{"error":false,"id":["149594"],"data":{"IVOD_ID":149594,"IVOD_URL":"https://ivod.ly.gov.tw/Play/Clip/1M/149594","日期":"2024-03-07","會議資料":{"會議代碼":"委員會-11-1-26-4","會議代碼:str":"第11屆第1會期社會福利及衛生環境委員會第4次全體委員會議","屆":11,"會期":1,"會次":4,"臨時會會次":null,"種類":"委員會","委員會代碼":[26],"委員會代碼:str":["社會福利及衛生環境委員會"],"標題":"第11屆第1會期社會福利及衛生環境委員會第4次全體委員會議"},"影片種類":"Clip","開始時間":"2024-03-07T13:02:14+08:00","結束時間":"2024-03-07T13:11:50+08:00","影片長度":"00:09:36","支援功能":["ai-transcript"],"video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/1441ba9c2015bdbe179b65eae6e3c4cddc62c46c87ca327ff8ba9b0039caa7a69ce1b1fe81fa1c0a5ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"楊曜","委員發言時間":"13:02:14 - 13:11:50","會議時間":"2024-03-07T09:00:00+08:00","會議名稱":"立法院第11屆第1會期社會福利及衛生環境委員會第4次全體委員會議（事由：邀請衛生福利部部長、中央健康保險署、食品藥物管理署就「健保藥價調整，藥廠停產慢性病用藥之因應作為」進行專題報告，並備質詢。）","transcript":{"pyannote":[{"speaker":"SPEAKER_01","start":0.03096875,"end":0.30096875},{"speaker":"SPEAKER_01","start":6.494093750000001,"end":8.87346875},{"speaker":"SPEAKER_01","start":9.66659375,"end":10.62846875},{"speaker":"SPEAKER_01","start":15.083468750000002,"end":16.602218750000002},{"speaker":"SPEAKER_01","start":16.85534375,"end":18.03659375},{"speaker":"SPEAKER_01","start":18.42471875,"end":20.88846875},{"speaker":"SPEAKER_01","start":21.27659375,"end":24.398468750000003},{"speaker":"SPEAKER_02","start":24.398468750000003,"end":24.53346875},{"speaker":"SPEAKER_01","start":24.53346875,"end":24.567218750000002},{"speaker":"SPEAKER_02","start":24.567218750000002,"end":24.60096875},{"speaker":"SPEAKER_01","start":24.60096875,"end":24.97221875},{"speaker":"SPEAKER_02","start":24.97221875,"end":25.79909375},{"speaker":"SPEAKER_01","start":25.79909375,"end":25.81596875},{"speaker":"SPEAKER_01","start":25.96784375,"end":26.035343750000003},{"speaker":"SPEAKER_02","start":26.035343750000003,"end":38.96159375},{"speaker":"SPEAKER_00","start":37.94909375,"end":39.65346875},{"speaker":"SPEAKER_02","start":39.65346875,"end":42.16784375},{"speaker":"SPEAKER_00","start":40.00784375,"end":40.93596875},{"speaker":"SPEAKER_00","start":42.52221875,"end":49.322843750000004},{"speaker":"SPEAKER_02","start":47.34846875,"end":49.305968750000005},{"speaker":"SPEAKER_02","start":49.322843750000004,"end":49.947218750000005},{"speaker":"SPEAKER_00","start":49.947218750000005,"end":50.38596875},{"speaker":"SPEAKER_02","start":50.63909375,"end":53.406593750000006},{"speaker":"SPEAKER_00","start":53.91284375,"end":54.385343750000004},{"speaker":"SPEAKER_00","start":55.29659375000001,"end":83.44409375000001},{"speaker":"SPEAKER_02","start":70.65284375,"end":71.66534375},{"speaker":"SPEAKER_00","start":83.54534375,"end":105.68534375},{"speaker":"SPEAKER_01","start":100.15034375,"end":101.09534375000001},{"speaker":"SPEAKER_01","start":102.02346875,"end":102.93471875},{"speaker":"SPEAKER_00","start":105.88784375,"end":112.70534375000001},{"speaker":"SPEAKER_00","start":112.95846875000001,"end":124.85534375},{"speaker":"SPEAKER_02","start":119.64096875000001,"end":120.13034375000001},{"speaker":"SPEAKER_01","start":120.13034375000001,"end":120.19784375},{"speaker":"SPEAKER_00","start":125.46284375,"end":126.57659