选一个嘛你的育儿津贴跟托育他就只能选择一个育儿津贴跟托育补助所以我讲的是这个族群的人你有没有办法协助他您说的是完全没有育儿津贴对"},{"start":883.577,"end":896.007,"text":"完全沒有參加任何保險沒有我講的是他可能沒有用到托育的那就是育兒津貼嘛對一個是托育補助一個是育兒津貼這二則一是您的意思是說"},{"start":897.779,"end":921.828,"text":"沒有托育的就是育兒津貼的部分就是他必須申請育兒津貼的這部分你有沒有考慮再把它往上提育兒津貼的部分再增加的意思我們來研究看看在政府的財政的能力下因為現在因為這個財法法的關係中央的統籌分配款也受到影響所以我們再來評估看看那我們再跟你做報告 謝謝好 謝謝陳委員 謝謝部長"}]}}},"gazette":{"lineno":236,"blocks":[["陳委員菁徽：（9時41分）主席謝謝，我想請石部長。"],["主席：來，請部長。"],["石部長崇良：陳委員早。"],["陳委員菁徽：部長好。部長，您是親子友善、兒少保護法還有促進我們國家生育率的大家長，但是您知道從9月22號開始，高鐵全面上路寧靜車廂的措施之後，現在網路上有帶著小孩的家長，還有反對小孩發出聲音的人，已經在網路上大戰，這件事情您知道嗎？"],["石部長崇良：我最近有聽說，我坐高鐵的時候也有看到現在都有個寧靜車廂的牌子。"],["陳委員菁徽：對，等一下我會提供您一些截圖，我先舉一些國外的案例。"],["石部長崇良：好。"],["陳委員菁徽：國外呢，他們是比如說為了促進生育率，一家四口、一家五口去旅行，搭乘國籍航空或是火車，或者是他們一家去遊樂園，業者是給予很多折扣的，但是反觀我們臺灣，我很希望你可以拿出魄力來，是不是可以跟交通部所轄高鐵或是國籍航空等等業者去談，如何可以兼顧親子友善、兼顧生育率，然後又不至於讓現在網路上吵成一團，那您也需要出來主持公道，我舉幾個案例讓您聽聽看。"],["石部長崇良：好。"],["陳委員菁徽：比如現在高鐵如果發現小朋友可能有發出一些聲音干擾到其他的乘客，他們會去協助安撫，並且給予「乖乖」，你覺得你贊成這樣子的做法嗎？"],["石部長崇良：這是不夠專業的做法。"],["陳委員菁徽：你說，為什麼？"],["石部長崇良：應該要先協助了解孩子哭鬧的原因，因為比較小的孩子，他要表達不容易，所以常常以哭鬧的方式來表達，所以應該先去了解這個孩子會哭鬧的真正原因是什麼再來解決問題，而不是隨便給一個零食，這個不是很好的……"],["陳委員菁徽：好。那高鐵的同仁如果給予一些安撫，再加上給予餅乾等等，請問你覺得這一組父母加上小孩，會不會有可能被標籤化，反而讓這個車廂其他乘客的人發現，就是這些人在吵，所以站務人員過來了。會不會？會不會被標籤化？"],["石部長崇良：有這個可能性，但是如果有孩子不斷地哭鬧，我們還是應該主動地去關心，我想這個站務人員……"],["陳委員菁徽：那我再舉第二個例子，這個都是實際發生的案例。有一個帶大寶跟二寶的媽媽，他因為被舉牌要求降低音量，所以被勸導說，你可以帶寶寶到車廂跟車廂中間的走道去安撫。這件事情我本人也做過，我有三個，三個都這樣子做過。結果他只能把大寶放在座位上，帶著二寶到車廂中間去安撫，我想問，他讓大寶單獨留在車廂，被迫單獨留在車廂，是不是違反了兒少保護法，是不是？"],["石部長崇良：這樣的處理方式並不恰當，不恰當。"],["陳委員菁徽：那您有什麼建議嗎？"],["石部長崇良：維持整個車廂的安寧，對於多數乘客有好處，這個我們不反對啦！但是按照我們兒少福利法的規定，在交通方面還是要對親子友善。"],["陳委員菁徽：好，這就是我一再強調的，我們跟其他國家差很多。其他國家也許會在一些觀光網站上特別註明哪些餐廳親子友善，推薦大家去；然後他們的車廂，有些國家是採取部分車廂寧靜，但其他車廂不會特別標註親子友善，可是也不會那麼在意音量。請問，你大概在什麼時間內可以去找高鐵或是交通部做這方面的溝通，可以給大家，滿多家長在關心這個議題，請問你大概多久以內可以去做這個協調？"],["石部長崇良：我們在9月2號其實已經發函去了解，請交通部去督導高鐵公司，因為高鐵公司的主管機關是交通部，所以我們也請了交通部去督導，我們會進一步去追蹤最後結果是如何。"],["陳委員菁徽：大概多久以內？因為現在每天他們都在……"],["石部長崇良：大概一個月內。"],["陳委員菁徽：他們都在網路上吵翻天，這個您知道嗎？一個月內嗎？"],["石部長崇良：好，一個月內。"],["陳委員菁徽：好，一個月內我希望你跟交通部可以共擬出一個稍微彈性的作法，不要再引起兩方之間的互相仇視，好嗎？"],["石部長崇良：好的，好，沒問題。"],["陳委員菁徽：好，謝謝。下一個是您接受了採訪，我知道你講了很多很多關於醫療方面的改革，但我今天稍微講兩點就好了。有一點是您提到在醫療飽和區，也就是蛋黃區，健保診所太多的地方就不給開了，請自行前往醫療資源不足的地方開立診所。好，現在有許多醫師，可能比較多是新出來的醫師，他會說：所以你是請我們回家吃自己嗎？因為為什麼會在蛋黃區、都會區開診所，我跟你講他們的心聲，很多人講：我要選擇在哪邊執業，當然除了薪資以外，我還要考慮我配偶的工作，對吧？我還要考慮小孩就學的問題；如果有長輩要就近照顧，還有長輩要照顧。這些地方變成蛋黃區是很多原因造成的，而不是他特意去把這些地方列為他的首選。所以我想要問，你可不可以變更你的做法，你要不要去針對醫療資源不足的地方給予更多的誘因，而讓各種不同世代的醫師都願意去那個地方？"],["石部長崇良：跟委員說明，按照醫師法或醫療法的規定，醫師當然有他的執業自由，他可以在任何一個地方，只要他取得合格的醫師執照，他都可以開業。但是健保有它的特約規定、醫療資源應該要納入健保特約時候的考量，因為健保的資源是有限的，所以有一些不是健保特約的診所，但是如果是要跟健保簽訂特約的診所，健保必須考慮到它所提供服務的可近性跟資源的平衡性。就好像我們現在在總額之下在分配各個縣市或是各個區域的總額，也是有其分配的考量……"],["陳委員菁徽：沒有，我剛剛已經跟你講得很清楚了，他會選擇這個地方，他當然也想兼顧你所謂的醫療資源等等，但他還有其他考慮的面向嘛。你現在的意思就是說，這一區已經很多人來了，你就不要再來了，那是先到先贏的概念……"],["石部長崇良：所以在這個制度之下，我們會有擇優特約的概念，而不是所有的人你要特約就一直特約、一直特約。我們在醫學生的總人數部分是有管制的，這不是一個完全自由的市場，所以在提供服務的時候也應該要堅持相同的邏輯，而不是完全採放任性的。那這樣前面加強管制進口端，就是醫師的供應端是管制的，結果到後來執行業務的時候卻採取自由放任，那這樣反而造成另外一種不公。"],["陳委員菁徽：我是給你一個建議，請部長考量一下，是不是願意到醫療資源不足的地方，你給予更多的誘因，而不是去限制他們不准去已經飽和的地方，這個是大家現在很反彈的地方。"],["石部長崇良：跟委員說明，要解決這個醫療資源不足地區還有很多的方式，不是單單的一個，不過這個是希望讓醫療資源的分布也能夠更平衡，多少人口多少醫師，因為我們所有的醫學生也是按照這樣在管制，所以要按照當地多少人口需要多少醫師來特約，這個才是符合我們整個健保的精神。"],["陳委員菁徽：這邊有兩件事情，我希望一個月看可不可以給可行性評估。第二件事情也是很多人在意的，現在在醫院執業的醫師，每一筆錢他都必須要繳稅，勞基法適用加班費免稅，可是你也知道非常多主治醫師以上層級的並不適用勞基法，所以工時比人家長很多，可是沒有免稅的比例原則。亞東醫院的院長最近就有出來講了很長的一段話，我大概跟你講，他說最具醫療韌性，也就是最具戰時韌性的這群人，反而是近年來流失最快的，其中包括五大科，包括急重症，包括急診等等，這些人才困難的地方就是在夜間、假日值班最多，除了提高他的健保點值以外，因為提高以後他工作很辛苦，但在最後又繳稅了，所以必須要雙重、雙軌之下，才有辦法留住這些人，第一個就是額外津貼，第二個就是他的夜間、他的假日值班，他的這些業務應該要免稅。請問以上兩點，就是關於擇量能特約，還有免稅跟津貼雙軌制，來拯救人才流失最多的這些科，你有沒有辦法一個月內給予可行性評估？因為你今年已經編了過兆的健保預算了。"],["石部長崇良：關於醫師稅賦公平性的問題，我之前就已經注意到這個事情，因為目前在醫院工作者裡面，只有醫師還沒有納入勞基法，其餘都已經適用勞基法，而適用勞基法人員裡面有一個加班費是適用所得稅法免稅規定，但是因為勞基法有它加班時數的上限，所以在那個額度內，其實是已經符合免稅，目前就已經在執行了。倒是因為醫師沒有適用勞基法的關係，再加上醫療的特性跟病人的需要，所以他的加班時間往往是高於勞基法所規定的加班上限，所以在這個現實的情形之下，我們一直在努力的溝通，希望擴大……"],["陳委員菁徽：你要跟誰溝通？勞動部？