375000001},{"speaker":"SPEAKER_00","start":126.62721875000001,"end":133.32659375},{"speaker":"SPEAKER_02","start":126.71159375,"end":127.08284375000001},{"speaker":"SPEAKER_02","start":129.64784375000002,"end":129.85034375},{"speaker":"SPEAKER_00","start":133.49534375000002,"end":135.11534375000002},{"speaker":"SPEAKER_00","start":135.48659375,"end":135.52034375},{"speaker":"SPEAKER_02","start":135.52034375,"end":136.80284375000002},{"speaker":"SPEAKER_02","start":137.89971875,"end":142.52346875},{"speaker":"SPEAKER_02","start":142.97909375,"end":143.75534375},{"speaker":"SPEAKER_02","start":144.49784375000002,"end":149.00346875},{"speaker":"SPEAKER_02","start":149.89784375000002,"end":152.54721875},{"speaker":"SPEAKER_02","start":153.28971875000002,"end":156.83346875},{"speaker":"SPEAKER_02","start":157.42409375,"end":160.81596875},{"speaker":"SPEAKER_02","start":161.64284375,"end":163.33034375},{"speaker":"SPEAKER_02","start":164.15721875,"end":168.29159375},{"speaker":"SPEAKER_02","start":168.61221875,"end":171.26159375},{"speaker":"SPEAKER_02","start":173.06721875000002,"end":175.75034375},{"speaker":"SPEAKER_00","start":174.31596875000002,"end":178.53471875000002},{"speaker":"SPEAKER_00","start":178.85534375,"end":191.56221875},{"speaker":"SPEAKER_02","start":180.89721875,"end":181.21784375000001},{"speaker":"SPEAKER_01","start":181.21784375000001,"end":181.23471875},{"speaker":"SPEAKER_00","start":191.86596875,"end":193.97534375},{"speaker":"SPEAKER_02","start":193.97534375,"end":200.40471875},{"speaker":"SPEAKER_00","start":196.87784375,"end":198.32909375},{"speaker":"SPEAKER_02","start":201.68721875,"end":204.37034375000002},{"speaker":"SPEAKER_02","start":204.64034375,"end":208.01534375},{"speaker":"SPEAKER_00","start":206.81721875000002,"end":207.28971875000002},{"speaker":"SPEAKER_02","start":208.99409375000002,"end":209.70284375},{"speaker":"SPEAKER_00","start":209.58471875,"end":209.95596875},{"speaker":"SPEAKER_02","start":209.82096875000002,"end":213.21284375000002},{"speaker":"SPEAKER_00","start":211.54221875000002,"end":211.77846875},{"speaker":"SPEAKER_00","start":213.31409375,"end":223.81034375000002},{"speaker":"SPEAKER_02","start":222.61221875,"end":231.38721875000002},{"speaker":"SPEAKER_00","start":227.84346875000003,"end":228.26534375000003},{"speaker":"SPEAKER_00","start":229.00784375,"end":233.49659375000002},{"speaker":"SPEAKER_02","start":231.85971875,"end":232.31534375},{"speaker":"SPEAKER_02","start":233.49659375000002,"end":233.98596875},{"speaker":"SPEAKER_00","start":234.07034375,"end":238.27221875},{"speaker":"SPEAKER_02","start":238.98096875000002,"end":239.26784375000003},{"speaker":"SPEAKER_00","start":239.26784375000003,"end":242.81159375000001},{"speaker":"SPEAKER_00","start":243.08159375000002,"end":245.73096875000002},{"speaker":"SPEAKER_00","start":246.27096875,"end":251.62034375000002},{"speaker":"SPEAKER_00","start":252.32909375000003,"end":254.99534375000002},{"speaker":"SPEAKER_00","start":256.75034375,"end":260.24346875000003},{"speaker":"SPEAKER_01","start":256.83471875000004,"end":256.85159375},{"speaker":"SPEAKER_02","start":256.85159375,"end":257.22284375