你要……"],["石部長崇良：財政部，稅賦的主管機關是財政部。"],["陳委員菁徽：所以你希望往院長講的這個方向前進？"],["石部長崇良：是，就是要讓稅賦公平，一樣是因為延長工作時間，他所得到的這些收入就是所謂的加班費。"],["陳委員菁徽：所以一個月內針對這兩點，我們等一下送個書面，可不可以請你給我們可行性的評估？"],["石部長崇良：書面是沒有問題，那只是說在推動的過程當中，也需要委員來給我們協助，因為這個還有跟財政部之間的溝通。"],["陳委員菁徽：好。第三個我們要問的問題是，最近我們有一個好孕三方案，當然右邊這邊我就先不多說了，右邊大家知道說，原來10萬塊講得很好聽，結果不同級別的保險，它只是去補差額，所以如果是勞保的，它幾乎差額只有一點點，並不是這麼的有感。但問到許多專家，他們都覺得每個月的津貼才是真正可以促進生育率的方式，而不是這種單次、一次性的。之前陳時中政委在其他的媒體採訪裡面，他自己都講，他說一個月他覺得要拿到3萬塊才算是有感的補貼，才願意促進生育等等，但我們去試算每一個縣市，就算是最好最好的狀況，大概都沒有到2萬。","那我們看一下這個表，現在0到6歲的嬰幼兒每月主要的開銷包括尿布、副食品或是你自己在家帶、托育等等，如果你是自己帶，或者是準公共，比較難抽到的，比較偏向2萬，但如果是送到托育，可能會偏向4萬塊，但是現在的育嬰育兒津貼已經非常久沒有調整了，第一名子女每個月5,000，第二名每個月6,000，第三名每個月7,000，你有沒有考慮把它調高？主席，快結束了。來響應陳時中政委所說的加總至少要折合3萬塊，民眾才會有感。"],["石部長崇良：跟委員說明，當然這一個擴大生育補助方案，就是讓大家的補助拉齊，不會因為你的身分不同，最後得到的補助不同，所以把公保、勞保、國保等等的保險，甚至都沒有保的也都把它拉在一起，所以這個是第一步而已。至於為了減輕年輕父母對於育兒上的壓力，當然有剛剛您提到的育兒津貼，但是我們也另外有準托育、公托跟準公托的補助，我記得如果是準公托的話，也到1萬3,000到1萬5,000，就是看你的胎次會逐步的增加。"],["陳委員菁徽：我知道，但是我剛剛就有講，有些人他是並沒有用到托育的，這個10萬塊我們才發現說，原來很多人是沒有勞保的，這個下去我們才發現為什麼我們要去補，所以他不一定會有用到托育，因為托育你就只能選一個，你的育兒津貼跟托育，他就只能選擇一個。"],["石部長崇良：對，育兒津貼跟托育補助。"],["陳委員菁徽：對，所以我講的是這個族群的人，你有沒有辦法協助他？"],["石部長崇良：您說的是完全沒有……"],["陳委員菁徽：育兒津貼，對。"],["石部長崇良：完全沒有參加任何保險？"],["陳委員菁徽：因為我講的是他可能沒有用到托育的。"],["石部長崇良：那就是育兒津貼嘛！"],["陳委員菁徽：對。"],["石部長崇良：一個是托育補助，一個是育兒津貼，這二擇一。"],["陳委員菁徽：是。"],["石部長崇良：您的意思是說，沒有托育的，就是育兒津貼的部分……"],["陳委員菁徽：就是他必須申請育兒津貼的這部分，你有沒有考慮再把他往上提？"],["石部長崇良：育兒津貼的部分再增加的意思？"],["陳委員菁徽：是。"],["石部長崇良：我們來研究看看，在政府的財政能力下，現在因為財劃法的關係，中央的統籌分配款也受到影響，所以我們再來評估看看。"],["陳委員菁徽：那我們再跟你做報告，謝謝。"],["石部長崇良：謝謝。"],["主席：謝謝陳委員、謝謝部長。","接下來請林淑芬委員來做詢答。"]],"agenda":{"page_end":260,"meet_id":"委員會-11-4-26-3","speakers":["劉建國","陳昭姿","林月琴","陳菁徽","林淑芬","王育敏","邱鎮軍","蘇清泉","黃秀芳","王正旭","盧縣一","鍾佳濱","楊瓊瓔","陳瑩","邱志偉","洪孟楷","謝衣鳯","廖偉翔","劉建國","葉元之","楊曜"],"page_start":189,"meetingDate":["2025-10-13"],"gazette_id":"1148201","agenda_lcidc_ids":["1148201_00005"],"meet_name":"立法院第11屆第4會期社會福利及衛生環境委員會第3次全體委員會議紀錄","content":"邀請衛生福利部部長及行政院食品安全辦公室就「重大食安事件處理之檢討與食安稽核人力不足\n問題」進行專題報告，並備質詢","agenda_id":"1148201_00004"}}}