000004},{"speaker":"SPEAKER_02","start":259.14659375,"end":265.00221875},{"speaker":"SPEAKER_00","start":260.68221875,"end":260.78346875},{"speaker":"SPEAKER_00","start":264.88409375000003,"end":269.89596875},{"speaker":"SPEAKER_02","start":269.89596875,"end":269.94659375000003},{"speaker":"SPEAKER_00","start":269.94659375000003,"end":272.84909375},{"speaker":"SPEAKER_02","start":270.13221875,"end":270.53721875},{"speaker":"SPEAKER_02","start":271.93784375,"end":276.93284375},{"speaker":"SPEAKER_00","start":278.29971875,"end":279.56534375},{"speaker":"SPEAKER_02","start":278.41784375000003,"end":278.83971875000003},{"speaker":"SPEAKER_02","start":279.49784375,"end":282.92346875000004},{"speaker":"SPEAKER_02","start":283.31159375000004,"end":286.18034375},{"speaker":"SPEAKER_00","start":283.37909375000004,"end":284.79659375},{"speaker":"SPEAKER_00","start":286.18034375,"end":295.59659375},{"speaker":"SPEAKER_02","start":286.21409375,"end":286.43346875000003},{"speaker":"SPEAKER_02","start":289.70721875000004,"end":290.07846875},{"speaker":"SPEAKER_02","start":294.06096875000003,"end":299.56221875},{"speaker":"SPEAKER_02","start":299.88284375,"end":300.76034375},{"speaker":"SPEAKER_02","start":301.60409375,"end":305.62034375},{"speaker":"SPEAKER_02","start":306.17721875,"end":307.42596875000004},{"speaker":"SPEAKER_00","start":307.42596875000004,"end":307.88159375000004},{"speaker":"SPEAKER_02","start":307.88159375000004,"end":313.41659375},{"speaker":"SPEAKER_02","start":313.70346875,"end":316.43721875},{"speaker":"SPEAKER_02","start":317.39909375,"end":319.42409375},{"speaker":"SPEAKER_02","start":319.91346875,"end":326.10659375},{"speaker":"SPEAKER_00","start":326.12346875000003,"end":330.51096875},{"speaker":"SPEAKER_02","start":328.46909375,"end":329.29596875000004},{"speaker":"SPEAKER_02","start":330.42659375,"end":334.69596875},{"speaker":"SPEAKER_00","start":330.79784375,"end":332.51909375},{"speaker":"SPEAKER_02","start":335.57346875,"end":360.14346875},{"speaker":"SPEAKER_01","start":350.20409375,"end":350.57534375},{"speaker":"SPEAKER_00","start":360.14346875,"end":377.64284375},{"speaker":"SPEAKER_02","start":361.81409375000004,"end":362.18534375},{"speaker":"SPEAKER_02","start":378.03096875,"end":386.31659375000004},{"speaker":"SPEAKER_00","start":378.21659375,"end":381.47346875000005},{"speaker":"SPEAKER_02","start":387.00846875,"end":389.20221875000004},{"speaker":"SPEAKER_02","start":390.04596875000004,"end":404.27159375},{"speaker":"SPEAKER_00","start":399.15846875000005,"end":399.52971875000003},{"speaker":"SPEAKER_01","start":404.27159375,"end":404.54159375},{"speaker":"SPEAKER_02","start":405.18284375,"end":407.83221875000004},{"speaker":"SPEAKER_02","start":408.25409375000004,"end":411.37596875},{"speaker":"SPEAKER_00","start":411.91596875000005,"end":412.30409375000005},{"speaker":"SPEAKER_02","start":412.27034375000005,"end":413.13096875},{"speaker":"SPEAKER_00","start":413.78909375,"end":418.69971875000005},{"speaker":"SPEAKER_02","start":417.58596875,"end":422.78346875000005},{"speaker":"SPEAKER_00","start":420.26909375,"end":420.72471875},{"speaker":"SPEAKER_00","start":422.49659375000005,"end":424.36971875},{"speaker":"SPEAKER_00","start":425.07846875,"end":427.10346875000005},{"speaker":"SPEAKER_02","start":427.10346875000005,"end":427.40721875},{"speaker":"SPEAKER_00","start":427.84596875000005,"end":432.16596875000005},{"speaker":"SPEAKER_02","start":432.38534375,"end":433.44846875},{"speaker":"SPEAKER_02","start":433.75221875000005,"end":435.47346875000005},{"speaker":"SPEAKER_00","start":435.54096875000005,"end":438.71346875},{"speaker":"SPEAKER_00","start":438.81471875000005,"end":449.34471875},{"speaker":"SPEAKER_00","start":449.44596875,"end":456.82034375},{"speaker":"SPEAKER_00","start":457.49534375,"end":459.65534375000004},{"speaker":"SPEAKER_00","start":460.14471875000004,"end":464.09346875000006},{"speaker":"SPEAKER_00","start":464.48159375,"end":467.65409375},{"speaker":"SPEAKER_02","start":467.72159375,"end":474.96096875},{"speaker":"SPEAKER_00","start":472.26096875,"end":473.00346875},{"speaker":"SPEAKER_00","start":473.71221875000003,"end":476.07471875000005},{"speaker":"SPEAKER_02","start":476.07471875000005,"end":489.11909375000005},{"speaker":"SPEAKER_00","start":483.65159375,"end":486.33471875000004},{"speaker":"SPEAKER_00","start":486.63846875,"end":486.68909375000004},{"speaker":"SPEAKER_00","start":486.70596875,"end":487.43159375000005},{"speaker":"SPEAKER_02","start":491.22846875000005,"end":493.72596875000005},{"speaker":"SPEAKER_02","start":494.23221875,"end":497.37096875000003},{"speaker":"SPEAKER_02","start":497.79284375000003,"end":498.92346875000004},{"speaker":"SPEAKER_02","start":499.76721875000004,"end":500.30721875},{"speaker":"SPEAKER_02","start":501.20159375000003,"end":504.72846875000005},{"speaker":"SPEAKER_02","start":504.96471875000003,"end":514.3303437500001},{"speaker":"SPEAKER_00","start":512.42346875,"end":512.82846875},{"speaker":"SPEAKER_02","start":514.68471875,"end":515.0053437500001},{"speaker":"SPEAKER_02","start":515.98409375,"end":516.5578437500001},{"speaker":"SPEAKER_02","start":516.9965937500001,"end":518.4140937500001},{"speaker":"SPEAKER_02","start":519.30846875,"end":520.99596875},{"speaker":"SPEAKER_02","start":521.60346875,"end":522.2109687500001},{"speaker":"SPEAKER_02","start":523.2065937500001,"end":525.3159687500001},{"speaker":"SPEAKER_02","start":526.78409375,"end":527.74596875},{"speaker":"SPEAKER_02","start":527.9990937499999,"end":528.4209687499999},{"speaker":"SPEAKER_00","start":528.35346875,"end":529.73721875},{"speaker":"SPEAKER_00","start":530.29409375,"end":544.4015937500001},{"speaker":"SPEAKER_02","start":533.50034375,"end":535.4578437499999},{"speaker":"SPEAKER_02","start":538.2084687500001,"end":538.59659375},{"speaker":"SPEAKER_02","start":541.9209687499999,"end":543.25409375},{"speaker":"SPEAKER_00","start":544.65471875,"end":550.71284375},{"speaker":"SPEAKER_02","start":549.9365937499999,"end":554.47596875},{"speaker":"SPEAKER_00","start":553.10909375,"end":554.50971875},{"speaker":"SPEAKER_02","start":554.50971875,"end":555.72471875},{"speaker":"SPEAKER_00","start":555.35346875,"end":561.36096875},{"speaker":"SPEAKER_02","start":556.5009687500001,"end":557.9184687500001},{"speaker":"SPEAKER_02","start":559.6228437500001,"end":561.47909375},{"speaker":"SPEAKER_02","start":561.79971875,"end":563.50409375},{"speaker":"SPEAKER_02","start":563.92596875,"end":566.17034375},{"speaker":"SPEAKER_02","start":566.6765937499999,"end":567.7903437500001},{"speaker":"SPEAKER_00","start":567.7903437500001,"end":568.14471875},{"speaker":"SPEAKER_02","start":568.11096875,"end":572.07659375},{"speaker":"SPEAKER_00","start":572.07659375,"end":572.2959687499999},{"speaker":"SPEAKER_02","start":572.2959687499999,"end":574.05096875},{"speaker":"SPEAKER_01","start":574.4897187500001,"end":576.97034375}],"whisperx":[{"start":6.894,"end":8.555,"text":"謝謝主席。主席我請一下部長。好,部長請。"},{"start":15.214,"end":41.952,"text":"委員好部長好部長我們談缺藥的問題之前有個問題我想要先跟部長做個探討就是為什麼我們民國70幾年就有掛號費的上限的規定為什麼突然那時候沒有那時候沒有那從什麼時候開始有"},{"start":43.329,"end":66.408,"text":"我記得是一百零幾年的時候才有公告那為什麼會突然想要取消因為從七十幾年的時候那時候的衛生署就有一個解釋這一個所謂的醫療機構的掛號費不是屬於醫療費用是屬於行政費用"},{"start":72.252,"end":101.015,"text":"他的目的就是說他不在那個醫療法的那個收費標準必須要到那個衛生局去備查範圍之內所以本來都是這個樣子但是一百零幾年我不知道當時的背景是怎麼樣就突然有一個公告說那這個醫療費那個括號費的話醫療機構的括號費如果超出什麼樣的一個上限之後的話那就必須要"},{"start":101.295,"end":102.636,"text":"那這樣子就是違反法律的規定了"},{"start":126.084,"end":151.989,"text":"因為法律沒有規定花費這種行政費用的話必須要去做審查沒有授權行政機關可以做這樣子部長講的我覺得是很有道理可是會不會有一個情形就是說因為他原本可能假如當初就沒有上線的規定"},{"start":153.342,"end":170.994,"text":"部長現在講的我覺得立場上完全認同因為現在有上限有上限的標準那現在突然取消了有沒有可能所有的醫院"},{"start":173.277,"end":199.983,"text":"如果是聯合的話,那就是公平會會介入,以前曾經有過某一個地區的幾家診所,他們講好了就同時把這瓜費調高,那這公平會就進去了,所以聯合行為是絕對不可以的。我知道啦,可是他總是會有規避的方式,因為大概就是各"},{"start":203.396,"end":206.038,"text":"醫療層級相同的他的行政費用其實"},{"start":209.039,"end":210.54,"text":"聯合行委最怕的就是同一個區域?"},{"start":239.531,"end":254.742,"text":"如果不同區域去聯合的話沒有太大意義因為病人都是會就近去就醫所以如果他同一個區域有幾家的醫療院所同時都長起來的話那我們就請公平會去查"},{"start":256.806,"end":258.808,"text":"所以這個問題我覺得最容易發生在醫學中心"},{"start":278.522,"end":303.634,"text":"醫學中心因為醫學中心就是大家沒得選啦他已經到最高層級了啦那假如說大家但是要看什麼病啦有些病可能是醫學中心才會處理的那但是大部分的病不會因為醫學中心他也可能就是以價自量啦我現在怕產生這個問題啦"},{"start":306.223,"end":327.367,"text":"部長你懂我的意思嗎?我知道因為醫學中心他假如說覺得他的病患病患太多他可能當他所有的醫學中心一起漲價的時候其實他區域是分散的這當然我們也會監測情況當然是不一樣不是用區域去看這個"},{"start":335.734,"end":359.782,"text":"其實我要來質詢的時候我就知道部長會怎麼回答,我也認同你的觀點不過就是有一些後續的問題我們還是要特別是漲價以後對於經濟比較弱勢的人的權益,這個後續可能要觀察一下"},{"start":360.542,"end":378.752,"text":"這個部分的話也跟委員報告,其實我們是在這一個所謂的公財的回饋金的部分的話,有分給各個縣市那他其中要補貼的就是一些低收中低收他的醫療費、就醫的這個括號費那個是已經寫在那裡對對對對好謝謝部長還沒問完藥的部分呢"},{"start":390.12,"end":403.951,"text":"我們缺藥的因素大概可以分為三個可能性一個是國際情勢的影響一個原物料的短缺一個國內用藥需求的激增"},{"start":405.473,"end":426.304,"text":"請問部長這三個因素哪一個因素對於臺灣影響最大?發生的時候其實是影響最大是第一個啦就是國際情勢國際情勢影響就是找不到了全世界都找不到了全世界都找不到或者說臺灣人家都不願意提供到臺灣"},{"start":428.258,"end":456.483,"text":"比方說有所謂的封鎖等等這類的情形那假如發生的話怎麼因應?所以我們就必須要在反應要在前面要去做這種預防措施預防措施就是我們會把必要的一些藥品的項目把它列出來然後我們這些藥品的項目的話要增加它的庫存、占備庫存那第二個就是要"},{"start":457.917,"end":472.645,"text":"鼓勵國內自己生產,不然的話到時候一封鎖的話,那原廠就進不來了。那自己又沒有辦法製造,這個就會有風險。也就是必須要準備盤點、監控相關的庫存。我們現在有480多箱。"},{"start":476.227,"end":480.771,"text":"我最後再問一個問題就是我們實施藥品費用分配比例目標"},{"start":502.307,"end":525.089,"text":"每年檢討以及調整藥價以後藥商必須要事先跟醫事機構重新議價藥品市場的穩定性會不會比之前兩年調整一次"},{"start":526.823,"end":530.425,"text":"之前兩年兩年一次比較可能產生藥價黑洞"},{"start":554.622,"end":573.584,"text":"對,那個幅度會變大,其實對藥廠來講的話也不是太大部長的回答就是只要有預期,大家就會做準備所以就不會有太大的變化好,謝謝部長、謝謝主席好,謝謝楊耀文的質詢"}]}},"supported_relations":[],"relations":[]}